Polypharmacy, Nutritional Risk, and Depressive Symptoms Among Older Outpatients at a Public Hospital: An Exploratory...

Previous studies have linked polypharmacy with nutritional and psychological vulnerability in older adults, but their concurrent presentation in routine outpatient care remains incompletely characterized. This exploratory study examined nutritional status and depressive symptom burden according to polypharmacy status among older adults attending outpatient clinics at a public hospital.

This exploratory cross-sectional observational study included 28 community-dwelling adults aged 65 years or older attending rehabilitation medicine or family medicine outpatient clinics at a single public hospital in Seoul, Republic of Korea. Polypharmacy was defined as the regular use of five or more physician-prescribed medications. Nutritional status was assessed using the full Mini Nutritional Assessment (MNA), and depressive symptoms were assessed using the interviewer-administered Korean 15-item Short Form Geriatric Depression Scale (SGDS). Continuous variables were compared using Mann-Whitney U-tests and categorical variables using Fisher's exact tests.

Polypharmacy was present in 8 participants (28.6%). Compared with participants without polypharmacy, those with polypharmacy had lower MNA scores (median [IQR], 21.25 [20.25-22.13] vs 24.25 [23.25-26.00]; p=0.005), more frequent nutritional risk or malnutrition (100.0% vs 35.0%; p=0.002), higher SGDS scores (8.00 [4.75-9.25] vs 3.00 [2.00-6.00]; p=0.024), and smaller calf circumference (31.50 [30.38-33.90] vs 35.25 [33.45-36.63] cm; p=0.042). The prevalence of depressive symptoms defined by SGDS ≥8 did not differ significantly (62.5% vs 20.0%; p=0.068).

In this small exploratory sample, polypharmacy co-occurred with poorer nutritional status and greater depressive symptom burden. These unadjusted findings are hypothesis-generating and do not establish that polypharmacy causes poorer nutritional status or depressive symptoms. Larger prospective studies with adequate adjustment for multimorbidity and other potential confounders are needed.