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.