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Ghimire S, Singh DR, McLaughlin SJ, Nath D, McCarren H, Subedi J. Adult Children's Migration and Health-Related Quality of Life Among Older Nepali Adults. J Cross Cult Gerontol 2024; 39:137-149. [PMID: 38345727 PMCID: PMC11093780 DOI: 10.1007/s10823-024-09500-1] [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] [Accepted: 02/03/2024] [Indexed: 05/16/2024]
Abstract
Traditionally, adult children have served as primary caretakers and providers for older Nepali adults. However, out-migration of adult children for employment and other opportunities is increasing. Health-related quality of life (HRQOL) in older Nepali adults in general and in the context of adult children's migration is poorly understood. This study aims to assess HRQOL of older Nepali adults and its relationship with adult children's migration. We used existing cross-sectional survey data on 260 older adults from Krishnapur municipality, which has witnessed a high rate of adult migration. HRQOL, quantified using the SF-12 scale, is expressed in terms of a physical (PCS) and mental (MCS) health component. A higher PCS and MCS score, each ranging from 0 to 100, indicates better physical and mental health, respectively. The correlates of HRQOL were assessed in simple and multiple linear regression. Participants had suboptimal HRQOL [mean (± SD): PCS = 40.4 ± 9.2 and MCS = 45.2 ± 7.7]. After adjusting for covariates, adult children's migration was associated with lower MCS scores (β: -2.33, 95%CI: -4.21, -0.44). Individuals with more than one child had higher MCS scores (β: 2.14, 95%CI: 0.19, 4.09). Females (β: -3.64, 95%CI: -7.21, -0.06) and those with a history of unemployment (β: -6.36, 95%CI: -10.57, -2.15) had lower PCS scores than their respective counterparts. The presence of chronic conditions was associated with significantly lower PCS and MCS scores. Our findings suggest that adult children's migration may negatively affect HRQOL among older Nepali adults, specifically their psychological well-being. Further research investigating potential moderating factors that may serve as important buffers is needed.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology, Miami University, 375 Upham Hall, 100 Bishop Circle, Oxford, OH, 45056, USA.
- Scripps Gerontology Center, Miami University, Oxford, OH, USA.
| | - Devendra Raj Singh
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, 375 Upham Hall, 100 Bishop Circle, Oxford, OH, 45056, USA
- Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Dhirendra Nath
- Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Hannah McCarren
- Department of Sociology and Gerontology, Miami University, 375 Upham Hall, 100 Bishop Circle, Oxford, OH, 45056, USA
| | - Janardan Subedi
- Department of Sociology and Gerontology, Miami University, 375 Upham Hall, 100 Bishop Circle, Oxford, OH, 45056, USA
- Scripps Gerontology Center, Miami University, Oxford, OH, USA
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Tasnim T, Sadiq MZA, Karim KMR. Depression level, nutritional status, and dietary nutrient intake of the older adult at the community level in a selected area of Bangladesh. Heliyon 2023; 9:e18199. [PMID: 37501974 PMCID: PMC10368819 DOI: 10.1016/j.heliyon.2023.e18199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Malnutrition is associated with higher rates of morbidity and death in the older population. Depression or mental health is a major component of older adult malnutrition. The aim of the study was to measure the level of malnutrition and depression in older adults, as well as their correlated factors, such as dietary energy and nutrient consumption. A cross-sectional study was conducted among 108 older individuals living in two areas of Faridpur, Bangladesh. The Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression (GD) Scale, and 24-h dietary recall were used to measure the nutritional status, depression level, and dietary nutrients, respectively. A total of 20.4% and 55.6% were malnourished or at risk of malnutrition, respectively. Around 81.5% of the study subjects exhibited a different degree of depression and 9.3% were identified as having severe depression. There was a significant inverse association between the MNA-SF score and the GD score (r = -0.684, p=<0.001). The average energy and protein consumption was 1387 kcal and 45.52 g, respectively; and energy and protein intake were significantly lower in the depressed group (1353 Kcal, 43.8 g) than in the non-depressed group (1530 Kcal, 52.4 g). An extremely low energy consumption (<20 kcal/kg body weight/day) was noted in 27.1% of the older adults. None of the participants in this study were able to meet the requirements for dietary fiber, calcium, vitamin B6, folate, vitamin D, and vitamin E. Specific nutrition-related intervention programs as well as social and familial support are recommended to improve the nutritional status of older adults.
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Affiliation(s)
- Tasmia Tasnim
- Department of Nutrition and Food Engineering, Daffodil International University, Daffodil Smart City, Birulia, 1216, Savar, Dhaka, Bangladesh
| | - Md Zafar As Sadiq
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, 1000, Bangladesh
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Dent E, Wright ORL, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet 2023; 401:951-966. [PMID: 36716756 DOI: 10.1016/s0140-6736(22)02612-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/15/2022] [Accepted: 12/01/2022] [Indexed: 01/29/2023]
Abstract
Malnutrition is a highly prevalent condition in older adults, and poses a substantial burden on health, social, and aged-care systems. Older adults are vulnerable to malnutrition due to age-related physiological decline, reduced access to nutritious food, and comorbidity. Clinical guidelines recommend routine screening for malnutrition in all older adults, together with nutritional assessment and individually tailored nutritional support for older adults with a positive screening test. Nutritional support includes offering individualised nutritional advice and counselling; oral nutritional supplements; fortified foods; and enteral or parenteral nutrition as required. However, in clinical practice, the incorporation of nutritional guidelines is inadequate and low-value care is commonplace. This Review discusses the current evidence on identification and treatment of malnutrition in older adults, identifies gaps between evidence and practice in clinical care, and offers practical strategies to translate evidence-based knowledge into improved nutritional care. We also provide an overview of the prevalence, causes, and risk factors of malnutrition in older adults across health-care settings.
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Affiliation(s)
- Elsa Dent
- Research Centre for Public Health, Equity & Human Flourishing, Torrens University Australia, Adelaide, SA, Australia.
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Jean Woo
- Department of Medicine and Therapeutics and Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong Special Administrative Region, China
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science and Department of General Practice, Location VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands; Amsterdam Public Health research institute and Ageing & Later Life Research Program, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Shuremu M, Belachew T, Hassen K. Nutritional status and its associated factors among elderly people in Ilu Aba Bor Zone, Southwest Ethiopia: a community-based cross-sectional study. BMJ Open 2023; 13:e067787. [PMID: 36720579 PMCID: PMC9890780 DOI: 10.1136/bmjopen-2022-067787] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES This study aimed to assess the nutritional status and its associated factors among elderly people. DESIGN A community-based cross-sectional study. SETTING The study was conducted in urban and semiurban areas. PARTICIPANTS The study included 620 elderly community dwellers in Southwest Ethiopia from 3 October 2021 to 10 November 2021. Those who were seriously ill, could not get around or were on special diets were excluded from the study. OUTCOME MEASURE The Mini Nutritional Assessment was used to evaluate nutritional status and the STEPwise approach was used to collect data on backgrounds and lifestyle. SPSS V.22.0 was used for data analysis. Logistic regression was computed. The level of significance was set at 0.05. RESULTS Elderly people who were malnourished or at risk of malnutrition were found to make up 48.1% (44.1%) and 17.4% (14.5%) of the population, respectively. Those aged 80 years and older had a chance of being at risk of malnutrition (adjusted OR (AOR)=22.555; 95% CI: 7.963 to 63.881), while the odds of being malnourished were 11.5 times higher (AOR=11.755; 95% CI: 4.825 to 28.638). Informal education was a significant predictor of being at risk of malnutrition (AOR=6.102; 95% CI: 2.684 to 13.871). Urban dwellers were 8.9 times more likely to be malnourished. Inadequate financial resources make people 3.7 times more likely to be malnourished. A lower wealth index was a significant predictor of being at risk of malnutrition (AOR=4.156; 95% CI: 1.361 to 12.692). Single elderly people had a 3.4-fold higher risk of malnutrition. Elderly people with chronic pain, who were smokers and alcoholics, and who had depression were all at risk of nutritional problems. CONCLUSION The risk of malnutrition and malnourishment was high. Age, urbanisation, finances, education, economics, being a woman, smoking and alcohol are associated factors. Interventional studies are warranted to minimise malnutrition challenges in the study population.
