Association Of Functionality And Nutritional Status Of Elderly Persons: A Comparison Between Institutionalized And Non – Institutionalized Elderly In Nairobi County, In Kenya

ABSTRACT

Malnutrition has been recognized as a common problem among the elderly persons and is associated with certain diseases and impaired functioning, but less is known about its relationship with nutrition intake and nutritional care among the elderly residents. This study determined the association of functionality and nutritional status of the Institutionalized elderly and compared with that of the elderly living with their family or community members. It also compared the functionality of the two categories of elderly men and women, and determined the extent to which functional independence impacts on the nutritional status of the elderly in the Nairobi County, Kenya. The Mini Nutritional Assessment questionnaire and the Modified Barthel Index were used to measure the nutritional status and functionality of the elderly. One Questionnaire was administered to the social welfare officer in each of the sampled institutions and a similar questionnaire administered to the care-giver of the elderly in the community to collect information on Institutions and Non- Institutional characteristics that relate to nutritional status and functionality of the elderly. Two hundred and seventy elderly men and women who met the inclusion criteria were sampled, 135 from 4 Institutions and 135 from Gumba, Kariobangi, Huruma and Kawangware divisions. Data were coded and entered using EPI Info version 9 and were analyzed using SPSS version 17. The participants were randomly selected and the response rate was 98.5% for the Non-Institutionalized elderly and 96.5% for the elderly living in the Institutions of the elderly. There was a significant relationship between gender and MUAC (2 = 12.745, df = 2, p = 0.002) with the mean MUAC measure among women (0.77  4.13) being higher than that of men (0.75  0.388), t = 4.446, df = 268, p = 0.714. There were more overweight non-institutionalized elderly (20.5%) compared to those in the institutions of the elderly (14.7%). There was a significant relationship between MUAC measure and CC (2 = 68.563, df = 2, p = 0.001), with the mean MUAC measure being higher (0.76  0.401) and mean measure of CC being 0.72  0.448, f = 45.28, df = 1, p = < 0.001. Eighty eight percent of the Institutionalized elderly consume 3 or more meals per day compared to 54.8% of the non-institutionalized elderly. There were more totally dependent elderly at Institutions (13.6%), compared to 3% who were Non-institutionalized. Functionality level was found to correlate positively with self-view of health status (r = + 0.133, p = 0.046) and the intake of 3 or more prescription drugs per day (r = + 0.139, p = 0.034). Body mass index of the elderly was found to correlate negatively to Calf Circumference (r = - 0.156, p = 0.027) and Stair Climbing (r = - 0.148, p = 0.025). Protein intake was found to correlate positively to the consumption of fruits and vegetables (r = +0.139, p = 0.029). Nutritional status of the elderly was found to correlate with functional ability. National and County governments should make and implement policies that would promote the nutritional status and functionality of the institutionalized and Non-institutionalized elderly.