ASSESSMENT OF NUTRITIONAL RISK IN OLDER ADULTS (65 YEARS AND ABOVE) IN EZINIHITTE AND OBOWO LOCAL GOVERNMENT AREAS OF IMO STATE.

 

 

Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients (World Health Organization WHO, 2016). It is more common and increasing in the older population with a report of 16% of those >65 years and 2% of those >85 years classed as malnourished (Office of National Statistics ONS, 2004). These figures are predicted to rise dramatically in the next 30 years (ONS, 2004).

Elderly people in developing countries are vulnerable to health related predicaments associated with low income society, poor eating pattern, under nutrition, over nutrition, chronic illness and diseases (World Health Organization, 2009). Poverty remains a major contributory factor to many of the diet-related disorders among the elderly (WHO, 2009). Nutritional status of the elderly is influenced by the ageing process (Roberts and Rosenberg, 2006). Malnutrition is a common problem among older people living in geriatric nursing homes (Johansson et al., 2014). This affects 37% of institutionalized elderly in Europe (Guigoz et al., 2013). Malnutrition in the elderly may be associated with diseases, social and financial conditions, and frequent hospitalization, functional status, psychological conditions, diminished sense of taste and smell (Arellano et al., 2004). This can be worsened with the possibilities associated with chronic diseases of lifestyle (Shlisky, 2017).   Most elderly people (60+) are prone to the consumption of fatty and sugary foods because they are most affordable and tasty (Canon, 2001).  They are also vulnerable to abuse and neglect from family members and caregivers (Leiknes et al., 2015). Income is another major hindrance for the elderly people to eat well and have normal nutrition (Ferreira, 2014 and Bohman et al., 2017). 

Malnutrition is a great hazard to which the aged appears to be more vulnerable than the younger age groups due to problems relating to ignorance on appropriate food choices, loneliness, social isolation which often times lead to depression, apathy, lack of appetite, physical disabilities, cardiovascular problems and poverty among others (Vesnaver and Keller, 2011). According to World Health Organization, the elderly are defined as persons above the age of 60 years with women comprising a majority of this population (WHO, 2010). The elderly population in the recent decade especially in Africa and other developing countries appear to be increasing (Charlton and Rose, 2013). Govender (2011) noted that the elderly are the gemstones of any society that are often ignored. Their care and wellbeing especially in rural communities depend largely on their children, relatives and sometimes government resources which places a huge financial burden on their caregivers with a consequent lack in adequately providing for the nutritional and health needs of the aged in their care (Govender, 2011). Inadequate household food security, war and famine, and the indirect impact of HIV infection and AIDS among others have been documented as important determinants of poor nutritional status of elderly Africans (Charlton et al., 2001). All these increases in the cost of living affects to a great extent dietary intakes and nutritional status of not only the general populace, but the often neglected elderly population (Charlton et al., 2001). Furthermore, the vulnerability of the aged being far greater than that of the younger population shows the need for continuous monitoring of the aged with a view to identifying the extent of malnutrition among them in Nigeria. Studies have documented poor nutritional status among the aged (Fadupin, 2012). Similarly, previous studies have documented that the energy and nutrient intakes of the elderly were low compared to recommended dietary allowances (Charlton et al., 2001). Older people are at nutritional risk, not only because of impaired digestion, absorption or utilization of nutrients associated with chronic disease or drug–nutrient interactions, but also due to an interaction between physiological, psychological and socioeconomic factors (Charlton and Rose, 2013). In addition, it is evident that the elderly in developing countries were vulnerable to health related predicaments associated with very low income, inadequate food intakes, poor food patterns, under nutrition, over-nutrition, chronic illness and diseases (WHO, 2009). In many developing countries including Nigeria, there is a dearth of information as well as epidemiological data on the nutritional status of the aged since studies regarding the nutrient intakes of these groups are limited and isolated. Studies on children particularly infants and preschool children appears to be more common than studies on the aged who are equally as vulnerable as young children to changes in social and economic conditions.

Therefore, the great role of nutrition in the maintenance of the health and functional rehabilitation of the elderly has awakened public interest and research. While only little information is available about them in literature in Nigeria (Pirlich and Lochs, 2001).

 

According to World Health Organization (2009), many of the diseases suffered by older persons are the result of dietary factors, some of which have been operating since infancy. These factors are then compounded by changes that naturally occur with the aging process (WHO, 2009). Dietary fats seem to be associated with cancer of the colon, pancreas and prostate (WHO, 2009).

 Atherogenic risk factors such as increased blood pressure, blood lipids and glucose intolerance, all of which are significantly affected by dietary factors, play a significant role in the development of coronary heart disease (WHO, 2009). Degenerative diseases such as cardiovascular disease, diabetes, osteoporosis and cancer, which are among the most common diseases affecting older persons, are all diet-related (WHO, 2009). Increasingly in the diet/disease debate, the role that micronutrients play in promoting health and preventing non communicable disease is receiving considerable attention (WHO, 2009). Micronutrient deficiencies are often common in elderly people due to a number of factors such as their reduced food intake and a lack of varieties in the food they eat (WHO, 2009). Another factor is the price of foods rich in micronutrients, which further discourages their consumptions. Compounding this situation is the fact that the older people often suffer from decreased immune function, which contributes to this group’s increased morbidity and mortality (WHO, 2009). Furthermore, other significant age-related changes include the loss of cognitive function and deteriorating vision, all of which hinder good health and dietary habits in old age (WHO, 2009).

Elevated serum cholesterol, a risk factor for coronary heart disease in both men and women, is common in older people and this relationship persists into very old age (WHO, 2009). Intervention trials have shown that reduction of blood pressure by 6 mm Hg reduces the risk of stroke by 40% and of heart attack by 15% and that a 10% reduction in blood cholesterol concentration will reduce the risk of coronary heart disease by 30% (WHO, 2009).

Dietary changes seem to affect risk-factor levels throughout life and may have even greater impact in older people (WHO, 2009). Relatively modest reductions in saturated fat and salt intake, which would reduce blood pressure and cholesterol concentrations, could have a substantial effect on reducing the burden of cardiovascular disease. Increasing consumption of fruit and vegetables by one to two servings daily could cut cardiovascular risk by 30% (WHO, 2009).

The general objectives of the study is to assess the nutritional risk in older adults in Eziniihite and Obowo Local Government Areas of Imo State.

The specific objectives will be to:

iv.         Determine the anthropometric status of the older adults.

Malnutrition has become a global problem which affects every individual both the poor and affluent, no family is left untouched according to report and findings of Food and Agricultural Organization FAO, 2015). However, nutritional assessment is very essential to achieve a healthy status and to combat malnutrition because it reveals the current state of food and nutrient intake of individuals. Therefore assessing the nutritional risk in older adults will be of great importance to prevent the high degree of morbidity and mortality rates among them.

This study will be of great benefit to medical professionals which include nutritionist, dietitians and clinicians to educate all the population groups on good dietary lifestyle which influences nutritional status. Furthermore, encouraging them to maintain ideal body weight which is the path to healthy living.