Functional status mediates the association of nutritional status with depressive symptoms in patients with heart failure

Abstract

Aims The decline of nutritional status and depressive symptoms are pandemic in heart failure patients and functional status may play a pivotal role between these. This study aimed to determine whether nutritional status is associated with depressive symptoms and whether functional status mediates this relationship in heart failure patients. Design This was a secondary analysis of a cross‐sectional study. Methods The data were collected from November 2015–April 2016. Heart failure patients (N = 254) being hospitalized were included in this secondary analysis. The Depression Sub‐Scale of the Hospital Anxiety and Depression Scale and the Duke Activity Status Index were used to assess patients' depressive symptoms and functional status. The nutritional status of patients was calculated using the Geriatric Nutritional Risk Index. Results In this study, the average scores of depressive symptoms, nutritional status and functional status were 4.91 (SD 3.12), 102.38 (SD 6.57) and 20.58 (SD 8.96) respectively. Out of the 254 patients, 46 patients (18.1%) had significant depressive symptoms (the score of Depression Sub‐Scale of the Hospital Anxiety and Depression Scale ≥ 8) and 55 (21.7%) suffered from malnutrition (the score of Geriatric Nutritional Risk Index ≤ 98). In the multiple regression analyses, nutritional status was negatively associated with depressive symptoms (β = −0.142, p = .02) and functional status mediated the relationship between nutritional status and depressive symptoms. Conclusions Many patients with heart failure have malnutrition and depressive symptoms. Functional status plays a mediating role in the relationship between nutritional status and depressive symptoms. Impact To relieve depressive symptoms in patients with heart failure, it is of importance to improve the functional status, especially for those with poor nutritional status.

Prevalence of depression and its association with health-related quality of life in people with heart failure in low- and middle-income countries: A systematic review and meta-analysis

“…Of the 21 studies, seven were conducted in East Asia and Pacific region [ 32 , 36 , 39 , 42 , 47 , 50 , 51 ], four in the Middle East and North Africa [ 31 , 34 , 46 , 49 ], three in Sub-Saharan Africa [ 33 , 37 , 43 ], three in Europe and Central Asia [ 38 , 40 , 44 ], and four in South Asia [ 35 , 41 , 45 , 48 ]. Most studies used a descriptive cross-sectional design (n = 17, 81%) and the remaining (n = 4, 19%) were prospective cohort studies.…”

“…Included studies assessed the prevalence of depression using nine different psychometrically validated instruments. Five studies [ 32 , 35 , 40 , 45 , 49 ] used Beck Depression Inventory (BDI), five [ 33 , 38 , 39 , 41 , 50 ] used Patient Health Questionnaire-9 (PHQ-9), four [ 31 , 34 , 47 , 48 ] used Hospital Anxiety and Depression Score (HADS), two [ 44 , 51 ] Geriatric Depression Scale (GDS), and the remaining five [ 36 , 37 , 42 , 43 , 46 ] each used Cardiac Depression Scale (CDS), Patient Health Questionnaire-2 (PHQ-2), Hamilton Rating Scale for Depression (24-items) (HAM-D 24 ), Geriatric Depression Scale (GDS), International Statistical Classification of Diseases and Related Health Problems V10 (ICD-10) ( Table 2 ).…”

A Comprehensive Assessment of the Chinese Version of the Duke Activity Status Index in Patients with Cardiovascular Diseases

“…Although the questionnaire has been used in Chinese patient populations [ 19 , 20 , 21 ], its reliability and validity in this specific group have not been thoroughly investigated. Furthermore, in our previous study [ 20 ] involving Chinese patients with pulmonary hypertension, we discovered a weak correlation (r = 0.467) between the DASI score obtained from the original questionnaire and Peak , a correlation that was even weaker compared to earlier foreign research findings [ 12 , 22 ].…”