Controlling Nutritional Status Score is Linked to Cardiovascular Diseases

In the TNM eighth edition, nutritional status and inflammatory scores are newly described as host-related prognostic factors for esophageal cancer, hepatocellular carcinoma, and pancreatic cancer. However, only age and race are listed as host-related prognostic factors for colorectal cancer. The purpose of this study was to evaluate the prognostic significance of nutritional and inflammatory scores for postoperative outcomes in patients with colorectal cancer. This was a retrospective study using a database that prospectively collects data. The study was conducted at a high-volume multidisciplinary tertiary cancer center in Japan. Study participants were 1880 consecutive patients with stage II to III colorectal cancer who underwent curative resection at the National Cancer Center Hospital between 2004 and 2012. Two nutritional scores (prognostic nutritional index and controlling nutritional status score) and 4 inflammatory scores (modified Glasgow prognostic score, neutrophil:lymphocyte ratio, platelet:lymphocyte ratio, and C-reactive protein:albumin ratio) were calculated. Correlations of nutritional scores and inflammatory scores with overall survival and postoperative complications were measured. After adjusting for key clinical and pathologic factors by multivariable analysis, 2 nutritional scores (prognostic nutritional index and controlling nutritional status score) and 2 inflammatory scores (neutrophil:lymphocyte ratio and C-reactive protein:albumin ratio) were independent prognostic factors for overall survival. With respect to discriminative ability, time-dependent receiver operating characteristic curves and Harrell concordance index revealed that prognostic nutritional index and controlling nutritional status score were superior to the 4 inflammatory scores for predicting overall survival. Multivariable logistic regression analyses also revealed that prognostic nutritional index, controlling nutritional status score, and C-reactive protein:albumin ratio were independent predictors for postoperative complications. The retrospective design of the study was a limitation. Preoperative nutritional scores are promising host-related prognostic factors for overall survival and postoperative complications in patients with stage II and III colorectal cancer. See Video Abstract at http://links.lww.com/DCR/B587. ANTECEDENTES:En las últimas etapificaciones T-N-M, tanto el estado nutricional como inflamatorio han sido descritos como factores pronósticos en cáncer de esófago, hepático y pancreático. Sin embargo en cáncer colorectal solo la edad y la raza son enumerados como factores pronósticos.OBJETIVO:Evaluar la importancia pronóstica de los scores nutricionales e inflamatorias para los resultados posoperatorios en pacientes con cáncer colorrectal.DISEÑO:Estudio retrospectivo utilizando una base de datos.AJUSTE:Centro oncológico teciario en Japón.PACIENTES:Fueron incluidos en el estudio 1880 pacientes, consecutivos, con cancer colorectal etapa II y III sometidos a reseeción curativa en el National Cancer Center Hospital entre 2004 y 2012. Se aplicaron dos scores: nutricional (índice nutricional pronóstico y puntuación del estado nutricional) e inflamatorias (Glasgow modificada, proporción de neutrófilos a linfocitos, de plaquetas a linfocitos y de proteína C reactiva a albúmina).PRINCIPALES MEDIDAS DE RESULTADO:Evaluar scores nutricional e inflamatorio con sobrevida y complicaciones postoperatoria.RESULTADOS:Después de ajustar los factores clínicos y patológicos clave mediante análisis multivariable, dos scores nutricionales (índice nutricional pronóstico y puntuación del estado nutricional de control) y dos inflamatorias (proporción de neutrófilos a linfocitos y proporción de proteína C reactiva a albúmina) fueron pronósticos independientes factores para la sobrevida. Con respecto a la capacidad discriminativa, las curvas de características operativas del receptor, dependientes del tiempo y el índice de concordancia de Harrell, revelaron que el índice nutricional pronóstico y del estado nutricional de control eran superiores a las cuatro inflamatorias para predecir la sobrevida general. Los análisis de regresión logística multivariable también revelaron que el índice nutricional pronóstico, el estado nutricional de control y la relación proteína C reactiva / albúmina fueron predictores independientes de complicaciones postoperatorias.LIMITACIONES:Estudio de tipo retrospectivo.CONCLUSIONES:Los scores nutricionales preoperatorias son factores pronósticos prometedores relacionados con la sobrevida y las complicaciones postoperatorias en pacientes con cáncer colorrectal en estadio II y III. Consulte Video Resumen en http://links.lww.com/DCR/B587.

