Nutritional Status Of Free Living And Institutionalized Elderly And Associated Factors In Trans Nzoia County, Kenya

ABSTRACT

Adequate nutrition, healthy ageing, and the ability to function independently are essential components of a good quality of life. Though it is recognized that nutritional challenges account for a significant proportion of elderly morbidity and mortality, less has been determined on nutritional status of the old age men and women living freely and in institutions. This study investigated the relationship between nutritional status of the elderly and related factors in free living and institutionalized elderly of Trans Nzoia County. It also determined the extent to which functional and dependence of the Elderly impacts on their nutritional status. A semi-structured interview questionnaire, Key Informant Interview guide, Focused Group Discussion guide and Observation checklists were used to measure the nutritional status of the Elderly, individual and structural activities affecting the Elderly nutrition status and the performance of functional activities of daily living by the Elderly. Three hundred elderly men and women who met the inclusion criteria were sampled, 69 from three institutions of the Elderly and the other 231 from the seven sub-counties. Data were coded and entered in Nutri Survey. Nutri Survey and QSR Nvivo were used to analyze data. Participants were randomly selected with a response rate of 98.6% for the free living elderly and 97.2% for the institutionalized Elderly. Pearson’s product moment correlation and chisquare were used to test the hypotheses. There was a significant relationship between gender and Mid Upper Arm Circumference of the elderly (χ2 = 8.173, df = 2, P = 0.000) with the mean MUAC measure for women (0.67 ± 0.152) being higher than that of men (0.61 ± 0.130), t = 6.414, df = 298, p = 0.732, t = 6.414, df = 298, p = 0.732. There were more (4%) obese free living elderly as compared to those in institutions (0.7%). Majority of women (20.3%) had a MUAC of less than 21 cm as compared to their male counterparts (7.5%), there was a significant relationship between gender and MUAC of the elderly (χ2 = 8.173, df = 2, P = 0.000) with the MUAC mean measure for women (0.67 ± 0.152) being higher than that of men (0.61 ± 0.130), t = 6.414, df = 298, p = 0.732. Majority (13.7%) of elderly who were overweight reported to have a very poor health status as compared to only 1% of those reporting to have a very good health status; with the results showing a significant relationship between BMI and self-view of their health status (χ2 = 7.983, df = 3, P = 0.036), and a positive correlation between health status and BMI which was also significant (r = 1.437, P = 0.051). Elderly nutritional status was being influenced by sources of food with food from farms being mostly preferred (2.793 ± 2.640) than food in institutions (2.991 ± 2.940) t = 1.313, df = 299, p =< 0.022. The greatest impediment to the elderly acquisition of food was their culture with level of significance indicating that the nutritional status mean measure for culture (2.493 ± 2.411) being higher than that of market reach (2.173 ± 2.319), t = 5.451, df = 299, p = 0.765. There were more dependent elderly in non-institutions (11%) as compared to those in institutions. Functional ability of the elderly was found to be significant to nutritional status (χ2 = 4.440, df = 4, P = 0.000). BMI was found to correlate positively with bathing (r = 1.349, p = 0.006), money handling (r = 1.065, p = 0.024) and bladder control (t = 1.334, p = 0.006). National and County governments should develop elderly focused nutritional interventions geared towards combating malnutrition.