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Association of GLIM-defined malnutrition with depressive mood in older adults undergoing rehabilitation

European Journal of Clinical Nutrition volume 79, pages 597–603 (2025)Cite this article

Subjects

Abstract

Background/Objectives

Depressive mood is prevalent in geriatric patients who undergo rehabilitation. Malnutrition, which frequently coexists in this demographic group, likely affects mental health status significantly. This study examined the association between malnutrition and depressive mood at discharge in geriatric patients who were undergoing rehabilitation and identified the mediating roles of specific malnutrition components in this association.

Subjects/Methods

This prospective cohort study comprised 189 geriatric rehabilitation patients. Malnutrition was determined using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and depressive mood was assessed using the Geriatric Depression Scale-15 (GDS-15). The potential mediation of the GLIM components in the relationship between malnutrition and depressive mood was evaluated using causal mediation analysis.

Results

Malnutrition was positively associated with increased GDS-15 scores at both admission (p = 0.007) and discharge (p < 0.001). The severity of malnutrition corresponded with increased odds of depressive mood at discharge (moderate malnutrition: odds ratio [OR] 3.84, 95% confidence interval [CI] 1.48–9.94, p = 0.005; severe malnutrition: OR 5.11, 95% CI 1.52–15.17, p = 0.003). Notably, both muscle mass reduction (OR 1.51, 95% CI 1.01–2.27, p = 0.042) and disease burden (OR 1.37, 95% CI 1.00–1.89, p = 0.047) were identified as mediators in the association between malnutrition and depressive mood at discharge.

Conclusions

Nutritional status significantly influenced the mental health of geriatric rehabilitation patients, with muscle mass reduction and disease burden mediating this relationship. These findings emphasize the importance of a multidimensional geriatric rehabilitation approach that includes nutritional interventions.

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Fig. 1: Comparison of depressive state at admission and discharge by nutritional status.
Fig. 2: Two models of multivariate logistic regression analyses for depressive mood at discharge and malnutrition.
Fig. 3: Mediating effects of diagnostic items on the association between GLIM-defined malnutrition and depressive mood.

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Data availability

This data utilized in this study is not publicly available by privacy regulations and the protection of personal information.

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Funding

AS reports financial support was provided by Japan Society for the Promotion of Science (23K16799).

Author information

Authors and Affiliations

  1. Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, Japan

    Akio Shimizu

  2. Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan

    Akio Shimizu, Junko Ueshima, Yuria Ishida, Ayano Nagano & Naoharu Mori

  3. Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan

    Akio Shimizu, Keisuke Maeda, Junko Ueshima & Tatsuro Inoue

  4. Nutrition Therapy Support Center, Aichi Medical University Hospital, 1-1, Yazakokarimata, Nagakute, Aichi, Japan

    Keisuke Maeda

  5. Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Tokyo, Japan

    Junko Ueshima

  6. Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Japan

    Yuria Ishida

  7. Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata, Japan

    Tatsuro Inoue

  8. School of Medical Technology, Kurume University, Kurume, Fukuoka, Japan

    Kenta Murotani

  9. Biostatistics Center, Kurume University, 67 Asahimachi, Kurume, Japan

    Kenta Murotani

  10. Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Japan

    Ayano Nagano

  11. Department of Dentistry, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Hamamatsu, Japan

    Tomohisa Ohno

  12. Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Hamamatsu, Japan

    Ichiro Fujisima

Authors
  1. Akio Shimizu
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  2. Keisuke Maeda
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Contributions

Akio Shimizu: Conceptualization, Data Curation, Writing - Original Draft Preparation, Keisuke Maeda: Supervision, Validation, Writing - Original Draft Preparation. Junko Ueshima: Methodology, Analysis, Data Curation. Yuria Ishida: Visualization, Analysis, Writing - Review & Editing. Tatsuro Inoue: Supervision, Analysis, Writing - Review & Editing. Ichiro Fujisima: Conceptualization, Investigation, Writing - Review & Editing. Naoharu Mori: Methodology, Resources, Writing - Review & Editing. Kenta Murotani: Software, Validation, Analysis. Ayano Nagano: Visualization, Validation, Writing - Original Draft Preparation. Tomohisa Ohno: Conceptualization, Visualization, Supervision.

Corresponding author

Correspondence to Akio Shimizu.

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The authors declare that there is no actual or potential conflict of interest with regard to the publication of this article.

Ethics

This study was approved by the Ethics Committee of the Hamamatsu City Rehabilitation Hospital (No. 21-82) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants provided verbal informed consent for participation in this study.

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Shimizu, A., Maeda, K., Ueshima, J. et al. Association of GLIM-defined malnutrition with depressive mood in older adults undergoing rehabilitation. Eur J Clin Nutr 79, 597–603 (2025). https://doi.org/10.1038/s41430-025-01584-3

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