Impact of preoperative nutritional scores on 1-year postoperative mortality in patients undergoing valvular heart surgery

As treatment modalities of severe AS, interventional treatments such as SAVR or TAVR with the decision of the heart team have been performed recently. Controlling nutritional status (CONUT) score and prognostic nutritional index (PNI) have a very important place among the scores that provide a simple, effective, and objective evaluation of prognosis. In our study, we aimed to investigate the short-term prognostic results of severe AS patients who underwent TAVR or SAVR by comparing the CONUT and PNI results of the patients. 258 patients who underwent percutaneous TAVR or SAVR in our clinic between December 2012 and December 2020 were included in the study in a randomized retrospective manner. The primary endpoint of the study was in-hospital and 1-year all-cause death. The results of all patient groups were compared by dividing them into 2 groups as all-cause death group (deceased group) and non-all-cause death group (survived group) within 1 year. All-cause mortality occurred in 57 (29%) patients within 1 year. As nutritional status scores, the PNI score (39.9±7.4 vs. 46.5±6.9, p<0.001) was lower in the deceased group and the median CONUT score [4(4) vs. 1(3) p<0.001] was found significantly higher. NLR score was also found to be significantly higher in the deceased group (p<0.001). They were divided into 3 tertiles containing an equal number of patients and compared according to the nutritional scores. Significantly higher 1-year mortality was observed in the high CONUT [10 (12%) deaths in T1, 12 (14%) in T2, and 35 (41%) deaths in T3, respectively, p<0.001] and low PNI [37 (43%) deaths in T1, 13 (15%) in T2, and 7 (8%) deaths in T3, respectively, p<0.001] groups, which can be considered as the worse nutritional group. In the surgical or transarterial treatment of symptomatic severe aortic stenosis, we found that a high CONUT score and a low PNI score were predictors of all-cause mortality at 1-year follow-up, regardless of the type of treatment. We think that checking patients with scores like the abovementioned procedure and making the necessary corrections will lead to positive results in terms of prognosis.

SUMMARYOBJECTIVES:While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up.METHODS:A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality.RESULTS:The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02–1.06, p<0.001), admission oxygen saturation value (SaO2) (OR 0.85; 95%CI 0.83–0.87, p<0.001), and Controlling Nutritional Status score (OR 1.34; 95%CI 1.23–1.45, p<0.001), were independent predictors. The patient groups with a low Controlling Nutritional Status score had a higher rate of discharge with recovery (p<0.001).CONCLUSIONS:Higher Controlling Nutritional Status scores may be effective in determining in-hospital mortality in patients with COVID-19. Nutrition scores can be used as a useful and effective parameter to determine prognosis in patients with COVID-19.

Hip fractures are a prevalent and serious health issue, particularly among the elderly population aged >65 years. These injuries are associated with elevated rates of postoperative complications and mortality, significantly diminishing patients' quality of life in both the short- and long-term. The prognosis for recovery is further exacerbated in individuals with signs of malnutrition. The primary objective of this study was to evaluate the predictive value of four distinct nutritional assessment scores in relation to postoperative mortality in patients undergoing surgical intervention for hip fractures at 1, 3, 6, 12, and 24 months. This observational study included patients admitted to the Department of Traumatology at the Medical University for the surgical management of hip fractures between January 2019 and November 2021. Nutritional assessment scores were derived from a retrospective analysis of clinical data. The statistical correlation between nutritional scores and postoperative mortality outcomes was rigorously evaluated. Logistic regression analysis revealed a statistically significant correlation (p < 0.01) between all four nutritional scores and postoperative mortality risk. The malnourished cohorts demonstrated a markedly higher risk of mortality compared to those with adequate nutritional status, as indicated by the following risk ratios: Graz Malnutrition Screening (risk ratio = 2.53-1.68), Prognostic Nutritional Index (risk ratio = 2.44-1.74), Geriatric Nutritional Risk Index (risk ratio = 2.05-1.58), and Controlling Nutritional Status (risk ratio = 2.34-1.46). Despite these findings, the receiver operating characteristic analysis yielded area under the curve (AUC) values ranging from 0.64 to 0.68, indicating limited predictive power. Although a significant correlation existed between the evaluated nutritional scores and postoperative mortality, the predictive value of these scores was quantitatively low. No single nutritional assessment tool has emerged as a strong predictor of postoperative outcomes in this patient population. Consequently, implementation of any specific nutritional screening tool for standard assessment in patients with hip fractures is not recommended at this time. Nevertheless, given the established association between malnutrition and postoperative mortality, a comprehensive evaluation of nutritional status is advisable and further research is needed.

