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Millimono TM, Camara A, Mabiama G, Daffé M, Boumédiène F, Preux PM, Desport JC, Fayemendy P, Jésus P. Nutritional status and associated factors among the elderly in Guinea: a first national cross-sectional study. Sci Rep 2023; 13:15307. [PMID: 37723221 PMCID: PMC10507041 DOI: 10.1038/s41598-023-42494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
Aging of the Guinean population is a public health concern for the coming years, and the nutritional status of older people is virtually unknown. We also know that this population is growing and that undernutrition and obesity can affect the health of older adults. This study aimed to assess the nutritional status of older people in the general population of Guinea and its associated factors. A representative cross-sectional survey was conducted using sociodemographic, clinical, and anthropometric data (weight and height). Oral status was assessed by using the University of Nebraska Oral Status Scale. Visual acuity was assessed using the Monoyer scale. The standardized prevalence ratio (SPR) of the nutritional status was calculated for each region. The sample included 1698 subjects with a mean BMI of 22.6 ± 4.3 kg/m2. A total of 50.3% had impaired oral status and 20.3% had moderately to severely impaired visual acuity. The prevalence of undernutrition was 14.4% and of obesity 5.7%. Differences in the prevalence of nutritional status were found between regions, with an SPR > 1 for undernutrition in the Labé region (SPR 1.9, 95% CI = 1.5-2.5) and for obesity in the Conakry and Kindia regions (SPR of 2.90, 95% CI = 2.0-4.05 and 2.32, 95% CI = 1.5-3.3, respectively). In Guinea, The prevalence of nutritional disorders was approximately 20%. Screening and management of the health and nutritional status of older adults should be a national priority, and management should be adapted to each region of the country.
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Affiliation(s)
- Thierno Mamadou Millimono
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France.
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea.
| | - Alioune Camara
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Gustave Mabiama
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Department of Family and Home Economics, Advanced Teachers Training College for Technical Education (ATTCTE), University of Douala, Douala, Cameroon
| | - Mamady Daffé
- Gamal Abdel Nasser University of Conakry, Conakry, Guinea
- Ministry of Health and Public Hygiene, Food and Nutrition Division, Conakry, Guinea
| | - Farid Boumédiène
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
| | - Jean-Claude Desport
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
| | - Philippe Fayemendy
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
- Nutrition Unit, University Hospital, Limoges, France
| | - Pierre Jésus
- Inserm U1094, IRD U270, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Univ. Limoges, OmegaHealth, NET - 2 rue du Dr Marcland, 87025, Limoges Cedex, France
- Resource Centre for Nutrition Nouvelle Aquitaine Region (CERENUT), Isle, France
- Nutrition Unit, University Hospital, Limoges, France
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Obeng P, Kyereh HK, Sarfo JO, Ansah EW, Attafuah PYA. Nutritional status and associated factors of older persons in sub-Saharan Africa: a scoping review. BMC Geriatr 2022; 22:416. [PMID: 35545755 PMCID: PMC9097054 DOI: 10.1186/s12877-022-03062-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The older person population is rapidly increasing globally, including sub-Saharan Africa (SSA). Concurrently, malnutrition is also increasing among older persons in SSA, with a dearth of empirical evidence on nutritional status and associated factors among the older persons in the region to inform effective interventions to promote healthy ageing. AIM/OBJECTIVE This review assessed the nutritional status and associated factors among older persons in SSA. METHOD PubMed, Google Scholar, and Cochrane Library electronic databases were searched for published articles from 2010 to 2021 using keywords and Boolean logic. Also, we carried out a free web-based search to retrieve other relevant evidence that assesses the older persons' nutritional status. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart was used to appraise the research articles that responded to the study's research questions. FINDINGS Twenty studies met the inclusion criteria, from which data were extracted as findings. The malnutrition prevalence was between 6 to 54% among older persons in SSA. We found that the prevalence of malnutrition vary and could be as high as 28.4% in a low socio-economic status area. Of these studies, twelve (12) provided data on undernutrition with prevalence ranging from 2.9 to 41%;10 provided data on overweight (8.1-54.1%) and 5 on obesity (2.7-44.7%). Seventeen of the studies evaluated factors associated with malnutrition; 4 studies revealed the association between socioeconomic status and malnutrition, 7 studies reported a significant association between dietary habits and malnutrition. Four studies showed an association between educational status and malnutrition. Disease conditions associated with malnutrition were reported in four of the studies. CONCLUSION This review shows that malnutrition is a problem among older persons in SSA coupled with many risk factors which should be given critical attention. We recommend nutrition education for older persons as well as the development of nutrition interventions for this vulnerable group.
