Evde bakım gören yaşlı hastaların nütrisyonel durumları ile depresyon düzeyleri arasındaki ilişkinin incelenmesi

Yıl 2019, Cilt: 3 Sayı: 12, 829 - 832, 03.12.2019

Neşe Karakaş Recep Bentli Betül Fırıncı Bilge Zabcı

https://doi.org/10.28982/josam.650233

Cited By: 3

Öz

Amaç: Depresyon ve malnütrisyon yaygın görülen geriatrik sendromlardandır. Bu çalışmanın amacı evde bakım gören yaşlı hastalarda malnütrisyon ve depresyon sıklığını belirleyip, malnütrisyon ve depresyon arasındaki ilişkinin incelenmesidir. 

Yöntemler: Kesitsel olarak planlanan çalışmada Malatya devlet hastanesine bağlı evde sağlık hizmetlerinden yararlanan 86 yaşlı hasta dış konsültasyonla değerlendirildi. Hastaların nütrisyonel durumları Mini Nütrisyonel Değerlendirme testi (MNA) depresyon düzeyleri Geriatrik Depresyon Ölçeği (GDS) ile, fonksiyonel durumları KATZ’ın Günlük Yaşam Aktiviteleri indeksi aracılığıyla değerlendirildi. 

Bulgular: Araştırma kapsamındaki 86 hastanın, 27’si kadın, 59’u erkekti. Hastaların nütrisyonel durumları incelendiğinde %12,8’inin normal, %50,0'sinin malnütrisyon riski altında ve %37,2'sinde ise malnütrisyon olduğu tespit edildi. Bu çalışmada, GDS'ye göre katılımcıların %79,1'inde depresyon saptanmıştır. Depresyon tanısı alan grubun MNA skorları, el kavrama gücü, folikasit seviyeleri depresyon tanısı almayan gruba göre istatistiksel olarak anlamlı derecede düşüktü (sırasıyla, P<0,001, P=0,03, P=0,04). 

Sonuç: Sonuç olarak, rutin tarama malnütrisyonun erken teşhisi ve tedavisi için beslenme bozukluklarına ek olarak depresyon belirtileri olabilir, daha geniş örnekleme grubu ile çalışılması önerilebilir.

Anahtar Kelimeler

Malnütrisyon, Depresyon, Evde bakım

Investigation of the relationship between depression and nutritional status of elderly patients in home care

Öz

Aim: Malnutrition and depression are common geriatric disorders. The aim of this study was to determine the prevalence of malnutrition and depression in the elderly, as well as assess the association between depression and malnutrition. 

Methods: A cross-sectional study was conducted with 86 elderly patients in the external consultation unit of a public specialty hospital in Malatya. Nutritional status was classified by the Mini Nutrition Assessment (MNA). Depression was assessed using the Geriatric Depression Scale (GDS). Functional autonomy indicators were obtained by Katz Index. 

Results: A total of 86 patients, 27 females and 59 males, were included in this study.  Among them, 12.8% were classified as in adequate nutritional status, 50.0% were classified as being at risk of malnutrition and 37.2% as malnourished. In this study, depression rate was determined as 79.1% according to the GDS. MNA scores, hand grip strength and folic acid levels of the group diagnosed with depression were statistically significantly lower (p˂0.001, P=0.03, P=0.04, respectively). 

Conclusion: We suggest routine screening of depression symptoms in addition to the nutritional disorders for the early diagnosis and treatment of malnutrition and depression, however, further studies including more patients are needed.