Objective: Gastric cancer surgery, including curative and palliative procedures, is crucial for managing gastric cancer. Accurate assessment of nutritional status is essential for risk stratification and improving patient outcomes. This retrospective study aims to identify the most reliable predictors of postoperative mortality by investigating the correlation between four nutritional scores and the mortality rate following gastric cancer surgery. Material and Method: This retrospective study evaluated 50 patients diagnosed with gastric adenocarcinoma and operated on at Hitit University Department of General Surgery between April 2021 and September 2023. Nutritional scores were calculated using albumin, cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio, along with mortality rates. Data collected included age, gender, operation type, laparoscopy usage, albumin, cholesterol, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, mortality rates, and TNM stages. Nutritional scores were calculated, and their predictive accuracy for mortality was assessed using time-dependent Receiver Operating Characteristic curve analysis. Results: Significant differences in albumin levels, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and nutritional scores were found between deceased and surviving patients. Specifically, albumin levels were significantly lower in deceased patients (median = 3.5 mg/dL) compared to surviving patients (median = 4.1 mg/ dL, p=0.001). The median neutrophil-to-lymphocyte ratio was higher in deceased patients (p=0.005), and the median lymphocyte-to-monocyte ratio was lower in deceased patients (p=0.009). Among the scores, the Naples Prognostic Score was significantly associated with mortality but was outperformed by the Prognostic Nutritional Index. The Prognostic Nutritional Index had the highest predictive accuracy with an Area Under the curve of 0.792, a sensitivity of 76%, and a specificity of 86.2%, outperforming the others. Conclusion: Among the evaluated scores, the Prognostic Nutritional Index is the most effective predictor of prognosis. Its superior predictive accuracy suggests that the PNI can be utilized to enhance risk assessment and guide nutritional interventions in gastric cancer patients undergoing surgery.

Background and Hypothesis The prognostic value of nutritional scoring tools in assessing the relationship between nutritional status and prognosis in hemodialysis patients is unclear. This multicenter retrospective cohort study compared the Prognostic Nutritional Index (PNI), Controlling Nutritional Status scores (CONUT), and Geriatric Nutritional Risk Index (GNRI) for predictive accuracy of all-cause and cardiovascular mortality, especially the impact of dynamic changes over time on prognosis. Methods Hemodialysis patients from four hospitals were included. Laboratory data and nutrition scores were collected at the initiation of dialysis, and at 6th, 12th, and 18th months after dialysis initiation. A joint model analyzed the relationship between dynamic nutritional scores and prognosis. Predictive values were assessed using the area under the curve (AUC). Results The study included 863 patients with a median follow-up of 37 months. During the follow-up, 23.8% of patients died, with 14% attributed to cardiovascular causes. Malnourished patients demonstrated higher risks for all-cause and cardiovascular mortality. Dynamic changes in PNI and GNRI scores were significantly associated with reduced all-cause and cardiovascular mortality risks. Precisely, longitudinal increases in PNI and GNRI scores corresponded to a 4% and 3% reduction in all-cause (PNI: HR, 0.96; 95% CI, 0.95–0.98; GNRI: HR, 0.97; 95% CI, 0.96–0.98) and cardiovascular mortality risk (PNI: HR, 0.96; 95% CI, 0.94–0.98; GNRI: HR, 0.97; 95% CI, 0.95–0.98) respectively, with longer dialysis duration. Changes in CONUT scores were not significantly associated with either all-cause or cardiovascular mortality. The AUCs of the three joint models indicated that the GNRI score (0.893) possessed higher predictive accuracy for all-cause mortality compared to PNI (0.832) and CONUT (0.852). Similar trends were observed for cardiovascular mortality. Conclusion Nutritional scores and their dynamic changes are intimately associated with mortality risk in hemodialysis patients. Compared to PNI and CONUT, the baseline GNRI and its post-dialysis variations demonstrate a superior predictive capability for all-cause and cardiovascular mortality in these patients.

