The multidimensional background of malnutrition among rural older individuals in Bangladesh--a challenge for the Millennium Development Goal.
OBJECTIVE
To investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh.


METHODS
A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant.


METHODS
Matlab, Bangladesh.


METHODS
A total of 625 randomly selected individuals (>or=60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women.


RESULTS
Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0.001), gastrointestinal disorders (P < 0.01), depressive symptoms (P < 0.001) and impaired cognitive function (P < 0.01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0.05), having no income (P < 0.01), being illiterate (P < 0.01) and not receiving regular financial support (P < 0.05) were also independently associated with poor nutritional status.


CONCLUSIONS
Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.
Ferdous
Tamanna
T
Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, 751 85 Uppsala, Sweden. tamanna.ferdous@pubcare.uu.se
Kabir
Zarina Nahar
ZN
Wahlin
Ake
A
Streatfield
Kim
K
Cederholm
Tommy
T
D000368:Aged; D000375:Aging; D001459:Bangladesh / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D011203:Poverty; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors