Depression and malnutrition: how they interact in hospital patients

Aim: Malnutrition and depression are prevalent in hospital patients, particularly the elderly. There is evidence to suggest an association exists between the two, with both malnutrition and depression co-existing in some patients. The aim of this study is to assess the association between nutritional status and depressive symptoms. Methods: Our study comprised 129 adult medical patients admitted to Chase Farm Hospital during the period of 15 August to 15 October 2009. Each individual's age and gender were noted, in addition to their nutritional status and incidence of depression, as assessed by the Liverpool Nutritional Score and PHQ-9 questionnaires respectively. Results: Six confused patients were excluded to avoid unreliable answers to the depression screening questionnaire. Of the 129 remaining patients, the mean age was 80.2 years; 60% were male and 40% female. Malnutrition was identified in 54% (n=70) and depression in 46.5% (n=60) of the sample. Of the malnourished patients, a total of 56.5% (n=40) were depressed. Of the non-malnourished patients only 15.2% (n=9) were found to be depressed. Conclusions: Nutritional deficit presented a significant association with depression. In patients suffering from one of these problems, this should prompt screening for the other. Further research is needed to analyse the direction of causation in this relationship: is depression a risk factor for malnutrition, is the converse true, or does another variable underpin both?