Given the scarce evidence regarding the impact of preoperative nutritional status on surgical outcomes of patients with hepatocellular carcinoma, predictive powers of nutritional/inflammatory scores for short-term surgical outcomes in patients with hepatocellular carcinoma were investigated. Outcomes of 1272 patients with hepatocellular carcinoma were reviewed, and predictive powers of nine nutritional/inflammatory scores for short-term surgical outcomes were compared using the receiver-operating characteristic curve analysis. Clinical relevance of the best nutritional score was then studied in detail to clarify its utility as an alternative predictive measure for surgical risk of patients with hepatocellular carcinoma. Receiver-operating characteristic curve analysis showed the controlling nutritional status score has the best performance in prediction of morbidity after hepatectomy for hepatocellular carcinoma (area under the curve, 0.593; 95% confidence interval: 0.552-0.635; p < 0.001), and multivariate analysis confirmed its correlation with the risk of any morbidity (odds ratio per +1 point, 1.17; 95% confidence interval: 1.08-1.27; p < 0.001) and major morbidity (odds ratio per +1 point, 1.14; 95% confidence interval: 0.99-1.27; p = 0.052). The undernutrition grade based on the controlling nutritional status score showed strong correlation with the degree of fibrosis in the liver (p < 0.001), platelet count (p < 0.001), and indocyanine green retention rate at 15 min (p < 0.001). In addition, the controlling nutritional status undernutrition grade well stratified the risk of postoperative morbidity especially in cirrhotic subpopulation (odds ratio, 1.17 per +1 point; 95% confidence interval: 1.05-1.29 for any morbidity and odds ratio, 1.20 per +1 point; 95% confidence interval: 1.03-1.40 for major morbidity). The controlling nutritional status score could be an alternative measure for underlying liver injury and the surgical risk of hepatocellular carcinoma.

Background: Aortic Stenosis (AS) is a common heart valve disease that especially affects the elderly population and is seen with the aging of the society. In recent years Transcatheter aortic valve replacement patients (TAVR) has been increasingly applied worldwide as a procedure for the treatment of severe AS. Recently, various biomarkers and derived marker approaches have been studied in AS patient groups as in many cardiovascular diseases. Since it has been previously shown that increased inflammatory scores and poor nutritional scores are closely associated with the development process and prognosis of cardiovascular diseases, we hypothesized that these scores may be associated with prognosis after TAVR. Therefore, in this study, we aimed to make a detailed evaluation in terms of mortality determinants after TAVR.&#x0D; Methods and Results: 118 TAVR patients were included in the analysis. Median follow-up of 118 patients was 40.5 months. In terms of inflammatory status scores, the systemic immune inflammatory (SII) score (p= 0.027), the neutrophil/lymphocyte ratio (NLR) score (p= 0.012), and the platelet/lymphocyte ratio (PLR) score (p= 0.012) in the death group was found to be significantly higher. As nutritional status scores, the prognostic nutritional index (PNI) score (p= 0.003) was lower in the death group and the median Controlling Nutritional Status (CONUT) score (p= 0.002)) found significantly higher.&#x0D; Conclusion: In severe and high-risk AS patients undergoing TAVR, measurement of malnutrition with the CONUT score and increased inflammatory status with the SII score was associated with an increased risk of all causes mortality in long-term follow-up. It has been determined that the development of complications related to the procedure is an indicator of increased mortality not only in the short term but also in the long-term follow-up.

