Malnutrition Concerning Geriatric Depression and Associated Risk Factors: A Community-based Case-control Study in Rural Elderly of Bangladesh

Abstract

Background: Malnutrition and depression are highly prevalent in the elderly and can lead to disparaging outcomes. Analytical studies on malnutrition concerning geriatric depression (GD) are very scarce in Bangladesh, although the size of the elderly population is increasing fast in the country. The current study aimed to assess the association between malnutrition and depression and associated risk factors in the rural elderly.Methods: A case-control study was conducted in 600 elderly residents (aged ≥60 years) of three rural communities of Bangladesh from January to October 2019. Three hundred depressed elderly people were enrolled as cases and 300 non-depressed elderly individuals were included as community controls by matching the age and living area of the cases. We used a semi-structured questionnaire based on the Geriatric Depression Scale-15 and the Bangla version of Mini-Nutritional Assessment-Short Form to collect data through face-to-face interviews. Measures included baseline and personal characteristics, malnutrition, GD, and associated risk factors. A binary logistic regression model was fitted to identify variables associated with the risk of GD.Results: The study found no significant difference in gender (male Vs. female) between cases (44.0% Vs. 56.0%) and controls (46.0% Vs. 54.0%). The study revealed that malnutrition was significantly (p<0.01) higher in cases (56.0%) than in controls (18.0%). The malnourished elderly had around three times AOR=3.155; 95% CI: 1.53-6.49, p=0.002) more (risk of having depression than the controls. The unemployed elderly (AOR=4.964; 95% CI: 2.361-10.440; p=0.0001) and the elderly of the lower and middle class (AOR=3.654; 95% CI: 2.266-7.767; p=0.001) were more likely to experience depression. The elderly having a poor diet were more likely to experience depression (AOR=3.384; 95% CI: 1.764-6.703; p=0.0001). The single elderly (AOR=2.368; 95% CI: 1.762-6.524; p=0.001) and the elderly tobacco users (AOR=2.332; 95% CI: 1.663-5.623; p=0.003) were more likely to experience depression.Conclusions: A significant association between malnutrition and depression is evident in the rural elderly individuals of Bangladesh. It will be a prolific initiative if policymakers merge malnutrition and the risk factors associated with geriatric depression in the provision of universal health care for better health and well-being of the rural elderly populations.