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Affiliation(s)
- Paul Obeng
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Henneh Kwaku Kyereh
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Jacob Owusu Sarfo
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
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Jésus P, Marin B, Pilleron S, Guerchet M, Mbelesso P, Ndamba-Bandzouzi B, Preux PM, Fayemendy P, Desport JC. Predictive formulas for estimation of height in sub-Saharan African older people: A new formula (EPIDEMCA study). Nutrition 2020; 73:110725. [PMID: 32135414 DOI: 10.1016/j.nut.2020.110725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Chumlea's formulas are a way of predicting height from knee height (KHt), including among individuals >60 y of age who cannot stand upright. However, the formulas were developed with white and African American people and have not yet been validated in native Africans >60 y of age. The aims of the study were to assess Chumlea's formulas in older people in central Africa and to propose a new validated formula for the same population. METHODS Height (MHt) and KHt were measured in a population of individuals >65 y of age from the Republic of Congo and the central African Republic. Predicted height (PHt) was calculated using Chumlea's formulas for the American black population (CBP) and for whites (CC). The percentages of accurate predictions (±5 cm) were compared between MHt and PHt. A new formula was estimated after randomization in a derivation sample (n = 877) and assessed for accuracy in a validation sample (n = 877). RESULTS The study included 1754 individuals. Prediction was accurate (±5 cm) in 66.8% and 63.2% of CBP and CC, respectively. Overestimation was as high as 24.1% and 29%, respectively. Because an overestimation is unacceptable in clinical practice and population surveys, a new formula was proposed: height (cm) = 72.75 + (1.86 × KHt [cm]) - (0.13 × age [y]) + 3.41 × sex (0: women; 1: men). This new formula significantly increases accuracy (71.3%) and decreases overestimation (14.7%). The nutritional status based on body mass index did not differ with the MHt and the PHt by the new formula. CONCLUSION Chumlea's formulas provided a poor estimate of height in this population sample. The proposed formula more accurately estimates height in older native Africans. This formula should be tested in other sub-Saharan African countries to extend its use in clinical practice and in future studies.
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Affiliation(s)
- Pierre Jésus
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France.
| | - Benoit Marin
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Center of Epidemiology, Biostatistics and Research Methodology, University Hospital of Limoges, France
| | - Sophie Pilleron
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Maëlenn Guerchet
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, London, UK
| | - Pascal Mbelesso
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Bébène Ndamba-Bandzouzi
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Neurology Department, University Hospital of Brazzaville, Brazzaville, Republic of Congo
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France; Center of Epidemiology, Biostatistics and Research Methodology, University Hospital of Limoges, France
| | - Philippe Fayemendy
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Jean-Claude Desport
- Nutrition Unit, University Hospital of Limoges, Limoges, France; INSERM, U1094, Tropical Neuroepidemiology, Limoges, France; Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France; IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
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Lewis EG, Coles S, Howorth K, Kissima J, Gray W, Urasa S, Walker R, Dotchin C. The prevalence and characteristics of frailty by frailty phenotype in rural Tanzania. BMC Geriatr 2018; 18:283. [PMID: 30445919 PMCID: PMC6240208 DOI: 10.1186/s12877-018-0967-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/26/2018] [Indexed: 01/24/2023] Open
Abstract
Background The frailty phenotype is defined by the presence of three from the following five clinical features: weakness, slow walking speed, unintentional weight loss, exhaustion, and low physical activity. It has been widely applied in different research and clinical contexts, including across many low and middle-income countries. However, there is evidence that the operationalisation of each component of the frailty phenotype significantly alters its characteristics and predictive validity, and care is needed when applying the phenotype across settings. The study’s objective was to operationalise the frailty phenotype in a rural Tanzanian population of older community-dwelling adults. Methods Consenting adults aged ≥60 years, and resident in five randomly selected villages of Hai district Demographic Surveillance Site, were eligible to participate in this cross-sectional study. From a screened sample of 1207 older adults, 235 were randomised and consented to an assessment of their frailty status by the frailty phenotype. Trained research fieldworkers (Tanzanian medical doctors and nurses) carried out measurements and questionnaires at local village centres or at participants’ homes. Results The prevalence of the frailty phenotype, calculated from complete data for 196 participants, was 9.25% (95% CI 4.39–14.12) When missing data were counted as meeting frailty criterion (i.e. missing due to inability to perform an assessment), the prevalence increased to 11.22% (95% CI 7.11–15.32). Frailty by phenotype criteria was more common in older age groups, and was associated with self-assessed poor health and depression symptoms. Conclusions Frailty can be successfully estimated using the frailty phenotype, however there are challenges in its operationalisation cross-culturally. Further work is needed to explore the potential clinical application of the frailty phenotype in such settings. Electronic supplementary material The online version of this article (10.1186/s12877-018-0967-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emma Grace Lewis
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. .,Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK. .,Education centre, North Tyneside General Hospital, Rake Lane, North Shields, NE29 8NH, UK.
