International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 05 Issue 16, August, 2013

Pages: 38-42

Date of Publication: 28-Aug-2013


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NUTRITIONAL STATUS OF THE ELDERLY FEMALE IN A MUNICIPAL TOWN OF WEST BENGAL

Author: Bigitendriya Debsharma

Category: Healthcare

Abstract:The present research based study was undertaken to determine the prevalence of undernutrition using two different variables, body mass index (BMI) and mid-upper arm circumference (MUAC) among elderly females (> 60 years) of Chakdah municipal town of Nadia District, West Bengal, India. A total of 250 were measured using standard techniques. Internationally recommended cut-off values of MUAC (< 22) and BMI were used to evaluate the nutritional status of the subjects. Result of the present study shows that the elderly females of Chakdah municipal town were experiencing high rate of undernutrition CED BMI (F = 0.586) and MUAC (F = 1.156). Maximum of the elderly people are daily labor and economically very pour. It is sensible to say that elderly people comprises good percentage of any population, so their needs a number of socio-economic and nutritional survey among the elderly people to make out their health related problems and thereafter draw the sketch Since MUAC is a much simpler measure compared to BMI, its use may be preferred in studies pertaining to the anthropometric evaluation of nutritional status in these population.

Keywords: Body mass index, Mid-upper arm circumference, chronic energy deficiency, Elderly female.

Full Text:

INTRODUCTION
Low socioeconomic status, limited functional ability and social isolation are often major driving factors for undernutrition in the community. Financial constraints will affect access to basic necessities such as nutritious food. Living or eating alone often results in lower food intake for older people and increases their risk of undernutrition [1] . World Health Organization (1995) has recommended that anthropometry could be used to assess the nutritional and health status of adults. Low Body Mass Index (BMI) and high levels of undernutrition (based on BMI) are major public health problem especially among rural underprivileged adults of developing countries (WHO, 1995) [2]. Although adult nutritional status can be evaluated in many ways, the BMI is most widely used because its use is simple, inexpensive, safe and suitable for large scale surveys (Lohman et al., 1988; Ferro-Luzzi et al., 1992; James et al., 1994; Lee and Nieman, 2003) [3]. Thus, BMI is the most established anthropometric indicator used for assessment of adult nutritional status (Lee and Nieman, 2003) [4]. Ferro-Luzzi and James [5] have proposed MUAC cut-off points for use in screening acute adult undernutrition. Nutritional problem mainly under-nutrition in older people is sadly far too common, even in developed countries. Protein energy malnutrition in older people comes at a significant cost to the individual, families, communities and the healthcare system. Failure to address this syndrome is not only unethical and unhealthy, but also costly. Vigilance and community awareness is important in ensuring that this important syndrome is detected and managed appropriately. Advances in medical technology, better nutrition and healthcare have extended the human life span in 20th century. The 21st century must therefore live with the consequences of that far-reaching achievement. One million people cross the 60 year mark every month, and of them 80 percent are in the developing world. The age of 60 or 65, roughly equivalent to retirement ages in most developed countries is said to be the beginning of old age. The United Nations generally uses 60+ years to refer to the older population. According to 2001 census total population of India is 102, 86, 10,328 of which 60+ population is 7, 66, 22,321(7.44% of the total population). In case of West Bengal, the total population is 8, 01, 76,197 of which the number of 60+ population is 57, 00,099 (7.11% of the total population of West Bengal). Among the total elderly persons of West Bengal 33.21% is urban and 66.79 % is rural. The objective of the present study is to evaluate the nutritional status, based on MUAC and BMI of elderly females of Chakdah Municipal Town of Nadia District, West Bengal, India. Another one is to find out the Socio-economic Problem of the elderly peoples of the proposed study area.

MATERIAL AND METHODS
Study Sample: The present cross sectional study was conducted among 250 elderly females age 60 years and above were measured from 22 wards of the Chakdah Municipal town of Nadia District. Random sampling method was used to sampling the population. Data on socioeconomic background of the individual respondent, food habits, last two years disease, their living condition and day-to-day activities have been collected with the help of household census survey, interview technique aided by structured question schedule.

Study Area:
The Chakdah Municipal Town is selected as study area which consisted with 22 wards, near the Chakdah Railway Station; approximately 95 KMs far from Kolkata, the provincial capital of West Bengal, India. Chakdah today is totally service sector oriented economy along with business as an unorganized informal sector. Total population of Chakdah Municipality is 86965 according to 2001 census. People of this region, work in neighbouring areas and in Kolkata. Industries are almost nonexistent except a few small-scale industries mainly plastic factories. There are just seven small scale industries in the municipal region.

CALCULATION
BMI was calculated with applying the formula BMI = Weight (kg) / height (m2 ). Nutritional status was evaluated using internationally accepted BMI guidelines. Anthropometric variables height, weight and mid upper arm circumferences were included. The following cut-off points were usedCED BMI <18.5, Normal: BMI = 18.5-24.9, Overweight: BMI ≥ 25.0, CED was further divided into CED III, CED II and CED I as BMI < 16.0, 16.0-16.9 and 17.0-18.4 kg/m2 , respectively. We followed the World Health Organization's classification (1995) [6] of the public health problem of low BMI, based on adult populations worldwide. This classification categorises prevalence according to percentage of a population with BMI< 18.5. Low (5-9%): warning sign, monitoring required. High (20- 39%): serious situation. Medium (10-19%): poor situation. Very high (≥ 40%): critical situation. MUAC value < 22: Undernutrition.

RESULT
In general, body mass increases during adulthood and decreases progressively with old age at a rate of approximately one kilogram per decade. Furthermore, during old age, height is estimated to decrease at 0.5 – 1.5cm per decade [7] . Standard deviation, mean and age-group specific number for the body mass index (BMI) and Mid-upper arm circumference (MUAC) of elderly females are presented in Table1 , 2 . The present study found that nutritional status based on BMI that is 87.2% elderly peoples are undernourished and 12.7% are normal as well as nutritional status based on MUAC that is 84.8% belongs to undernutrition and 16.2% only in normal situation out of 250 elderly females. Mean BMI of different age group were calculated 21.24, 21.9 and 21.46 where F=0.586 and P=0.558. Mean MUAC were 22.26cm, 22.09cm and 22.33cm, SD (Standard Deviation) were 0.96, 0.95 and 0.79 Where F=1.156, P =0.316. Mean height, Weight and SD were calculated in different age groups. The Mean BMI and MUAC showing the elderly females in different age groups are undernourished but there showing no significant differences.

DISCUSSION
In particular, protein requirements for older people are approximately 25% higher than for younger adults [8]. Based on the limited data available, the recommended dietary intake for people aged ≥70 years is 81g per day for men and 57 g for women, or approximately 1g protein per kg body weight [9] . Under-nourished older people are not only at risk of increased mortality. They are also at risk of multiple complications, which can significantly impact on their overall quality of life. The population of the world is ageing and under-nutrition amongst older people is a global crisis that is set to increase. The present study is on the nutritional status of Elderly female that is consider as 60 aged people, that time the elderly people gradually loose their working strength and muscle power, so they have to need regular diet intake nutritious food for proper nutritional status. Mid upper arm circumference (MUAC) has recently emerged in the literature as a potential screening tool for poor nutritional status analyzed its usefulness in adults, and calculated cutoffs equivalent to body mass index (BMI) and cutoffs for chronic energy deficiency (CED), using a range of data sets from developing countries. MUAC is an appropriate indicator for the assessment of acute adult undernutrition. This indicator is useful for both screening acute adult undernutrition and for estimating prevalence of undernutrition at a population level. The assessment of adult nutritional status using MUAC requires no equipment apart from a tape measure. As the index is the actual measurement itself, mathematical manipulation of the measurement obtained is not necessary. The ease with which MUAC can be assessed makes it suitable for nutritional screening during the height of an emergency where time and skilled personnel are at a premium. The MUAC measurement reflects adult nutritional status as defined by BMI. The measurement of MUAC has been used as a useful screening method for the assessment of nutritional status in different ethnic groups [10, 3] . Since it is the most reproducible and simplest measurement to perform, its use has been recommended in nutritional studies [11] . Measuring MUAC has several advantages; the measurement can be taken quickly and at little cost. It requires neither sophisticated equipment nor anything but the most basic literacy level to carry out. However, although an MUAC value < 23cm have been recommended for use to define undernutrition [5] this value may not be the most appropriate cut-off point in all ethnic groups.

