ABSTRACT
Nutrition is a fundamental pillar of human life, health and development across the entire life span which why this study determined the nutritional risk factors in older persons from different age groups in Okpe Local Government Area of Delta State, Nigeria. Simple random sampling was used to select 180 respondents. A structure questionnaire was used to elicit information on the respondent’s socioeconomic characteristics and food habit variables. Anthropometric characteristics and nutrition risks were assessed and compare with WHO and MNA reference standards. The date collected were analysed using descriptive statistics and chi square analysis. The result revealed that 14.9% of the older person had normal weight, 45.9% had overweight and 39% were obese, majority (79.4%) of the adult had normal waist circumference, while one fifth of the ( 20.6%) of the respondent are risk of been overweight and 72.4% of the older person had normal waist-Hip Ratio and 27.6% were at risk of been obese. the result also revealed that most (42.4%) of the older person of 60-69 years were at risk of malnutrition, for 70-79 years age group, more than half (58%) of them were malnourished and for 80years and above age group, most(60%) of them was malnourished. The result revealed that the frequency of the dairy food consumption was significantly associated with waist circumference (p=0.04), drinks consumption also has statistically significance associated with the body mass index (BIM) of the older person in the study area and vegetable consumption has statistically significantly associated with body mass index (P=0.04) of the older persons inth3e study area. However, the study confirmed that malnutrition remains a common problem among older persons living in Okpe Local Government Area of Delta State. It is recommended amongst others that older persons should balance their food intake with physical activity. The more active they are, the more food they need. They should also keep an eye on their meal portion size, if they are less active, they should choose smaller serving sizes and add plenty of vegetables, salad and fruit.
TABLE OF CONTENTS
TITLE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGEMENT iv
TABLE OF CONTENTS v
LIST OF TABLES ix
ABSTRACT x
CHAPTER
1
INTRODUCTION
1.1 Background
of the study 1
1.2 Statement of the Problem 2
1.3 Objectives of the Study 3
1.4 Significance of the Study 4
CHAPTER
TWO
LITERATURE
REVIEW
2.1 Concept of Older Adult 5
2.2 Ageing and Nutrition 8
2.3 Nutritional Requirements of Older People 9
2.3.1 Energy 10
2.3.2 Proteins 10
2.3.3 Minerals and vitamins 10
2.3.4 Fluid intake 14
2.4 Assessment of Nutritional Status of Older
People 14
2.4.1 Anthropometric measurements 14
2.4.3 Body
mass index 14
2.4.1.1 Weight 14
2.4.1.2 Height 14
2.4.1.3 Arm span and half span 15
2.4.1.4 Waist circumference 15
2.4.1.5 Waist to hip ratio 16
2.5 Prevalence Studies on
Nutritional Status in Older People in Nigeria and Different Part of the World 16
2.6 Causes of Malnutrition in Older People 20
2.6.1 Immediate causes 20
2.6.2 Underlying causes 21
2.6.3 Basic causes 21
2.7 Risk Factors Associated with Nutrition in
Older People 23
2.7.1 Decreased taste 23
2.7.2 Loss of appetite 23
2.7.3 Financial issues and lack of mobility 25
2.7.4 Nutrient absorption 25
2.7.5 Menopause and prostate problems 25
2.7.6 Heart disease risk 25
2.7.7 Depression and Isolation 26
2.8 Health Consequences of Under and Over
Nutrition in Older People 26
2.8.1 Obesity 26
2.8.2 Weak bones 26
2.8.3 Weak immune system 26
2.8.4 Tooth decay 27
2.8.5 Constipation 27
2.8.6 Decreased brain function 27
2.9 Healthy Nutrition and its
Importance for Older People 27
CHAPTER
THREE
MATERIALS
AND METHODS
3.1 Study Design 30
3.2 Area of Study 30
3.3 Population of the Study 31
3.4 Sampling and Sampling
Techniques 31
3.4.1 Sample size 31
3.4.2 Sampling procedure 32
3.5 Preliminary
Activities 32
3.5.1 Preliminary
visits 32
3.5.2 Training
of research assistants 32
3.6 Data Collection 33
