Depressive symptoms in the elderly are related to the advancing of age, loss of life purpose, medical multi-morbidity, cognitive decline and social-economic problems mounting evidence suggests that lifestyle behaviors and certain dietary patterns may improve mood and overall well-being in older adults. In the present study we investigated (i) the association of adherence to Med-Diet with depressive symptoms and multi-morbidity in a cohort of geriatric medical outpatients and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multi-morbidity.

Morbidity was assessed using the severity index of cumulative illness rating scale for geriatrics (CIRSG-SI). Montreal cognitive assessment (MoCA) and geriatric depression scale (GDS) were administrated to evaluate cognitive and depressive symptoms. Adherence to Med-Diet was evaluated using the Med-Diet 14-Item questionnaire (MDQ). Pearson correlation was used to test association between variables. The Preacher and Hayes’ strategy was used to test the mediational model.

One hundred and forty-three subjects were included in the study. Significant inverse correlations of MDQ with GDS (r=-0.317; P<0.001) and CIRSG-SI (r=-0.247; P=0.003) were found, with and without adjustment for potential confounders. A direct correlation between CIRSG-SI and GDS was also observed (r=0.304; P=0.001), with this association being moderated by MDQ (b=0.386; P=0.047).

These findings (i) add to the accumulating evidence that Med-Diet is crucially involved in the regulation of physical and mental health of elderly people, and (ii) suggest that a Mediterranean-style diet may contribute to protect elderly subjects with higher levels of polypathology/multi-morbidity from the development of depressive symptoms.