Functional status mediates the association of nutritional status with depressive symptoms in patients with heart failure

Abstract Aims The decline of nutritional status and depressive symptoms are pandemic in heart failure patients and functional status may play a pivotal role between these. This study aimed to determine whether nutritional status is associated with depressive symptoms and whether functional status mediates this relationship in heart failure patients. Design This was a secondary analysis of a cross‐sectional study. Methods The data were collected from November 2015–April 2016. Heart failure patients ( N = 254) being hospitalized were included in this secondary analysis. The Depression Sub‐Scale of the Hospital Anxiety and Depression Scale and the Duke Activity Status Index were used to assess patients' depressive symptoms and functional status. The nutritional status of patients was calculated using the Geriatric Nutritional Risk Index. Results In this study, the average scores of depressive symptoms, nutritional status and functional status were 4.91 ( SD 3.12), 102.38 ( SD 6.57) and 20.58 ( SD 8.96) respectively. Out of the 254 patients, 46 patients (18.1%) had significant depressive symptoms (the score of Depression Sub‐Scale of the Hospital Anxiety and Depression Scale ≥ 8) and 55 (21.7%) suffered from malnutrition (the score of Geriatric Nutritional Risk Index ≤ 98). In the multiple regression analyses, nutritional status was negatively associated with depressive symptoms ( β = −0.142, p = .02) and functional status mediated the relationship between nutritional status and depressive symptoms. Conclusions Many patients with heart failure have malnutrition and depressive symptoms. Functional status plays a mediating role in the relationship between nutritional status and depressive symptoms. Impact To relieve depressive symptoms in patients with heart failure, it is of importance to improve the functional status, especially for those with poor nutritional status.