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Affiliation(s)
- Muluneh Shuremu
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
- Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Kalkidan Hassen
- Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
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Adhikari P, McLaren S. Functional Impairment and Depressive Symptoms among Older Adults of Rural Nepal: The Moderating Role of Three Sources of Social Support. Clin Gerontol 2023; 46:832-843. [PMID: 36880604 DOI: 10.1080/07317115.2023.2187732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES This study aimed to determine whether social support from family, friends, and significant others moderated the relationship between functional impairment and depressive symptoms among Nepali older adults living in rural areas. METHODS The participants were 147 women (Mage = 66.71, SDage = 5.97) and 153 men (Mage = 67.41, SDage = 6.47) aged 60 years and older who lived in the rural mid-hills of Nepal. They completed the Karnofsky Performance Status Scale, the Multidimensional Scale of Perceived Social Support, and the Geriatric Depression Scale-Short Form. RESULTS Only 6.3% participants experienced some degree of functional impairment. Almost half (44.33%) of participants had depressive symptoms. Social support from family and friends, but not significant others, moderated the relationship between functional impairment and depressive symptoms. Social support from family was protective for older adults with moderate to high levels of functional impairment. Social support from friends was protective at no to low levels of functional impairment. CONCLUSIONS Interventions aimed at increasing social support from family among Nepali older adults living in rural hilly areas may reduce depressive symptoms, particularly among those with high levels of functional impairment. CLINICAL IMPLICATIONS Family support is important to alleviate depressive symptoms among functionally impaired older adults.
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Affiliation(s)
- Pralhad Adhikari
- Department of Psychology and Philosophy, TriChandra Multiple College, Kathmandu, Nepal
| | - Suzanne McLaren
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
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Urgessa M. The Mini Nutritional Assessment tool's applicability for the elderly in Ethiopia: validation study. PeerJ 2022; 10:e14396. [PMID: 36411835 PMCID: PMC9675339 DOI: 10.7717/peerj.14396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Mini Nutrition Assessment (MNA) is a widely used and valid tool for screening and assessment of malnutrition among the elderly population worldwide. However, MNA has not been validated among the Ethiopian elderly population and this study assessed the validity of the tool for the target population. Methods Cross-sectional validation study design employed to validate MNA in Meki town, East Ethiopia. This study included 176 randomly selected elders living in the community, whereas amputated, bedridden, visible deformity, known liver and/or renal disorders were excluded. The original MNA questionnaires were translated to local language and administered to each participant after doing the pretest. The anthropometric, self-perception of nutritional status and serum albumin concentrations were measured. Reliability, validity, sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated. Receiver-operating characteristic (ROC) curve analysis was plotted to identify the area under the curve (AUC) and optimal cut-off value for the prediction of malnutrition. Result A total of one hundred and seventy-six elders participated in this study. Of the total participants, 78(44.3%) were males. The mean (SD) age of the participants was 67.6 (±5.8) years and ranged from 60 to 84 years. The prevalence of malnutrition based on the MNA criteria (MNA < 17 points) was 18.2%, and 13.1% based on serum albumin concentration (<3 g/dl).The MNA had an overall Internal consistency of Cronbach's alpha 0.61. The tool also demonstrated significant criterion-related validity (0.75, p < 0.001) and concurrent validity (0.51, p < 0.001) with serum albumin concentration and self-perception of nutritional status respectively. Using the original cut-off point, the sensitivity, specificity, PPV and NPV of the tool were 93.5%, 44.6%, 65.4% and 86.0%, respectively. By modifying, the cut-off point to a value of <20.5, the sensitivity and specificity of the tool increases to 97.6% and 82.8% respectively. The AUC (95%CI) showed an overall accuracy of 92.7% (88.5, 96.9). Conclusion The MNA tool can be used as a valid malnutrition screening tool for the Ethiopian elderly population by modifying the original cut-off point.
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Affiliation(s)
- Megersso Urgessa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Shashemene, Oromia, Ethiopia
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Dawed A, Mekonnen TC, Genetu M, Tadesse SE, Dewau R, Muche A, Zerga AA, Ayele FY, Gill TK. Comparing the validity of anthropometric measurements in identifying malnutrition status of older age people in Borena district, North Central Ethiopia: a cross_sectional study. BMC Geriatr 2022; 22:776. [PMID: 36192694 PMCID: PMC9528122 DOI: 10.1186/s12877-022-03467-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malnutrition among older age people is becoming significantly higher in spite of improvements in the health care system. Life expectancy of Ethiopian elders is increasing; but reliable and valid tools for screening and diagnosis of malnutrition in this subgroup are limited. This study aimed to assess the validity of anthropometric measurements: Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), and Calf Circumference (CC) in detecting malnutrition status of older age people in Ethiopia. Methods A community based cross-sectional study was conducted in Borena District from January to March, 2020. A total of 421 participants aged were systematically included in the study. To test reliability and validity of the measurements,Cronbach’s α coefficient and Pearson’s correlations were used, respectively. The full Mini-Nutritional Assessment (MNA) tool was used to diagnosis malnutrition. Overall accuracy, sensitivity and specificity of BMI, MUAC and CC were estimated using Receiver Operating Characteristic curves. The Youden Index was used to determine the best cut-off point. Results The reliability of BMI, MUAC and CC by Cronbach’s alpha was found 0.847. Significant positive correlations between MNA, BMI(r = 0.56, p < 0.01); MNA, MUAC(r = 0.43, p < 0.01; and MNA, CC(r = 0.52, p < 0.01) revealed. The area under the curve (AUC) of BMI, MUAC and CC were found: 0.98(95% CI, 0.96–0.99, p < 0.001), 0.94(95% CI, 0.89–0.98, p < 0.001) and 0.96(95% CI, 0.94–0.98, p < 0.001) indicating the overall accuracy respectively. The sensitivity and specificity of BMI, MUAC and CC using established cut off points were found: 90%, 96%; 78%, 94% and 84%, 95% respectively. However, using the Youden index the best cut-off point, the sensitivity and specificity of MUAC and CC were 88%, 86%; 92% and 89% respectively and adjusted for age and sex. Conclusions The current study demonstrated that BMI was a reliable and valid method to identify the malnutrition status of older age people. A MUAC value of 19 cm and CC of 30 cm were simple and efficient cut-off points for the determination of malnutrition in the older age people. A future study is needed to validate the validity of BMI, MUAC and CC against biochemical tests as gold standard. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03467-9.
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Affiliation(s)
- Abdu Dawed
- Dessie Comprehensive Specialized Hospital, Dessie, North Eastern, Ethiopia
| | - Tefera Chane Mekonnen
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Muluken Genetu
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aregash Abebayehu Zerga
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide, South Australia, Australia
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BELİBAĞLI MC. The Risk and The Prevalence of Malnutrition in Elderly Home-care Patients. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.986356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Vijewardane SC, Balasuriya A, Myint PK, Johnstone AM. Determinants of Undernutrition and Associated Factors of Low Muscle Mass and High Fat Mass among Older Men and Women in the Colombo District of Sri Lanka. Geriatrics (Basel) 2022; 7:geriatrics7020026. [PMID: 35314598 PMCID: PMC8938783 DOI: 10.3390/geriatrics7020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
Undernutrition is a health challenge due to an expanding older population. The aims of the study were to assess the prevalence and determinants of undernutrition and, associated factors of low muscle and high fat mass among older men and women in the Colombo district of Sri Lanka. A cross sectional study was conducted using a multistage cluster sampling technique. Undernutrition was defined based on anthropometry and body composition assessed using bio-electrical impedance. Sex-specific multivariable logistic regression analyses were conducted. Of 800 participants (30.6% men), 35.3% were undernourished. The factors significantly associated with undernutrition among older women were hypertension with an adjusted odds ratio (aOR) (1.97; 1.36–2.88) and musculoskeletal disabilities aOR (2.19; 1.36–3.53). Among women, age ≥ 70 (1.79; 1.18–3.34) and diabetes (1.77; 1.10–2.84) were associated with low muscle mass and age ≥ 70 (2.05; 1.21–3.47), diabetes (2.20; 1.35–3.59) and disability in chewing (2.39; 1.30–4.40) were associated with high fat mass. Among men, age ≥ 70 years, no/up to grade 5 education, diabetes, visual disability, little/no responsibility in food shopping and not getting nutritional advice from media were associated with reduced odds of low muscle mass and no/up to grade 5 school education, disability in chewing and little/no responsibility in food shopping were associated with reduced odds of high fat mass. Undernutrition among older people is common in Sri Lanka. We have identified key factors associated with low muscle mass and high fat mass in this setting. Given the potential consequences of these conditions, our study provides potential targets for prevention of undernutrition and sarcopenic obesity.
