Factors Influencing Malnutrition Among The Elderly In Loikaw Township, Myanmar

Ageing is not a disease, but it is a process. Nonetheless, due to risky behaviors, genetic factors, social environment or personalities, ageing may be correlated with some worsening in senses and non-communicable diseases.1 Elderly people encountered physical and mental problems.1 The United Nations (UN) defines elderly by 60 years but World Health Organization (WHO) defines elderly, not by time (years), but by new roles, loss of previous roles, or inability to contribute effectively to society. In Myanmar, elderly means the people whose aged was 60 years and above.6

United Nations estimates the population above 60 years old will reach 1.2 billion globally by 2050 which is ascending from 901 million in 2015.17 The world’s ageing population is increasing18 but the current health system is poorly designed for the elderly to obtain information on the specific nutritional needs and the long term care needs.19 Malnutrition is a condition with an inadequate, abundant or imbalance of energy, protein or other nutrients. Hence, malnutrition means over-nutrition, under-nutrition and imbalanced diet.2,3 Most of the elderly people suffer malnutrition problem.5 Older adults are at the risk of developing malnutrition due to various causative factors such as co-morbidities and their complications such as polypharmacy, inflammation and pain;7 lifestyle factors;8 psychological problems;9 and age-related pathophysiology such as dysfunctions in swallowing, taste, smell, sight, appetite and gastric emptying.9

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Several reports have revealed that malnutrition remains under-recognized in the elderly.10 In Myanmar study, the prevalence of malnutrition and at risk of malnutrition among the old by using MNA-SF (MNA-Short Form) screening tool was 7.2% and 38.6% respectively.19 Increasing trend of malnutrition indicates the crucial development of screening tools to detect early and treat effectively. 4 In this regard, several screening tools have been developed to identify malnutrition.11Among those, the Mini Nutritional Assessment (MNA) which is accepted globally12 and European Society for Clinical Nutrition and Metabolism (ESPEN) suggests it to be used for routine geriatric nutritional assessments.13

There were very few studies on factors influencing on malnutrition among the elderly and use of MNA for geriatric nutritional assessment in Myanmar. The previous study in Myanmar used MNA-SF (MNA-Short Form) instead of MNA. MNA has four parameter of assessment: anthropometric, general condition, dietary pattern and self-perceived health status. At that time, MNA-SF has two: anthropometric and general assessment. One of the Germany studies state that MNA was superior than MNA-SF in expecting mortality and distinguishing functional decline during 1 year of follow-up.20 Although MNA is simple, non-invasive, inexpensive and can be done easily, it is not well known in Myanmar.

Therefore, the objective of this study was to estimate the prevalence of malnutrition by using MNA and the factors influencing malnutrition among the elderly in Loikaw Township, Myanmar. This study was a community based, cross-sectional study to explore the malnutrition of the elderly. The study population was the 60 years of age or more of the old who reside in Loikaw Township. Very ill and mentally retarded persons were excluded from this study.

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