Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh

Abstract

Aim: To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. Methods: A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community-living elderly persons aged 60 years or more (60-92 years; 69 AE 7 years). Mobility, activities of daily living (ADL), performance tests, handgrip strength, the Mini Nutritional Assessment (MNA) and a structured questionnaire were used to assess physical function, nutritional status, socioeconomic status and health status, respectively. Descriptive and linear hierarchical regression analyses were applied. Results: Seven per cent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties in performing one or more items in the performance tests. According to the MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants than well-nourished participants reported limited mobility, impaired ADL and difficulties in the performance tests. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socioeconomic and health status differences. Conclusions: Good nutritional status is important for the physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation.

Nutritional status, physical performance and functional capacity in an elderly population in southern Brazil

“…4,5 The functional limitations and disabilities are conditions prevalent in the elderly, [6][7][8][9] with implications for increased use of health services and institutionalization, creating a serious public health problem. 8,9 Some studies suggest that nutritional status is an indicator of health and an important factor associated with motor performance limitations 7,10,11 and disability relating to basic and instrumental activities of daily life (ADLs and IADLs). 11,14 However, there are disagreements about whether this association is due to the underweight and/ or overweight obesity status.…”

“…8,9 Some studies suggest that nutritional status is an indicator of health and an important factor associated with motor performance limitations 7,10,11 and disability relating to basic and instrumental activities of daily life (ADLs and IADLs). 11,14 However, there are disagreements about whether this association is due to the underweight and/ or overweight obesity status.…”

Mini-Nutritional Assessment predicts functional decline of elderly Taiwanese: result of a population-representative sample

“…Ruiz-López et al (30) observed a correlation between the MNA score and the mobility of institutionalised elderly women rated by the Katz score; and Chevalier et al (11) observed that malnourishment was correlated with poor physical performance (gait speed) in elderly patients undergoing ambulatory rehabilitation. Poor ADL and IADL status has been found to be correlated with poor nutritional status rated with the MNA in community-living (23) , institutionalised (6,31) and hospitalised elderly (32) . In several studies involving hospitalised or institutionalised elderly, the MNA has also been observed to have a functional status-predictive ability (7,23,24,33) .…”

“…Poor ADL and IADL status has been found to be correlated with poor nutritional status rated with the MNA in community-living (23) , institutionalised (6,31) and hospitalised elderly (32) . In several studies involving hospitalised or institutionalised elderly, the MNA has also been observed to have a functional status-predictive ability (7,23,24,33) . Cereda et al (33) have shown that the MNA is suitable for grading functional status of institutionalised elderly.…”

“…The MNA is a multifunctional scale and has been found to have the ability to evaluate the risk of depression, cognition impairment, physical functional decline and mortality in addition to grading the nutritional status of older adults. Several studies have shown that the MNA score is associated with physical functional status (5,6,12) , and some studies have found that it has a physical functional status-predictive ability (7,23,24) . However, most of these studies have been conducted in small samples of community-living (23) , institutionalised (6) or hospitalised elderly (24) .…”