The Effect of Malnutrition, Nutritional Status and Physical Activity Levels on Emotional State in the Elderly

Öz

The aim of this study is to evaluate nutritional habits in individuals aged 65 years and over, to detect physical activity, depression and malnutrition status, and to evaluate its effect on depression. Individuals and Method: This cross-sectional study was conducted with 120 individuals aged 65 years and over. In the study, individuals' descriptive characteristics, anthropometric measurements and some biochemical findings were questioned with survey questions. Nutrition and physical activity status of individuals were evaluated by taking 24-hour food consumption records and 24-hour physical activity records. In addition, malnutrition was recorded with the Mini Nutritional Assessment (MNA) and depression with the Geriatric Depression Scale (GDS). In the study, according to MNA, 89.2% (n=107) of the individuals were evaluated as having normal nutritional status and 10.8% (n=13) as being at risk of malnutrition. The GDS average values of individuals at risk of malnutrition were found to be higher than the GDS average values of individuals with normal nutritional status (p = 0.02). Additionally, it was observed that the physical activity level (PAL) average values of individuals at risk of malnutrition were lower than those of individuals with normal nutritional status (p =0.04). A negative correlation was found between the GDS score of individuals at risk of malnutrition and dietary magnesium and phosphorus values (p = 0.03, p = 0.05, respectively). It has been observed that individuals aged 65 and over, who are at risk of malnutrition, are less physically active and the depression score in these individuals is higher than in individuals with normal nutritional status. Additionally, low dietary magnesium and phosphorus consumption is associated with a higher depression score.

Anahtar Kelimeler

• Elderly
• Nutrition
• Malnutrition
• Depression
• Physical Activity

Malnütrisyon, beslenme durumu ve fiziksel aktivite düzeylerinin yaşlı bireylerde duygu durumuna etkisi

Öz

Bu çalışmanın amacı 65 yaş ve üzeri bireylerde beslenme, malnütrisyon, fiziksel aktivite ve depresyon durumunun saptanması ve bu değişkenlerin duygu durumu üzerindeki etkisinin değerlendirilmesidir. Bu kesitsel çalışma, 65 yaş ve üzeri 120 birey ile yürütülmüştür. Çalışmada bireylerin tanımlayıcı özellikleri, antropometrik ölçümleri ve bazı biyokimyasal bulguları anket soruları ile sorgulanmıştır. Bireylerin beslenme ve fiziksel aktivite durumları, 24 saatlik geriye dönük besin tüketimleri ve 24 saatlik fiziksel aktivite kayıtları alınarak değerlendirilmiştir. Yaşlı bireylerde malnütrisyon durumunu saptamak için Mini Nütrisyonel Değerlendirme (MNA- Mini Nutritional Assessment), depresyon durumunu değerlendirmek için ise geriatrik depresyon ölçeği (GDÖ) kullanılmış ve elde edilen veriler kayıt altına alınmıştır. Çalışmada, MNA’ya göre bireylerin %89.2’si (s=107) beslenme durumu normal, %10,8’i (s=13) ise malnütrisyon riski altında olarak değerlendirilmiştir. Malnütrisyon riski altında olan bireylerin GDÖ ortalama değerleri beslenme durumu normal olan bireylerin GDÖ ortalama değerinden daha yüksek bulunmuştur (p=0.02). Ayrıca malnütrisyon riski altında olan bireylerin fiziksel aktivite düzeyi (PAL) ortalama değerlerinin beslenme durumu normal olan bireylere göre daha düşük olduğu görülmüştür (p=0.04). Malnütrisyon riski altında olan bireylerin GDÖ skoru ile, diyetle alınan magnezyum ve fosfor değerleri arasında negatif yönde bir korelasyon (sırasıyla p=0.03, p=0.05) bulunmuştur. Malnütrisyon riski olan 65 yaş ve üzeri bireylerin fiziksel olarak daha az aktif olduğu ve bu bireylerde depresyon skorunun beslenme durumu normal olan bireylere göre daha yüksek olduğu, ayrıca diyetle alınan düşük magnezyum ve fosfor tüketiminin daha yüksek depresyon skoru ile ilişkili olduğu görülmüştür.

