A Study on nutritional status and prevalence of noncommunicable diseases among the rural elderly of Tamil Nadu: A community based cross sectional study.
Abstract
Background: The elderly are one of the most vulnerable and high risk groups in terms of health status in any society. Nutrition is an important determinant of health in persons over the age of 60 years. Malnutrition in the elderly is often under diagnosed and neglected. Careful nutritional assessment is necessary for both the successful diagnosis and development of comprehensive treatment plans for malnutrition in this population. “You do not heal old age. You protect it; you promote it; you extend it [1].” Evaluation of nutritional status and chronic morbidity status are important for any health action plan. Aim: To estimate the nutritional status and prevalence of non communicable diseases among the rural elderly.
Methodology: A community based Cross sectional study conducted during the period of December 2011 to June 2012. Persons aged 60 and above years and willing to participate into the study. Random sampling design was used; twenty three elderly were selected randomly from each of the selected villages. In final analysis a total of 571 individuals included for this study. Data was analysed by Chi squire and Z tests, at 95% confidence interval; p value less than 0.05(p<0.05) was consider for significant. Results: Out of the 571 elderly persons 297 (52.1%) were males and 274(47.9%) were females. Mean age for the entire study population was 69.8 +7.8 years. The mean weight of the studied elderly persons was 46.2+10.1 Kgs. Nearly half of the elderly 236 (41.3%) were undernourished (BMI<18.5), 297 (52.0%) were in normal nutrition or overweight 38 (6.6%). Majority of the elderly people were suffered with one or more chronic diseases. Mainly visual defects 400 (70.0%) followed by musculoskeletal system disorders 197 (34.5%), anaemia 122 (21.3%) and hearing defects 118 (20.8%). Conclusions and recommendations: This study will be important tool to plan the health actions. Geriatric nutritional centres as to be establish in the rural areas like that of ICDS to provide the adequate nutrition to the elderly. Old age pension scheme has to implement in all the states especially in the rural area for the elderly people to make them financially independent and it should be revised frequently based on consumer price index.
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- Nutritional survey conducted by National Nutritional Monitoring Bureau (NNMB) among representative samples of tribal elderly from various states of India had also shown a prevalence of 61.8% and 65.4% malnutrition among elderly men and women respectively (Arlappa et al., 2009). Similar higher levels of under-nutrition were reported from Haryana, Rajasthan and Tamil Nadu using BMI for categorization of nutritional status (Jamir et al., 2013a; Singh et al., 2008; Bayapa Reddy et al., 2014). However, low prevalence of 14% under-nutrition was reported using MNA tool from Tamil Nadu (Vedantam et al., 2010).
[Show abstract] [Hide abstract] ABSTRACT: Background: Under-nutrition among elderly goes undetected, despite their nature of vulnerability to it. Majority of the available literature assessed under nutrition in the facility based settings. We aimed to determine the prevalence of under-nutrition and its associated factors among elderly, in a rural setting. Methods: A community based cross sectional survey was conducted among elderly in one of the randomly selected sub centre catchment area in rural Puducherry, south India. Information on socio demographic characteristics, morbidities and perception on their nutritional status were obtained. Anthropometric measures such as weight and arm span were measured by trained medical graduate as per the standard guidelines. Bodymass index (BMI) less than 18.5kg/m(2) was considered as under-nutrition. Results: Of total 296 elderly in the study setting, 271 (92%) participated in the study. The prevalence of under nutrition among the elderly was 24.8% (95% CI: 19.7-30.3). More than half of the elderly (58.7%) perceived their nutritional status as poor; of them 28.9% were actually under-nourished. Mean (SD) BMI scores were higher for elderly women compared to that of men [elderly women vs men: 22 (4.6)kg/m(2) vs 21 (3.8)kg/m(2), p=0.03]. In multivariate analysis, being an elderly male, age more than 70 years and per capita income less than 1000 INR were found to be significantly associated with under-nutrition. Conclusion: In this rural area, one fourth of elderly were under nourished. Urgent inter-sectoral measures including food security programs are required to address this huge nutritional problem in this vulnerable group.
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