Prevalence and Risk factors of Malnutrition among Elderly-A Cross Sectional Study

 

Ninu Sophia¹*, Anu Jacob Kachappillil², Ashitha Jose³, Bibiya P Reji³,

Bincy Varghese³, Bini Saju³, Blessymol Chacko³

¹Assistant Professor, Malankara Orthodox Syrian Church College of Nursing, Kolenchery, Kerala, India

²Assistant Professor, Department of Medical Surgical Nursing, MOSC College of Nursing, Kolenchery.

 

ABSTRACT:

Aim: A cross sectional study was conducted to assess Prevalence and risk factors of malnutrition among elderly in rural areas of Ernakulam district, Kerala. Background: The world health organization has stated that aging population will present new challenges to health care. The health of the elderly will be an important issue defining the health status of a population. Malnutrition is a nutritional disorder that adversely affects the body from a functional or clinical perspective. It is very often observed in the elderly population. Methods: A Quantitative, Cross Sectional study was used to assess the prevalence and risk factors of malnutrition on a sample size of 200 elderly people aged 60-90 years in Aikkaranad Grama Panchayat, Ernakulam district. A non probability convenience sampling technique was used to select the samples for the study. The data was collected using Mini Nutritional Assessment Questionnaire and a Structured Risk Factor Analysis Questionnaire. Results: The study shows that majority (60.5%) of the subjects are at risk of malnutrition and 28% of the subjects are malnourished and remaining 11.5% has normal nutritional status. The study also revealed that there is an association between malnutrition and regular use of medicines(p<0.00), activities of daily living(p<0.00) and instrumental activities of daily living (p< 0.45). Conclusion: The study reveals that 60.5% elderly people were at risk of malnutrition, 28% are malnourished and only 11.5% have normal nutritional status. Study also shows that there was a significant association between nutritional status of elderly people and their regular use of medicines, activities of daily living and instrumental activities of daily living. Being health professionals we recognized the importance of awareness programmes regarding prevention and management of malnutrition to reduce the prevalence of malnutrition.

 

 

 

 

INTRODUCTION:

The world health organization has stated that aging population will present new challenges to health care. The health of the elderly will be an important issue defining the health status of a population.¹ The number of older adults globally is expected to increase from 420 million in 2000 to 974 million in 2030. At present nearly 60% of older adults reside in the developing countries. In India, there has been a sharp increase in the number of elderly: 6.4% of total population of 1.21 billion [2011 census]. According to 2011 census, elderly constitute 5.3% of total population [male 29,364,920 & females 3,291,030]. The likely number of elderly by 2016 will be around 313 million and it is projected that by the year 2015, the number of elderly would be about 324 million. Malnutrition is becoming increasingly more common among the elderly population. This is a cause for concern considering malnutrition negatively affects the health of the older adult.²

 

MATERIAL AND METHODS:

A Quantitative, Cross Sectional study was used to assess the prevalence and risk factors of malnutrition on a sample size of 200 elderly people aged 60-90 years in Aikkaranad Grama Panchayat, Ernakulam district. A non probability convenience sampling technique was used to select the samples for the study. The data was collected using Mini Nutritional Assessment Questionnaire and a Structured Risk Factor Analysis Questionnaire.

 

RESULTS:

Section A: Description of sample characteristics.

 

Table 1: Frequency (f) and percentage (%) distribution of selected demographic variables (n=200)

SL. No	Socio demographic variables		Frequency (f)	Percentage (%)
1	Gender	Male	101	50.5
		Female	99	49.5
2	Religion	Christian	120	60
		Hindu	80	40
3	Family Type	Nuclear	197	98.5
		Joint	3	1.5
4	Marital Status	Married	162	81
		Others	38	19
5	Monthly Income	<7000	121	60.5
		>7000	79	39.5
6	Education	Higher Education	21	10.5
		High School	75	37.5
		Primary School	79	39.5
		Illiterate	25	12.5
7	Alcohol	Absent	131	65.5
		Present	68	34
8	Smoking	Absent	128	64
		Present	72	36
9	Pension	Yes	169	84.5
		No	31	15.5
10	Diseases	Yes	42	21
		No	158	79
11	Medication	Yes	104	52
		No	96	48
12	Activities of daily Living	Yes	182	91
		No	18	9
13	Instrumental Activities of Daily Living	Yes	74	37
		No	126	63

 

Table.1. reveals with regards to gender that, most of the subjects 101 (50.5%) were males and majority were christians 120 (60%). Majority of the subjects belongs to nuclear family 197 (98.5%) and 162 (81%) were married. Most of the subjects 121 (60.5%) had monthly income <7000 and 79 (39.5%) had only primary school education. Majority of the subjects 131 (65.5%) are non alcoholic and 128 (64%) are non smokers. Most of the subjects 169 (84.5%) have pension. Majority of the subjects 158 (79%) had diseases and 104 (52%) were taking regular medications. Majority of the subjects 182 (91%) are able to do activities of daily living and 126 (63%) are not able to do instrumental activities of daily living.