Anahtar Kelimeler

• Yaşlılık
• beslenme
• malnütrisyon
• depresyon
• fiziksel aktivite

Kaynakça

1. Agarwal, E., Miller, M., Yaxley, A., & Isenring, E. (2013). Malnutrition in the elderly: a narrative review. Maturitas, 76(4), 296–302. https://doi.org/10.1016/j.maturitas.2013.07.013
2. Agostini, D., Gervasi, M., Ferrini, F., Bartolacci, A., Stranieri, A., Piccoli, G., Barbieri, E., Sestili, P., Patti, A., Stocchi, V., & Donati Zeppa, S. (2023). An ıntegrated approach to skeletal muscle health in aging. Nutrients, 15(8), 1802. https://doi.org/10.3390/nu15081802
3. Aparicio, A., Robles, F., López-Sobaler, A. M., & Ortega, R. M. (2013). Dietary glycaemic load and odds of depression in a group of institutionalized elderly people without antidepressant treatment. European journal of nutrition, 52(3), 1059–1066. https://doi.org/10.1007/s00394-012-0412-7
4. Atalay B.G. Akciğer hastalıkları ve magnezyum. Mercanlıgil SM, editör. Sağlıkta, hastalıklarda ve özel durumlarda magnezyum. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.35-9.
5. Balcı, E., Şenol, V., Eşel, E., Günay, O., & Elmalı, F. (2012). 65 yaş ve üzeri bireylerin depresyon ve malnutrisyon durumları arasındaki ilişki. Turkish Journal of Public Health. 10(1), 37-43
6. Baysal, A. (2017). Beslenme. Hatiboğlu Yayınları, Ankara.
7. Baysal, A. (2020). Yaşlılıkta beslenme. Hatiboğlu Yayınları, Ankara.
8. Blaum, C. S., Fries, B. E., & Fiatarone, M. A. (1995). Factors associated with low body mass index and weight loss in nursing home residents. The journals of gerontology. Series A, Biological sciences and medical sciences, 50(3), M162–M168. https://doi.org/10.1093/gerona/50a.3.m162

