Research Article
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The Relationship Between Malnutrition, Depressive Symptoms, and Cognitive Impairment in Geriatric Patients

Year 2022, Volume: 4 Issue: 2, 217 - 23, 01.05.2022
https://doi.org/10.37990/medr.1082777

Abstract

Aim: Malnutrition is an important health problem that is frequently seen in elderly individuals and has cognitive and psychological effects. In this study, it was aimed to evaluate the frequencies of malnutrition, cognitive impairment and depression in the elderly population and the relationship between these three variables.
Material and Methods: In this retrospective study, data of 433 patients aged 65 and over who applied to a university hospital geriatrics outpatient clinic in Turkey were included. Nutritional status was evaluated with the Mini Nutritional Assessment Short Form (MNA-SF), depressive symptoms with the Geriatric Depression Scale-Short Form (GDS-15) and cognitive functions with the Mini Mental State Examination results (MMSE).
Results: According to the MNA-SF results, 13.6% of the elderly were malnourished, 30% were at risk of malnutrition. Of all patients, 45.0% had a GDS-15 score of ≥5, 12.5% had severe dementia, and 24.7% had mild dementia. The frequency of depressive symptoms was 62.7% in malnourished patients, and 42.3% in those with malnutrition risk. Malnutrition and malnutrition risk were observed in 70.4% of patients diagnosed with severe dementia. There was a correlation between the severity of malnutrition and depressive symptoms and cognitive dysfunction.
Conclusion: Malnutrition was common in the older population sample and was associated with cognitive impairment and depressive symptoms. These findings emphasize that counseling and psychiatry services should be provided to risky groups and they should be evaluated regularly for early diagnosis.

