Association between nutritional status and anxiety levels in elderly diabetic patients with frailty: a hospital-based cross-sectional study.

BACKGROUND

Elderly diabetic patients with frailty represent a vulnerable population at heightened risk for both malnutrition and psychological distress. However, the association between nutritional status and anxiety in this specific population remains poorly characterized. This study aimed to investigate the relationship between nutritional status and anxiety levels in elderly diabetic patients with established frailty.

METHODS

This cross-sectional study enrolled 318 elderly diabetic patients (age ≥65 years) with confirmed frailty (FRAIL scale ≥3). Nutritional status was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) and anxiety using the Generalized Anxiety Disorder-7 (GAD-7) scale (score ≥10 indicating clinically significant anxiety). Multivariate logistic regression identified independent associations.

RESULTS

The mean age was 75.20 ± 6.45 years, with 60.4% female. Overall anxiety prevalence was 56.6%, and malnutrition risk (MNA-SF ≤ 11) was present in 83.0% of participants. Anxiety prevalence increased significantly across nutritional categories: 25.9% (normal), 52.1% (at risk), and 80.2% (malnourished; p < 0.001). MNA-SF scores were negatively correlated with GAD-7 scores (ρ = -0.523, p < 0.001). Compared to normal nutritional status, at-risk (aOR = 3.21, 95% CI: 1.57-6.55) and malnourished status (aOR = 12.71, 95% CI: 5.52-29.28) were independently associated with anxiety. Depression and living alone were additional significant predictors.

CONCLUSION

Poor nutritional status is strongly and independently associated with anxiety in elderly diabetic patients with frailty, demonstrating a clear dose-response relationship. Integrated nutritional and mental health screening is warranted in this vulnerable population.