 

Section B: Prevalence and risk factors of malnutrition among elderly.

 

Table 2: Nutritional status of elderly (n=200)

Mini nutritional assessment scale	Frequency (f)	Percentage (%)
Normal nutritional status	23	11.5
At risk of malnutrition	121	60.5
Malnourished	56	28

 

 

Section C: Association between prevalence and selected socio demographic variables

 

Table 3: Association between the nutritional status of elderly people with their selected demographic variables. (n=200)

Variable		Nutritional Status			Chi Square/ Fishers exact test	p value
		Malnourished	At Risk of Malnutrition	Normal Nutritional Status
Gender	Male	30	58	13	0.86	0.65
	Female	26	63	10
Religion	Christian	34	72	14	0.03	0.98
	Hindu	22	49	9
Family Type	Nuclear	54	120	23	2.35	0.31
	Joint	2	1	0
Marital status	Married	42	101	19	1.83	0.40
	Others	14	20	4
Monthly Income	<7000	38	72	11	2.87	0.24
	>7000	18	49	12
Education	Higher education	7	11	3	5.67	0.46
	High school	19	46	10
	Primary school	20	53	6
	Illiterate	10	11	4
Alcohol	Absent	37	80	14	0.29	0.88
	Present	19	40	9
Smoking	Absent	36	78	14	0.11	0.95
	Present	20	43	9
Pension	Yes	45	103	21	1.58	0.45
	No	11	18	2
Diseases	Yes	10	29	3	1.85	0.39
	No	46	92	20
Medicine	Yes	16	69	19	22.17	*p<0.001
	No	40	52	4
Activities of daily living	Yes	43	116	23	19.59	*p<0.001
	No	13	5	0
Instrumental activities of daily living	Yes	18	52	4	6.2	*p<0.001
	No	38	69	19

* Significant (P<=0.05)

 

Inference:

The table shows that there is a significant association between nutritional status of elderly people with medicines, ADL, IADL. Null hypothesis is rejected and research hypothesis is accepted. And none of the other selected demographic variables were found significant.

 

DISCUSSION:

In our study, 60.5% were at risk of malnourishment, 28% were malnourished and only 11.5% had normal nutritional status. In a Cross sectional study conducted by Ayon Ghosh, Aparajita Dasgupta, Bobby Paul, Sembagamuthu, Bijit Biswas, Nazrul Mallik in West Bengal to explore the screening for malnutrition among 114 elderly people. It is found that the majority of samples 50% were at risk of malnutrition and 31.2% were malnourished.³ A Cross Sectional study was conducted by S. Chitrasena, R. Ramaubramaniam, conducted in Tamilnadu, to explore the prevalence of malnutrition among elderly persons. The study shows that majority of the findings 47.4% were at risk of malnutrition and 2.9% were malnourished.⁴

 

In our study, malnutrition had a significant association was found with regular use of medicines, activities of daily living, instrumental activities of daily living (p< 0.05). A Cross sectional study was conducted by Mathew AC, Das D, Sampath S, Vijayakumar M, Ramakrishnan N, Ravishankar SL in coimbatore to explore the prevalence and correlates of malnutrition among 154 elderly. The study shows that there was significant association between malnutrition and instrumental activities of daily living (p< 0.05).

 

CONCLUSION:

A study was conducted to assess the prevalence and risk factors of malnutrition among elderly of Aikkaranadu Grama Panchayat, Kolenchery. After the data collection, data were analyzed, interpreted and tabulated. The study reveals that 60.5% elderly people were at risk of malnutrition, 28% are malnourished and only 11.5% have normal nutritional status. Study also shows that there was a significant association between nutritional status of elderly people and their regular use of medicines, activities of daily living and instrumental activities of daily living. Being health professionals we recognized the importance of awareness programmes regarding prevention and management of malnutrition to reduce the prevalence of malnutrition.

 

ACKNOWLEDGEMENT:

Here we extend our sincere thanks to all the elderly people who participated in the study.

 

CONFLICT OF INTEREST:

The authors declare no conflict of interest in the study.

 

REFERENCE:

1.      Van Lerberghe W. The world health report 2008: primary health care: now more than ever. World Health Organization; 2008

2.      Lewis, Dirksen, Heitkemper, Bucher Lewis`s Medical Surgical Nursing Second South Asian Edition Volume-1, Elsevier publications Page no: 59.

3.      Ghosh A, Dasgupta A, Paul B, Sembiah S, Biswas B, Mallik N. Screening for Malnutrition among the Elderly with MNA Scale: A Clinic based Study in a Rural Area of West Bengal. Journal of Contemporary Medical Research. 2017; 4(9):1978-82.

4.      Chitrasena S, Ramasubramaniam R. A prevalence study on malnutrition among elderly persons of kancheepuram district in Tamilnadu.

 

 

 

 

 

Received on 18.07.2019         Modified on 13.08.2019

Accepted on 08.09.2019      ©A&V Publications All right reserved