הקשר בין תסמינים של דיכאון לבין תחושת התיאבון ומידת האכילה בקרב זקנים מאושפזים במחלקה פנימית: [מאמר מחקר]

Background: Inadequate food intake is prevalent among hospitalized older adults and is linked to negative hospitalization outcomes, including functional decline and increased mortality. Up to 20% of hospitalized older adults suffer from depressive symptoms. When depression is a well-established risk factor of inadequate food intake in the community at timeof hospitalization this association yet to be adequately studied.Objectives: To examine the associations between depressive symptoms and appetite, as related to the quantity of food that elderly inpatients consume at time of hospitalization.Methods: The present study is a secondary data analysis of a prospective cohort data set called״Hospitalization Process Effects on Functional Outcomes and Recovery״, which examined the association between treatment processes during hospitalization and functional outcomes. The present study included 724 subjects aged 70 or older with existing data regarding the main study variables. Depressive symptoms were evaluated with Tucker׳s Short Zung Instrument(TSZI) at time of admission. Food intake and appetite were examined using self-report of quantities of food consumed at every meal (breakfast, lunch and supper) based on the n Day Express Questionnaire during daily follow-up interviews.Findings: Approximately 40% of the subjects reported eating half or less of each meal. The risk of depression was prevalent among a third of the subjects, 54% of whom were identified with high risk of depression. The association between depression and inadequate food intake during hospitalization was found to be negative [F(2,716)=9.00,p=0.000,η2 =0.025]. Lack of appetite was found to be significantly linked to reduced food consumption [β=-0.39, t=-12.06, p=0.000],contributing considerably to explained variance of food consumed during hospitalization[F-change (1,717)=145.41, p=0.000]. Decreased appetite partially mediated the association between depressive symptoms and food intake during hospitalization (B (unstandardized)=-0.001,UCI=-0.001; LCI=-0.002) controlling for confounders (malnutrition, cognitive status, base line functioning, acute disease severity, age, and gender). Conclusions: Older hospitalized patients with high risk of depression consume less food during hospitalization, and their lack of appetite is linked to their inadequate food intake.Lack of appetite partially explains the association between depression and inadequate food intake among the hospitalized elderly. These research findings contribute to the understanding of inadequate food intake during hospitalization and indicates the importance of detecting depression among elderly hospital patients.