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References

  • Yannakoulia M, Mamalaki E, Anastasiou CA, Mourtzi N, Lambrinoudaki I, Scarmeas N. Eating habits and behaviors of older people: Where are we now and where should we go?. Maturitas. 2018; 114:14-21.
  • Leslie W, Hankey C. Aging, Nutritional Status and Health. Healthcare (Basel). 2015 Jul 30;3(3):648-58.
  • Bernstein M, Munoz N. Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: food and nutrition for older adults: promoting health and wellness. J Acad Nutr Diet. 2012;112(8):1255-1277.
  • Donini LM, Dominguez LJ, Barbagallo M, Savina C, Castellaneta E, Cucinotta D, Fiorito A, Inelmen EM, Sergi G, Enzi G, Cannella C. Senile anorexia in different geriatric settings in Italy. J Nutr Health Aging. 2011;15(9):775-81.
  • Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, Tsai AC, Vellas B, Sieber CC; Mini Nutritional Assessment International Group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010 ;58(9):1734-8.
  • Ramage-Morin PL, Gilmour H, Rotermann M. Nutritional risk, hospitalization and mortality among community-dwelling Canadians aged 65 or older. Health Rep. 2017: 20;28(9):17-27. PMID: 28930364.
  • Bergeron CD, John JM, Sribhashyam M, Odonkor G, Oloruntoba O, Merianos AL, Horel S, Smith ML. County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas. J Nutr Health Aging. 2021;25(7):862-868.
  • Chun H, Doo M. Factors Related to Depression Associated with Chewing Problems in the Korean Elderly Population. Int J Environ Res Public Health. 2021;18(11):6158.
  • Mantzorou M, Vadikolias K, Pavlidou E, Serdari A, Vasios G, Tryfonos C, Giaginis C. Nutritional status is associated with the degree of cognitive impairment and depressive symptoms in a Greek elderly population. Nutritional Neuroscience, 2020;23(3):201-209.
  • Kok RM, Reynolds CF 3rd. Management of Depression in Older Adults: A Review. JAMA. 2017;317(20):2114-2122.
  • Referans11. Greenwood CE, Parrott MD. Nutrition as a component of dementia risk reduction strategies. Healthc Manag Forum 2017;30(1):40-45.
  • Choi KW, Stein MB, Nishimi KM, Ge T, Coleman JRI, Chen CY, Ratanatharathorn A, Zheutlin AB, Dunn EC; 23andMe Research Team; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Breen G, Koenen KC, Smoller JW. An Exposure-Wide and Mendelian Randomization Approach to Identifying Modifiable Factors for the Prevention of Depression. Am J Psychiatry. 2020;177(10):944-954.
  • Lassale C, Batty GD, Baghdadli A, Jacka F, Sánchez-Villegas A, Kivimäki M, Akbaraly T. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry. 2019;24(7):965-986.
  • Nicolaou M, Colpo M, Vermeulen E, Elstgeest LEM, Cabout M, Gibson-Smith D, Knuppel A, Sini G, Schoenaker DAJM, Mishra GD, Lok A, Penninx BWJH, Bandinelli S, Brunner EJ, Zwinderman AH, Brouwer IA, Visser M. Association of a priori dietary patterns with depressive symptoms: a harmonised meta-analysis of observational studies. Psychol Med. 2020;50(11):1872-1883.
  • Chen JH, Lin KP, Chen YC. Risk factors for dementia. J Formos Med Assoc. 2009;108(10):754-64.
  • World Health Organization. Ageing. Avalible from https://www.who.int/health-topics/ageing#tab=tab_1. (Accessed 02.03.2022)
  • Buchner A, Erdfelder E, Faul F et al. G* Power 3.1 manual. Düsseldorf, Germany: Heinrich-Heine-Universitat Dusseldorf. 2017.
  • Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, Diekmann R, Drey M, Bollwein J, Tempera S, Guerra A, Ricciardi LM, Sieber CC. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc. 2011;59(11):2124-8.
  • Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, Ozturk S, Gungor E, Karabulut E, Balam Yavuz B, Cankurtaran M, Ariogul S. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
  • Sheikh JI, Yesavage JAGeriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health. 1986.
  • Durmaz B, Soysal P, Ellidokuz H, Isik AT. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. Northern clinics of Istanbul, 2018;5(3):216.
  • Borson S, Scanlan JM, Watanabe J, Tu SP, Lessig M. Simplifying detection of cognitive impairment: comparison of the Mini-Cog and Mini-Mental State Examination in a multiethnic sample. J Am Geriatr Soc. 2005;53(5):871-4.
  • Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini Mental test'in türk toplumunda hafif demans tanisinda geçerlik ve güvenilirliği [Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population]. Turk Psikiyatri Derg. 2002;13(4):273-81.
  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
  • Gündüz E, Eskin F, Gündüz M, Bentli R, Zengin Y, Dursun R, İçer M, Durgun HM, Gürbüz H, Ekinci M, Yeşil Y, Güloğlu C. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study. Med Sci Monit. 2015; 21:2750-6.
  • Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: a narrative review. Maturitas 2013;76(4):296–302
  • Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015;27(5):29-35.
  • Padayachey U, Ramlall S, Chipps J. Depression in older adults: prevalence and risk factors in a primary health care sample. South African family practice. 2017;59(2):61-66.
  • Onuh JC, Mbah PO, Ajaero CK, Orjiakor CT, Igboeli EE, Ayogu CK.Rural-urban appraisal of the prevalence and factors of depression status in South Africa. Journal of affective disorders reports. 2021; 4:100082.
  • Wu X, Hou G, Han P, Yu X, Chen X, Song P, Zhang Y, Zhao Y, Xie F, Niu S, Hu H, Sun C, Zhao Y, Wang H, Guo Q. Association Between Physical Performance and Cognitive Function in Chinese Community-Dwelling Older Adults: Serial Mediation of Malnutrition and Depression. Clin Interv Aging. 2021;16:1327-1335.
  • Engel JH, Siewerdt F, Jackson R, Akobundu U, Wait C, Sahyoun N. Hardiness, depression, and emotional well-being and their association with appetite in older adults. J Am Geriatr Soc. 2011; 59(3):482-7.
  • DiPietro L, Anda RF, Williamson DF, Stunkard AJ. Depressive symptoms and weight change in a national cohort of adults. Int J Obes Relat Metab Disord. 1992;16(10):745-53.
  • Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015;27(5):29-35.
  • Al-Rasheed R, Alrasheedi R, Al Johani R, Alrashidi H, Almaimany B, Alshalawi B, Alqadheb A. Malnutrition in elderly and its relation to depression. Int J Community Med Public Health, 2018; 5(6);2156-60.
  • Alexopoulos GS. Depression in the elderly. Lancet. 2005:4-10;365(9475):1961-70.
  • Rodda J, Walker Z, Carter J. Depression in older adults. BMJ. 2011;343: d5219.
  • Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, Burke JR, Hurd MD, Potter GG, Rodgers WL, Steffens DC, McArdle JJ, Willis RJ, Wallace RB. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med. 2008;148(6):427-34.
  • Suma S, Watanabe Y, Hirano H, Kimura A, Edahiro A, Awata S, Yamashita Y, Matsushita K, Arai H, Sakurai T. Factors affecting the appetites of persons with Alzheimer's disease and mild cognitive impairment. Geriatr Gerontol Int. 2018;18(8):1236-1243.
  • Sanders C, Behrens S, Schwartz S, Wengreen H, Corcoran CD, Lyketsos CG, Tschanz JT. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study1. J Alzheimers Dis. 2016;52(1):33-42.
  • Yılmaz G, Karaca KE. "Demans Tanısı Alan ve Almayan Geriatrik Bireylerin Beslenme Durumlarının Değerlendirilmesi". Turkish Journal of Family Medicine and Primary Care. 2021;15(3): 521-530.
  • Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, Muscaritoli M, Nyulasi I, Ockenga J, Schneider SM, de van der Schueren MA, Singer P. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015;34(3):335-40.

