ABSTRACT
World Health Organization (WHO) defines people of age 65 and
above as “old age”. Data shows a rapid growing trend of the older persons,
especially in developing countries of which Ghana is not an exception, In-spite
of this increasing trend, little has so far been documented on the nutritional
status and associated factors of the aged in Ghana, which can contribute to
formulating appropriate policies for this vulnerable group. To help address
this, a cross-sectional study was conducted among 384 participants, of them
were individuals 65 years or above at the West Gonja District, Ghana to assess
their nutritional status and its associated factors. Respondents were selected
from twenty-five (25) communities, and a structured questionnaire was used to
elicit response on socio-demographic status, dietary habits and food choices,
and morbidity. Anthropometric measurements, including height and weight were
taken, from which BMIs were calculated. Nutrient analysis template was used
extract specific total nutrient values per 100g whilst data entry and analysis
was done using statistical package of social sciences (SPSS) version 23 with p <
0.05 considered as statistical significant. Pearson chi-square correlation and
regression were used to establish the relationship between exposure and outcome
variables. Among the 384 respondents, 161(41.9%) were males and 223(58.1%) were
females. In total, malnutrition was (43.8%) among the respondents with
Underweight (27.9%), 56.2% were of normal BMI while few (15.9%) were either
obese or overweight. Majority of the respondent (79.9%) consumed three meals a
day, 15.1% consumed two meals a day whilst 2.9% was once a day. A significant
association (p = 0.001) was observed between meal frequency and nutritional
status, with overweight/obese participants recording greater meal frequency
compared with underweight/normal participants. Equally, a Chi square analysis
showed a significant association between protein intake (p < 0.001), total fat
intake (p < 0.012) and carbohydrate intake (p = 0.216) with BMI status. A
significant association was also observed between weight loss and BMI
(P = 0.002), morbidity (p = 0.012), having personal food preferences (p = 0.001) and
being on diet (p = 0.002). Generally, micronutrient intake among the respondents
was very poor with 48.4% of the respondents having low iron intake while none
of the respondents meeting the RDAs for calcium. In conclusion, the findings
shows greater proportion of the participants being malnourished, Significant
association between meal frequencies and BMI status, macronutrient and BMI
status, and lastly, BMI status, morbidity, food preferences, and being on diet
with weight loss. Further study is recommended on how food quality is related
to the nutritional status of the elderly.
CHAPTER ONE
1.0 GENERAL INTRODUCTION
This study was carried out in the West Gonja District in the
Northern region, Ghana. The first chapter introduces the study, and also
entails the problem statement, research objectives as well as the
justifications. The second chapter is made up of the literature review, which
gives information related to the research topic. The third chapter elaborates
on the methodology deployed in the study comprising of the background of the
study area, target population, target sample size, study design, the sampling
techniques, data collection, data analysis, and ethical considerations. Chapter
four involves analysis of data obtained and discussion of results. The fifth
Chapter gives detailed implication of the study findings and its associations
to other researches of its kind. Chapter Six concludes the study and goes on to
give some recommendations based on the research findings.
1.1 Background
Ageing is the period that starts prior to birth and continues
until the end of life. These are inevitable physiological and anatomical change
that happens over the course of time. World Health Organization (WHO, 2010)
therefore defines people of age 65 and above as “old age” or older persons.
Accordingly, the progressive changes among older persons and their body
functions are classified as follows; individuals between the age group of 65–74
are classified as “young old”, 75–84 age group as “old” and the group of age 85
and above is categorized as “oldest old” (Aksoydan et al., 2006).
It is believed that growth among
individuals aged 65 years and above will rise from 524 million in 2010 to about
1.5 billion in 2050.Although studies have proved that developed countries have
the highest older person‟s population in the world, yet still less developed
countries have proven to have the fastest aging population profile with a significant
proportion of their population being the aged. Between 2010 and 2050, the
proportion of older persons in less developed countries is estimated to
increase beyond 250 percent, compared with the 71% rise in the developed
countries (World Population Prospect, 2010).
Data has shown a significant rise in aged population. In
Ghana, the elderly population has increased from a total 213 thousand (4.5%) of
the total national population to 1.6 million (6.7%) between 1960 and 2010
indicating rapid increment of more than seven folds of the total national
population (GSS, 2010). However, one of the major challenges battling planners
and policy makers is the absence of systematic reliable data on the needs of
older Africans (Ramashala et al., 2002). Some data relatively exist for few
countries, but the current lack of in depth reliable national-level data about
the older populations presents a major limitation to understanding their
nutritional wants and associated factors, making policy formulation and interventions
difficulty in this aged group (Ramashala et al., 2002).
According to the National Institute on Aging, (2011) the
remarkable improvements in life expectancy over the past century were part of
the shift in the leading causes of diseases and death. Among developing
countries today, a clear cast reflection on the changes of diet, life style and
ageing is evidenced with the magical rise of chronic non-communicable diseases
such as coronary heart disease, cancers, diabetes among others in the human
population.
Liu et al., (2000) indicated that
dietary habits have contributed significantly to health-related disease
especially among the aged group. It was observed that, atherosclerosis reduced
by 30% among individuals who ate 5-10 servings of fruits and vegetables per/day
compared with individuals who ate 2-5 servings of fruits and vegetables
per/day. Aksoydan et al., (2006) also stated that, proper health promotion,
disease prevention and management among the aged populace cannot be achieved
without appropriate nutrition.
The basic diseases which afflict older men and women are
usually same: cardiovascular diseases, ulcers, cancers, musculoskeletal
problems, diabetes, mental illnesses, sensory impairments, incontinence,
especially in poorer parts of the world with other infectious diseases which
cannot be completely ruled out (WHO, 2002).
The above mentioned illnesses are the notable conditions that
are said to accounts for bulk of mortality and morbidity among the old aged
stem from early life style behaviours and experiences such as alcoholism,
smoking, poor nutrition thus under and over nutrition, lack of physical
activity, poor personal and environmental hygiene, violence, poor health care,
injuries, and lack of or poor education, these and many same other experiences
during early childhood age, adolescent and adult age are the main attributable
factors to poor or ill health in later life (WHO, 2002).
By the year 2000, individuals 60
years and above in the world‟s population were estimated as 10%,which means
that a total of 400 million older persons are expected to be living in
developed countries whilst over 1.5 billion of same age group will be in the
less developed countries. Clearly, the interests of the elderly, including
their health concerns are poised to take on greater prominence in coming years
(WHO, 2002).
Potentially, the sudden rises in the chronic non-communicable
diseases in this age group has been foresight in long term to have a detrimental
effect on the economic earns and societal cost in most African countries (WHO,
2002). A survey on older persons by World Health Organization (WHO) analysed in
23 low- and middle-income countries reveals a huge economic loss of about US$83
billion between 2006 and 2015 among three non-communicable diseases (heart
disease, stroke, and diabetes) (UNWPP, 2010).
Coupled with this, United Nation, (2009) observed a total
negligence of aged health care in the sub-Saharan Africa (SSA) in spite of the
increasing trend of their aged population (50 years and above) from 2005 to
2030. This in effect is seen among the regions in the world with the highest
percentage (108%) thus about 76-157 million aged (Kimokoti et al., 2008).
Relatively, this cannot be taught off without considering the economic and
health impact of it.
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