| | - Selina Coles
- The Medical school, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Kate Howorth
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - John Kissima
- Hai District Hospital, Boma Ng'ombe, Hai, Kilimanjaro, Tanzania
| | - William Gray
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Sarah Urasa
- Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Richard Walker
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
| | - Catherine Dotchin
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
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Jésus P, Guerchet M, Pilleron S, Fayemendy P, Maxime Mouanga A, Mbelesso P, Preux PM, Desport JC. Undernutrition and obesity among elderly people living in two cities of developing countries: Prevalence and associated factors in the EDAC study. Clin Nutr ESPEN 2017; 21:40-50. [PMID: 30014868 DOI: 10.1016/j.clnesp.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/24/2017] [Accepted: 05/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Nutritional status among elderly people living in Sub-Saharan Africa is poorly studied, even though undernutrition and obesity are known to cause many complications and are risk factors for progression and death in several diseases. The aims of this study were to assess the nutritional status of the elderly in Central Africa and to study the factors associated with nutritional disorders (undernutrition and obesity). METHODS Two cross-sectional population-based studies were carried out in the capitals of Central African Republic (CAR) and Republic of Congo (ROC) between 2008 and 2009. Participants were aged ≥65 years old and underwent nutritional assessment including the following measurements: weight, height, body mass index (BMI), waist circumference (WC). Diet was also investigated. Nutritional status was defined according to the WHO BMI classification (<18.5 = undernutrition; ≥30 = obesity). Multinomial regression analysis was performed in order to identify factors associated with nutritional status. RESULTS 990 elderly people underwent nutritional assessment (482 in CAR and 508 in ROC). Mean BMI was 22.7 ± 4.8 kg/m2. The prevalence of undernutrition was 19.2% and was lower in ROC than in CAR (9.5% vs. 29.5%; p < 0.0001). The prevalence of obesity was 8.8% and was higher in ROC than in CAR (14.6% vs. 2.7%; p < 0.0001). The mean WC was 85.3 ± 28.4 cm. Adjusted on study site, increasing age (OR = 1.6 [95% CI: 1.1-2.3] for 75-84 years, OR = 2.6 [95% CI: 1.4-4.8] for 85+ years), occupation as farmer/breeder (OR = 2.2 [95% CI: 1.1-4.2]), smoking (OR = 1.71 [95% CI: 1.14-2.56]) and low sugar consumption (OR = 1.7 [95% CI: 1.1-2.7]) were positively associated with undernutrition whereas only female sex was positively associated with obesity (OR = 5.0 [95% CI: 2.2-11.0]). CONCLUSIONS The prevalence of undernutrition is high in the elderly population of these countries, in contrast to obesity. Undernutrition and obesity are associated with different socio-economic factors and food consumption. Simple nutritional advice could contribute to improving the nutritional status of elderly people in Central Africa.
