Risk factors associated with nutritional status among the older persons in selected homes for the aged in Nairobi and Kiambu Kenya

Abstract

Nutrition plays an important role in aging and health. Little is documented on the risks of relocation from home to an institution in relation to the nutritional status of the older persons in Kenya and other developing countries. The purpose of the study was to investigate risk factors associated with nutritional status of the older persons in the homes. The objectives of the study were to; establish the risk factors associated with nutritional status of the older persons in these homes and identify the relationship between risks that have an effect on nutritional status. A conceptual framework derived from Help age International publications guided the study. A descriptive survey design using a multi instrument approach was used. All the 69 (sixty nine) older persons aged between 63 (sixty three) and 107 (a hundred and seven) from the two homes whereby 50 (fifty) came from Nyumbani situated in Nairobi while 19 (nineteen) came from Thogoto in Kiambu were used to provide the required data. Data were collected using an interview schedule for the older persons; self-administered questionnaire for the nurse and social worker in the two homes and an observation checklist. Food frequency table and anthropometric measurements were used to provide information on growth and development in size and composition. Data were analyzed using both qualitative and quantitative means whereby SPSS Version 8 computer analysis package was used and statistics such as means, percentages, standard deviation, Pearson's correlation and cross tabulations were used to organize, describe and summarize the data. Risks found to be associated with poor nutritional status included; health problems, economic problems, lack of social contacts, food intake obstacles, food frequency, and amount of care given, lack of exercises, and advanced age. There were equal numbers of the older persons who were severely, moderately and mildly malnourished were 2 (3.2%). Those with normal nutritional status were 46 (73.0%) while overweight or grade 1 obesity were 8 (12.7%). Nyumbani was found to have a mean nutritional status of 22.4 while Thogoto had 19.5. Females had an average of 22.4 while males had 21.1 nutritional status. The study found that health conditions formed major risks to the older person's nutritional status. Economic ability influenced the foods eaten in the home. Lack of social contacts brought about emotional/psychological stress, which then influenced food intake and utilization. Refusal to eat so as to control incontinence acted as a nutritional risk. Other risks that had an influence on nutritional status includes; the food frequency, amount of care given, lack of exercises that would have boosted the nutrient absorption and food intake. Advanced age also acted as nutritional risk as increase in age nutritional status declined (r=-0.54, P=0.007). The study recommends that a similar study comparing the risks that are present in different living condition those living alone, with relatives, in the streets and those in the homes. Also the NGOs that concentrate on children and mothers should include the older persons in their service provision, as they are equally vulnerable.