3.6.1 Questionnaire administration 33
3.6.2 Interview 33
3.6.3 Anthropometric Measurement 33
3.6.3.1 Weight
Measurement 34
3.6.3.2 Height
Measurement 34
3.6.2.3
Mid-upper arm circumference 34
3.6.4 Dietary Measurements 34
3.7 Data Analysis 35
3.8 Statistical Analysis 36
CHAPTER FOUR
RESULTS AND DISCUSSIONS
4.1 Socio-demographic Characteristics of
Older Persons 37
4.2 Socio-economic Characteristics of Older
Persons 40
4.3 Food Habits of Older persons 43
4.4 Anthropometric Status of Older Persons 51
4.5 Food
Consumption Patterns of Older Persons 53
4.6 Relationship between Food Habits and Anthropometric
Status of the
Older Persons 58
4.7 Association between MNA Scores and Age
group of Older Persons in the
Study Area 60
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
5.1 Conclusion 63
5.2 Recommendations 64
REFERENCE 65
APPENDIX
LIST OF TABLES
Table 4.1: Socio-demographic characteristics of older persons 39
Table 4.2: Socio-economic characteristics of older persons 39
Table 4.3: Food habits of older persons 52
Table 4.4: Anthropometric status of older persons 56
Table 4.6: relationship between food habits and
anthropometric status of older persons 59
Table 4.7 Association between MNA scores and age group of
older persons in the study area
62
CHAPTER 1
INTRODUCTION
1.1 Background of the study
Nutrition is a
fundamental pillar of human life, health and development across the entire life
span (WHO, 2000). From the earliest stages of fetal development, at birth,
through infancy, childhood, adolescence, and on into adulthood and old age,
proper food and good nutrition are essential for survival, physical growth,
mental development, health and well-being (WHO, 2000). Poor nutrition can lead
to reduced immunity, increased susceptibility to disease, impaired physical and
mental development, and reduced productivity and the major problems of
nutrition in older persons can be defined in terms of under nutrition and being
overweight, (Evans, 2005, WHO, 2017). Under nutrition continues to affect
approximately 462 million elderly people worldwide with the rate of overweight
and obesity also rising in all countries (WHO, 2018). In Nigeria the national
population commission estimated that there are 6,987,047 older persons within
the age of 60 years and above which represents 4.98% of the total population
(NPC, 2006). The proportion of older persons in Nigeria is projected to
increase from 4.9% in the year 2005 to 6.0% by 2025 and 9.9% in the year 2050,
representing a doubling of the proportion of older persons in Nigeria within 45
years (Ajomale, 2007). Furthermore, the habits of older persons living in
Nigeria lean heavily toward consumption of foods that provide high energy such
as carbohydrates and animal fats, which is contrary to what is best for a
healthy weight and healthy life (Bakare, et
al., 2004). They are also vulnerable
to abuse and neglect from family members and caregivers (Steyn and Temple,
2008). Income is another major hindrance for the elderly people to eat well and
have normal nutrition (Ferreira, 2004; Bohman et al., 2007; Ogunmefun, 2008; Ogunmefun and Schatz, 2009).
Although, most
studies on the nutritional status of older persons have focused on those living
in the communities, homes, institutions, and hospitals. Little or no work has
been done on the nutritional risk factors in older persons from Okpe local
government area of Delta, Nigeria who may have various health conditions that
could be significantly worsened by nutritional problems. Therefore this study
was designed and conducted to determine the nutritional risk factors from
different aged group in Okpe local government area of Delta state Nigeria.
1.2 Statement
of the Problem
Nutrition is an
essential part of healthy ageing but can be affected by factors such as living
situations, income, support services and use of medications (Emily, 2014). When
these factors are compromised in older people, it can lead to nutritional risk,
further health problems, loss of independence and poor quality of life.