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Affiliation(s)
- Samantha Chandrika Vijewardane
- Nutrition Division, Ministry of Health, Colombo 00600, Sri Lanka
- Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK;
- Correspondence: ; Tel.: +44-78-6925-6729
| | - Aindralal Balasuriya
- Department of Public Health and Family Medicine, Faculty of Medicine, General Sir John Kotelawala Defense University, Dehiwala-Mount Lavinia 10390, Sri Lanka;
| | - Phyo Kyaw Myint
- Ageing Clinical & Experimental Research Team, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK;
| | - Alexandra M. Johnstone
- The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK;
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Razon AH, Haque M, Ahmed M, Ahmad T. Assessment of dietary habits, nutritional status and common health complications of older people living in rural areas of Bangladesh. Heliyon 2022; 8:e08947. [PMID: 35243069 PMCID: PMC8857427 DOI: 10.1016/j.heliyon.2022.e08947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/09/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Old age is one of the vulnerable and prone stages in terms of health status. So this study aimed to assess the nutritional status and common health complications of older people. Methods Simplified Nutritional Appetite Questionnaire (SNAQ), Anthropometric measurements, Diet History Method, and Mini Nutritional Assessment (MNA) tools were used to measure the nutritional status. Data were analyzed by using Statistical Package for Social Science (SPSS) version 16. Results Out of the total 320 elderly participants the mean ± SD value for the age of male and female was 67.25 ± 6.5 and 67.32 ± 7.7 years respectively. According to BMI classification, it was noticed that with advancing age the percentage of underweight was also increased such as for 60–75 years old age group the underweight percentage was 30.0% where for 76 to 85 and >85 years old age group the underweight percentage was 45.0% and 60.0% respectively. According to the MNA score, 97 elderly respondents were malnourished and a total of 172 respondents had SNAQ scores below 14. This study found a statistically significant (P < 0.05) correlations among various health complications with nutritional status according to MNA score. In addition 56.6% (OR = 1.24, 95% CI = .799–1.939), 63.8% (OR = 1.18, 95% CI = .745–1.857) and 64.7% (OR = 1.14, 95% CI = .720–1.804) respondents had diabetes mellitus, hypertension and cardiovascular disease respectively. The risk of musculoskeletal pain (OR = 1.073, 95% CI = .684–1.681), bedsore (OR = 1.884, 95% CI = .903–3.934) and decreased sense of thirst (OR = 1.278, 95% CI = .821–1.991) were higher among females than males. A little number of the elderly used to take milk, meat, and fish daily. Conclusion During this cross-sectional study, significant correlations among nutritional changes with health complications were determined. To prevent malnutrition among the elderly a proper health policy as well as periodical nutritional screening should be conducted.
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Bala K, Sahni B, Mir L, Langeh S, Kalotra A. Assessment of nutritional status of community-dwelling older adults in rural North India using mini nutritional assessment-short form. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_114_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Del Brutto OH, Rumbea DA, Mera RM, Recalde BY, Sedler MJ. Social Determinants of Health (Social Risk) and Nutritional Status Among Community-Dwelling Older Adults Living in a Rural Setting: The Atahualpa Project. J Prim Care Community Health 2022; 13:21501319221087866. [PMID: 35352591 PMCID: PMC8972921 DOI: 10.1177/21501319221087866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Several studies have attempted to clarify the role of social determinants of health (SDH) on nutritional status of older adults, but results are inconsistent due to differences in SDH assessments at different levels of population development. In this study, we assessed this association in community-dwelling older adults living in rural Ecuador. Methods: SDH were measured by the Gijon’s Social-Familial Evaluation Scale (SFES) and nutritional status by the Mini Nutritional Assessment (MNA®). Multivariate logistic regression models were fitted to assess the association between SDH components and nutritional status. Locally weighted scatterplot smoothing (LOWESS) and a generalized linear model were used to evaluate the potential non-linearity of the association between the Gijon’s SFES and MNA® scores. Results: A total of 295 individuals (mean age: 72.1 ± 7.6 years; 58% women) were enrolled. There was an inverse association between the total Gijon’s SFES and nutritional status (OR: 0.75; 95% C.I.: 0.65-0.86; P < .001). Three of five components of the Gijon’s SFES (family situation, social relationships, and support networks) were inversely associated with nutritional status in multivariate logistic regression models. A LOWESS plot, together with a generalized linear model, showed an inverse linear relationship between the continuous Gijon’s SFES and MNA® scores. One standard deviation of increase in the continuous Gijon’s SFES score (2.39 points) decreased the MNA® score by 0.78 points. Conclusion: Study results show a significant inverse association between high social risk and a good nutritional status. Components of the Gijon’s SFES measuring social isolation are responsible for this association.
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Affiliation(s)
- Oscar H Del Brutto
- Universidad Espíritu Santo-Ecuador, Samborondón, Ecuador.,Hospital-Clínica Kennedy, Samborondón, Ecuador
| | | | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
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Olawumi AL, Grema BA, Suleiman AK, Omeiza YS, Michael GC, Shuaibu A. Nutritional status and morbidity patterns of the elderly in a Northwestern Nigerian hospital: A cross-sectional study. Niger Postgrad Med J 2021; 28:160-168. [PMID: 34708701 DOI: 10.4103/npmj.npmj_545_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Nutrition is a significant factor in determining the health of older people because it affects almost all organs and systems, which could lead to varieties of diseases and premature death. Aim To determine the nutritional status and its association with the morbidity patterns of elderly patients. Settings and Design A cross-sectional hospital-based descriptive study involving 348 patients aged 60 years and above who presented at the Family Medicine Clinic. Subjects and Methods Data of the socio-demographic profile, anthropometric measurements and clinical diagnosis were collected. The co-morbidities were classified based on the number, duration and affected organ or system. The nutritional status was assessed with the Mini-Nutritional Assessment tool. Statistical Analysis Chi-square test and logistic regression analysis were used to determine associations between nutritional status and morbidity patterns of the elderly. The level of significance was set at a P ≤ 0.05. Results A total of 348 respondents were recruited with 60.9% of females and mean age of 67.83 (standard deviation ± 7.53) years. The prevalence of malnutrition was 25.3% and of risk of malnutrition 56.6%. Furthermore, the prevalence of multi-morbidity was 74.4%. Advanced age (odd ratio = 8.911, confidence interval [CI] = 1.992-39.872, P = 0.004), underweight (OR = 1.167, CI = 0.291-37.846, P < 0.001), lack of formal education, (OR = 1.569, CI = 0.357-0.908, P = 0.018), low monthly income (OR = 1.975, CI = 1.376-2.836, P < 0.001), chronic respiratory diseases (OR = 4.250, CI = 4.025-4.492, P < 0.001) and physical inactivity (OR = 2.466, CI = 1.063-5.722, P = 0.036) were the predictors of malnutrition. Furthermore, the duration of chronic disease for more than 10 years (OR = 1.632, CI = 0.408-0.979, P = 0.040) was significantly associated with at-risk of malnutrition. Conclusion The study revealed advanced age, underweight, low educational status, chronic respiratory diseases and physical inactivity as independent risk factors for malnutrition among the elderly.
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Affiliation(s)
| | - Bukar Alhaji Grema
- Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Yakubu Sule Omeiza
- Department of Clinical Services and Training, National Orthopedic Hospital, Kano, Nigeria
| | | | - Abdulrahman Shuaibu
- Office of the Executive Secretary, Primary Healthcare Development Agency, Gombe State, Nigeria
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Moloney L, Jarrett B. Nutrition Assessment and Interventions for the Prevention and Treatment of Malnutrition in Older Adults: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2108-2140.e6. [PMID: 34581276 DOI: 10.1016/j.jand.2020.09.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Older adults living in the community or long-term residence such as a nursing home are at increased risk for malnutrition due to factors such as depression and isolation. The purpose of this scoping review is to identify the best available research that evaluates the validity and reliability of nutrition assessment tools, and the effectiveness of nutrition interventions to prevent or treat malnutrition among older adults. A literature search was conducted in Medline, Embase, CINAHL, and Cochrane Central databases to identify clinical trials, published in the English language, evaluating assessment and intervention methods aimed to treat or prevent malnutrition among older adults living in the community or their long-term residence such as nursing homes. Articles were screened by 2 reviewers, then data were extracted and narratively synthesized. The literature search retrieved 20,937 articles and 197 articles were included in narrative synthesis. A total of 73 assessment articles were identified, 36 of which were validity and reliability trials. A total of 122 intervention articles were identified, the majority of which were randomized controlled trials. A few of the most commonly evaluated interventions were oral nutrition supplements, medical nutrition therapy, fortification and enrichment, and nutrition education. Several systematic reviews were identified, however, that did not meet the criteria of this review. There is a need to conduct systematic reviews for nutrition assessment and intervention trials to guide development of evidence-based nutrition practice recommendations for older adults living in the community or their long-term residence.
