Common Nutritional Problems Among Community-dwelling Older Adults

According to Esther M. et al. (2004) community dwelling elderly people are defined by their age (≥60 years of age) and by living independently. This group can suffer from a large variety of health care problems; from just getting older (not diseases specific) to suffering from multiple pathologies. Thus, we are going to discuss the prevalance, causes and consequences of four common nutritional problems that may happened among community-dwelling older adults.

1) Malnutrition

On July 2015 to May 2016, a cross-sectional study has been conducted in Kandy district, Sri Lanka to estimate the prevalance of malnutrition and its associated factors among community-dwelling older persons. Malnutrition causes adverse effects on health as well as the quality of life of older persons. Further, it presents high costs to health care systems [10, 11]. Hence, malnutrition has become an important component of geriatric care that warrants monitoring.

Results show the prevalance of 12.5% of the participants were malnourished, 52.4% were at risk malnutrition while 35.1% were well-nourished. From th findings, this may cause by low economic condition which related with the house hold food security for the older population. Further studies also showed that this malnoutrition due to the extended family support especially in nutritional care. The psychological changes of aging also affect body metabolism and those older adults with sarcopenia and osteoporosis might limit their mobility to prepare foods, grocery shopping and even consuming foods. Participants with hypertension contribute 70% to be malnourished. It also might because of oathophysiological efects of diseases which lead to loss of appetite, slowing digestion, absorption and metabolism.

Consequences of having malnutrition will contribute to progressive decline in health, reduced physical and cognitive functional status, increased utilization of health care services, premature institutionalization, and increased mortality.

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2) Obesity

Obesity among older adults nowdays has become the most common nutritional disorder. Based on a study conducted in America, it indicates that older people range 65 to 74 years old, approximately 27% of women and 24% of men are considered obese. This study shows that older adults in America have higher rates of obesity. Obesity is commonly associated with insulin resistance, hypertension and lipid abnormalities (Schwartz, 1997).This association has highly increase the risk factor of being obese Being executed with family also give impact on elderly nutrition intake, most of them were had difficulties in preparing healthy foods thus they have to eat whatever food that easily prepared. A substantial body of evidence links overweight to hypertension, dyslipidemia, heart disease, insulin resistance and diabetes, cholelithiasis, respiratory impairment, gout, and osteoarthritis (Pi-Sunyer, 1993). However, there is also study shows that being overweight could protect them from hip fracture.

3) Depression

Depression is one of the common illness among elderly and it can be occurred with many factors such as socioeconomic factors (Mohammad Reza et al., 2010).

Based on a study conducted in 2017 among residents in FELDA scheme in Johor, Malaysia, the prevalence of depressive symptomps was 3.7%. Majority of them were married and have no chewing and vision problem. Findings show that depressive symptom found to have significant correlation with socio-demographic characteristics sucha as age, gender, education level and monthly income, Health related Characteristics such as chewing problem, vision problem and chronic diseases, Functional status characteristic, anthropometric parameters and lifestyle characteristics.

Depression will impact older people differently than younger people. In the elderly, depression often occurs with other medical illnesses and disabilities and lasts longer. Depression in the elderly is associated with an increased risk of cardiac diseases and an increased risk of death from illness. At the same time, depression reduces an elderly person's ability to rehabilitate. Studies of nursing home patients with physical illnesses have shown that the presence of depression substantially increases the likelihood of death from those illnesses. Depression also has been associated with increased risk of death following a heart attack.

4) Sarcopenia

Sarcopenia was a term proposed by Rosenburg in 1989 referring to the age‐related decline in lean body mass. This nutritional problem has become a relatively well‐known condition among researchers and physicians. The prevalance of elderly with Sarcopenia based on study conducted in Japan in 2016 was ranged from 2.5 to 28.0% in Japanese men and 2.3 to 11.7% in Japanese women. From findings, it shows that BMI was the only factor associated with sarcopenia across all definitions within the Japanese population studied, and a predominant risk factor for sarcopenia in previous studies. Having sarcopenia will possible effects of sarcopenia include decreased muscle strength, problems with mobility, weak bones (osteoporosis), falls and fractures, decreased activity levels, diabetes, middle‐age weight gain and a loss of physical function and independence.