CONCLUSION
Elderly people who are underweight are at greater risk of mortality than those who are overweight [12] . The undernourished elderly peoples are more in number than the normal elderly peoples on the basis of BMI and MUAC.

The Mean BMI and MUAC showing the elderly females in different age groups are undernourished but there showing no significant differences. There is a need for more studies using MUAC in different ethnic groups of India so that they provide ethnic-specific cut-off points of MUAC to facilitate better public health planning and implementation.

Abbreviation used
BMI- Body Mass Index,
MUAC- Mid Upper Arm Circumference, C
ED- Chronic Energy Deficiency,
WHO- World Health Organization,
SD- Standard Deviation

ACKNOWLEDGEMENTS
All participating elderly are greatly acknowledged for their cooperation and actively participation. Specially addressing acknowledge to the Municipal Chairman of Chakdah Municipality as well as other staffs for their good cooperation. I would like to thanks my supervisor Professor Falguni Chakrabarty for his positive, inspiring, encouraging and relaxed attitude for giving me a speedy start into academic research. I fully acknowledge to my parents who all-time inspire me about research. However, the authors assume full responsibility for all data and content presented.

References:

1. Sampson G. Weight loss and malnutrition in the elderly – the shared role of GPs and ADPs. Aust Fam Physican 2009; 38:507– 10.

2. World Health Organization (1995) Physical status: the use and interpretation of anthropometry. Technical Report Series no. 854. World Health Organization, Geneva.

3. Ferro-Luzzi, A., W. P. James, Lee and Nieman, 2003, British Journal of Nutrition, 75 (1996) 3.- Lee, R.D. andNieman, D.C. (2003). Nutritional Assessment. New York: McGraw Hill.

4. James WPT, Mascie-Taylor CGN, Norgan NG, Bristrian BR, Shetty P, Ferro-Luzzi A (1994) The value of arm circumference measurements in assessing chronic energy deficiency in Third World adults. European Journal Clinical Nutrition. 48:883–894.

5. World Health Organization (1995) Physical status: the use and interpretation of anthropometry.

6. Technical Report Series no. 854. World Health Organization, Geneva.

7. van Veenrooij LMW, de Vos R, BorgmeijerHoelen AMMJ, Kruizenga HM, JonkersSchuitema CF, de Mol BAMJ. Quick-andeasy nutritional screening tools to detect disease-related undernutrition in hospital inand outpatient settings: a systematic review of sensitivity and specificity. Clin Nutr 2007;2:21–37.

8. Janssen I, Mark AE. Elevated body mass index and mortality risk in the elderly. Obes Rev 2007;8:41–59.

9. Paddon-Jones D, Short KR, Campbell WW, Volpi E, Wolfe RR. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr 2008;87:1562S–6.

10. Olukoya, A. A. Internet Journal of Gynecology and Obstetrics, 31 (1990) 231.-

11. Harries, A.D., A. J. Laura., R. V. Heatley., R. G. Newcombe., J. Rhodes, Clinical Nutrition, 2, (1984) 193.

12. Zunzunegui MV, Sanchez MT, Garcia A, Casado JM, Otero A. Body mass index and long-term mortality in an elderly Mediterranean population. J Aging Health 2012; 24:29–47.

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
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A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
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A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
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A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
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A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
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A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
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A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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