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Affiliation(s)
- Lisa Moloney
- Academy of Nutrition and Dietetics, Evidence Analysis Center, Chicago, IL.
| | - Brittany Jarrett
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
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Quality of Life and Nutritional Status of the Geriatric Population of the South-Central Part of Nepal. J Nutr Metab 2021; 2021:6621278. [PMID: 34007486 PMCID: PMC8110372 DOI: 10.1155/2021/6621278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/31/2021] [Accepted: 04/24/2021] [Indexed: 11/18/2022] Open
Abstract
Background The main objective of the study was to assess the nutritional status and quality of life in the geriatric population of Lahan municipality of Siraha district. Methods A cross-sectional analytical study was conducted in Lahan municipality of Siraha district from June to December 2017. The Mini-Nutritional Assessment tool was used to investigate the nutritional status, and World Health Organization Quality of Life-OLD questionnaires were used to assess the quality of life among geriatric population. Result Out of the total participants, one-third (45.7%) of the participants were at risk of malnutrition and 19.8% were malnourished while 34.5% had normal nutritional status. It was seen that 48.2% of participants had good quality of life whereas 51.8% of them had poor quality of life. There was a significant association between nutritional status and quality of life in the elderly population. Conclusion The findings showed the need for active ageing interventions to improve the nutritional status and quality of life of elders at the community settings. Proper attention should be focused on elders' nutrition to reduce the observed prevalence of malnutrition, and focus should be given on the nutrition status that leads to improve the quality of life of elders.
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Hweidi IM, Carpenter CL, Al-Obeisat SM, Alhawatmeh HN, Nazzal MS, Jarrah MI. Nutritional status and its determinants among community-dwelling older adults in Jordan. Nurs Forum 2021; 56:529-538. [PMID: 33834507 DOI: 10.1111/nuf.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/12/2021] [Accepted: 03/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The elderly population of Jordan is growing, due to the low mortality rate, high total fertility rate, and the high rate of forced migration from neighboring countries to Jordan in recent years. However, the prevalence of chronic illnesses associated with other comorbidities among the elderly population in Jordan is high. Maintaining a good nutritional status is essential for maintaining general health and well-being among older people. AIM The aim of this study is to identify the nutritional status of community-dwelling older adults in Jordan and determine its possible associated factors. METHODOLOGY A cross-sectional, descriptive design was utilized. Proportional multistage nonprobability sampling was employed to obtain a convenient sample of 225 Jordanian community-dwelling older adults. The participants were asked to complete a set of questionnaires related to nutritional status, which included a demographic information sheet, and the Mini Nutritional Assessment (MNA). RESULTS Among the sample, only 60 participants (26.7%) showed normal nutritional status. Most of the participants (n = 156; 68.3%) were found to be at risk of malnutrition, and nine participants (4%) were found to suffer from malnutrition. Advanced age (r = -0.631; p = 0.001), body mass index (BMI) (r = 0.546; p = 0.001), being single (mean (M) = 20.43, SD = 3.55), being male (M = 21.10, SD = 3.73), being unemployed (M = 21.71, SD = 3.51), being dependent in activities of daily living (ADLs) (M = 21.35; SD = 3.62), eating only two meals per day (M = 19.60; SD = 3.39), having suffered from illness or anxiety in the preceding 3 months (M = 21.11; SD = 2.39), having a mid-arm circumference of less than 31 cm (M = 19.51; SD = 3.47), low consumption of fruit and vegetables (M = 20.79; SD = 2.53), and polypharmacy (M = 20.62, SD = 4.09) were found to predict susceptibility to malnutrition among the participating older adults. Amongst the variables, age was identified as the most significant predictor of nutritional status and explained approximately 40% of the variance in nutritional status. CONCLUSION Malnutrition in older adults is a multifaceted phenomenon that needs to be integrated into the comprehensive assessment of older adults. It is essential that health-care professionals, particularly nurses, are fully aware of the associated risks of malnutrition among the elderly population. The high prevalence of the risk factors for malnutrition warrants conducting a controlled national-based assessment, using probability sampling, of the nutritional status among older adults in Jordan. Specifically, there is a real need to assess nutritional status among older adults who are at high risk of malnutrition, including senior, unmarried, male, unemployed, ADL dependent, and/or poly-medicated older adults.
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Affiliation(s)
- Issa M Hweidi
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Catherine L Carpenter
- Department of Nutritional Epidemiology & Clinical Nutrition, Center for Human Nutrition, School of Medicine and Nursing, University of California at Los Angles (UCLA), Los Angeles, California, USA
| | - Salwa M Al-Obeisat
- Maternal-Child Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Hossam N Alhawatmeh
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad S Nazzal
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamad I Jarrah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Rahman KMT, Khalequzzaman M, Khan FA, Rayna SE, Samin S, Hasan M, Islam SS. Factors associated with the nutritional status of the older population in a selected area of Dhaka, Bangladesh. BMC Geriatr 2021; 21:161. [PMID: 33673811 PMCID: PMC7934473 DOI: 10.1186/s12877-021-02068-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh. Methods A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Results The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p < 0.05) higher odds of having depression (OR 15.6; 95% CI 3.1–78.1), poor oral health (OR 7.3; 95% CI 1.3–41.8), and no formal education (OR 6.5; 95% CI 1.3–32.1) was observed among the malnourished respondents. Though it was not statistically significant, among the malnourished, 31.3, 25.0 and 25.0% avoided highly oily food, beef/mutton, and sugary food, respectively. Conclusions More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population.
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Affiliation(s)
- K M Thouhidur Rahman
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
| | - Md Khalequzzaman
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh.
| | - Fahmida Afroz Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
| | - Shahrin Emdad Rayna
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
| | - Sharraf Samin
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
| | - Md Hasan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
| | - Syed Shariful Islam
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Room # 309, Block # B, Shahbag, Dhaka, 1000, Bangladesh
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Yadav UN, Ghimire S, Mistry SK, Shanmuganathan S, Rawal LB, Harris M. Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study. BMJ Open 2021; 11:e041728. [PMID: 33632751 PMCID: PMC7908905 DOI: 10.1136/bmjopen-2020-041728] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study's objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors. DESIGN This was a community-based cross-sectional study conducted between January and April 2018. SETTING Rural municipalities of Sunsari and Morang districts in eastern Nepal. PARTICIPANTS 794 older Nepalese adults, 60 years and older, were recruited using a multistage cluster sampling approach. PRIMARY OUTCOME MEASURES Prevalence of four major non-communicable chronic conditions (osteoarthritis, cardiovascular disease, diabetes and chronic obstructive pulmonary disease (COPD) and multimorbidity. RESULTS Almost half (48.9%: men 45.3%; women 52.4%) of the participants had at least one of four non-communicable chronic conditions, and 14.6% (men 12.5%; women 16.8%) had two or more conditions. The prevalence of individual conditions included: osteoarthritis-41.7% (men 37.5%; women 45.9%), cardiovascular disease-2.4% (men 2.8%; women 2.0%), diabetes-5.3% (men 6.0%; women 4.6%) and COPD-15.4% (men 13.3%; women 17.5%). In the adjusted model, older adults aged 70-79 years (adjusted OR (AOR): 1.62; 95% CI: 1.04 to 2.54), those from Madhesi and other ethnic groups (AOR: 1.08; 95% CI: 1.02 to 1.72), without a history of alcohol drinking (AOR: 1.53; 95% CI: 1.18 to 2.01) and those physically inactive (AOR: 5.02; 95% CI: 1.47 to 17.17) had significantly higher odds of multimorbidity. CONCLUSIONS This study found one in seven study participants had multimorbidity. The prevalence of multimorbidity and associated socioeconomic and behavioural correlates need to be addressed by integrating social programmes with health prevention and management at multiple levels. Moreover, a longitudinal study is suggested to understand the temporal relationship between lifestyle predictors and multimorbidity among older Nepalese adults.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
- Center for Research Policy and Implementation, Biratnagar, Nepal
- Torrens University, Sydney, New South Wales, Australia
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, Ohio, USA
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Selvanaayagam Shanmuganathan
- Torrens University, Sydney, New South Wales, Australia
- Menzies Centre for Health Policy, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Lal B Rawal
- School of Health Medical and Allied Sciences, Central Queensland University-Sydney Campus, Sydney, New South Wales, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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Alsayyad E, Helmy AA, Kishk NA, Farghaly M, Ragab AH, El-Jaafary SI. Gender difference in health issues and cognitive functions among an Egyptian normal elderly population. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-0146-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Aging is associated with changes in cognitive functions. However, many other factors may affect cognitive functions and this interaction needs further assessment.
Objectives
To detect gender differences in sleep quality, nutritional status, and health-related quality of life and their impact on performance in verbal fluency tasks among apparently healthy elderly.
Subjects and methods
The study was conducted on 102 normal aged subjects, 51 males and 51 females. Subjects were divided according to age into group ≥ 60 years and group < 60 years as a control. They were subjected to clinical assessment, Medical outcome study Short-Form 36-item Health Survey, Pittsburgh sleep quality index, mini nutritional assessment and Category Verbal fluency for animals and girls’ names.
Results
Among the older group, females had significantly poorer physical and mental health, sleep quality and nutritional status than males (p value 0.001, 0.003, 0.012, and 0.014, respectively). Older females had significantly lower performance in verbal fluency (girls’ names) compared to younger females (p value 0.013), but no significant gender difference was found among the older group. Verbal fluency tasks are correlated to the level of education in both males and females (r 0.392 and 0.42, p value 0.029 and 0.019, respectively), However, in older males, it is also correlated to sleep latency (r 0.41 and p value 0.021).
