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Nutritional risk versus established malnutrition in older adults: metabolic considerations for the association with
Arman A Gholami1, Bakhtiyar Iriskulov2, Daminov Feruz3
1School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:
The association between depression and nutritional status in older adults has garnered increasing attention. Golafrouz and colleagues recently reported a significant association between malnutrition and depression in community-dwelling older adults. However, two methodological issues warrant consideration. First, pooling metabolically distinct nutritional categories may obscure differential metabolic profiles while malnutrition involves protein-calorie deficiency. Second, excluding lipid and glycemic markers from adjustment models, combined with data-driven variable selection, raises concerns about potential bias. We suggest that future studies separate these categories in sensitivity analyses using penalized regression for the small malnourished subgroup, and examine metabolic markers within a causal framework to clarify whether associations are driven by metabolic disturbances, malnutrition, or their combination.
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