9. Bozoğlu, E., & Öztürk, A. (2016). Malnütrisyonun tanımı, sıklığı ve etiyolojik faktörler. Türkiye Klinikleri-Geriatri Özel Konular, Yaşlılarda Beslenme ve Beslenme Bozuklukları Özel Sayısı, 2(1):7-15.
10. Cabrera, M. A., Mesas, A. E., Garcia, A. R., & de Andrade, S. M. (2007). Malnutrition and depression among community-dwelling elderly people. Journal of the American Medical Directors Association, 8(9), 582–584. https://doi.org/10.1016/j.jamda.2007.07.008
11. Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., Compher, C., Correia, I., Higashiguchi, T., Holst, M., Jensen, G. L., Malone, A., Muscaritoli, M., Nyulasi, I., Pirlich, M., Rothenberg, E., Schindler, K., Schneider, S. M., de van der Schueren, M. A., Sieber, C., … Singer, P. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical nutrition (Edinburgh, Scotland), 36(1), 49–64. https://doi.org/10.1016/j.clnu.2016.09.004 Cereda E. (2012). Mini nutritional assessment. Current opinion in clinical nutrition and metabolic care, 15(1), 29–41. https://doi.org/10.1097/MCO.0b013e32834d7647
12. Cuervo, M., García, A., Ansorena, D., Sánchez-Villegas, A., Martínez-González, M., Astiasarán, I., & Martínez, J. (2009). Nutritional assessment interpretation on 22,007 Spanish community-dwelling elders through the Mini Nutritional Assessment test. Public health nutrition, 12(1), 82–90. https://doi.org/10.1017/S136898000800195X
13. Edington, J., Boorman, J., Durrant, E. R., Perkins, A., Giffin, C. V., James, R., Thomson, J. M., Oldroyd, J. C., Smith, J. C., Torrance, A. D., Blackshaw, V., Green, S., Hill, C. J., Berry, C., McKenzie, C., Vicca, N., Ward, J. E., & Coles, S. J. (2000). Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clinical nutrition (Edinburgh, Scotland), 19(3), 191–195. https://doi.org/10.1054/clnu.1999.0121
14. Ertan, T., Eker, E., & Şar, V. (1997). Geriatrik depresyon ölçeğinin Türk yaşlı nüfusunda geçerlik ve güvenirliği. Nöropsikiyatri Arşivi 34(1),67–71.
15. German, L., Feldblum, I., Bilenko, N., Castel, H., Harman-Boehm, I., & Shahar, D. R. (2008). Depressive symptoms and risk for malnutrition among hospitalized elderly people. The journal of nutrition, health & aging, 12(5), 313–318. https://doi.org/10.1007/BF02982661
16. Groce, N., Challenger, E., Berman-Bieler, R., Farkas, A., Yilmaz, N., Schultink, W., Clark, D., Kaplan, C., & Kerac, M. (2014). Malnutrition and disability: unexplored opportunities for collaboration. Paediatrics and international child health, 34(4), 308–314. https://doi.org/10.1179/2046905514Y.0000000156
17. https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2020-37227. (Haziran, 2022)
18. https://www.cdc.gov/aging/mentalhealth/depression.htm/, Centers for disease control and prevention, “depression is not a normal part of growing older,” Division of Population Health, January, 2017. (Temmuz, 2023) https://www.who.int/, World Health Organization, (Haziran, 2022)
19. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health/, World Health Organization. Ageing and health. (October 2021). (Haziran, 2022)
20. Leggo, M., Banks, M., Isenring, E., Stewart, L., & Tweeddale, M. (2008). A quality improvement nutrition screening and intervention program available to home and community care eligible clients. Nutrition & Dietetics 65,162–7. Merker, M., Gomes, F., Stanga, Z., & Schuetz, P. (2019). Evidence-based nutrition for the malnourished, hospitalised patient: one bite at a time. Swiss medical weekly, 149, w20112. https://doi.org/10.4414/smw.2019.20112
21. Miki, T., Kochi, T., Eguchi, M., Kuwahara, K., Tsuruoka, H., Kurotani, K., Ito, R., Akter, S., Kashino, I., Pham, N. M., Kabe, I., Kawakami, N., Mizoue, T., & Nanri, A. (2015). Dietary intake of minerals in relation to depressive symptoms in Japanese employees: the Furukawa Nutrition and Health Study. Nutrition (Burbank, Los Angeles County, Calif.), 31(5), 686–690. https://doi.org/10.1016/j.nut.2014.11.002
22. Morley, J. E., & Kraenzle, D. (1994). Causes of weight loss in a community nursing home. Journal of the American Geriatrics Society, 42(6), 583–585. https://doi.org/10.1111/j.1532-5415.1994.tb06853.x
23. Norman, K., Haß, U., & Pirlich, M. (2021). Malnutrition in older adults-recent advances and remaining challenges. Nutrients, 13(8), 2764. https://doi.org/10.3390/nu13082764
24. Nuchols, C. (2013). American psychiatric association, “diagnostic and statistical manual of mental disorders, fifth edition,” American psychiatric publishing, Washington, D.C. Pages 160-168.
25. Pekcan, AG. (2016). Diyet el kitabı 9.baskı. Editör: Baysal A. Ankara: Hatiboğlu Yayınevi, s: 67-142.
26. Smoliner, C., Norman, K., Wagner, K. H., Hartig, W., Lochs, H., & Pirlich, M. (2009). Malnutrition and depression in the institutionalised elderly. The British journal of nutrition, 102(11), 1663–1667. https://doi.org/10.1017/S0007114509990900
27. Song, Y., Han, K., Jia, W. P., Wang, S. S., Zhu, Q., Ning, C. X., Liu, M., Zhao, Y. L., & He, Y. (2022). Zhonghua yi xue za zhi, 102(2), 114–118. https://doi.org/10.3760/cma.j.cn112137-20210520-01171
28. Sun, C., Wang, R., Li, Z., & Zhang, D. (2019). Dietary magnesium intake and risk of depression. Journal of affective disorders, 246, 627–632. https://doi.org/10.1016/j.jad.2018.12.114
29. Szulc, P., Munoz, F., Marchand, F., Chapurlat, R., & Delmas, P. D. (2010). Rapid loss of appendicular skeletal muscle mass is associated with higher all-cause mortality in older men: the prospective MINOS study. The American journal of clinical nutrition, 91(5), 1227–1236. https://doi.org/10.3945/ajcn.2009.28256
30. Tramontano, A., Veronese, N., Giantin, V., Manzato, E., Rodriguez-Hurtado, D., Trevisan, C., De Zaiacomo, F., & Sergi, G. (2016). Nutritional status, physical performance and disability in the elderly of the Peruvian Andes. Aging clinical and experimental research, 28(6), 1195–1201. https://doi.org/10.1007/s40520-016-0591-9
31. Verde, Z., Giaquinta, A., Sainz, C. M., Ondina, M. D., & Araque, A. F. (2019). Bone Mineral Metabolism Status, Quality of Life, and Muscle Strength in Older People. Nutrients, 11(11), 2748. https://doi.org/10.3390/nu11112748
32. Visvanathan, R., Macintosh, C., Callary, M., Penhall, R., Horowitz, M., & Chapman, I. (2003). The nutritional status of 250 older Australian recipients of domiciliary care services and its association with outcomes at 12 months. Journal of the American Geriatrics Society, 51(7), 1007–1011. https://doi.org/10.1046/j.1365-2389.2003.51317.x
33. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4