Nutrition Research and Practice

  • 제18권3호
  • /
  • Pages.400-411
  • /
  • 2024
  • /
  • 1976-1457(pISSN)
  • /
  • 2005-6168(eISSN)
한국영양학회 (The Korean Nutrition Society)
권호 표지
DOI QR코드

DOI QR Code

Malnutrition and its associated factors among community-dwelling older men living alone

  • Gahye Kim (College of Nursing, Seoul National University) ;
  • Minhwa Hwang (College of Nursing, Seoul National University) ;
  • Seonghyeon Lee (College of Nursing, Seoul National University) ;
  • Yeon-Hwan Park (College of Nursing, Seoul National University)
  • 투고 : 2023.12.22
  • 심사 : 2024.04.15
  • 발행 : 2024.06.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

BACKGROUND/OBJECTIVES: Older men who live alone are more vulnerable to poor nutrition. However, little attention has been paid to malnutrition among this population. This study aimed to examine malnutrition and its associated factors among community-dwelling older men living alone. SUBJECTS/METHODS: This cross-sectional descriptive study used cohort data of community-dwelling older adults living alone in South Korea. A total of 230 older men aged 65 and over were included in this study. Nutritional status was assessed using the Mini Nutritional Assessment-Short Form. Multidimensional factors (sociodemographic, health-related, psychosocial, and lifestyle characteristics) were evaluated. Hierarchical logistic regression analyses were conducted to identify the malnutrition-related factors. RESULTS: The prevalence of malnutrition was 32.2% in older men living alone. Low income (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.01-5.90), polypharmacy (OR, 2.23; 95% CI, 1.16-4.28), suicidal ideation (OR, 2.13; 95% CI, 1.02-4.45), meal skipping (OR, 3.26; 95% CI, 1.60-6.64), and smoking (OR, 2.86; 95% CI, 1.43-5.73) were significantly associated with malnutrition. CONCLUSION: Malnutrition is a severe health problem in older men living alone. This study highlights the importance of comprehensive and tailored interventions to mitigate malnutrition among older men living alone.

키워드

과제정보

This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C1284); and the BK21 4 project (Center for Human-Caring Nurse Leaders for the Future) funded by the Ministry of Education (MOE, Korea) and National Research Foundation of Korea (NRF) (grant number: 4120200413721).

