The multidimensional background of malnutrition among rural older individuals in Bangladesh – a challenge for the Millennium Development Goal

Abstract

AbstractObjectiveTo investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh.DesignA multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant.SettingMatlab, Bangladesh.SubjectsA total of 625 randomly selected individuals (≥60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women.ResultsTwenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0·001), gastrointestinal disorders (P < 0·01), depressive symptoms (P < 0·001) and impaired cognitive function (P < 0·01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0·05), having no income (P < 0·01), being illiterate (P < 0·01) and not receiving regular financial support (P < 0·05) were also independently associated with poor nutritional status.ConclusionsMalnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.