Graduation Year

2025

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Mental Health Law and Policy

Major Professor

Amber Gum, Ph.D.

Committee Member

Dinorah Martinez-Tyson, Ph.D., MPH, MA

Committee Member

Lawrence Schonfled, Ph.D.

Committee Member

Janice Zgibor, RPh, Ph.D., CPH, FACE

Keywords

COVID-19 pandemic, Depressive, Mental health, Nutrition programs, aging

Abstract

By the year 2050, it is projected that the population of individuals aged 60 years and older will increase by 47 percent, reaching a total of 82 million in the United States. Many older adults experience depressive symptoms, and some never recover from it. Depression is one of the most common psychiatric disorders among older adults. Approximately 3.2% of community-dwelling older adults experience major depressive disorder in a 12-month period, although many more experience clinically significant depressive symptoms, with a recent estimate of 35% based on a global meta-analysis. In addition to physical functioning and depressive symptoms, another domain in which older adults experience challenges is their nutritional status. The overall goal of this dissertation was to examine relationships between nutritional status and depressive symptoms in older adults, in order to inform how to improve their depression and nutrition status, specifically in relation to publicly-funded aging services. The findings from the three studies highlight critical issues impacting older adults in the United States. The studies underscore the multifaceted challenges faced by older adults, with a focus on nutritional status and depression. The three aims of this dissertation are highlighted below and summarized for all three studies. In conclusion, the findings across the three studies align to suggest that nutrition is a key factor in the management and potential alleviation of depressive symptoms, where a nutritional intervention that addressed the key factors found (isolation, eating and swallowing problems, healthy tailored meals) may be sufficient in decreasing depressive symptoms in older adults. Additionally, a nutritional intervention could be incorporated into other behavioral programs developed for older adults in the aging services system like "Do More Feel Better.” By addressing factors such as eating problems, providing tailored meals, and combatting social isolation, interventions could be developed to improve nutritional intake, mental well-being, and relationships. These results also emphasize the need for individualized approaches, as the relationships between nutrition and depressive symptoms vary across people and contexts. By enhancing the infrastructure of the aging services network and addressing the individual needs of older adults, we can improve the health outcomes and quality of life for growing older adults’ population.

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