DEPRESSIVE SYMPTOMS ARE ASSOCIATED WITH FOOD INSUFFICIENCY AND NUTRITIONAL DEFICIENCIES IN POOR COMMUNITY-DWELLING ELDERLY PEOPLE

Depression is associated with nutritional deterioration in older persons and is highly prevalent among people of low socioeconomic status (LSES). Objectives: To determine the prevalence of depressive symptoms and food insufficiency, and to examine the relationship between dietary intake, food insufficiency and depression, in LSES community dwelling elderly. Design: Cross-sectional study. Setting: Lod, a town in the central Israel. Participants: Community-dwelling welfare recipients aged 60 to 92. Measurements: Depression was assessed by 15-item Geriatric Depression Scale (GDS-short version), using a score >= 10 as the cut off point for clinically important depressive symptoms. Dietary intake was evaluated using a 24-hour dietary recall. Food insufficiency was defined by participants reporting that they did not have enough food to eat sometimes or often. Results: This study reports on 112 persons aged 60 years and above (27.1% men). The prevalence of depression in this population was 47%; 25% of the study sample was classified as food insufficient. Macronutrients intake was similar for depressed and non-depressed persons, except for polyunsaturated fats which was lower among the depressed group (7.9 +/- 4.9 vs. 11.0 +/- 7.5 g/day in the non-depressed, p = 0.03). Vitamins and minerals intake was lower than recommended for both groups; vitamin E intake was associated with depression. In regression models controlling for confounding variables, an increase of 1 mg in vitamin E intake and 1 gram in polyunsaturated fatty acids (PUFA) intake was associated with lower risk for depression (OR = 0.73, p = 0.008 and OR = 0.86, p= 0.007 respectively) Participants who reported food insufficiency were 10 times more likely to be depressed compared with those who reported sufficient food. Conclusions: Given the evaluated adverse association between depressive symptoms and food insufficiency, more efforts are needed to guarantee adequate food intake, particularly foods rich in vitamin E and PUFA, in poor elderly people. Further studies are needed to clarify the temporal relationship between the emotional and nutritional domains in this vulnerable population.