Conclusion
Older females had poorer sleep quality, lower health-related quality of life and lower nutritional status. No gender difference was found in verbal fluency tasks. Although no single variable could independently affect verbal fluency, education remains the main player in the difference in performance.
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Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: a scoping review. Nutr Res Rev 2020; 34:107-116. [PMID: 32727634 DOI: 10.1017/s0954422420000189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Low socio-economic status (SES) is often associated with various health-related problems. Therefore, the present paper aims to review the available literature to identify the prevalence of malnutrition, prevalence of poor diet quality and its associated risk factors among older adults with low SES. A literature search was performed using four databases, namely PubMed, Google Scholar, Springer and Science Direct. The search terms used were 'diet quality', 'nutritional status', 'dietary intake', 'overweight', 'obesity', 'underweight', 'older people' and 'low socioeconomic status (SES)'. The overall prevalence of undernutrition among older adults with low SES worldwide was in the range of 28·9 to 48 %, while overnutrition was reported to be between 8·1 to 28·2 %. In Asia, the prevalence of undernourished older adults ranged from 3 to 64·9 %, while 2·5 to 32·8 % were overnourished. Most of the studies (60 %) included in the present review used BMI as the tool to identify malnutrition, but none of the nutritional screening tools were considered to be the 'gold standard'. For dietary assessment, FFQ and multiple 24 h dietary recall improved the estimation of individual dietary intake. Risk factors for poor diet quality included financial hardship, functional limitation, sex, place of residence, smoking and oral health. Poor nutritional status, especially lack of good-quality diet, and thinness are prevalent among older adults with low SES. Hence, it is important to establish nutrition-related programmes and intervention studies among this group of individuals for improving their health status and quality of life.
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Singh DR, Ghimire S, Jeffers EM, Singh S, Nath D, Szabo S. Food insecurity among senior citizens in high out-migration areas: evidence from Western Nepal. BMC Nutr 2020; 6:31. [PMID: 32577295 PMCID: PMC7304115 DOI: 10.1186/s40795-020-00356-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 06/15/2020] [Indexed: 01/08/2023] Open
Abstract
Background Food insecurity is a critical public health challenge, particularly in low- and middle-income countries such as Nepal. The demographic transition has resulted in a growing population of senior citizens. However, the determinants of food insecurity among Nepali senior citizens remain unknown. This study aims to fill this gap by assessing food insecurity among the older populations in the far-western region, one of the poorest regions of the country. Further, we also aim to assess the potential association between adult children's migration and the food insecurity status of the left behind older parents. Methods A community-based cross-sectional study was conducted among 260 randomly selected senior citizens in the Kanchanpur district in far-western Nepal. The short form of the household food security scale, originally developed by the United States Department of Agriculture, was used to measure household food security. Associations were examined by logistic regression. Results The prevalence of food insecurity in senior citizens' households was 41.1%. Senior citizen households with their adult children's migration (AOR = 0.47, 95% CI: 0.24-0.95) had lower odds of being food insecure whereas households with lower family income (<$100 compared to ≥ $100) had two times higher odds of being food insecure (AOR = 2.26, 95% CI: 1.08-4.76). Also, households owning a cultivable land/farm (AOR = 0.14, 95% CI: 0.05-0.40), primary source of income as service/pension (AOR = 0.26, 95% CI: 0.08-0.89) or business (AOR = 0.15, 95% CI: 0.03-0.59) and participants who received geriatric allowances (AOR = 0.05, 95% CI = 0.01-0.16) had lower odds of being food insecure. Conclusion The prevalence of food insecurity among households with a senior citizen in Kanchanpur district was high and associated with the migration status of adult children, and household socioeconomic status. This calls for a greater policy response focused specifically on households with older adults and the integration of gerontological evidence into the existing food security and nutrition strategies.
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Affiliation(s)
- Devendra Raj Singh
- Department of Public Health, Asian College for Advance Studies, Purbanchal University, Satdobato, Lalitpur, Nepal.,Southeast Asian Development Actions Network (SADAN), Lalitpur, Nepal
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH USA
| | - Eva M Jeffers
- Colorado School of Public Health at the University of Northern Colorado, Greeley, CO USA
| | - Sunita Singh
- Central Department of Home Science, Padma Kanya Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Dhirendra Nath
- Southeast Asian Development Actions Network (SADAN), Lalitpur, Nepal
| | - Sylvia Szabo
- Department of Development and Sustainability, Asian Institute of Technology, Khlong Luang, Pathum Thani, Thailand
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Shrestha N, Mishra SR, Ghimire S, Gyawali B, Pradhan PMS, Schwarz D. Application of single-level and multi-level modeling approach to examine geographic and socioeconomic variation in underweight, overweight and obesity in Nepal: findings from NDHS 2016. Sci Rep 2020; 10:2406. [PMID: 32051421 PMCID: PMC7016110 DOI: 10.1038/s41598-019-56318-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/27/2019] [Indexed: 11/09/2022] Open
Abstract
Nepal's dual burden of undernutrition and over nutrition warrants further exploration of the population level differences in nutritional status. The study aimed to explore, for the first time in Nepal, potential geographic and socioeconomic variation in underweight and overweight and/or obesity prevalence in the country, adjusted for cluster and sample weight. Data came from 14,937 participants, including 6,172 men and 8,765 women, 15 years or older who participated in the 2016 Nepal Demography and Health Survey (NDHS). Single-level and multilevel multi-nominal logistic regression models and Lorenz curves were used to explore the inequalities in weight status. Urban residents had higher odds of being overweight and/or obese (OR: 1.89, 95% CI: 1.62-2.20) and lower odds of being underweight (OR: 0.81, 95% CI: 0.70-0.93) than rural residents. Participants from Provinces 2, and 7 were less likely to be overweight/obese and more likely to be underweight (referent: province-1). Participants from higher wealth quintile households were associated with higher odds of being overweight and/or obese (P-trend < 0.001) and lower odds of being underweight (P-trend < 0.001). Urban females at the highest wealth quintile were more vulnerable to overweight and/or obesity as 49% of them were overweight and/or obese and nearly 39% at the lowest wealth quintile were underweight.
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Affiliation(s)
- Nipun Shrestha
- Institute for Health and Sport (IHeS), Victoria University, Melbourne, Australia
| | | | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, USA
| | - Bishal Gyawali
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pranil Man Singh Pradhan
- Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Dan Schwarz
- Nyaya Health Nepal, Kathmandu, Nepal.,Ariadne Labs, Harvard T.H. Chan School of Public Health and Brigham and Women's Hospital, Boston, MA, USA.,Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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Ghimire S, Singh DR, Nath D, Jeffers EM, Kaphle M. Adult Children's Migration and Well-being of Left Behind Nepalese Elderly Parents. J Epidemiol Glob Health 2019; 8:154-161. [PMID: 30864757 PMCID: PMC7377568 DOI: 10.2991/j.jegh.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/25/2018] [Indexed: 11/01/2022] Open
Abstract
The objective of this study is to assess whether adult children's migration is associated with overall well-being of left-behind elderly parents in Nepal. A cross-sectional house-to-house survey was conducted among 260 community-dwelling elderly residents of Krishnapur municipality, Nepal. Binary logistic regression was used to identify whether migration of adult children was associated with elderly parent's self-reported chronic diseases, depressive symptoms, perceived loneliness and social support. More than half of the study household (51.2%) had at least one adult migrant child. Compared to participants without a migrant child, participants with a migrant child had higher odds of self-reported chronic diseases (OR = 1.79, 95%CI: 0.91-3.54), presence of depressive symptoms (OR = 1.07, 95%CI: 0.64-1.77), and self-perceived loneliness (OR = 1.23, 95%CI: 1.06-1.42) but except for loneliness, the odds ratio for other indicators of well-being were not statistically significant. Although the literature posits an inverse relationship between adult children's migration and the overall well-being of the elderly parents, in our study, adult children's migration was not associated with inverse health outcomes among study participants. However, from a policy perspective, it should be understood that these observations may be transient since the family structure of Nepalese society is rapidly changing.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal
| | - Devendra Raj Singh
- Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Dhirendra Nath
- National Open College, Pokhara University, Lalitpur, Nepal.,Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
| | - Eva M Jeffers
- Colorado School of Public Health at the University of Northern Colorado, CO, USA
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Validity of Nutritional Screening Tools for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2019; 20:1351.e13-1351.e25. [PMID: 31409560 DOI: 10.1016/j.jamda.2019.06.024] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/23/2019] [Accepted: 06/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this systematic review was to summarize the validity of nutritional screening tools to detect the risk of malnutrition in community-dwelling older adults. DESIGN A systematic review and meta-analysis. The protocol for this systematic review was registered in the PROSPERO database (CRD42017072703). SETTING AND PARTICIPANTS A literature search was performed in PubMed, EMBASE, CINAHL, and Cochrane using the combined terms "malnutrition," "aged," "community-dwelling," and "screening." The time frame of the literature reviewed was from January 1, 2001, to May 18, 2018. Older community-dwellers were defined as follows: individuals with a mean/median age of >65 years who were community-dwellers or attended hospital outpatient clinics and day hospitals. All nutritional screening tools that were validated in community-dwelling older adults against a reference standard to detect the risk of malnutrition, or with malnutrition, were included. MEASURES Meta-analyses were performed on the diagnostic accuracy of identified nutritional screening tools validated against the Mini Nutritional Assessment-Long Form (MNA-LF). The symmetric hierarchical summary receiver operating characteristic models were used to estimate test performance. RESULTS Of 7713 articles, 35 articles were included in the systematic review, and 9 articles were included in the meta-analysis. Seventeen nutritional screening tools and 10 reference standards were identified. The meta-analyses showed average sensitivities and specificities of 0.95 (95% confidence interval [CI] 0.75-0.99) and 0.95 (95% CI 0.85-0.99) for the Mini Nutritional Assessment-Short Form (MNA-SF; cutoff point ≤11), 0.85 (95% CI 0.80-0.89) and 0.87 (95% CI 0.86-0.89) for the MNA-SF-V1 (MNA-SF using body mass index, cutoff point ≤11), 0.85 (95% CI 0.77-0.89) and 0.84 (95% CI 0.79-0.87) for the MNA-SF-V2 (MNA-SF using calf circumference instead of body mass, cutoff point ≤11), respectively, using MNA-LF as the reference standard. CONCLUSIONS AND IMPLICATIONS The MNA-SF, MNA-SF-V1, and MNA-SF-V2 showed good sensitivity and specificity to detect community-dwelling older adults at risk of malnutrition validated against the MNA-LF. Clinicians should consider the use of the cutoff point ≤11 on the MNA-SF, MNA-SF-V1, and MNA-SF-V2 to identify community-dwelling older adults at risk of malnutrition.
