بررسي ارتباط بين سوءتغذيه و افسردگي در سالمندان ايراني

Relationship between malnutrition and depression among Iranian elderly population

با افزايش جمعيت سالمندان، حفظ سلامت آن ها يكي از مهم ترين اولويت هاي دولت ها به شمار مي رود. از جمله بيماري هاي شايع در اين دوران سوءتغذيه و افسردگي است كه منجر به نتايج نامطلوبي گردد. هدف مطالعه ملي حاضر تعيين ارتباط بين سوءتغذيه و افسردگي در سالمندان ايراني بود. مواد و روش ها در مطالعه مقطعي حاضر(كه در سال 1397 انجام شد) كه داده هاي آن از طرح ملي سيماي سلامت سالمندان استخراج شد، 1133 نفر سالمند شركت كردند. اين طرح ملي به بررسي وضعيت سلامت افراد 60 سال و بالاتر در پنج استان كشور با نمونه گيري خوشه اي از 106 مركز بهداشتي درماني در 66 شهرستان پرداخته است. از پرسش نامه هاي ارزيابي مختصر تغذيه اي (MNA, Mini Nutritional Assessment) و مقياس افسردگي سالمندان (GDS-15,Geriatric Depression Score) استفاده شد. يافته ها ﺣﺪود 47% از ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن ﻣﺮدان ﺑﻮدﻧﺪ. ﻣﯿﺎﻧﮕﯿﻦ و اﻧﺤﺮاف ﻣﻌﯿﺎر ﺳﻦ ﺷﺮﮐﺖﮐﻨﻨﺪﮔﺎن 7/22 ±69/11 ﺑﻮد. ﻣﯿﺰان ﺷﯿﻮع اﻓﺴﺮدﮔﯽ 35/7% )28/5%ﻣﺮدان و 42/3% زﻧﺎن( وﺳﻮءﺗﻐﺬﯾﻪ 6/1% )5/4% ﻣﺮدان و 6/7% زﻧﺎن( ﺑﻪدﺳﺖ آﻣﺪ. ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﭼﻨﺪﻣﺘﻐﯿﺮه ﻧﺸﺎن داد ﮐﻪ اﻓﺮاد در ﻣﻌﺮض ﺧﻄﺮ ﺳﻮءﺗﻐﺬﯾﻪ 3 ﺑﺮاﺑﺮ ﺑﯿﺶﺗﺮ از اﻓﺮاد ﻃﺒﯿﻌﯽ ﺧﻄﺮ اﺑﺘﻼ ﺑﻪ اﻓﺴﺮدﮔﯽ را دارﻧﺪ. ))4/60-2/59(=P<0/001، OR=3/45، CI( نتيجه گيري با توجه به شيوع نسبتا بالاي افسردگي سالمندان ايراني نسبت به برخي از كشورها و افزايش تعداد سالمندان در معرض خطر ابتلا به سوءتغذيه، به كارگيري مداخلات لازم مي تواند كمك كننده باشد. هم چنين با وجود ارتباط ميان سوءتغذيه و افسردگي، كارشناسان بهداشتي و درماني در طول درمان سالمندان مبتلا به افسردگي، سوء تغذيه و يا هر دو بايستي به جنبه هاي جسمي و روحي توجه داشته باشند.

Considering the increasing pace of population ageing, health maintenance of the elderly is one of the top priorities of governments. Depression and malnutrition are very common problems with various consequences for the elderly population. The purpose of the present national study was to determine the relationship between malnutrition and depression in an Iranian elderly population in 2017. Materials and Methods In this cross-sectional study was perfomed in 2017, data were extracted from the Iran National Health Survey of the Elderly, evaluating 1133 elderly people. Relatively, this national survey focused on the health status of individuals aged 60 years or above, who were selected from 106 health centers in 66 cities of Iran via cluster sampling. For data collection, the Mini Nutritional Assessment (MNA) and Geriatric Depression Score (GDS-15) were used. Results Nearly 47% of the participants were male. The mean±SD of the participants’ age was 69.11±7.22 years. The prevalence of depression was 35.7% (28.5% in men vs. 42.3% in women), while the prevalence of malnutrition was 6.1% (5.4% in men vs. 6.7% in women). The results of multivariate logistic regression showed that the risk of depression was three times higher in people at risk of malnutrition compared to normal people (P< 0.001, OR= 3.45, CI (4.60-2.59)). Conclusion Considering the relatively higher prevalence of depression in the elderly population of Iran compared to some other countries, besides the increasing number of elderly people at risk of malnutrition, use of proper interventions can be helpful. Despite the association between malnutrition and depression, healthcare professionals should consider both physical and mental aspects in the treatment of elderly people with depression, malnutrition, or both.