title: The AMEL study, a cross sectional population-based survey on aging and malnutrition in 1200 elderly Lebanese living in rural settings: protocol and sample characteristics.
abstract: BACKGROUND
  Lebanon is faced with a particular challenge because of large socioeconomic inequality and accelerated demographic transition. Rural residents seem more vulnerable because of limited access to transport, health and social services. No information is available regarding health, nutrition and living conditions of this specific population. The purpose of the AMEL (Aging and Malnutrition in Elderly Lebanese) study is to assess the nutritional status of community dwelling elderly people, aged 65 years and above, living in a rural settings in Lebanon, in line of socioeconomic factors, health and living conditions. The present paper will describe the gender specific characteristics of the study population.
  
  
  METHODS
  AMEL is a cross-sectional population based study conducted between April 2011 and April 2012 including 1200 elderly individuals living in the 24 rural Caza (districts) of Lebanon. People aged greater than or equal to 65 y were randomly selected through multistage cluster sampling. Subjects were interviewed at their homes by trained interviewers. The questionnaire included the following measures: socio-demographic factors, nutritional status (Mini Nutritional Assessment, MNA), health related characteristics, functional ability, cognitive status, mood and social network.
  
  
  RESULTS
  The sample included 591 men (49.3%) and 609 women (50.8%). Mean age was 75.32 years and similar between genders. Malnutrition (MNA < 17) and risk of malnutrition (MNA between 17 and 23.5) were present in 8.0% (95%CI 4.9%-11.1%) and 29.1% (95%CI 24.0%-34.2%) respectively of the participants, and more frequent in women (9.1% and 35.3% respectively). Regarding socio-demographic status, among women the level of illiteracy and poor income was significantly higher than in men. Moreover, chronic diseases, poor self perceived health, frailty, functional disability, depressive symptoms and cognitive impairment were particularly high and significantly more frequent in women than in men.
  
  
  CONCLUSIONS
  The present study provides unique information about nutritional status, health and living conditions of community dwelling rural residents of Lebanon. These findings may alert policy makers to plan appropriate intervention in order to improve the quality of life and increase successful aging.
authors.affiliation: Department of Nutrition, Faculty of Pharmacy, Saint Joseph University, Beirut, Lebanon. christa.boulos@gmail.com.
authors.forename: Christa
authors.initials: C
authors.lastname: Boulos
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D009735:Nursing Homes / Q000706:statistics & numerical data; D015596:Nutrition Assessment; D012424:Rural Population; D011795:Surveys and Questionnaires