Geriatrik Hastalarda Malnütrisyon, Depresif Belirtiler Ve Bilişsel Bozulma Arasındaki İlişki

Year 2022, Volume: 4 Issue: 2, 217 - 23, 01.05.2022
https://doi.org/10.37990/medr.1082777

Abstract

Amaç: Beslenme bozukluğu, yaşlı bireylerde sık görülen, bilişsel ve psikolojik etkileri olan önemli bir sağlık sorunudur. Bu çalışma yaşlı popülasyonda yeme bozukluğu, bilişsel bozukluk ve depresyon yaygınlığı ile bu üç değişken arasındaki ilişkiyi değerlendirmeyi amaçlamıştır.
Materyal ve Metod: Retrospektif nitelikteki bu çalışmaya Türkiye’de bir üniversite hastanesi geriatri polikliniğine başvuran 65 yaş ve üstü 433 hastaya ait veriler dahil edildi. Beslenme düzeyleri Mini Nutrisyon Testi Kısa Formu (MNA-SF), depresif semptomlar Geriatrik Depresyon Skalası-Kısa Form (GDS-15) ve bilişsel fonksiyonlar Mini Mental Durum Değerlendirme Test (MMSE) sonuçlarıyla değerlendirildi.
Bulgular: MNA-SF sonuçlarına göre yaşlıların %13.6’sı malnutre, %30’u malnutrisyon riski altındaydı. Hastaların %45’inin GDS-15 puanı ≥5 iken, %12.5’inde ciddi demans, %24.7’sinde hafif demans vardı. Malnütrisyonlu hastalarda depresif belirtilerin sıklığı %62.7, malnütrisyon riski olanlarda %42.3 idi. Demans teşhisi alan hastaların %70.4’ünde malnütrisyon ve malnutrisyon riski görüldü. MNA-SF puanı ile depresif belirtiler ve bilişsel fonksiyonlar arasında ilişki vardı.
Sonuç: Yaşlı popülasyon örneğinde malnütrisyon yaygındı ve bilişsel bozulma ve depresyon ile ilişkiliydi. Bu bulgular, riskli gruplara danışmanlık ve psikiyatri hizmetlerinin verilmesi, erken teşhis için düzenli olarak değerlendirilmesi gerektiğini vurgulamaktadır. 