Malnutrition is associated with adverse outcomes in patients with diabetic kidney disease (DKD). However, it is uncertain which nutritional assessment tools are most effective in predicting the adverse outcomes of DKD. This retrospective study was conducted at a single center and included 367 patients diagnosed with DKD based on biopsy results between August 2009 and December 2018. Four nutritional assessment indices, namely the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI), and Controlling Nutritional Status (CONUT) score, were selected and calculated. We aimed to assess the association between these nutritional scores and adverse outcomes, including progression to end-stage kidney disease (ESKD), cardiovascular diseases events (CVD), and all-cause mortality. Univariate and multivariate Cox regression analyses, Kaplan-Meier analysis, along with Restricted cubic spline analysis were used to examine the relationship between nutritional scores and adverse outcomes. Furthermore, the area under the curve (AUC) was calculated using time-dependent receiver operating characteristics to determine the predictive value of the four nutritional scores alone and some combinations. Lastly, ordered logistic regression analysis was conducted to explore the correlation between the four nutritional scores and different renal histologic changes. The incidence of ESKD, CVD, and all-cause mortality was significantly higher in patients with DKD who had a lower PNI, lower GNRI, and higher CONUT score. Additionally, The TCBI performed the worst in terms of grading and risk assessment. The PNI offer the highest predictive value for adverse outcomes and a stronger correlation with renal histologic changes compared to other nutritional scores. Patients diagnosed with DKD who have a worse nutritional status are more likely to experience higher rates of adverse outcomes. The PNI might offer more valuable predictive values and a stronger correlation with different renal histologic changes compared to other nutritional scores.

Background and AimsMalnutrition is a well known risk factor for adverse outcomes in patients with cancer, cardiovascular disease (CVD) and chronic kidney disease, but epidemiological evidence on its relationship with the long-term risk of all-cause mortality and cardiovascular death is limited.MethodsA total of 20,116 adults from the United States National Health and Nutrition Examination Survey 2007–2014 were enrolled. The Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT) score, and Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI) were calculated at baseline. Cox regression and the Kaplan–Meier analysis were conducted when participants were divided into three groups according to the tertiles of objective nutritional scores. Restricted cubic spline was performed to further explore the shape of the relationship between all-cause mortality, cardiovascular death, and nutritional scores. In addition, the area under the curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were conducted to assess which nutritional scores have the greatest predictive value for all-cause death and cardiovascular death in the general population.ResultsThe cumulative incidence of all-cause death and cardiovascular death was significantly higher in participants with a higher CONUT score, lower GNRI, and lower PNI. TCBI showed the worst performance on grading and risk assessment. After adjusting confounding factors, the lowest PNI and GNRI tertile and highest COUNT score were independently and significantly associated with increased risk of all-cause death (all P < 0.01) and cardiovascular death (all P < 0.05) analyzed by a multivariate Cox regression model. An L-shaped association between the HR (hazard ratio) of all-cause mortality and nutritional scores (GNRI, PNI and TCBI) was observed in the overall populations. In addition, the PNI had the highest predictive value for all-cause mortality [AUC: 0.684, 95% confidence interval (CI): 0.667–0.701] and cardiovascular death (AUC: 0.710, 95% CI: 0.672–0.749) in the general population compared with other nutritional scores.ConclusionThe poorer the nutritional status of the general population, the higher the all-cause mortality and cardiovascular mortality. The PNI score may provide more useful predictive values than other nutritional scores.

Introduction: The relationship between heart failure and malnutrition is significant. The most commonly used nutritional indices are theprognostic nutritional index, controlling nutritional status, and albumin–bilirubin grade. We aimed to investigate the clinical impact of nutritional status in elderly acute decompensated heart failure patients and the relationship between the prognostic nutritional index, controlling nutritional status, and albumin–bilirubin grade nutritional indices to detect 12-month and 3-month rehospitalization rates, mortality, and length of stay in the Coronary Intensive Care Unit. Our study is the first to evaluate the controlling nutritional status and albumin–bilirubin grade in our study cohort in Turkey. Materials and Methods: The medical records of 1162 patients hospitalized in the Coronary Intensive Care Unit were evaluated retrospectively. A total of 123 patients were included. Results: We found a statistically significant difference between the prognostic nutritional index, albumin–bilirubin grade and controlling nutritional status scores and mortality. However, the most statistically significant relationship was found in the prognostic nutritional index score. We found that as the nutritional scores worsened, the length of hospital stay was prolonged. The albumin–bilirubin grade score in the short term and controlling nutritional status score in the long term were not statistically significant to show rehospitalization. Conclusion: Prognostic nutritional index is an independent predictor of mortality, short- and long-term rehospitalizations, and length of stay in elderly patients with acute decompensated heartfailure. Its predictive power was better than the albumin–bilirubin grade and controlling nutritional status scores evaluated in our study. Keywords: Heart Failure; Malnutrition; Aged; Coronary Care Unit; Nutritional Status.

