Effects of dietary supplements on depressive symptoms in older patients: A randomised double-blind placebo-controlled trial
Abstract
Background & aims The effect of nutritional supplements on mental health in older patients has received little attention so far. The aims of this trial were therefore to test the effect of nutritional support on older patient's depressive symptoms and cognitive function. Methods In this prospective, double-blind, placebo-controlled study, we randomly assigned 225 hospitalised acutely ill older patients to receive either normal hospital diet plus 400 mL oral nutritional supplements (106 subjects) or normal hospital diet plus a placebo (119 subjects) daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy old person for vitamins and minerals. Outcome measures were 6 weeks and 6 months changes in nutritional status, depressive symptoms and cognitive state. Results Randomisation to the supplement group led to a significant increase in red-cell folate and plasma vitamin B12 concentrations, in contrast to a decrease seen in the placebo group. There were significant differences in symptoms of depression scores in the supplement group compared with the placebo group at 6 months (p = 0.021 for between groups difference). The effect of supplement was seen in all patient groups including those with no symptoms of depression, mild depression and those with severe depression (p = 0.007). There was no evidence of a difference in cognitive function scores at 6 months. Conclusion Oral nutritional…
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The ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals had a significant positive effect on self-reported quality of life (treatment effect in QoL scores using the SF-36 form at 6 months was 7.0, 95% CI 0.5 to 13.6, p=0.04 for physical function, 10.2, 95% CI 0.1 to 20.2, p=0.047 for role physical, and 7.8, 95% CI 0.0 to 15.5,
“with a significant positive effect on their self-reported QoL (i.e. the treatment effect in QoL scores using the SF-36 form at 6 months was 7.0, 95% CI 0.5 to 13.6, p ¼ 0.04 for physical function, 10.2, 95% CI 0.1 to 20.2, p ¼ 0.047 for role physical, and 7.8, 95% CI 0.0 to 15.5, p ¼ 0.05 for social function domains, compared to placebo) [40,41] (Level of evidence 1þþ for both).”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [41]
The ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals had no other effect on cognitive performance in older medical inpatients.
“In addition, provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p ¼ 0.021) in older medical inpatients, with no other effect on their cognitive performance but with a significant positive effect on their self-reported QoL”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [41]
Provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p=0.021) in older medical inpatients.
“In addition, provision of ONS containing 995 kcal from macronutrients and covering 100% of the RDA for healthy older adults in vitamins and minerals led to a lower incidence of depressive symptoms (p ¼ 0.021) in older medical inpatients, with no other effect on their cognitive performance but with a significant positive effect on their self-reported QoL”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [41]
A first RCT studied the effect of a high-energy (995 kcal/day) ONS used for six weeks in 225 hospitalized patients (roughly, one third had depressive symptoms assessed with the 15-item Geriatric Depression Scale (GDS), baseline nutritional status not described).
“A first RCT studied the effect of a high-energy (995 kcal/day) ONS used for six weeks in 225 hospitalized patients (roughly, one third had depressive symptoms assessed with the 15-item Geriatric Depression Scale (GDS), baseline nutritional status not described) (204).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [204]
GDS was significantly better in the intervention compared to the control group at six months, but not at six weeks.
“GDS was significantly better in the intervention compared to the control group at six months, but not at six weeks.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [204]
Two trials have considered the effect of nutrition intervention on depressive symptoms in older hospitalized patients.
“Two trials have considered the effect of nutrition intervention on depressive symptoms in older hospitalized patients.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [204]
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References 13 · Cited by 85
- Authors
- Gariballa, S., & Forster, S.
- Affiliations
- United Arab Emirates University (AE)
- University of Sheffield (GB)
- Corresponding author
- Gariballa, Salah
- ORCID
- Gariballa, Salah
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2007-10
- Volume
- 26
- Issue
- 5
- Pages
- 545-551
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2143515085
- Cited by
- 85
- References
- 13
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 5 · 2013: 8 · 2012: 7
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- oral nutritional supplements, depressive symptoms, elderly patients, cognitive function, red blood cell folate, vitamin B12, nutritional status, geriatric depression
- MeSH terms
- Aged, Aging, Energy Intake, Cognition, Depression, Double-Blind Method, Erythrocytes, Female, Folic Acid, Food, Formulated, Humans, Male, Minerals, Nutritional Status, Nutritive Value, Placebos, Prospective Studies, Time Factors, Vitamin B 12, Vitamins, Treatment Outcome, Nutrition Policy, Dietary Supplements
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