Project Number

-

References

  • Yannakoulia M, Mamalaki E, Anastasiou CA, Mourtzi N, Lambrinoudaki I, Scarmeas N. Eating habits and behaviors of older people: Where are we now and where should we go?. Maturitas. 2018; 114:14-21.
  • Leslie W, Hankey C. Aging, Nutritional Status and Health. Healthcare (Basel). 2015 Jul 30;3(3):648-58.
  • Bernstein M, Munoz N. Academy of Nutrition and Dietetics. Position of the Academy of Nutrition and Dietetics: food and nutrition for older adults: promoting health and wellness. J Acad Nutr Diet. 2012;112(8):1255-1277.
  • Donini LM, Dominguez LJ, Barbagallo M, Savina C, Castellaneta E, Cucinotta D, Fiorito A, Inelmen EM, Sergi G, Enzi G, Cannella C. Senile anorexia in different geriatric settings in Italy. J Nutr Health Aging. 2011;15(9):775-81.
  • Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, Tsai AC, Vellas B, Sieber CC; Mini Nutritional Assessment International Group. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010 ;58(9):1734-8.
  • Ramage-Morin PL, Gilmour H, Rotermann M. Nutritional risk, hospitalization and mortality among community-dwelling Canadians aged 65 or older. Health Rep. 2017: 20;28(9):17-27. PMID: 28930364.
  • Bergeron CD, John JM, Sribhashyam M, Odonkor G, Oloruntoba O, Merianos AL, Horel S, Smith ML. County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas. J Nutr Health Aging. 2021;25(7):862-868.
  • Chun H, Doo M. Factors Related to Depression Associated with Chewing Problems in the Korean Elderly Population. Int J Environ Res Public Health. 2021;18(11):6158.
  • Mantzorou M, Vadikolias K, Pavlidou E, Serdari A, Vasios G, Tryfonos C, Giaginis C. Nutritional status is associated with the degree of cognitive impairment and depressive symptoms in a Greek elderly population. Nutritional Neuroscience, 2020;23(3):201-209.
  • Kok RM, Reynolds CF 3rd. Management of Depression in Older Adults: A Review. JAMA. 2017;317(20):2114-2122.
  • Referans11. Greenwood CE, Parrott MD. Nutrition as a component of dementia risk reduction strategies. Healthc Manag Forum 2017;30(1):40-45.
  • Choi KW, Stein MB, Nishimi KM, Ge T, Coleman JRI, Chen CY, Ratanatharathorn A, Zheutlin AB, Dunn EC; 23andMe Research Team; Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Breen G, Koenen KC, Smoller JW. An Exposure-Wide and Mendelian Randomization Approach to Identifying Modifiable Factors for the Prevention of Depression. Am J Psychiatry. 2020;177(10):944-954.
  • Lassale C, Batty GD, Baghdadli A, Jacka F, Sánchez-Villegas A, Kivimäki M, Akbaraly T. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psychiatry. 2019;24(7):965-986.
  • Nicolaou M, Colpo M, Vermeulen E, Elstgeest LEM, Cabout M, Gibson-Smith D, Knuppel A, Sini G, Schoenaker DAJM, Mishra GD, Lok A, Penninx BWJH, Bandinelli S, Brunner EJ, Zwinderman AH, Brouwer IA, Visser M. Association of a priori dietary patterns with depressive symptoms: a harmonised meta-analysis of observational studies. Psychol Med. 2020;50(11):1872-1883.
  • Chen JH, Lin KP, Chen YC. Risk factors for dementia. J Formos Med Assoc. 2009;108(10):754-64.
  • World Health Organization. Ageing. Avalible from https://www.who.int/health-topics/ageing#tab=tab_1. (Accessed 02.03.2022)
  • Buchner A, Erdfelder E, Faul F et al. G* Power 3.1 manual. Düsseldorf, Germany: Heinrich-Heine-Universitat Dusseldorf. 2017.
  • Kaiser MJ, Bauer JM, Uter W, Donini LM, Stange I, Volkert D, Diekmann R, Drey M, Bollwein J, Tempera S, Guerra A, Ricciardi LM, Sieber CC. Prospective validation of the modified mini nutritional assessment short-forms in the community, nursing home, and rehabilitation setting. J Am Geriatr Soc. 2011;59(11):2124-8.
  • Sarikaya D, Halil M, Kuyumcu ME, Kilic MK, Yesil Y, Kara O, Ozturk S, Gungor E, Karabulut E, Balam Yavuz B, Cankurtaran M, Ariogul S. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60.
  • Sheikh JI, Yesavage JAGeriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health. 1986.
  • Durmaz B, Soysal P, Ellidokuz H, Isik AT. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. Northern clinics of Istanbul, 2018;5(3):216.
