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Malnutrition in older adults on financial assistance in an urban Asian country: a mixed methods study

  • Yu Xuan Koo (a1), Min Li Kang (a1), Angie Auyong (a1), Glen Zq Liau (a1), Jeremy Hoe (a1), Melody Long (a1), Aaron Koh (a1), Frederick Koh (a1), Rain Liu (a2) and Gerald Koh (a3)...

Abstract

Objective

The objectives of the present study were to assess the nutritional status, identify factors for malnutrition risk and evaluate barriers to adequate nutrition among recipients of the Public Assistance (PA) scheme for socio-economically disadvantaged Singaporeans.

Design

Using a cross-sectional study design, we assessed PA recipients’ malnutrition risk using the DETERMINE Nutritional Health checklist and the full Mini-Nutritional Assessment (MNA), as well as their nutritional knowledge, co-morbidity burden, depression risk, instrumental and basic activities of daily living (IADL and BADL), and awareness and utilization of available food services. In-depth interviews were also conducted on malnourished individuals (MNA score < 17) to understand barriers to adequate nutrition.

Setting

Homes of community-living older adults and nursing homes of institutionalized older adults.

Subjects

All PA recipients aged ≥55 years in Central Singapore District.

Results

Four hundred and sixty-five of 511 (91·0 %) eligible PA recipients participated in the study. The prevalence of malnutrition in the study population was 2·8 %. However, 50·3 % were at risk of malnutrition. Among community-dwelling respondents, the risk of malnutrition was independently associated with age >75 years, currently unmarried, BADL impairment, depression risk and BMI < 19·0 kg/m2. Qualitative analysis revealed that financial, social and physical barriers and lack of knowledge were the main contributors to poor nutritional status. Only half were aware of subsidized food services and education increased interest in utilizing food services. Among nursing home respondents, those who were BADL impaired were more likely to be at risk of malnutrition.

Conclusions

Among PA recipients, the prevalence of malnutrition is low but the risk of malnutrition is high. Education on adequate nutrition and food services are recommended.

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Copyright

Corresponding author

*Corresponding author: Email gerald_koh@nuhs.edu.sg

References

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1. Ministry of Social and Family Development (2012) Permanently Unable to Work (Also known as Public Assistance). Version current 12 June 2012. http://app.msf.gov.sg/ComCare/FindTheAssistanceYouNeed/PermanentlyUnabletoWork.aspx (accessed August 2013).
2. Yap, KB, Niti, M & Ng, TP (2007) Nutrition screening among community-dwelling older adults in Singapore. Singapore Med J 48, 911916.
3. Chan, M, Lim, YP, Ernest, A et al. (2010) Nutritional assessment in an Asian nursing home and its association with mortality. J Nutr Health Aging 14, 2328.
4. Moshfegh, AJ (2007) Research to advance understanding of the interrelationship of poverty and nutrition. J Am Diet Assoc 107, 18821885.
5. Keller, HH (2006) Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors. J Am Diet Assoc 106, 10421048.
6. Posner, BM, Jette, AM, Smith, KW et al. (1993) Nutrition and health risks in the elderly: the nutrition screening initiative. Am J Public Health 83, 972978.
7. Guigoz, Y & Vellas, B (1998) The Mini-Nutritional Assessment for grading the nutritional state of elderly patients: presentation of the MNA, history and validation. Nestle Nutr Workshop Ser Clin Perform Programme 1, 311.
8. Health Promotion Board (2010) Food Pyramid. Version current 3 April 2010. http://internet-stg.hpb.gov.sg/foodforhealth/article.aspx?id=2638 (accessed February 2011).
9. Hendrie, GA, Coveney, J & Cox, D (2008) Exploring nutrition knowledge and the demographic variation in knowledge levels in an Australian community sample. Public Health Nutr 11, 13651371.
10. Charlson, ME, Pompei, P, Ales, KL et al. (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40, 373383.
11. De Groot, V, Beckerman, H, Lankhorst, GJ et al. (2003) How to measure comobidity: a critical review of available methods. J Clin Epidemiol 56, 221229.
12. Marc, LG, Raue, PJ & Bruce, ML (2008) Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. Am J Geriatr Psychiatry 16, 914921.
13. De Craen, AJ, Heeren, TJ & Gussekloo, J (2003) Accuracy of the 15 item Geriatric Depression Scale in a community sample of oldest old. Int J Geriatr Psychiatry 18, 6366.
14. Lim, PP, Ng, LL, Chiam, PC et al. (2000) Validation and comparison of three brief depression scales in an elderly Chinese population. Int J Geriatr Psychiatry 15, 824830.
15. Gresham, GE, Alexander, D, Bishop, DS et al. (1997) American Heart Association Prevention Conference. IV. Prevention and Rehabilitation of Stroke. Rehabilitation Stroke 28, 15221526.
16. Lawton, MP & Brody, EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9, 179186.
17. Graf, C (2008) The Lawton instrumental activities of daily living scale. Am J Nurs 108, 5262.
18. Sainsbury, A, Seebass, G, Bansal, A et al. (2005) Reliability of the Barthel Index when used with older people. Age Ageing 34, 228232.
19. Beck, AM, Ovesen, L & Osler, M (1999) The ‘Mini Nutritional Assessment’ (MNA) and the ‘Determine Your Nutritional Health’ Checklist (NSI Checklist) as predictors of morbidity and mortality in an elderly Danish population. Br J Nutr 81, 3136.
20. Crabtree, BF & Miller, WL (editors) (1999) Doing Qualitative Research. Thousand Oaks, CA: Sage Publications.
21. Han, Y, Li, S & Zheng, Y (2009) Predictors of nutritional status among community-dwelling older adults in Wuhan, China. Public Health Nutr 12, 11891196.
22. Tsai, AC, Ho, CS & Chang, MC (2008) Assessing the prevalence of malnutrition with the Mini Nutritional Assessment (MNA) in a nationally representative sample of elderly Taiwanese. J Nutr Health Aging 12, 239243.
23. Cuervo, M, García, A, Ansorena, D et al. (2009) Nutritional assessment interpretation on 22,007 Spanish community-dwelling elders through the Mini Nutritional Assessment test. Public Health Nutr 12, 8290.
24. Chen, CC (2005) A framework for studying the nutritional health of community-dwelling elders. Nurs Res 54, 1321.
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Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
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