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Poda GG, Hsu CY, Rau HH, Chao JCJ. Impact of socio-demographic factors, lifestyle and health status on nutritional status among the elderly in Taiwan. Nutr Res Pract 2019; 13:222-229. [PMID: 31214290 PMCID: PMC6548706 DOI: 10.4162/nrp.2019.13.3.222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/OBJECTIVES Aging is an imperative problem for many countries in this century, and presents several challenges for the maintenance of good nutritional status. This study aims to assess the impact of socio-demographic factors, lifestyle and health status on the nutritional status among the elderly in Taiwan. SUBJECTS/METHODS A cross-sectional study was carried out in Taiwan. Data were obtained from the Mei Jau Health Management Institution, which is a private health evaluation provider with multiple health screening centers in Taiwan and Asia. This study included 7947 adults aged 65 years or above. The data were extracted between 2001 to 2010. Nutritional status was assessed using anthropometric data, biochemical data and dietary intake information. RESULTS Among the 7947 participants with mean age of 70.1 (SD = 4.5) years, 20.2%, 6.6%, 10.5% and 52.5% experienced underweight, protein malnutrition, anemia and inadequate dietary intake in the past month, respectively. Age was negatively correlated with body weight (r = -0.19, P = 0.02), body mass index (r = -0.41, P < 0.001), albumin level (r = -0.93, P < 0.001) and hemoglobin level (r = -0.30, P = 0.008). Age above 70 years, gender, unmarried status, retirement, lack of education, low family income, smoking, alcohol drinking, sleep duration of 6-8 hours, vegetarian diet, multiple medications, comorbidity and dysphagia were positively associated with malnutrition in older adults. CONCLUSIONS Underweight and inadequate dietary intake are prevalent among the elderly in Taiwan. Vegetarian diet, multiple medications, comorbidity, dysphagia and lifestyle factors such as smoking, alcohol drinking and sleep duration of 6-8 hours are risk factors for undernutrition in older adults.
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Affiliation(s)
- Ghislain G Poda
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Ministry of Health, Avenue of Burkina, Ouagadougou 7035, Burkina Faso
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei 112, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Hsiao-Hsien Rau
- Joint Commission of Taiwan, 5F, No. 31, Sec. 2, Sanmin Rd., Banqiao Dist., New Taipei City 220, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Master Program in Global Health and Development, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan.,Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
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Wong MMH, So WKW, Choi KC, Cheung R, Chan HYL, Sit JWH, Ho B, Li F, Lee TY, Chair SY. Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community. BMC Geriatr 2019; 19:138. [PMID: 31122189 PMCID: PMC6533669 DOI: 10.1186/s12877-019-1148-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background Although China is undergoing rapid economic development, it is facing an ageing population. No data exists on malnutrition risks of older adults in an affluent Chinese society. The aim of this study is to examine these risks and identify their associated factors among home-living older Chinese adults in Hong Kong. Methods This is a cross-sectional study, to which home-living subjects aged 60 or above were recruited, between May and September 2017, from a non-governmental community organisation located in three different districts of Hong Kong. Nutritional status was assessed by the Mini Nutritional Assessment (MNA), and its associated factors examined included socio-demographic characteristics, lifestyle, health status and diet. Multivariable logistic regression analysis was performed to identify factors associated with malnutrition risks (MNA < 24). Results Six hundred thirteen subjects (mean age: 78.5 ± 7.4; 54.0% females) completed the survey. Nearly 30% (n = 179) were at risk of malnutrition. By multivariable logistic regression, subjects (1) whose vision was only fair or unclear, (2) with poor usual appetite and (3) with main meal skipping behaviour had significantly higher malnutrition risk (all p < 0.05). Conclusions In this affluent Chinese society, the malnutrition risk in older adults is close to the global average, which is a matter for much concern. Interventions are therefore warranted that target vulnerable groups with poor vision, appetite, and meal skipping behaviour. Trial registration Not applicable.
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Affiliation(s)
- Martin M H Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Regina Cheung
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Helen Y L Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Janet W H Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Brenda Ho
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Francis Li
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Tin Yan Lee
- The Neighbourhood Advice-Action Council, North Point, Hong Kong, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Tamang MK, Yadav UN, Hosseinzadeh H, Kafle B, Paudel G, Khatiwada S, Sekaran VC. Nutritional assessment and factors associated with malnutrition among the elderly population of Nepal: a cross-sectional study. BMC Res Notes 2019; 12:246. [PMID: 31039794 PMCID: PMC6492417 DOI: 10.1186/s13104-019-4282-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/25/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This study aimed at assessing the nutritional status among the elderly population and factors associated with malnutrition in the community setting in rural Nepal. Results Out of 339 participants, 24.8% (95% CI 20.21–29.30) fell into the normal nutritional status range; 49.6% (95% CI 44.29–54.91) were at risk for malnutrition while 24.8% (95% CI 20.21–29.30) were in the malnourished range, based on Mini Nutritional Assessment scores. Our findings revealed that belonging to a Dalit community, being unemployed, having experience of any form of mistreatment, lack of physical exercise, experiencing problems with concentration in past 30 days and taking medication for more than one co-morbidity was significantly associated with the malnutrition status of the elderly.
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Affiliation(s)
- Man Kumar Tamang
- Department of Nutrition and Dietetics, Central Campus of Technology, Tribhuvan University, Dharan, Nepal
| | - Uday Narayan Yadav
- Forum for Health Research and Development, Dharan, Nepal. .,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | - Hassan Hosseinzadeh
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Bharat Kafle
- Central Department of Population Studies, Tribhuvan University, Kirtipur, Bagmati, Nepal
| | - Girish Paudel
- Forum for Health Research and Development, Dharan, Nepal
| | - Saroj Khatiwada
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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Bahat G, Kilic C, Ilhan B, Karan MA, Cruz-Jentoft A. Association of different bioimpedanciometry estimations of muscle mass with functional measures. Geriatr Gerontol Int 2019; 19:593-597. [PMID: 31006968 DOI: 10.1111/ggi.13668] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/07/2019] [Accepted: 03/20/2019] [Indexed: 11/27/2022]
Abstract
AIM To investigate the muscle mass adjustment technique that best correlates with functional measures. METHODS A cross-sectional study was designed. Community-dwelling older adults aged ≥60 years were assessed for body composition and functional measures between November 2012 and July 2017 in the geriatric outpatient clinic of a university hospital. Body composition was assessed with bioimpedance analysis. Skeletal muscle mass (SMM) was adjusted by height2 , weight or body mass index (BMI). Functional and disability measures included handgrip strength assessed by a Jamar hydraulic hand dynamometer, gait speed by 4-m usual gait speed, frailty by the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight scale score, activities of daily living (ADL) and instrumental ADL scores. Nutrition was evaluated by the Mini Nutritional Assessment - Short Form. RESULTS A total of 1437 older adults (458 men, 979 women) with a mean age of 74.6 ± 7.0 years were included. The prevalences of low muscle mass were 2.4%, 47.8% and 20.3% when SMM was adjusted by height2 , weight and BMI, respectively. Multivariate analyses adjusted for age, number of diseases, drugs and the Mini Nutritional Assessment - Short Form score revealed that when the SMM was adjusted by BMI, low muscle mass showed better associations with grip strength, gait speed, ADL, instrumental ADL and frailty than the height2 or the weight-adjusted SMM. CONCLUSIONS SMM adjustment by BMI to designate low muscle mass was better associated with functional and disability measures than adjustment by height2 and weight. The present results put forward the SMM index (by BMI) as the best adjustment method for SMM. These findings might be relevant for defining both sarcopenia and malnutrition. Geriatr Gerontol Int 2019; 19: 593-597.