Association of nutritional status and mortality in a population with cardiovascular disease: Predictive role of CONUT score.

Objectives: we used the Controlling Nutritional Status score (CONUT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI) to explore three different nutritional scores in predicting postoperative complications after pancreaticoduodenectomy (PD). Methods: data were retrospectively reviewed from 113 patients who underwent PD to treat pancreatic cancer and periampullary neoplasms at the Second Affiliated Hospital of Soochow University between 2015 and 2020. Nutritional status was assessed by the CONUT, GNRI, and PNI scores, and patients were categorized as either at risk or not at risk for malnutrition by each score. Postoperative complications were defined according to the Clavien-Dindo classification. Data were analyzed using Fisher's exact probability method and multivariate logistic regression analysis. The relationships between the three nutritional scoring systems and postoperative complications were examined. Results: CONUT, GNRI and PNI scores were closely related to the occurrence of postoperative complications. CONUT (OR = 0.92, 95 % CI, 0.75-1.12, p = 0.043), GNRI (OR = 0.98, 95 % CI, 0.93-1.02, p = 0.036), PNI (OR = 0.96, 95 % CI, 0.89-1.03, p = 0.024), and operation periods (OR = 1.01, 95 % CI, 0.99-1.02, p = 0.034) were independent risk factors for complications in patients after PD. The predictive value of the three nutritional screening methods for overall complications in patients with PD had a sensitivity of 31.8 %, 56.06 % and 74.24 %, a specificity of 85.10 %, 68.08 % and 76.81 %, a Youden index of 0.17, 0.24 and 0.71, and a kappa value of 0.460, 0.389 and 0.472, respectively. The predictive value of the three nutritional screening methods in predicting the severity of complications in patients with PD had a sensitivity of 82.11 %, 58.95 % and 65.26 %, a specificity of 38.89 %, 55.56 % and 66.67 %, a Youden index of 0.21, 0.15 and 0.36, and a kappa value of 0.664, 0.416 and 0.645, respectively. Among the three nutrition scoring systems, PNI score had better diagnostic efficiency (0.660 area under the AUC curve), higher specificity (66.67 %), and was consistent with postoperative complications (KCONUT = 0.664, KGNRI = 0.416, KPNI = 0.645) when compared to the GNRI and CONUT scores. Conclusions: CONUT, GNRI and PNI scores, especially PNI score, have good predictive values for the occurrence and severity of postoperative complications in PD patients, and should be used as preoperative nutritional risk screening tools for PD patients.

Nutritional status is a significant determinant of overall health and well-being among older adults and is linked to adverse mental health outcomes, such as depression. This study examined nutritional status as a risk factor for depression among 4,469 older adults receiving home- and community-based services from agencies overseen by a five-county Area Agency on Aging in west central Florida. It was hypothesized that older adults with a higher nutritional score (i.e., increased risk of malnourishment) would be more likely to have elevated depressive symptoms compared to those with lower nutritional risk. The cross-sectional study used secondary data from the AAA, including demographic and social variables, a 20-point nutritional risk score, and the Patient Health Questionnaire-9 (PHQ-9; not depressed = 0-9, depressed = &amp;gt;10) from clients in the AAA planning and service area. In logistic regression, the most significant predictor of depression was the client’s nutrition score (OR= 1.22, p &amp;lt; 0.0001). This OR suggests that, for every 1-point increase of the nutrition score, the odds of being depressed increases by 22%. The findings suggest that older adults receiving aging services with worse nutritional status are at increased risk of depression, consistent with other studies. The findings suggest that programs focused on improving nutritional status among older adults may reduce depressive symptoms may improve and may potentially improve long-term physical and mental health outcomes and decrease healthcare burden.