Determinants of Nutritional Status among Geriatric Populations in Kween District, Eastern Uganda

Special Article - Malnutrition

Austin J Nutri Food Sci. 2018; 6(4): 1110.

Determinants of Nutritional Status among Geriatric Populations in Kween District, Eastern Uganda

Alphas C, Atuhairwe C, Amongin D and Taremwa MI*

Clarke International University (Formerly, International Health Sciences University), Uganda

*Corresponding author: Ivan Mugisha Taremwa, Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda

Received: November 21, 2018; Accepted: December 12, 2018; Published: December 19, 2018

Abstract

Background: Geriatric persons may exhibit diverse feeding patterns due to age-associated changes. We report the determinants of nutritional status of geriatric population in Kween district, Eastern Uganda.

Methods: A cross-sectional survey was conducted among of 250 adults above 50 years during June 2014 to August 2015. Data was collected using a structured questionnaire, and Chisquare test for association analysis was done to assess factors associated with geriatric nutritional status.

Results: The determinants of geriatric nutritional status were; age, weight, education attained, number of children, declined food intake, neuropsychological problems, and body mass index.

Conclusion: The study results affirm a nutrition gap which necessitates awareness strategies through caregiver nutrition education and health promotion.

Keywords: Geriatric; Determinants; Nutrition status; Uganda

Introduction

Population ageing is a global pattern that describes a life-course trend. It affects all countries, although at varied levels [1], and is a measure of better lifespan and lowered mortality [2]. Despite, the geriatric population is prawn to various challenges, including malnutrition [3,4]. This is due to varied feeding ability as well as ageassociated patterns dictated by factors like financial status, physical and functional changes in relation to physiological and psychological status [5-7]. This leads to nutritional difficulties manifesting with a poor quality of life [4,8-11].

As the poverty levels remain high in sub Saharan Africa [12,13], 64% of Uganda’s geriatric lives below the poverty line; which fosters a high risk of malnutrition [14]. Socio-ecological and geographical aspects further amplify the situation, for example, 84.3% of the population of Kween district depends on subsistence farming. As environmental factors have hindered agronomic yields, there has been a discernible poor quality of life. These combined with rapid population growth, cattle rustling practices among the Karamajong have exacerbated food insecurity. These complex factorial interplays fosters low standards of living, which prompts to poor feeding and quality of life. These may portend the recently launched Sustainable Development Goals (SDGs) that seeks to attain sustainable development in a balanced manner for all aspects of the society, at all ages, with a particular focus on the most vulnerable, which includes older persons [15]. The geriatric population cuts through a section of varied goals, namely: poverty eradication, good health, gender equality, economic growth and decent work, reduced inequalities and sustainable cities.

As part of improved geriatric livelihood, the government of Uganda initiated a Social Assistance Grants for Empowerment (SAGE) support program [16,17], nonetheless, challenges have not seen its countrywide operation and also the costs of living continues to escalate, hence poor quality of life. As major programs have centered on the productive population (under 50 year category), it ought to be known that the geriatric population has in part been neglected. One critical risk of the geriatric population is the risk of malnutrition, which is reportedly high in most part of Uganda [12]. This study explored the geriatric nutritional status and its determinants among the population of Kween district, eastern Uganda.

Materials and Methods

Study design and setting

This was a community based cross sectional study that enrolled the geriatric population aged 50 years and above in all sub-counties of Kween district. Participants were selected using cluster sampling; which involved a random selection of 10 out of 19 parishes in five sub-counties in Kween district. The district is inhabited by Sebei; a sub-tribe of Kalengins that originated from Kenya. It is divided into 3 zones; the upper mountainous zone, the middle and lower zones with a warm weather and plain terrain. Agriculture is the main source of income.

Sample size estimation and enrolment criteria

Using Kish and Leslie formula to estimate the sample size [18], given the prevalence of geriatric malnutrition reported at 33.3% in Mpigi district, Uganda [19] and the allowable error of 5%, we consecutively enrolled a total of 250 geriatric populations.

Data collection tools and management

A structured questionnaire was designed to capture socioeconomic and health related data on the geriatric nutritional status [20-22]. The main outcome measure was assessed using the Body Mass Index (BMI) and Mid-Upper Arm Circumference (MUAC). Weight measurements were taken using a digital scale while putting on light clothing, height was recorded to the nearest 0.1 Centimeter (Cm) and a non-stretch insertion tape was used to measure MUAC. A food-frequency questionnaire was used to determine dietary intake data with focus on the interactive 24-hour recalls [23,24].

Adult equivalent a measure of the household’s calories for its members was determined by scaling the requirements of each individual to those of a reference adult based on age, sex and assumed moderate activity. Data was entered into the EPI-INFO; BMI was calculated as a ratio of weight to height. MUAC less than 19 were considered thin, 19.1-23 were nourished and those above 23 were overweight [25,26]. The MUAC under 21 and calf circumference (CA) below 31 were regarded as thin and under nourished [25].

Ethical approval

We obtained ethical approval from the research and ethics committee of Clarke International University (Formerly, International Health Sciences University). In addition, informed consent was sought from all participants.

Results

We enrolled 250 participants. Of these, 134 (53.6%) were males, participants’ median age was 65.5years (IQR, 61-70). Majority; 178 (71.2%) were 161-180cm in height, and 147 (58.8%) were 51-70Kg in weight. 169 (67.6%) were in a monogamous marriage with almost half of the families 124(49.6%) having 6 or more children. 108 (43.2%) of the respondents lacked formal education and more than three quarters (N=215, 86.0%) were unemployed as shown in (Table 1).