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Affiliation(s)
- Gulistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Cihan Kilic
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Birkan Ilhan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Mehmet A Karan
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
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Ghimire S, Shrestha N, Callahan KE, Nath D, Baral BK, Lekhak N, Singh DR. Undergraduate nursing students' knowledge of aging, attitudes toward and perceptions of working with older adults in Kathmandu Nepal. Int J Nurs Sci 2019; 6:204-210. [PMID: 31406893 PMCID: PMC6608660 DOI: 10.1016/j.ijnss.2019.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 11/06/2022] Open
Abstract
Objectives This study aims to examine Nepalese undergraduate nursing students’ knowledge of aging, attitudes towards older adults and perceptions of working with older adults, and to assess differences in these outcomes by socio-demographic characteristics as well as type of nursing program. Methods A cross-sectional study was conducted among 385 undergraduate nursing students in six nursing colleges located in the Kathmandu Valley. Knowledge of aging, attitudes toward older adults and perceptions of working with older adults were assessed using standardized tools, the Palmore Facts on Aging Quiz, Kogan's Attitudes towards Older People Scale, and Nolan's Intent to Work with Older People Questionnaire, respectively. Results The mean knowledge scores on older adults and aging were relatively low; participants scored an average of 26.9 out of 50. Scores assessing attitudes towards and perceptions of working with older adults were more favorable. Compared to students pursuing a Bachelor of Science in Nursing (BSN), students pursuing a Bachelor of Nursing (BN) had a significantly higher score on the knowledge, attitudes and perception of aging scales. Linear regression analyses showed that the students’ knowledge of aging (β = 0.55; 95% CI = 0.25–0.86) and perceptions of working with older adults (β = 0.22; 95% CI = 0.05–0.38) had a significant positive association with their attitudes toward older adults. Conclusions Undergraduate nursing students in the Kathmandu Valley of Nepal displayed a relatively low level of knowledge, but a positive attitude towards older adults, and a positive perception of working with older adults. Observed differences in knowledge, attitude, and perception scores between students in BSN and BN programs needs further investigation; closing this gap may be important for bolstering undergraduate gerontological preparation in Nepal.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal.,School of Public Health, University of Nevada, Las Vegas, USA
| | - Nitisha Shrestha
- Asian College for Advanced Studies, Purbanchal University, Lalitpur, Nepal
| | | | - Dhirendra Nath
- Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
| | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | | | - Devendra Raj Singh
- Asian College for Advanced Studies, Purbanchal University, Lalitpur, Nepal
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Lin YM, Wang M, Sun NX, Liu YY, Yin TF, Chen C. Screening and application of nutritional support in elderly hospitalized patients of a tertiary care hospital in China. PLoS One 2019; 14:e0213076. [PMID: 30849099 PMCID: PMC6407756 DOI: 10.1371/journal.pone.0213076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/14/2019] [Indexed: 12/25/2022] Open
Abstract
Background Malnutrition is very common in elderly patients admitted to the hospital. The aim of our study is to assess the nutritional status of elderly patients and the use of nutritional support in a tertiary care hospital in China and to analyze the impacts of nutritional status and nutritional support on clinical outcomes. Methods Statistical analysis was performed on a sample of 745 elderly patients in the geriatric medicine department of Qilu Hospital of Shandong University from March 2012 to March 2015. The Nutrition Risk Screening 2002 (NRS 2002) and Mini Nutritional Assessment-short forms (MNA-SF) were utilized for the nutritional risk screening at admission. Personal information, anthropometric measurements, laboratory tests, nutritional support and clinical outcomes were recorded. Comparisons were carried out to analyze impacts on clinical outcomes and prognosis based on incidence rate of nutritional risk, nutritional support rate, and different methods of support. Results NRS 2002 and MNA-SF were utilized to screen for nutritional risk at admission. The results of this screening were 39.81% and 44.10%, respectively. Based on the results of the MNA-SF, 33.38% of elderly patients were at risk of malnutrition and 5.5% were malnourished. The incidence of nutritional risk in the departments of Gastroenterology, Hematology, and Respiratory were 51.72%, 46.88%, 43.33%, respectively, higher than in other departments. Patients with nutritional risk were more likely to have a longer hospital stay compared to those without (P < 0.05). The nutritional support rate of patients overall was 16.49%, and the ratio of Parenteral nutrition (PN):Enteral nutrition (EN) was 5.13:1. Patients at nutritional risk had an in-hospital support rate of 29.63% and 28.57%, respectively, identified via screening by NRS 2002 and MNA-SF. Nutritional support rate of patients without nutritional risk was 7.8%(35/449) and 6.96%(29/417), respectively. Patients in the departments of Gastroenterology and Hematology had higher rates of nutritional support than patients in other departments. In addition, results showed that in patients with nutritional risk and malnutrition, nutritional support decreased the length of hospital stay (P<0.05). The patients that received nutritional support also had a lower incidence of infectious complications than the patients without nutritional support (NRS 2002 was 6.82%:18.18% and MNA-SF was 9.57%:20.23%)(P<0.05). Conclusions Undernourishment and nutritional risk in elderly patients at hospital admission is a common occurrence. In the current study, the nutritional risk rate in the Gastroenterology department was higher than in other departments. Patients with normal nutritional status were still receiving nutritional support. Overall, there is a need to better apply nutritional support in the clinical treatment of elderly patients. In elderly patients with nutritional risk and malnutrition, nutritional support reduced the length of hospital stay and the incidence of infectious complications.
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Affiliation(s)
- Ying-Min Lin
- Department of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Min Wang
- Department of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
- Department of Gastroenterology, Geriatrics, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
- * E-mail:
| | - Nuan-Xin Sun
- Jiangxi medical school, Nanchang University, Queen Mary University of London, Nanchang, Jiangxi Province, China
| | - Yan-Yan Liu
- Department of Gastroenterology, Chengyang People’s Hospital, Qingdao, Shandong Province, China
| | - Teng-Fei Yin
- Department of Gastroenterology, Geriatrics, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Chen Chen
- Chen Chen, Donga County people’s Hospital, Liaocheng, Shandong Province, China
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Ghimire S, Mishra SR, Baral BK, Dhimal M, Callahan KE, Bista B, Aryal KK. Noncommunicable disease risk factors among older adults aged 60-69 years in Nepal: findings from the STEPS survey 2013. J Hum Hypertens 2019; 33:602-612. [PMID: 30647463 DOI: 10.1038/s41371-019-0161-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/04/2018] [Accepted: 12/21/2018] [Indexed: 12/21/2022]
Abstract
Both the noncommunicable diseases (NCDs) burden and the population of older adults are increasing in Nepal. This study aims to estimate the prevalence of behavioral and biological risk factors of common NCDs among Nepali older adults aged 60-69 years. A subsample analysis of data from the 2013 Nepal STEPwise approach to Surveillance (STEPS) survey was conducted with 526 older adults aged 60-69 years. STEPS sample weighting and domain analyses were used to include the entire sample for variance estimation and to obtain prevalence estimates and corresponding 95% confidence intervals (CI) for our selected population of older adults. All participants had at least one risk factor for NCDs; about one-fourth had four. Of the eight examined risk factors, inadequate fruit/vegetable intake (98.6%, 95% CI: 96.9-100.0), hypertension (57.2%, 95% CI: 51.0-63.4), and hypercholesterolemia (37.9%, 95% CI: 30.8-44.9) were ranked the three most prevalent risk factors while physical inactivity (2.5%, 95% CI: 1.0-4.0) was least prevalent. Prevalence of smoking was 31% (95% CI: 24.9-37.2), overweight/obesity was 19% (95% CI: 13.1-25.2), alcohol use was 18% (95% CI: 12.2-23.5), diabetes was 15% (95% CI: 8.5-21.4), and 36% (95% CI: 30.9-42.0) of the older participants suffered discomfort due to oral health problems. Several risk factors, including current alcohol consumption, daily servings of fruit/vegetable intake, and overweight/obesity showed signficant variation in prevalence by gender, ethnicity, and place of residence, urban vs. rural. Epidemiological and demographic transitions are two emerging public health issues in Nepal. The baseline information provided by this study on the prevalence of NCD risk factors among Nepali older adults aged 60-69 years can inform policies and programs that focus on maximizing the health and well-being of older adults.
