The independent association of nutritional status with quality of life beyond depression, frailty, and loneliness in community-dwelling older adults: a cross-sectional study

BMC Geriatr. 2026 Jul 3. doi: 10.1186/s12877-026-07772-5. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to assess the nutritional status of community-dwelling older adults and to investigate the unique explanatory power of nutritional status for quality of life, while controlling for psychosocial factors such as depression, frailty, and loneliness.

METHODS: This cross-sectional study was conducted with 758 participants (330 men, 428 women; age: 71.1 ± 5.79 years) aged 65 and over living in Ankara. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF), loneliness perception using the UCLA Loneliness Scale, frailty using the FRAIL Scale, depression using the Geriatric Depression Scale (GDS-15), and quality of life using the EUROHIS-QOL-8. Data were analyzed using multiple linear regression and three-stage hierarchical regression analysis.

RESULTS: Nutritional assessment showed that 34.7% of participants were at risk of malnutrition, and 7.3% were malnourished. Multiple regression analysis identified depression, Body Mass Index (BMI), frailty, loneliness, and the number of comorbidities as significant predictors of nutritional status (p < 0.05). The strongest correlation was observed between depression and quality of life (p < 0.001). Hierarchical regression indicated that the inclusion of psychosocial variables significantly increased the model’s explanatory power (p < 0.001). Notably, MNA-SF scores remained an independent predictor of quality of life (p < 0.01) even after controlling for all psychosocial factors. Depression, frailty, and loneliness persisted as significant predictors in the final model (p < 0.01).

CONCLUSIONS: This study revealed that nutritional status is independently associated with quality of life in older adults, independent of strong psychosocial determinants. Although depression, frailty, and loneliness were dominant predictors, the independent contribution of nutritional status suggests that nutritional assessment and interventions could be considered as an integral part of geriatric care. The findings highlight the potential role of comprehensive care models that combine psychosocial support, mental health services, and nutritional interventions in improving quality of life, subject to further confirmation through interventional studies. These results may inform the consideration of including nutrition, depression, frailty, and loneliness screenings in routine geriatric assessments in primary healthcare settings, pending longitudinal validation.

PMID:42399785 | DOI:10.1186/s12877-026-07772-5