Predictors of malnutrition among older adults aged above 65 years in eastern Ethiopia: neglected public health concern

Abstract

Background A nutritional problem, especially under nutrition is one of the common public health problems in older population causing greater mortality and economic loss in developing countries. However, evidences on the risk factors for increased nutritional risk among older population is not well stated in Ethiopia. This study aimed to assess the nutritional status and predictors of malnutrition among older adults (> = 65 years) in Eastern Ethiopia. Methods A community-based analytical survey was conducted among randomly selected 592 older people aged above 65 years of age in Harari region. Subjects were selected using multistage sampling pretested Full Mini Nutritional Assessment (MNA) tool was used to classify as malnourished (MNA score < 17), at risk of malnutrition (MNA score of 17 to 23.5) and otherwise normal. Validated geriatric depression scale short form (15 items) was employed to screen for depression. Data were presented using statistical tables, frequency, percentage, and graphs. Ordinary logistic regression was employed to identify predictors of malnutrition and plum method was used to generate odds ratio. The level of statistical significance was declared at P-value less than 5%. Chi-square test, crude and adjusted odds ratio with 95% confidence was reported. Results A total of 592 respondents (93.4%) were interviewed. About 306 (51.7%) and 93 (15.7%) were found to be at risk of malnutrition and malnourished respectively. The predicted log odds of being malnourished was higher among those from rural residents (AOR = 2.08: 1.25–3.45), not on working (AOR = 1.31: 95% CI: 0.87–1.95) and did not have health insurance (AOR = 1.58; 95% CI; 0.97–2.58). Those with chronic pain (AOR = 1.70; 95% CI: 1.15–2.51), previous hospitalization (AOR = 1.59: 95% CI: 1.27–2.38) and not able to cover their personal expense (AOR =1.61: 95% CI: 1.12–2.30) were predictors of malnutrition. The relationship between previous hospitalizations with malnutrition among older adults people is moderated significantly by the presence of chronic pain (β = 0.113, p = 0.015). Conclusions Malnutrition among old age is a public health concern that needs attention. Economical vulnerability, residence, depression, presence of chronic disease, and hospitalization were important risk factors for malnutrition among old age.

Prevalence of malnutrition and associated factors among older adults from urban and rural residences of Metu district, Southwest Ethiopia

“…Thus, the risk of malnutrition was 3.8 times higher in older adults with chronic diseases. This finding was consistent with the findings of a study conducted in Eastern Ethiopia [ 27 ] and rural Lebanese [ 32 ]. This could be because chronic disease can account for nearly half of all malnutrition in older adults [ 42 ].…”

“…The prevalence of malnutrition in urban and rural residences was 9.9% (95% CI: 6.3—13.7%) and 25.2% (95% CI: 20.4—30.4%) respectively. The overall finding was in line with the study done in Harar, Ethiopia (15.7%) [ 27 ] and the study done in Egypt (17.9%) [ 6 ]. Besides, the finding was lower than the study done in Nairobi, Machakos (29.8%), and Uganda (22.5%).…”

“…It was supported by the studies done in Benin, where malnutrition was found to be 17.0% and 22.2% in urban and rural older adults, respectively [ 28 ]. Furthermore, it was supported by a study conducted in Harar, Ethiopia, which found that older adults in rural residences had a higher proportion of malnutrition 17.1% than older adults in urban residences.4.9% [ 27 ].…”

Determinants of nutritional status among old age population in eastern Ethiopia: a general linear model approach

“…According to the MNA scoring, more than half (49 %) and 22 % (n 158) were found to be at risk of malnutrition and malnourished, respectivtively. However, the present finding was higher than local finding reported from 15⋅7 % Harari region, Ethiopia ( 18 ) , 10⋅4 % in South Africa ( 34 ) , 12⋅5 % in Sri Lanka ( 19 ) , and 10⋅5 % in Korea ( 35 ) and 14 % in Bangladesh ( 36 ) . The present finding was consistent with local studies from Debre Markos town (22⋅7%), Northwest Ethiopia ( 37 ) , Hawassa city (28⋅3%), Southern Ethiopia ( 24 ) , Iran (49⋅6%) ( 38 ) , Nepal (24⋅8%) ( 39 ) .…”

“…The prevalence of malnutrition among older age population significantly varies within the regions (11) . Malnutrition in the older age population segment is caused by multifactorial factors such as insufficient food intake, illness or both, which results in increased nutrient loss, poor nutrient absorption or both (12)(13)(14)(15)(16) , socio-cultural, and socio-economic characteristics (11,15,17,18) , depression (15) , not able to cover their personal expense (18) , alcohol consumption (19) , and psychological concern (11) . In Ethiopia, the number of older age group population is dramatically increasing and seeks great attention (20)(21)(22) , however, to the best of our knowledge, there is a little or lack of comprehensive data about the prevalence and the factors influencing the nutritional status of the older population using mini nutritional assessment (MNA) tool (23,24) in Ethiopia as well in the present study area.…”