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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
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.
REFERENCES
- World Health Organization. Ageing and Health Fact sheet. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Published Febuary 5, 2018. Accessed November 30, 2019.
- Valentini L, Schulzke JD. Mundane, yet challenging: the assessment of malnutrition in inflammatory bowel disease. Eur J Intern Med. 2011;22(1):13-15.
- Keller HH. Malnutrition in institutionalized elderly: how and why? J Am Geriatr Soc. 1993;41(11):1212-1218.
- Amarantos E, Martinez A, Dwyer J. Nutrition and quality of life in older adults. J Gerontol A Biol Sci Med Sci. 2001;56(suppl 2):54-64.
- Morley JE. Undernutrition in older adults. Fam Pract. 2012;29 (suppl 1):i89–i93.
- Oo MY, Punpuing S, Chamchan C. Factors Affecting Quality of Life of Older People in Taungu Township, Bago Region, Myanmar. J Health Res. 2015:29(4):235-242. doi:10.14456/jhr.2015.14.
- Pourhassan M, Bottger S, Janssen G, Sieske L, Wirth R. The Association of Inflammation with Food Intake in Older Hospitalized Patients. J Nutr Health Aging. 2018;22(5):589-593.
- Dent E, Hoogendijk EO, Wright ORL. New insights into the anorexia of ageing: from prevention to treatment. Curr Opin Clin Nutr Metab Care. 2019;22(1):44-51. doi:10.1097/MCO.0000000000000525.
- Morley JE, Bauer JM. Nutrition and aging successfully. Curr Opin Clin Nutr Metab Care. 2017;20(1):1-3. doi:10.1097/MCO.0000000000000330.
- Adams NE, Bowie AJ, Simmance N, Murray M, Crowe TC. Recognition by medical and nursing professionals of malnutrition and risk of malnutrition in elderly hospitalised patients. Clinical Nutrition and Diabetics. 2008;65(2):144-150.
- Guyonnet S, Rolland Y. Screening for malnutrition in older people. Clin Geriatr Med. 2015;31(3):429-437. doi:10.1016/j.cger.2015.04.009.
- Guigoz Y, Vellas B. Malnutrition in the elderly: the mini nutritional assessment (MNA). Ther Umsch. 1997;54(6):345-350.
- Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening. Clin Nutr. 2003;22(4):415-421. doi:10.1016/S0261-5614(03)00098-0.
- Bauer JM, Kaiser MJ, Anthony P, Guigoz Y, Sieber CC. The Mini Nutritional Assessment-its history, today’s practice, and future perspectives. Nutr Clin Pract. 2008;23(4):388-396. doi:10.1177/0884533608321132.
- United Nations. World Population Prospects The 2015 Revision. Department of Economic and Social Affairs. https://www.un.org/en/development/desa/publications/world-population-prospects-2015-revision.html. Published July 29, 2015. Accessed November 30, 2019.
- Baweja S, Agarwal H, Mathur A, Haldiya KR, Mathur A. Assessment of nutritional status and related risk factors in community dwelling elderly in western Rajasthan. J Indian Acad Geriatr. 2008;1:5-13.
- Aye LL, Linn H, Hlaing MM, Aung AM. Dietary habits and nutritional status of the elderly in Insein Township, Yangon Region in 2013. Myanmar Health Sciences Research Journal. 2017;29(1):37-43.
- Kiesswetter E, Pohlhausen S, Uhlig K, et al. Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care. J Am Geriatri Soc. 2014;62(3):512-517.
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