Malnutrition among the Elderly in Malaysia and Its Associated Factors: Findings from the National Health and Morbidity Survey 2018

Abstract

Background. Malaysia is predicted to become an ageing population by 2035. Malnutrition among the elderly is one of growing concern. This study aims to identify the prevalence of malnutrition and its associated factors among the elderly in Malaysia. Methods. Data from the National Health and Morbidity Survey (NHMS) 2018 was analysed. This survey applied a multistage stratified cluster sampling design to ensure national representativeness. Malnutrition was identified using a validated Mini Nutrition Assessment-Short Form (MNA-SF). Variables on sociodemographic, health status, and dietary practices were also obtained. The complex sampling analysis was used to determine the prevalence and associated factors of at-risk or malnutrition among the elderly. Result. A total of 3,977 elderly completed the MNA-SF. The prevalence of malnutrition and at-risk of malnutrition was 7.3% and 23.5%, respectively. Complex sample multiple logistic regression found that the elderly who lived in a rural area, with no formal or primary level of education, had depression, Instrumental Activity of Daily Living (IADL) dependency, and low quality of life (QoL), were underweight, and had food insecurity and inadequate plain water intake were at a significant risk of malnutrition (malnutrition and at-risk), while Chinese, Bumiputra Sarawak, and BMI more than 25 kgm−2 were found to be protective. Conclusions. Currently, three out of ten elderly in Malaysia were at-risk or malnutrition. The elderly in a rural area, low education level, depression, IADL dependency, low QoL, underweight, food insecurity, and inadequate plain water intake were at risk of malnutrition in Malaysia. The multiagency approach is needed to tackle the issue of malnutrition among the elderly by considering all predictors identified from this study.

Undernutrition and associated factors among elderly people served in Public Servants Social Security Agency in Harar, Eastern Ethiopia

“…The elderly who were food secure were 41% less likely to be undernourished than those who were food insecure. The studies in Malaysia 24 and Aykel Town Administration, Amhara Regional State, Northwest Ethiopia, 25 reported similar findings. Food insecurity is linked to low income, low educational status, social isolation, living alone, and functional impairments.…”

“…Food insecurity is linked to low income, low educational status, social isolation, living alone, and functional impairments. 24 This could ultimately result in limited access to adequate quantity and quality of foods, resulting in adverse nutritional outcomes among elderly individuals. The elderly with chronic illness were two times more likely to be undernourished compared to their healthy counterparts.…”

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“…Although few had a BMI corresponding to underweight, almost a quarter of the respondents in the HNC cohort had a BMI in the lower range of normal weight, below 22. For elderly persons, several studies have found that having a BMI in the higher range of normal weight, or even being overweight is associated with better functional level and nutritional status [ 42 , 43 ]. The majority of the HNC cohort were 70 years or older, which suggests that many of them might have experienced general health benefits from gaining weight.…”

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“…In older women, phytoestrogens found in soyabeans prevent the occurrence of post-menopausal osteoporosis while lycopene in foods such as tomatoes improves prostate health among men [19][20][21]. In spite of the critical role nutrition plays in older age, the elderly group is at signifcant risk of malnutrition and diet-related diseases and faces various nutrition challenges that afect their dietary habits and overall wellbeing [22]. Research conducted among older persons in Ghana by Agbozo et al [23] showed that greater than 50% of study participants had a poor dietary pattern.…”