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Affiliation(s)
- Saruna Ghimire
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA.
| | | | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Meghnath Dhimal
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Karen E Callahan
- School of Community Health Sciences, University of Nevada, Las Vegas, NV, 89154, USA
| | - Bihungum Bista
- Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal
| | - Krishna Kumar Aryal
- Nepal Health Sector Programme 3 (NHSP3), Monitoring Evaluation and Operational Research Project, Abt Associates, Lalitpur, Nepal
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Ghimire S, Baral BK, Pokhrel BR, Pokhrel A, Acharya A, Amatya D, Amatya P, Mishra SR. Depression, malnutrition, and health-related quality of life among Nepali older patients. BMC Geriatr 2018; 18:191. [PMID: 30143004 PMCID: PMC6109328 DOI: 10.1186/s12877-018-0881-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 08/15/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Little is known about the health, nutrition, and quality of life of the aging population in Nepal. Consequently, we aimed to assess the nutritional status, depression and health-related quality of life (HRQOL) of Nepali older patients and evaluate the associated factors. Furthermore, a secondary aim was to investigate the proposed mediation-moderation models between depression, nutrition, and HRQOL. METHODS A cross-sectional survey was conducted from January-April of 2017 among 289 Nepali older patients in an outpatient clinic at Nepal Medical College in Kathmandu. Nutritional status, depression and HRQOL were assessed using a mini nutritional assessment, geriatric depression scales, and the European quality of life tool, respectively. Linear regression models were used to find the factors associated with nutritional status, depression, and HRQOL. The potential mediating and moderating role of nutritional status on the relationship between depression and HRQOL was explored; likewise, for depression on the relationship between nutritional status and HRQOL. RESULTS The prevalence of malnutrition and depression was 10% and 57.4% respectively; depression-malnutrition comorbidity was 7%. After adjusting for age and gender, nutritional score (β = 2.87; BCa 95%CI = 2.12, 3.62) was positively associated and depression score (β = - 1.23; BCa 95%CI = - 1.72, - 0.72) was negatively associated with HRQOL. After controlling for covariates, nutritional status mediated 41% of the total effect of depression on HRQOL, while depression mediated 6.0% of the total effect of the nutrition on HRQOL. CONCLUSIONS A sizeable proportion of older patients had malnutrition and depression. Given that nutritional status had a significant direct (independently) and indirect (as a mediator) effect on HRQOL, we believe that nutritional screening and optimal nutrition among the older patients can make a significant contribution to the health and well-being of Nepali older patients. Nonetheless, these findings should be replicated in prospective studies before generalization.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal
| | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Buddhi Raj Pokhrel
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Asmita Pokhrel
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Anushree Acharya
- Department of Nutrition and Dietetics, College of Applied Food and Dairy Technology, Purbanchal University, Kathmandu, Nepal
| | - Dipta Amatya
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal
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Ghimire S, Baral BK, Karmacharya I, Callahan K, Mishra SR. Life satisfaction among elderly patients in Nepal: associations with nutritional and mental well-being. Health Qual Life Outcomes 2018; 16:118. [PMID: 29880002 PMCID: PMC5992629 DOI: 10.1186/s12955-018-0947-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/30/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Nepal's demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal's Senior Citizen Act (2006). Our study, abbreviated NepEldQOLII, aims to assess perceived life satisfaction, and evaluate its relationship with nutritional health and mental well-being among the burgeoning Nepalese elderly population. METHODS A cross-sectional survey among 289 Nepalese elderly, aged ≥60 years, attending an outpatient clinic of a hospital in Kathmandu, Nepal was conducted. Nutritional status, depression, and life satisfaction were assessed by a mini-nutritional assessment scale (range: 0-14), a geriatric depression scale (range: 0-15), and a satisfaction with life scale (range: 5-35), respectively. Mediation analyses, adjusted for age, sex, marital status, and family type, were used to assess mediating relationships between nutritional and mental wellbeing with life satisfaction as the outcome. RESULTS Approximately 21% of the participants were dissatisfied with their life. Life satisfaction was positively associated with being married, high family income, involvement in active earning, and a high nutritional score. Conversely, life satisfaction was inversely associated with living in a nuclear (as opposed to joint) family, the perception of having worse health than peers, the perception of being ignored/hated due to old age, and a higher depression score. In mediation analyses, both nutrition (β = 0.48, bias-corrected and accelerated (BCa) 95% CI: 0.27, 0.69) and depression (β = - 0.87, BCa 95% CI: -1.01, - 0.74) had significant direct associations with life satisfaction. Furthermore, both nutrition (β = 0.30, BCa 95% CI: 0.13, 0.49) and depression (β = - 0.07, BCa 95% CI: -0.14, - 0.03) mediate each other's association with life satisfaction. Nutritional score mediated 7% of the total association between depression and life satisfaction; depression mediated 38% of the total association between nutrition and life satisfaction. CONCLUSIONS Life satisfaction shows a pattern of decline as nutritional and mental health status decrease. Both depression and under-nutrition had a significant association with life satisfaction. The pathway by which nutrition affects life satisfaction is influenced by depression as a mediator. Moreover, nutritional status explained a small portion of the relationship between depression and life satisfaction. These observed preliminary findings should be confirmed in future longitudinal studies.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal
| | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Isha Karmacharya
- School of Health and Allied Sciences, Pokhara University, Lekhnath, Nepal
| | - Karen Callahan
- School of Community Health Sciences, University of Nevada Las Vegas (UNLV), 4505 S. Maryland Parkway, Las Vegas, USA
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Ghimire S, Singh DR, Nath D, Jeffers EM, Kaphle M. Adult Children’s Migration and Well-being of Left Behind Nepalese Elderly Parents. J Epidemiol Glob Health 2018. [DOI: 10.1016/j.jegh.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Saruna Ghimire
- Agrata Health and Education (AHEAD)-Nepal, Kathmandu, Nepal
| | - Devendra Raj Singh
- Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Dhirendra Nath
- National Open College, Pokhara University, Lalitpur, Nepal
- Southeast Asia Development Actions Network (SADAN), Lalitpur, Nepal
| | - Eva M. Jeffers
- Colorado School of Public Health at the University of Northern Colorado, CO, USA
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Ghimire S, Pradhananga P, Baral BK, Shrestha N. Factors Associated With Health-Related Quality of Life among Hypertensive Patients in Kathmandu, Nepal. Front Cardiovasc Med 2017; 4:69. [PMID: 29164136 PMCID: PMC5681715 DOI: 10.3389/fcvm.2017.00069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/23/2017] [Indexed: 12/02/2022] Open
Abstract
Introduction Nepal has a high prevalence of hypertension. While improving the overall health-related quality of life (HRQOL) is a central tenet to public health plans in developed nations, this focus has yet to be articulated in Nepal. Therefore, this study aims to identify the factors associated with HRQOL among hypertensive patients in Nepal. Method The EuroQol-5Dimension HRQOL survey was administered to 180 hypertensive patients, attending the outpatient clinic at Shahid Gangalal National Heart Center in Kathmandu, Nepal. Multiple linear regression models, adjusted for age and sex, were used to identify factors associated with HRQOL. Results The mean age and EuroQol visual analytic scale of the participants were 53.2 years and 63.7, respectively. Age [β = −0.56; 95% confidence interval (CI): −0.75 to −0.37], income (β = 0.02; 95% CI: 0.01, 0.03), family size (β = −0.98; 95% CI: −1.89, −0.07), number of antihypertensive drugs use (β = 4.62; 95% CI: 1.33, 7.90), and compliance to dietary salt advise (β = 4.86; 95% CI: 0.29, 9.43) were significant factors associated with HRQOL among participants. In addition, levels of education and self-perceived health were associated in a positive gradient to HRQOL. In mediation analysis, both, dietary low salt compliance and use of antihypertensive drugs, had a significant direct effect on HRQOL, and the use of antihypertensive drugs did not significantly mediate the relationship between dietary salt compliance and HRQOL. Conclusion Various factors were found to be associated with HRQOL among hypertensive patients in Kathmandu. Assessing HRQOL is a valuable technique to identify populations in need of services and interventions. This assessment can serve as a baseline, and in conjunction with multiple stakeholders, can guide public health policy, planning, and practices, especially those aimed toward improving the HRQOL of Nepalese with hypertension.
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Affiliation(s)
- Saruna Ghimire
- Agrata Health Education and Development (AHEAD)-Nepal, Kathmandu, Nepal
| | | | - Binaya Kumar Baral
- Department of Biochemistry, Nepal Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Naveen Shrestha
- Agrata Health Education and Development (AHEAD)-Nepal, Kathmandu, Nepal.,School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
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