Anahtar Kelimeler

Depression, Malnutrition, Home care

Kaynakça

• 1. Çuhadar SG, Lordoğlu K. Aging and issues in turkey during the demographic transformation process. İstanbul University Journal of the Faculty of Political Sciences. 2016;(54):63-80.
• 2. Genç Y, Barış I. Contemporary approach in elderly care services: strengthening home care services instead of institutional care. Academic Journal of Social Research. 2015;3(10):36-57.
• 3. Regulation on the Provision of Home Health Services by the Ministry of Health and Its Affiliated Organizations. Ankara, 27.02.2015; Official Gazette Issue: 29280.
• 4. Karaman D, Kara D, Atar NY. Assessment of disease status and care needs of individuals provided home health care: Zonguldak Case. Gümüşhane University Journal of Health Sciences. 2015;4(3):347-59.
• 5. Çatak B, Kılınç AS, Badıllıoğlu O, Sütlü S, Sofuoğlu AE, Aslan D. Profile of elderly patients receiving home health care in burdur and home health services. Turkey Journal of Public Health. 2012;10(1):13-21.
• 6. Ironside PM, Tagliareni ME, McLaughlin B, King E, Mengel A. Fostering geriatrics in associate degree nursing education: an assessment of current curricula and clinical experiences. J Nurs Educ. 2010;49(5):246–52.
• 7. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55(5):78.
• 8. Mete B, Fırıncı B, Doğan E, Pehlivan E. Depression and affecting factors in patients over 50 years of age: A cross-sectional study. J Surg Med. 2019;3(2):149-54.
• 9. Meriç ÇS., Yabancı AN. Importance of home health care and malnutrition in the elderly. Journal of Nutrition and Diet. 2017;45(3):287-93.
• 10. Sarıkaya D. Validity study of long and short (MNA-SF) form of Mini Nutritional Assessment (MNA) test in geriatric patients. Medical Thesis, Hacettepe University, Faculty of Medicine, 2013, Ankara.
• 11. Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;30(2):135-42.
• 12. Flood A, Chung A, Parker H, Kearns V, O'Sullivan TA. The use of hand grip strength as a predictor of nutrition status in hospital patients. Clin Nutr. 2014;33(1):106-14.
• 13. Pehlivanoğlu EFO, Özkan MU, Balcıoğlu H, Bilge U, Ünlüoğlu İ. Adaptation to Turkish and reliability of the katz index of activities of daily living for the elderly. Ankara Medical Journal. 2018;18(2):219-23.
• 14. Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: Are there different factor structures for different cultures? Int Psychogeriatr. 2000;12:163-72.
• 15. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40:373-83.
• 16. Çevik AÇ, Basat AO, Uçak S. Evaluation of nutritional status in elderly patients receiving home health care and examining the effect of nutritional status on laboratory parameters. Konuralp Medical Journal. 2014;6(3):31-7. DOI: 10.18521/ktd.58144
• 17. Akan H, Ayraler A, Hayran O. Nutritional status of elderly patients admitted to the home health unit. Turkish Family Physician's Journal. 2013;17(3):106-12.
• 18. Soini H, Routasalo P, Lagström H. Characteristics of the mini-nutritional assessment in elderly home-care patients. Eur J ClinNutr. 2004;58(1):64-70.
• 19. Bentli R, Karakaş N, Fırıncı B, Deniz S. Nutritional status of elderly people living in nursing homes and some related factors. Medicine Science International Medical Journal. 2019;8(2):430-5.
• 20. Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, BoirieY, et al. Prevalence and interventions for sarcopenia in aging adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Aging. 2014;43(6):748-59.
• 21. Göçer S, Günay O. Kayseri’de bir huzurevinde yaşayan yaşlıların günlük yaşam aktiviteleri ve depresif belirti düzeyleri. Euras J Fam Med. 2018;7(3):116-24.
• 22. Balcı E, Şenol V, Eşel E, Günay O, Elmalı F. Relationship between depression and malnutrition status of individuals 65 years and over. Turkish Journal of Public Health. 2012;10(1):37-43.
• 23. Ahmadi SM, Mohammadi MR, Mostafavi SA, Keshavarzi S, Kooshesh SM, Joulaei H, et al. Dependence of the geriatric depression on nutritional status and anthropometric indices in elderly population. Iranian Journal of Psychiatry. 2013;8(2):92–6.
• 24. Wang H, Hai S, Liu Y, Cao L, Liu Y, Liu P, et al. Association between depressive symptoms and sarcopenia in older Chinese community-dwelling individuals. Clinical Interventions in Aging. 2018;13:1605–11. doi:10.2147/CIA.S173146
• 25. Saka B, Özkuluk H. Evaluation of nutritional status in elderly patients admitted to internal medicine outpatient clinic and the relationship between malnutrition and other geriatric syndromes. Gülhane Journal of Medicine. 2008;50(3):151-7.
• 26. Yildiz D, Pekel NB, Kilic AK, Tolgay EN, Tufan F. Malnutrition is associated with dementia severity and geriatric syndromes in patients with Alzheimer disease. Turkish Journal of Medical Sciences. 2015;45(5):1078-81.