  • Borson S, Scanlan JM, Watanabe J, Tu SP, Lessig M. Simplifying detection of cognitive impairment: comparison of the Mini-Cog and Mini-Mental State Examination in a multiethnic sample. J Am Geriatr Soc. 2005;53(5):871-4.
  • Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Standardize Mini Mental test'in türk toplumunda hafif demans tanisinda geçerlik ve güvenilirliği [Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population]. Turk Psikiyatri Derg. 2002;13(4):273-81.
  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98.
  • Gündüz E, Eskin F, Gündüz M, Bentli R, Zengin Y, Dursun R, İçer M, Durgun HM, Gürbüz H, Ekinci M, Yeşil Y, Güloğlu C. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study. Med Sci Monit. 2015; 21:2750-6.
  • Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: a narrative review. Maturitas 2013;76(4):296–302
  • Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015;27(5):29-35.
  • Padayachey U, Ramlall S, Chipps J. Depression in older adults: prevalence and risk factors in a primary health care sample. South African family practice. 2017;59(2):61-66.
  • Onuh JC, Mbah PO, Ajaero CK, Orjiakor CT, Igboeli EE, Ayogu CK.Rural-urban appraisal of the prevalence and factors of depression status in South Africa. Journal of affective disorders reports. 2021; 4:100082.
  • Wu X, Hou G, Han P, Yu X, Chen X, Song P, Zhang Y, Zhao Y, Xie F, Niu S, Hu H, Sun C, Zhao Y, Wang H, Guo Q. Association Between Physical Performance and Cognitive Function in Chinese Community-Dwelling Older Adults: Serial Mediation of Malnutrition and Depression. Clin Interv Aging. 2021;16:1327-1335.
  • Engel JH, Siewerdt F, Jackson R, Akobundu U, Wait C, Sahyoun N. Hardiness, depression, and emotional well-being and their association with appetite in older adults. J Am Geriatr Soc. 2011; 59(3):482-7.
  • DiPietro L, Anda RF, Williamson DF, Stunkard AJ. Depressive symptoms and weight change in a national cohort of adults. Int J Obes Relat Metab Disord. 1992;16(10):745-53.
  • Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015;27(5):29-35.
  • Al-Rasheed R, Alrasheedi R, Al Johani R, Alrashidi H, Almaimany B, Alshalawi B, Alqadheb A. Malnutrition in elderly and its relation to depression. Int J Community Med Public Health, 2018; 5(6);2156-60.
  • Alexopoulos GS. Depression in the elderly. Lancet. 2005:4-10;365(9475):1961-70.
  • Rodda J, Walker Z, Carter J. Depression in older adults. BMJ. 2011;343: d5219.
  • Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, Burke JR, Hurd MD, Potter GG, Rodgers WL, Steffens DC, McArdle JJ, Willis RJ, Wallace RB. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med. 2008;148(6):427-34.
  • Suma S, Watanabe Y, Hirano H, Kimura A, Edahiro A, Awata S, Yamashita Y, Matsushita K, Arai H, Sakurai T. Factors affecting the appetites of persons with Alzheimer's disease and mild cognitive impairment. Geriatr Gerontol Int. 2018;18(8):1236-1243.
  • Sanders C, Behrens S, Schwartz S, Wengreen H, Corcoran CD, Lyketsos CG, Tschanz JT. Nutritional Status is Associated with Faster Cognitive Decline and Worse Functional Impairment in the Progression of Dementia: The Cache County Dementia Progression Study1. J Alzheimers Dis. 2016;52(1):33-42.
  • Yılmaz G, Karaca KE. "Demans Tanısı Alan ve Almayan Geriatrik Bireylerin Beslenme Durumlarının Değerlendirilmesi". Turkish Journal of Family Medicine and Primary Care. 2021;15(3): 521-530.
  • Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, Muscaritoli M, Nyulasi I, Ockenga J, Schneider SM, de van der Schueren MA, Singer P. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015;34(3):335-40.
There are 41 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Neslihan Cansel 0000-0002-5519-205X

Funda Datlı Yakaryılmaz 0000-0001-5633-0939

Project Number -
Publication Date May 1, 2022
Acceptance Date March 19, 2022
Published in Issue Year 2022 Volume: 4 Issue: 2

Cite

AMA Cansel N, Datlı Yakaryılmaz F. The Relationship Between Malnutrition, Depressive Symptoms, and Cognitive Impairment in Geriatric Patients. Med Records. May 2022;4(2):217-23. doi:10.37990/medr.1082777

17741

Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

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