Assessment of Nutritional Status and Disease Prevalence among Elderly Population in Elderly Homes in Kandy

A study was conducted to assess the nutritional status and the prevalence of non-communicable diseases among elderly people in elderly homes in Kandy. A population of 105 elderly people (>65 years), representing 7 elderly homes in Kandy was examined using the Mini Nutritional Assessment (MNA) tool and an additional questionnaire. Skinfold thickness was measured using the Harpenden caliper and body fat was measured using a digital Fat Analyzer. According to the MNA tool 59.1% were at risk of being malnourished, 3.8% weres malnourished and 37.1% were normal. Based on BMI classification, 16.2% was under-weight, 55.2% was normal and 28.6% was over-weight. According to waist-to-hip ratio, 51.4% had a lower risk, 32.4% a moderate risk and 16.2% a higher risk for health problems while 41.9% of the population had hypertension, 13.3% had diabetes and 19.0% had airway obstructive disorders. Furthermore, 31.4% of the population was less active and 67.6% was moderately active. The daily mean energy intake (1945.6 kcal) of subjects was higher than the calculated energy requirement (1490.1 kcal). Among the variables studied BMI had a strong positive correlation with body fat mass (r=0.901, p<0.0001) and skin fold thickness (biceps r=0.594, p=0.000; triceps r=0.538, p<0.0001). Waist circumference also had a positive correlation with skinfold thickness (biceps, r=0.521, p<0.0001; triceps, r=0.337, p<0.01) and fat mass(r=0.645, p<0.0001). Waist-to-hip ratio showed a positive correlation (r=0.322, p <0.05) with biceps skinfold thickness. With waist-tohip ratio >0.95, the prevalence of non-communicable diseases was clearly high. Further studies are needed using data from other regions in the country to verify the above findings. INTRODUCTION There was an estimated 605 million elderly population in the world in 2002 and among them nearly 400 million were living in low-income countries. By 2025, these statistics were expected to reach more than 1.2 billion, with about 840 million living in low-income countries (WHO, 2002). The achievement and maintenance of good nutritional status among the elderly population are critical for their health, functioning and quality of life (Food & Nutrition Board, 2000). An insufficient food intake with associated imbalances of essential nutrients and energy from food can increase the vulnerability of the elderly to adverse health outcomes. These include low immune response (Lesourd et al., 1998), longer periods of hospitalization and increased chances of hospital readmission (Chima et al., 1997), impairment in physical and cognitive functions (Galanos et al., 1994), premature institutionalization (Herndon, 1995) and 1 Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Sri Lanka Fernando and Wijesinghe 230 mortality (McCormack, 1997). Many of the diseases suffered by the elderly are due to dietary factors, some of which have been operating since infancy. These factors are then confounded by changes that naturally occur with the ageing process. The availability, preparation and consumption of an appropriate quantity and quality of food are direct interfering factors of food intake, which in turn may be negatively influenced by many other factors such as multiple medications (Ausman and Russell, 1999), burden of diseases (Payette et al., 1995), social isolation (Melnik et al., 1994), oral health problems (Ritchie et al., 1997), depression and life stresses (Payette et al., 1995) and chemosensory dysfunction (Rolls, 1999). However, many of these studies were limited to evaluate the adequacy of nutrient intakes among the elderly. In most studies, the nutrient inadequacy was based on nutrient intakes from a single 24-h dietary recall (Bianchetti et al., 1990). The Mini Nutritional Assessment (MNA) tool, which is a validated, reliable and easy to use nutritional assessment technique, was used in the present study. This tool was developed to assess nutritional status as part of the standard evaluation of elderly persons aged 65 years and older. Anthropometric assessments, general assessments, dietary assessments and subjective assessments are used through the MNA to assess the nutritional status of elderly people. According to MNA tool, a total score below 17 (out of 30) is considered malnourished, a score between 1723.5 is at-risk of malnutrition and a score above 23.5 is considered normal (Guigoz et al., 1994). Furthermore, several anthropometric indicators are available to measure the nutritional status of adults, such as body mass index, waist circumference, waist-to-hip ratio and skinfold thickness. Among these, it is important to find out indicators which are more suitable for measuring nutritional status of the elderly population. The objectives of the present study were to assess the nutritional status and the noncommunicable disease prevalence of the elderly people living in elderly homes in Kandy, Sri Lanka and to investigate relationships among different anthropometric and health parameters of the elderly people. MATERIALS AND METHODS