참고문헌

  1. United Nations, Department of Economic and Social Affairs, Population Division. Database on household size and composition 2022 [Internet]. New York (NY): United Nations, Department of Economic and Social Affairs, Population Division; 2022 [cited 2023 November 1]. Available from: https://www.un.org/development/desa/pd/data/household-size-and-composition.
  2. KOSIS. Number of private households by head's age and household type [Internet]. Daejeon: Statistics Korea; 2022 [cited 2023 November 1]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BZ0502&conn_path=I2&language=en.
  3. KOSIS. Seoul survey 2021, the elderly living alone [Internet]. Daejeon: Statistics Korea; 2022 [cited 2023 November 1]. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=201&tblId=DT_201004_F030011&conn_path=I2.
  4. Joo CL, Park JJ, Kim A, Park NL, Lim J, Park HS. Health behaviors and lifestyle patterns of elderly living alone in Korea. Korean J Fam Pract 2019;9:247-53.
  5. Yokoro M, Otaki N, Yano M, Tani M, Tanino N, Fukuo K. Associations between dietary variety and frailty in community-dwelling older people who live alone: gender differences. J Frailty Aging 2023;12:30-6.
  6. Kandler U, Meisinger C, Baumert J, Lowel H; KORA Study Group. Living alone is a risk factor for mortality in men but not women from the general population: a prospective cohort study. BMC Public Health 2007;7:335.
  7. World Health Organization. Malnutrition [Internet]. Geneva: World Health Organization; 2021 [cited 2023 November 1]. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition.
  8. O'Keeffe M, Kelly M, O'Herlihy E, O'Toole PW, Kearney PM, Timmons S, O'Shea E, Stanton C, Hickson M, Rolland Y, et al. Potentially modifiable determinants of malnutrition in older adults: a systematic review. Clin Nutr 2019;38:2477-98.
  9. Cereda E, Pedrolli C, Klersy C, Bonardi C, Quarleri L, Cappello S, Turri A, Rondanelli M, Caccialanza R. Nutritional status in older persons according to healthcare setting: a systematic review and meta-analysis of prevalence data using MNA(R). Clin Nutr 2016;35:1282-90.
  10. Norman K, Hass U, Pirlich M. Malnutrition in older adults-recent advances and remaining challenges. Nutrients 2021;13:2764.
  11. Tani Y, Kondo N, Takagi D, Saito M, Hikichi H, Ojima T, Kondo K. Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: results of the JAGES. Appetite 2015;95:1-8.
  12. Wham CA, Bowden JA. Eating for health: perspectives of older men who live alone. Nutr Diet 2011;68:221-6.
  13. Thompson J, Tod A, Bissell P, Bond M. Understanding food vulnerability and health literacy in older bereaved men: a qualitative study. Health Expect 2017;20:1342-9.
  14. Bakhtiari A, Pourali M, Omidvar S. Nutrition assessment and geriatric associated conditions among community dwelling Iranian elderly people. BMC Geriatr 2020;20:278.
  15. Besora-Moreno M, Llaurado E, Tarro L, Sola R. Social and economic factors and malnutrition or the risk of malnutrition in the elderly: a systematic review and meta-analysis of observational studies. Nutrients 2020;12:737.
  16. Mills CM, Keller HH, DePaul VG, Donnelly C. Social network factors affect nutrition risk in middle-aged and older adults: results from the Canadian Longitudinal Study on Aging. J Nutr Health Aging 2023;27:46-58.
  17. Wong MM, So WK, Choi KC, Cheung R, Chan HY, Sit JW, Ho B, Li F, Lee TY, Chair SY. Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community. BMC Geriatr 2019;19:138.
  18. Lee C, Cho B, Yang Q, Chang SJ, Ko H, Yi YM, Cho HR, Park YH. Psychosocial risk profiles among older adults living alone in South Korea: a latent profile analysis. Arch Gerontol Geriatr 2021;95:104429.
  19. Volkert D, Kiesswetter E, Cederholm T, Donini LM, Eglseer D, Norman K, Schneider SM, Strobele-Benschop N, Torbahn G, Wirth R, et al. Development of a model on determinants of malnutrition in aged persons: a MaNuEL project. Gerontol Geriatr Med 2019;5:2333721419858438.
  20. Mills CM, Keller HH, DePaul VG, Donnelly C. Nutrition risk varies according to social network type: data from the Canadian Longitudinal Study on Aging. Fam Med Community Health 2023;11:e002112.
  21. Zewdu E, Daniel L, Derso T, Ferede YM. Level of malnutrition and associated factors among community-dwelling rural older adults in Fogera Zuriya district, Northwest Ethiopia. Nutrition 2023;113:112085.
  22. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 2001;56:M366-72.
  23. e-Nara Index. Trend in median family incomes [Internet]. Daejeon: Statistics Korea; 2023 [cited 2023 November 1]. Available from: https://www.index.go.kr/unity/potal/main/EachDtlPageDetail.do?idx_cd=2762.
  24. Alic A, Pranjic N, Ramic E. Polypharmacy and decreased cognitive abilities in elderly patients. Med Arh 2011;65:102-5.
  25. Won CW, Yang KY, Rho YG, Kim SY, Lee EJ, Yoon JL, et al. The development of Korean activities of daily living (K-ADL) and Korean instrumental activities of daily living (K-IADL) scale. J Korean Geriatr Soc 2002;6:107-20.
