MALNUTRITION IS ASSOCIATED WITH DEPRESSION IN LONG-TERM CARE POPULATION

Abstract

Rationale: Frailty in elderly is a multifactorial syndrome and is associatet with an increased risk of poor health outcomes (falls, disability, hospital- ization and mortality), malnutrition and depression are the must impor- tant factors contributing to frailty. This study describes the application of multidimensional evaluation for the early identification of frailty in long- term care population.Methods: Clinical data from 100 long-term care inpatients (53 female and 47 male, mean age 69.6 years) were collected at the ARNAS Civico- DiCristina-Benfratelli, Palermo, Italy. Each inpatient had undergone a multidimensional assessment through a multiprofessional team. Nutri- tional state was assessed with the Malnutrition Universal Screening Tool (MUST) and Geriatric Nutritional Risk Index (GNRI), sarcopenia was esti- mated whit Skeletal Muscle Index (SMI). Also, nutritional and biochemical variables were under consideration (serum albumin, cholesterol, iron, and hemoglobin). Cognitive impairment was evaluated by the Short Blessed Test (SBT). Depression was analyzed using the Geriatric Depression Scale 5-items (GDS). Self-caring capacity was measured with Barthel Index (BI). Results: The prevalence of cognitive impairment and depression was 63% and 73,7% respectively. MUST showed 81,8% of patients at high risk of malnutrition. Sarcopenia was found in 77% of patients. BI showed that 57,6% of patients were not autonomous. The statistical analysis pointed out a significant association between male gender and severe sarcopenia (P<0.001). GNRI was significantly association to depression (P<0.001). Conclusion: The results of the study went towards an association between hight risk of malnutrition and risk of depression. Multidimensional assessment that includes assessment of nutritional state, sarcopenia, cognitive impairment and depression is a powerful instrument to evaluate the clinical complexity of long-term care units and potentially may improve the quality of care allowing the early identification of frail patients.