Abstract
OBJECTIVE: To examine the association between the Charlson Comorbidity Index and anorexia of aging and to test whether depressive symptoms mediate this relationship. METHODS: In November 2024, 382 older adults were recruited from three economic regions of Guangxi using multi-stage stratified sampling. Logistic regression identified risk factors, and a mediation model was constructed to test whether depressive symptoms mediate the relationship between the Charlson Comorbidity Index and anorexia of aging. RESULTS: Anorexia prevalence was 26.7%. Charlson Comorbidity Index was a risk factor for anorexia of aging (OR = 2.835, 95% CI 1.693-4.746), and the PHQ-9 score was also associated with anorexia (OR = 1.179, 95% CI = 1.077-1.291). The indirect effect via PHQ-9 accounted for 17.8% of the total effect; when depression was dichotomised, the mediated proportion was 12.3%. CONCLUSION: Comorbidity burden increases the risk of anorexia of aging directly and indirectly by inducing depressive symptoms. Simultaneous management of chronic diseases and negative affect is warranted to prevent anorexia of aging and its downstream adverse health consequences.