Overweight, Obesity, and Depression in Multimorbid Older Adults: Prevalence, Diagnostic Agreement, and Associated Factors in Primary Care—Results from a Multicenter Observational Study.
Background/Objectives: Obesity and depression, in conjunction with multimorbidity, are interconnected conditions increasingly managed in general practitioner (GP) settings, yet these associations remain insufficiently studied in older patients. This study investigates the prevalence of depression ac...
| Publicado en: | Nutrients Vol. 17; no. 8; pp. 1394 - 1414 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
MDPI
Apr2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=184755619&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184755619 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726643 B0TT jtl: Nutrients issn: 20726643 maglogo: N pubinfo: dt: Apr2025 vid: 17 iid: 8 pid: 97109 pub: MDPI artinfo: ui: 184755619 184755619 184755619 10.3390/nu17081394 184755619 ppf: 1394 ppct: 20 formats: tig: atl: Overweight, Obesity, and Depression in Multimorbid Older Adults: Prevalence, Diagnostic Agreement, and Associated Factors in Primary Care—Results from a Multicenter Observational Study. aug: au: Bludau, Daniel Christopher Pabst, Alexander Bleck, Franziska Weyerer, Siegfried Maier, Wolfgang Gensichen, Jochen Mergenthal, Karola Bickel, Horst Fuchs, Angela Schäfer, Ingmar König, Hans-Helmut Wiese, Birgitt Schön, Gerhard Wegscheider, Karl Scherer, Martin Riedel-Heller, Steffi G. Löbner, Margrit affil: Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany sug: subj: Body Weight In Old Age Obesity Epidemiology Depression Epidemiology Comorbidity Epidemiology Depression Diagnosis Primary Health Care Physicians, Family Geriatric Assessment Methods Age Factors Sex Factors Reliability Human Funding Source Male Female Aged Aged, 80 and Over Multicenter Studies Nonexperimental Studies Prospective Studies Germany Questionnaires Body Mass Index Depression Symptoms kappa Statistic Sensitivity and Specificity Descriptive Statistics Logistic Regression Odds Ratio Clinical Assessment Tools Evaluation Marital Status Activities of Daily Living Physical Activity Educational Status Obesity Classification Geriatric Depression Scale Psychological Tests Scales Aged: 65+ years Aged, 80 & over Male Female ab: Background/Objectives: Obesity and depression, in conjunction with multimorbidity, are interconnected conditions increasingly managed in general practitioner (GP) settings, yet these associations remain insufficiently studied in older patients. This study investigates the prevalence of depression across different body mass index (BMI) classes and includes age and gender differences in multimorbid older patients, offering a novel perspective on subgroup-specific patterns. Further the agreement between GP depression diagnoses and the Geriatric Depression Scale (GDS) is studied and patient-specific factors that may affect the agreement are explored, aiming to improve future diagnostics for vulnerable subgroups. Methods: Data were provided by the baseline assessment of the MultiCare Study, a prospective multicenter observational cohort of multimorbid patients aged 65+ years recruited from 158 GP practices across eight study centers in Germany. Data from 2568 study participants were analyzed based on GP-coded International Classification of Diseases (ICD) diagnoses, structured GP questionnaires, and patient questionnaires. Assessments included data on the BMI and depression (15 item version of the GDS). Agreement between GP diagnoses of depression and GDS assessment was measured using Cohen's kappa. Four logistic regression models were used to examine the effects of patient-specific factors on the agreement of depression diagnosis (match or mismatch). Results: GPs diagnosed depression in 17.3% of cases, compared to the detection of depressive symptoms in 12.4% of the patients by GDS (cut-off ≥ 6 points). The highest prevalence rates were observed in patients with obesity class III (25.0% by GP; 21.7% by GDS). Women were significantly more likely to receive a depression diagnosis by a GP across most BMI classes (except obesity classes II and III). The detection of depressive symptoms by GDS was significantly more prevalent in older multimorbid obese patients (≥75 years), except for patients with obesity class III. The overall agreement between GP diagnosis and GDS assessment was weak (κ = 0.156, p < 0.001). The highest agreement was found for people with obesity class III (κ = 0.256, p < 0.05). Factors associated with a True Positive depression diagnosis (match by both GDS and GP) were female gender (odds ratio (OR) = 1.83, p < 0.05), widowhood (OR = 2.43, p < 0.01), limited daily living skills (OR = 3.14, p < 0.001), and a higher level of education (OR = 2.48, p < 0.01). A significantly lower likelihood of a False Negative depression diagnosis was found for patients with obesity class III. Conclusions: This study highlights the significant prevalence of depression among multimorbid older adults across different BMI classes, particularly in those with obesity class III. The weak diagnostic agreement between GP diagnosis and GDS assessment suggests a need for improved diagnostic practices in primary care. Implementing standardized screening tools and fostering collaboration with mental health specialists could enhance the identification and management of depression in this vulnerable population. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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