Ageing and nutrition in developing countries

Malnutrition among community dwelling older adults in a rural block area of South India

Background:

Kerala state has highest proportion of older adults in India. There is paucity of information on burden of malnutrition (under-nutrition) among them in the state. This study aimed to measure prevalence and associated factors of malnutrition among older adults in a rural community of Kerala.

Methods:

A community based cross-sectional study was conducted in 2018, among randomly selected 245 older persons (age ≥ 60 years) across rural area of Nemom block panchayath in Thiruvananthapuram district of Kerala. Nutritional status was determined by Mini Nutritional Assessment tool. Other components of the interviewer-administered questionnaire were Barthel Index, Geriatric Depression Scale-15, socio-demography, morbidity and substance abuse details. Chi Square test and binary logistic regression were done appropriately.

Results:

Prevalence of malnutrition was 14.3% (95% CI – 9.9% to 18.7%) and 44.1% (95% CI – 37.9% to 50.3%) were at risk of malnutrition. Older-old (70-79 years), oldest-old (≥80 years), unmarried or widowed, those with chewing and swallowing difficulties, those who screened positive for depression and those who had higher grade of dependency in any activities of daily living were more likely to be malnourished (p < 0.05). Older-old age (aOR – 3.358), depression (aOR – 4.859) and higher grade of dependency in activities of daily living (aOR – 2.940) were the attributes independently associated with malnutrition after adjusting for other factors.

Conclusions:

The older persons in the rural area of Kerala had high burden of malnutrition. Older-old, dependent and depressed individuals are more likely to be affected.

Nutritional status, health conditions and socio-demographic factors in the elderly of Havana, Cuba: data from SABE survey

OBJECTIVE

To assess the association of nutritional status with sex, age, race/color, education, smoking, physical activity, hypertension, diabetes, and hospitalization in older adults residing in the city of Havana, Cuba.

METHODS

This was a cross-sectional, population-based household survey. A total of 1,905 persons (1,197 women and 708 men; ≥ 60 years) were examined between 1999 and 2000, selected by probabilistic sampling. Nutritional status was assessed by body mass index (BMI): BMI < 22.0 kg/m2 = underweight; BMI > 27.0 kg/m2 = overweight. Multinomial logistic regression analysis (crude and adjusted) was used.

RESULTS

The estimation of the prevalence of underweight was 33.0% and that of overweight was 29.6%. The adjusted regression model showed that the probability of underweight was higher in older age groups (OR = 1.63, 70-79 years; OR = 2.05, ≥ 80 years) and among smokers (OR = 1.83). There was negative association between underweight, and hypertension and diabetes. Hypertension (OR = 1.99) was positively associated with overweight. The lower likelihood of overweight was observed among men, smokers, and those aged 80 years and more.

CONCLUSION

The elderly population of Havana presents a vulnerable nutritional status in view of the prevalence of underweight and overweight. Increasing age, smoking, gender, and hypertension are the factors positively associated with vulnerable nutritional status.

Nutrition, health, and aging in sub-Saharan Africa

The proportion of the population that is > or = 60 years of age in sub-Saharan Africa (SSA) is increasing rapidly and is likely to constrain healthcare systems in the future. Nevertheless, the elderly are not a health policy priority for African countries. This paper reviews the nutritional and health status of older adults in SSA and their determinants. Literature was abstracted through the Medline, Google Scholar, and Dogpile databases using the following search terms: sub-Saharan Africa, older adults, nutrition, health. Findings showed that up to half (6-48%) of elderly Africans in SSA are underweight and almost a quarter (2.5-21%) are overweight, while 56% of older South Africans are obese. Low-quality diets contribute to poor nutritional status. Poverty, HIV/AIDS, and complex humanitarian emergencies are major determinants of undernutrition. Effective interventions need to consider socioeconomic, health, and demographic factors; social pensions may be the most cost-effective option for improving the health and nutritional status of the elderly in SSA.

Aging, Nutritional Status, and Infection in the Developing World

The fast rate of increase in the number of older people in less-developed countries threatens to further strain the limited health resources of these countries. However, very little is known about their health status and the risk factors that contribute to it. In this article, we review the burden of infectious diseases in elderly people in less-developed countries, discuss the contribution of nutrition and immune response to morbidity and mortality, identify gaps in current knowledge, and suggest strategies to address this fast-growing public health problem.