Abstract: Objective: To test whether depressive symptoms mediate the effects of activities of daily living (ADLs) on nutritional status of older adults living in long-term care (LTC) facilities in Taiwan. Design: A crosssectional study. Setting: Seventy-three community-based LTC facilities in northern Taiwan. Participants: This study sampled 306 adults ranging in age from 65 to 97 years who were free of acute infection or disease and who were able to communicate. Measurements: Nutritional status was assessed by the Mini-Nutritional Assessment (MNA) scale and depressive symptoms were assessed by the short form of the Geriatric Depressive Scale (GDSSF). Results: MNA scores revealed that 65% of the subjects were at risk for malnutrition (17 to 23.5 points). In addition, depressive symptoms partially mediated the relationship between ADLs and nutritional status, with 10.7% of the effect of depressive symptoms on nutritional status going through the mediator. Conclusion: Interventions to reduce depressive symptoms among institutionalized older adults should focus on improving nutritional status rather than promoting ADLs, which are believed to be difficult to change.
