{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:16:53Z","timestamp":1792012613150,"version":"4.4.0"},"reference-count":63,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Ministry of Education and Research","award":["01ET0725-31"],"award-info":[{"award-number":["01ET0725-31"]}]},{"name":"German Federal Ministry of Education and Research","award":["01ET1006A-K"],"award-info":[{"award-number":["01ET1006A-K"]}]},{"name":"German Federal Ministry of Education and Research","award":["01GY2108"],"award-info":[{"award-number":["01GY2108"]}]},{"name":"German Federal Ministry of Education and Research","award":["01ET0725-31"],"award-info":[{"award-number":["01ET0725-31"]}]},{"name":"German Federal Ministry of Education and Research","award":["01ET1006A-K"],"award-info":[{"award-number":["01ET1006A-K"]}]},{"name":"German Federal Ministry of Education and Research","award":["01GY2108"],"award-info":[{"award-number":["01GY2108"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Obesity and depression, in conjunction with multimorbidity, are interconnected conditions increasingly managed in general practitioner (GP) settings, yet these associations remain insufficiently studied in older patients. This study investigates the prevalence of depression across different body mass index (BMI) classes and includes age and gender differences in multimorbid older patients, offering a novel perspective on subgroup-specific patterns. Further the agreement between GP depression diagnoses and the Geriatric Depression Scale (GDS) is studied and patient-specific factors that may affect the agreement are explored, aiming to improve future diagnostics for vulnerable subgroups. Methods: Data were provided by the baseline assessment of the MultiCare Study, a prospective multicenter observational cohort of multimorbid patients aged 65+ years recruited from 158 GP practices across eight study centers in Germany. Data from 2568 study participants were analyzed based on GP-coded International Classification of Diseases (ICD) diagnoses, structured GP questionnaires, and patient questionnaires. Assessments included data on the BMI and depression (15 item version of the GDS). Agreement between GP diagnoses of depression and GDS assessment was measured using Cohen\u2019s kappa. Four logistic regression models were used to examine the effects of patient-specific factors on the agreement of depression diagnosis (match or mismatch). Results: GPs diagnosed depression in 17.3% of cases, compared to the detection of depressive symptoms in 12.4% of the patients by GDS (cut-off \u2265 6 points). The highest prevalence rates were observed in patients with obesity class III (25.0% by GP; 21.7% by GDS). Women were significantly more likely to receive a depression diagnosis by a GP across most BMI classes (except obesity classes II and III). The detection of depressive symptoms by GDS was significantly more prevalent in older multimorbid obese patients (\u226575 years), except for patients with obesity class III. The overall agreement between GP diagnosis and GDS assessment was weak (\u03ba = 0.156, p &lt; 0.001). The highest agreement was found for people with obesity class III (\u03ba = 0.256, p &lt; 0.05). Factors associated with a True Positive depression diagnosis (match by both GDS and GP) were female gender (odds ratio (OR) = 1.83, p &lt; 0.05), widowhood (OR = 2.43, p &lt; 0.01), limited daily living skills (OR = 3.14, p &lt; 0.001), and a higher level of education (OR = 2.48, p &lt; 0.01). A significantly lower likelihood of a False Negative depression diagnosis was found for patients with obesity class III. Conclusions: This study highlights the significant prevalence of depression among multimorbid older adults across different BMI classes, particularly in those with obesity class III. The weak diagnostic agreement between GP diagnosis and GDS assessment suggests a need for improved diagnostic practices in primary care. Implementing standardized screening tools and fostering collaboration with mental health specialists could enhance the identification and management of depression in this vulnerable population.<\/jats:p>","DOI":"10.3390\/nu17081394","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T20:38:26Z","timestamp":1745267906000},"page":"1394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Overweight, Obesity, and Depression in Multimorbid Older Adults: Prevalence, Diagnostic Agreement, and Associated Factors in Primary Care\u2014Results from a Multicenter Observational Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7644-3376","authenticated-orcid":false,"given":"Daniel Christopher","family":"Bludau","sequence":"first","affiliation":[{"name":"Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0432-5681","authenticated-orcid":false,"given":"Alexander","family":"Pabst","sequence":"additional","affiliation":[{"name":"Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Bleck","sequence":"additional","affiliation":[{"name":"Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5518-6749","authenticated-orcid":false,"given":"Siegfried","family":"Weyerer","sequence":"additional","affiliation":[{"name":"Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Gensichen","sequence":"additional","affiliation":[{"name":"Institute of General Practice and Family Medicine, University Hospital of LMU Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karola","family":"Mergenthal","sequence":"additional","affiliation":[{"name":"Institute of General Practice, Goethe-University Frankfurt, 60590 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Bickel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Technical University of Munich, 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Institute of General Practice, Medical Faculty of the Heinrich Heine University D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingmar","family":"Sch\u00e4fer","sequence":"additional","affiliation":[{"name":"Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5711-6862","authenticated-orcid":false,"given":"Hans-Helmut","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitt","family":"Wiese","sequence":"additional","affiliation":[{"name":"MHH Information Technology, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Sch\u00f6n","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Wegscheider","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-6090","authenticated-orcid":false,"given":"Steffi G.","family":"Riedel-Heller","sequence":"additional","affiliation":[{"name":"Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5984-8127","authenticated-orcid":false,"given":"Margrit","family":"L\u00f6bner","sequence":"additional","affiliation":[{"name":"Institute for Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2008). 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