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Affiliation(s)
- Pierre Jésus
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France.
| | - Maëlenn Guerchet
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, UK
| | - Sophie Pilleron
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Fayemendy
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
| | - Alain Maxime Mouanga
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Psychiatry Department, University Hospital of Brazzaville, Brazzaville, Congo
| | - Pascal Mbelesso
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Pierre Marie Preux
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Medical Information & Evaluation, Clinical Research and Biostatistics Unit, University Hospital of Limoges, Limoges, France
| | - Jean Claude Desport
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
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Validity of equations using knee height to predict overall height among older people in Benin. Nutrition 2017; 42:46-50. [PMID: 28870478 DOI: 10.1016/j.nut.2017.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/21/2017] [Accepted: 05/31/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Chumlea's formulas are a validated means of predicting overall height from knee height (KH) among people >60 y of age, but, to our knowledge, no formula is validated for use in African countries, including Benin. The aim of this study was to compare height provided by predictive formulas using KH to measured height in an elderly population in Benin. METHODS Individuals >60 y of age in Benin underwent nutritional assessment with determination of weight, body mass index (BMI), height, and KH. A Bland-Altman analysis was carried out by sex and age. The percentage of predictions accurate to ±5 cm compared with the measured height was calculated. The tested formulas were Chumlea's formulas for non-Hispanic Black people (CBP) and two formulas for use among Caucasians. RESULTS Data from 396 individuals (81.1% male) were analyzed. The three formulas achieved 98% accuracy, but with 4.6% risk for error (±2 SD: -6 to +9 cm), which appeared to make them unfit for the whole population. Nevertheless, if a level of prediction ±5 cm is considered acceptable in clinical practice, the CBP formula achieved 83.1% accuracy. Moreover, there was no significant difference in BMI calculated with the measured and the predicted height, and the nutritional status based on BMI did not differ. CONCLUSION CBP formulas seem applicable in 83% of cases (±5 cm) to assess the height with KH of older people in Benin and do not overestimate the prevalence of malnutrition.
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Abstract
Sub-Saharan Africa (SSA) has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation, SSA is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases (NCD). The aim of this review is to highlight available research on the health status of older persons in SSA, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in SSA on older persons (aged 50 years and older) related to health indicators including nutritional status, NCD and HIV burden. While it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.
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Abstract
The prevalence of osteoporosis and the incidence of age-related fragility fracture vary by ethnicity. There is greater than 10-fold variation in fracture probabilities between countries across the world. Mineral and bone metabolism are intimately interlinked, and both are known to exhibit patterns of daily variation, known as the diurnal rhythm (DR). Ethnic differences are described for Ca and P metabolism. The importance of these differences is described in detail between select ethnic groups, within the USA between African-Americans and White-Americans, between the Gambia and the UK and between China and the UK. Dietary Ca intake is higher in White-Americans compared with African-Americans, and is higher in White-British compared with Gambian and Chinese adults. Differences are observed also for plasma 25-hydroxy vitamin D, related to lifestyle differences, skin pigmentation and skin exposure to UVB-containing sunshine. Higher plasma 1,25-dihydroxy vitamin D and parathyroid hormone are observed in African-American compared with White-American adults. Plasma parathyroid hormone is also higher in Gambian adults and, in winter, in Chinese compared with White-British adults. There may be ethnic differences in the bone resorptive effects of parathyroid hormone, with a relative skeletal resistance to parathyroid hormone observed in some, but not all ethnic groups. Renal mineral excretion is also influenced by ethnicity; urinary Ca (uCa) and urinary P (uP) excretions are lower in African-Americans compared with White-Americans, and in Gambians compared with their White-British counterparts. Little is known about ethnic differences in the DR of Ca and P metabolism, but differences may be expected due to known differences in lifestyle factors, such as dietary intake and sleep/wake pattern. The ethnic-specific DR of Ca and P metabolism may influence the net balance of Ca and P conservation and bone remodelling. These ethnic differences in Ca, P and the bone metabolism may be important factors in the variation in skeletal health.
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Affiliation(s)
- J. Redmond
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
| | | | - B. Zhou
- Department of Public health, Shenyang Medical College, 146 Huanghe North Street, Shenyang 110034, People's Republic of China
| | - A. Prentice
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
- Medical Research Council Keneba, The Gambia
| | - I. Schoenmakers
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
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