Nutritional status and self-reported and performance-based evaluationof physical function of elderly persons in rural Bangladesh

Abstract

Aim: To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. Methods: A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community living elderly persons aged 60 years or more (60-92years; 69±7years). Mobility, Activities of Daily Living (ADL), performance tests, handgrip strength, Mini Nutritional Assessment (MNA), and a structured questionnaire were used to assess physical function, nutritional status, socio-economic and health status respectively. Descriptive and linear hierarchical regression analyses were applied. Results: Seven percent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties performing one or more items in the performance tests. According to MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants reported limited mobility, impaired ADL, and difficulties in the performance tests compared to the well-nourished participants. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socio-economic and health status differences. Conclusion: Good nutritional status is important for physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation