Association Between Depression, Nutritional Status, and Dietary Intake in Community-Dwelling Older Adults: A Cross-Sectional Analysis on Baseline Data of the Birjand Longitudinal Aging Study (Blas) Publisher



Golafrouz H ; Fakhrzadeh H ; Moodi M ; Karimi K ; Khorashadizadeh M ; Khodabakhshi H ; Ejtahed HS ; Sharifi F
Source: Journal of Diabetes and Metabolic Disorders Published:2026

Abstract

Background: Malnutrition is a concern among older adults, leading to physical health issues and psychological challenges, including depression. Moreover, poor nutritional habits can adversely impact mood, while depression can, in turn, deteriorate nutritional status. This study examined food group intake and malnutrition of older adults in Birjand, Iran, to determine their association with depression. Methods: In this cross-sectional study, 1,344 adults aged 60 years and older from the Birjand Longitudinal Aging Study (BLAS) were included. Participants were categorized based on nutritional status into two distinct groups: a well-nourished group and a combined group comprising individuals who were malnourished or at risk of malnutrition. Depression and nutritional status were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Mini Nutritional Assessment (MNA), respectively. The intake of major food groups was also evaluated. Results: Out of 1,344 participants, 268 (20%) were diagnosed with depression. The sample included 648 men and 696 women, with a mean age of 69.7 years. Logistic regression showed that malnourished participants had higher odds of depression than well-nourished individuals (fully adjusted OR = 2.47, 95% CI: 1.95–3.14). In binary analyses, depression was significantly associated with lower intake of animal protein and milk products (p < 0.01). Ordinal logistic regression indicated that higher intake of animal protein, milk/dairy, and fruits and vegetables, and cereals was related to lower odds of more severe depression (animal protein: OR = 0.59, 95% CI: 0.44–0.78; milk/dairy: OR = 0.54, 95% CI: 0.41–0.69; fruits and vegetables: OR = 0.61, 95% CI: 0.46–0.81; and cereals: OR = 0.72, 95% CI:0.56–0.94), whereas beans were not significantly associated. Conclusions: Malnutrition was significantly associated with depression in community-dwelling older individuals. Higher intake of fruits, vegetables, cereals, dairy, and animal protein was associated with improved depressive symptoms; however, no such association was observed for beans intake. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2026.