  26. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-98.
  27. Kim OS. Korean version of the revised UCLA loneliness scale: reliability and validity test. Kanho Hakhoe Chi 2017;27:871-9.
  28. Russell D, Peplau LA, Cutrona CE. The revised UCLA loneliness scale: concurrent and discriminant validity evidence. J Pers Soc Psychol 1980;39:472-80.
  29. Li Y, Jiang Y, Zhang M, Yin P, Wu F, Zhao W. Drinking behaviour among men and women in China: the 2007 China chronic disease and risk factor surveillance. Addiction 2011;106:1946-56.
  30. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95.
  31. The IPAQ group. Guidelines for data processing analysis of the international physical activity questionnaire (IPAQ) - short and long forms [Internet]. [place unknown]: The IPAQ group; 2005 [cited 2023 November 1]. Available from: https://sites.google.com/view/ipaq/score.
  32. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med 2008;3:17.
  33. Hsu YH, Chou MY, Chu CS, Liao MC, Wang YC, Lin YT, Chen LK, Liang CK. Predictive effect of malnutrition on long-term clinical outcomes among older men: a prospectively observational cohort study. J Nutr Health Aging 2019;23:876-82.
  34. Leij-Halfwerk S, Verwijs MH, van Houdt S, Borkent JW, Guaitoli PR, Pelgrim T, Heymans MW, Power L, Visser M, Corish CA, et al. Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults ≥65 years: a systematic review and meta-analysis. Maturitas 2019;126:80-9.
  35. Zorbas C, Palermo C, Chung A, Iguacel I, Peeters A, Bennett R, Backholer K. Factors perceived to influence healthy eating: a systematic review and meta-ethnographic synthesis of the literature. Nutr Rev 2018;76:861-74.
  36. Statistics Korea. 2022 Statistics on the aged [Internet]. Daejeon: Statistics Korea; 2022 [cited 2024 March 15]. Available from: https://kostat.go.kr/board.es?mid=a10301010000&bid=10820&tag=&act=view&list_no=420896&ref_bid.
  37. Lee Y, Kim S, Hwang N, Lim J, Joo B, Namkung E, et al. 2020 National Survey of Older Koreans. Sejong: Korea Institute for Health and Social Affairs, Ministry of Health and Welfare; 2020. Report No.:11-1352000-000672-12.
  38. Kok WE, Haverkort EB, Algra YA, Mollema J, Hollaar VR, Naumann E, de van der Schueren MA, JerkovicCosic K. The association between polypharmacy and malnutrition(risk) in older people: a systematic review. Clin Nutr ESPEN 2022;49:163-71.
  39. Kuzuya M. Effect of drugs on nutritional status and drug-nutrition interactions in older patients. Geriatr Gerontol Int 2023;23:465-77.
  40. Eskelinen K, Hartikainen S, Nykanen I. Is loneliness associated with malnutrition in older people? Int J Gerontol 2016;10:43-5.
  41. Kwak Y, Kim Y. Association between mental health and meal patterns among elderly Koreans. Geriatr Gerontol Int 2018;18:161-8.
  42. Hwang IC, Choi S. Association between consumption of fruits and vegetables with suicidal ideation. Public Health Nutr 2021;25:1-6.
  43. Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med 2000;51:843-57.
  44. Zeballos E, Todd JE. The effects of skipping a meal on daily energy intake and diet quality. Public Health Nutr 2020;23:3346-55.
  45. Fukuda Y, Ishikawa M, Yokoyama T, Hayashi T, Nakaya T, Takemi Y, Kusama K, Yoshiike N, Nozue M, Yoshiba K, et al. Physical and social determinants of dietary variety among older adults living alone in Japan. Geriatr Gerontol Int 2017;17:2232-8.
  46. Korean Women's Development Institute. A Study on the National Survey of Families 2020. Seoul: Ministry of Gender Equality & Family South Korea; 2021. p.545. Report No.: 11-1383000-000684-13.
  47. Paoli A, Tinsley G, Bianco A, Moro T. The influence of meal frequency and timing on health in humans: the role of fasting. Nutrients 2019;11:719.
  48. van Bokhorst-de van der Schueren MA, Lonterman-Monasch S, de Vries OJ, Danner SA, Kramer MH, Muller M. Prevalence and determinants for malnutrition in geriatric outpatients. Clin Nutr 2013;32:1007-11.
  49. Masood S, Cappelli C, Li Y, Tanenbaum H, Chou CP, Spruijt-Metz D, Palmer PH, Johnson CA, Xie B. Cigarette smoking is associated with unhealthy patterns of food consumption, physical activity, sleep impairment, and alcohol drinking in Chinese male adults. Int J Public Health 2015;60:891-9.
  50. Wild H, Gasevic D, Woods RL, Ryan J, Berk M, Wolfe R, McNeil J, Owen AJ. Correlates of meal skipping in community dwelling older adults: a cross-sectional study. J Nutr Health Aging 2023;27:159-65.
  51. Chao AM, Wadden TA, Ashare RL, Loughead J, Schmidt HD. Tobacco smoking, eating behaviors, and body weight: a review. Curr Addict Rep 2019;6:191-9.
  52. Kather F, Hadzic M, Hehle T, Eichler S, Klein J, Voller H, Salzwedel A. Test-retest reliability of the Mini Nutritional Assessment-Short Form (MNA-SF) in older patients undergoing cardiac rehabilitation. J Geriatr Cardiol 2020;17:574-9.