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Evaluation of the relationship among malnutrition, dehydration, and depressive symptoms in older adults: a cross-sectional study
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DOI：10.1186/s12877-026-07912-x.png)
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Abstract
En 中文
Malnutrition, dehydration, and depressive symptoms are common and clinically important conditions in older adults. Although these conditions are frequently assessed separately, studies evaluating them together in primary care settings are limited. This study aimed to determine the prevalence of malnutrition, dehydration, and depressive symptoms and to evaluate the associations among these conditions in older adults receiving primary care. A cross-sectional study was conducted among 243 adults aged 65 years and older registered at a family health center in Konya, Türkiye. Nutritional status was assessed using the Mini Nutritional Assessment, depressive symptoms using the 15-item Geriatric Depression Scale, and dehydration using calculated plasma osmolarity. A score of ≥ 5 on the 15-item Geriatric Depression Scale was considered indicative of depressive symptoms. Dehydration was defined as calculated plasma osmolarity > 295 mOsm/L. Information on sociodemographic characteristics, chronic diseases, lifestyle factors, and medication use was collected using a structured questionnaire. Group comparisons, correlation analyses, and univariable and multivariable binary logistic regression analyses were performed. The participants’ mean age was 72.81 ± 6.34 years, and 56.4% were female. Overall, 27.2% of participants were at risk of malnutrition, 2.4% were malnourished, 37.4% were dehydrated, and 54.7% had depressive symptoms. Being at risk of malnutrition or malnourished was significantly more frequent among participants with depressive symptoms than among those without depressive symptoms (46.6% vs. 9.1%, p < 0.001). Mini Nutritional Assessment scores were negatively correlated with 15-item Geriatric Depression Scale scores (rho = − 0.638; p < 0.001) and calculated plasma osmolarity (rho = − 0.192; p = 0.003). In univariable logistic regression analysis, depressive symptoms were strongly associated with being at risk of malnutrition or malnourished (OR = 8.732; 95% CI: 4.192–18.189; p < 0.001). In univariable analyses, polypharmacy was associated with being at risk of malnutrition or malnourished (OR = 3.227; 95% CI: 1.822–5.714; p < 0.001) and dehydration (OR = 1.855; 95% CI: 1.094–3.147; p = 0.022). Nutritional risk, dehydration, and screen-positive depressive symptoms were common among older adults registered in primary care. Nutritional status and depressive symptoms showed a strong cross-sectional association, whereas the observed association between polypharmacy and dehydration did not persist after adjustment. Combined assessment of nutritional status, depressive symptoms, hydration status, and medication burden may support comprehensive primary care evaluation.
Keywords:
Malnutrition
Dehydration
Depressive symptoms
Older adults
Primary care
Polypharmacy
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