2026 Volume 2 Issue 1 Pages 348-355
Background: In older adults, chronic pain and reduced physical activity can trigger depressive mo od and appetite loss, leading to a vicious cycle of malnutrition. Practical interventions based on th e perspective of nutritional psychiatry are therefore required.
Case: A 73-year-old woman living alone developed depressive mood and loss of motivation after the onset of rheumatoid arthritis and experienced approximately 10 kg of weight loss over six mo nths. At the first examination, her weight was 47 kg, body mass index 19.1, Mini Nutritional Ass essment–Short Form score 5, Geriatric Depression Scale-15 score 8, SARC-F score 8, serum albu min 3.2 g/dL, and C-reactive protein 7.08 mg/dL. Nutritional intervention was conducted in collab oration with a registered dietitian during regular dental maintenance visits, including daily administ ration of 187.5 mL of a high-energy enteral formula and dietary guidance focused on high-protein foods with low preparation burden. After the intervention, weight increased to 57 kg, body mass i ndex to 23.1, MNA-SF to 13, GDS-15 to 2, SARC-F to 3, and serum albumin to 4.0 g/dL. Depr essive mood improved, enteral nutrition was discontinued, and no relapse was observed thereafter.
Conclusion: Nutritional psychiatry–oriented intervention based on dental maintenance, delivered thr ough multidisciplinary collaboration, may be associated with improvement in depressive mood and malnutrition in elderly patients with rheumatoid arthritis living alone.