Ageing is
associated with significant changes in the physiological, physical,
psychological and immune function, particularly cell-mediated immunity,
resulting in progressive generalized impairment that increases susceptibility
to infectious diseases (Lesourd, 2007).
Older people are vulnerable to rapid degenerative processes, reduced efficiency
of the gastrointestinal tract, loss of appetite due to a decline in sensory
perception and a decline in health (Wardlaw,
2013). Also, eye problems, tooth loss/decay, rheumatism and hypertension are on
the rise among older people (Apt, 2009). In spite of the vulnerability to poor
nutrition and health status of older people, there is relatively little
information on their nutritional status and general wellbeing in developing
countries such as Nigeria and they are victims of social discrimination.
Most programmes
designed to assess nutrition situations are often targeting children and women
and little or none for older people. The traditional support that existed in
Africa is being diminished because of changing lifestyle and socio-economic
crisis in developing countries such as Nigeria. After retirement age at 60
years in Nigeria, older people realize that their saving might not be enough to
secure their living. Social disintegration, economic problems, natural
calamities and man-made conflicts may not only affect nutritional status but
also the life expectancy of older people.
Although older
people are commonly accepted as being a vulnerable group, at present, very
little is done to meet their particular needs, or to recognize their unique
capacities and contribution. Interventions often ignore special needs of the
older persons. The interventions discriminate against and on occasion,
undermine their capacity to support themselves. Though agencies have spent
significant resources in developing and improving best practice protocols for
emergency nutrition intervention for children, it is widely recognized that
significant gaps exist in knowledge skills and capacity of the humanitarian
agencies to respond to the nutritional needs of older people (Help age
International, 1999). Under nutrition continues to affect approximately 462
million elderly people worldwide (WHO, 2018). Majority of older persons in
Nigeria lean heavily toward consumption of foods that provide high energy such
as carbohydrates and animal fats, which is contrary to what is best for a
healthy weight and healthy life (Bakare,
et al., 2004, NPC, 2006). With the rise in proportion of older people in
Nigeria, the assessment of nutritional status will help to determine those at
nutritional risk. Therefore this study focuses on the risk factors of nutrition
in older persons especially in Okpe local government area of Delta State,
Nigeria.
1.3 Objectives
of the Study
The general
objective of this study is to determine the nutritional risk factors in older persons
from different age group in Okpe local government area of Delta State, Nigeria
while the specific objectives are to:
i.
Ascertain
the socio-economic characteristics of the older persons.
ii.
Assess
the dietary intake of the older persons.
iii.
Investigate
the nutritional status in terms of the relationship between Food habits and
anthropometric measurements of the older persons.
iv.
Determine
the nutritional risk factors in the different age groups.
1.4 Significance
of the Study
The
findings and recommendations of this study on nutritional risk factors in older
persons from different age groups in Okpe local government area of Delta State, Nigeria,
will contribute immensely in aiding nutritionist/dietitians and other health
care professionals in developing effective strategies geared towards improving
the and nutritional status of the older people.
Result from this
study will be used to gain a better understanding of risk factors associated
with nutrition in older persons which will be beneficial to nutritionist and
dietitians so as to help them proffer adequate solutions for the prevention of
such risk factors.
Result from this study will reveal the
associated nutritional risk factors of older persons which would facilitate
both the government and NGOs to design more effective campaign programs against
under nutrition and ways
of improving the nutritional status and wellbeing of the aged in older persons.
To people
working in old people’s homes, the study will be beneficial to them as it would
reveal to them the risky factors and foods associated with the nutritional
status of older persons which they would look out for in order to attend
effectively to the older persons.
This
study will serve as a guide to researchers to form a data base for further
research aimed at improving the nutritional status of older persons. This
research work will also be a base for statistical inference to other works and
research analysis. The findings from this research will contribute to available
literature on nutritional risk factors of older persons.
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