A Moderated-Mediation Model of the Relationship between Dietary Satisfaction and Fatigue in Older Adults with Diabetes: The Role of Meal Planning and Depressive Symptoms.

Hyerang Kim,Heesook Son

doi:10.3390/ijerph17238823

Abstract

Little research has examined the pathways between psychological factors and fatigue in older adults with diabetes. This study explored the pathways between diet-related quality of life and depressive symptoms in predicting fatigue using a moderated-mediation model. A convenience sample of adults ≥65 years (n = 127) with diabetes completed a cross-sectional survey including measures of fatigue severity, diet-related quality of life, and depressive symptoms, and a moderated-mediation analysis assessed the relationships between them. Diet satisfaction was negatively related to fatigue, which was mediated by depressive symptoms. In the moderated-mediation model, diet satisfaction had a conditional effect on fatigue through the mediating effect of depressive symptoms, moderated by meal planning difficulty. At higher levels of perceived meal planning difficulty, lower diet satisfaction was indirectly associated with higher fatigue through depressive symptoms, but this pathway was non-significant at lower levels. Findings suggest that supportive care for diet therapy might improve psychological outcomes in older adults with diabetes, especially for those having difficulties with daily dietary practice. Meal planning difficulties in the dietary management of diabetes accompanied by low diet satisfaction may lead to negative psychological outcomes. Monitoring satisfaction and burdens associated with dietary practices could improve fatigue in this population.

Highlights

The global prevalence of diabetes in adults aged 65 years or older is approximately 20% due to the growth in the aging population and extended life expectancy [1]
Thatthat satisfaction with influence on fatigue are closely related, but little is known about the specific mechanism by which with and difficulty withplanning meal planning from the measured aspects of diet‐related quality of life diet anddiet difficulty with meal from the measured aspects of diet-related quality of life were these factors lead to fatigue among adults with diabetes
Our results provide additional informationinformation on the mechanism with diet and difficulty with meal planning from the measured aspects ofand diet‐related quality of life mechanism by which satisfaction with diet, difficulty with meal planning, depressive symptoms which satisfaction with diet, difficulty with meal planning, and depressive symptoms contribute to were significantly associated with fatigue

Summary

Introduction

The global prevalence of diabetes in adults aged 65 years or older is approximately 20% due to the growth in the aging population and extended life expectancy [1]. The progression of diabetes in older adults differs from other age groups since the double burden of aging and diabetes synergistically imposes physical, psychological, and social impairment, increasing the risk of diabetes complications and mortality [2]. Diabetes fatigue has been reported to be influenced by multiple factors, including physiological and psychological status and lifestyle [6,7,8]. These factors can have a cyclic relationship with diabetes fatigue, such that they negatively affect optimal blood glucose control, which, in turn, increases the risk of undesirable health outcomes [8,9]. Older adults with diabetes have been shown to be more vulnerable to fatigue than older adults without diabetes and younger adults

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