From Sarcopenia to Depressive Symptoms in Elderly: A Path Analysis

Cedomir Ustevic, Nina Rajovic (), Dejana Stanisavljevic, Danijela Tiosavljevic, Andrija Pavlovic, Radica Tasic, Tatjana Rajovic, Jovana Grupkovic, Filip Pilipovic, Vedrana Pejin, Petar Milcanovic, Sanja Mazic and Natasa Milic
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Cedomir Ustevic: Special Hospital for Medical Rehabilitation “Termal”, 22408 Vrdnik, Serbia
Nina Rajovic: Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Dejana Stanisavljevic: Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Danijela Tiosavljevic: Department of Humanities, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Andrija Pavlovic: Department of Humanities, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Radica Tasic: Medical School, College of Vocational Studies, 11080 Belgrade, Serbia
Tatjana Rajovic: Special Hospital for Medical Rehabilitation “Termal”, 22408 Vrdnik, Serbia
Jovana Grupkovic: Department for Orthopedic and Trauma Surgery, Clinical Centre of Serbia, 11000 Belgrade, Serbia
Filip Pilipovic: Institute for Orthopedic Surgery “Banjica”, 11040 Belgrade, Serbia
Vedrana Pejin: Clinical Centre of Serbia, 11000 Belgrade, Serbia
Petar Milcanovic: Laboratory for Sports Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Sanja Mazic: Laboratory for Sports Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Natasa Milic: Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: Background: Sarcopenia is an age-related progressive, generalized skeletal muscle disorder involving the accelerated loss of muscle function and muscle mass. The aim of this study was to assess the complex relationship between sarcopenia, malnutrition, cognitive impairment, physical activity, and depression in the elderly, with the potential role of quality of life as a mediator in these associations. Methods: A cross-sectional study was conducted on a sample ( n = 298) of elderly patients admitted to Special Hospital for Rehabilitation “Termal”, Vrdnik, Serbia. Sarcopenia, the risk for malnutrition, cognitive impairment, physical activity, quality of life, and depressive symptoms were measured by standardized instruments. Additional data included sociodemographic characteristics. Simultaneous assessment of the direct and indirect relationships of all determinants was performed by path analysis. Results: A total of 40% ( n = 120) of the elderly were diagnosed with sarcopenia, and 42.6% had depression symptoms. The risk of malnutrition was present in 23.5%, cognitive impairment in 5.4%, and a low level of physical activity was reported in 26.2% of elderly participants. The mean reported quality of life measured by Sarcopenia and Quality of Life Questionnaire was 60 (on the scale ranging from 0 to 100; where a higher score reflects a higher quality of life). The best-fitted model (χ 2 /DF = 1.885, NFI = 0.987, CFI = 0.993, GFI = 0.997, RMSEA = 0.055) highlighted the mediating effect of quality of life between sarcopenia, malnutrition, cognitive impairment, lower level of physical activities and depression. According to the model, quality of life was a direct negative predictor of depressive symptoms in the elderly, while malnutrition positively affected depression. Conclusions: The presented path model may assist rehabilitation centers in developing strategies to screen for sarcopenia and risk of malnutrition, and promote physical activity in elderly, aiming to prevent their negative effects on mental health. For the elderly currently affected by sarcopenia, we consider regenerative medicine and stem cell therapy, which, in view of their etiology, could be a potential therapeutic strategy for sarcopenia.

Keywords: sarcopenia; malnutrition; quality of life; depression; elderly; path analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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