Factors associated with total satisfaction with food-related life among elderly in Rumah Seri Kenangan, Selangor

Background: There are various factors that may alter elderly relationship with food as they get older and eventually their satisfaction with food-related life (SWFL). Materials and Methods: A cross-sectional study was conducted to determine the associations between SWFL and socio-demographic factors, dietary intake, food access and malnutrition risk among elderly in Rumah Seri Kenangan. Socio-demographic, Mini- Nutritional Assessment (MNA), Experiences of food access (Naithani et al., 2009) and SWFL (Grunert et al., 2007) were assessed using sets of questionnaires. Dietary intake and anthropometric measurements were assessed using forms. All statistical analysis was performed using IBM SPSS version 21. Result: A total of 57 elderly were participated in this study where 47% of them were male and 53% were female. 40.4% of the subjects were at risk of malnutrition and 12.3% was malnourished. Male subjects consumed significantly higher in total energy and protein intake than female (p=0.008 and 0.034 respectively). However, 89.5% of subjects did not achieve for both recommended energy and protein intake of RNI. Experience with food access showed that majority of subjects had greater difficulty with physical barrier domain of food access (p=0.086) and the mean total score of each items in SWFL of 4.91 which indicated that elderly was somewhat agree with their SWFL. However, socio-demographic backgrounds, dietary intake, risk of malnutrition and food access were not associated with total SWFL Conclusion: Majority of subjects experienced difficulties in physical barrier domain and quite satisfied with their food-related life. Thus, improvement in the nutritional status can be achieved by providing adequate nutrition and enhancing food availability and accessibility to elderly in care homes

Prevalence of malnutrition and its associated factors among hemodialysis elderly in selected hemodialysis centres, Selangor

Background: In Malaysia, the number of patients on dialysis increased from 59 to almost 15,000 patients and the largest new population is older patients’ age 55 years. Most of the hemodialysis (HD) patient’s (69%) intake fall behind the recommendations which was lower than 35 kcal/kg energy and 50% lower than 1.2 gram protein/kg. This study aimed to determine the association between socio-demographic factors, medical history, anthropometry data, dietary intake and QOL with malnutrition among HD elderly. Materials and Methods: A total of 112 HD elderly (aged 60 years and above) were recruited from selected HD centers. Interview-based questionnaires were used to measure patients’ socio-demographic, medical history, anthropometry data, dietary intake and QOL. The dietary intake was measured using 24-hour diet recall (non-HD day) and one day food record (HD day). KDQOL-36 consists of 3 parts with 36 questions to assess respondents QOL. The nutritional status was assessed by using SGA-DMS which divided into medical history and physical examination. Result: Majority (45.5%) of the respondent had moderate malnourished, 30.4% were well nourished and 24.1% had severe malnutrition. The HD duration (p< 0.001), phosphate level (p= 0.010) and the BMI (p= 0.010) were significantly associated with SGA-DMS. The energy and protein intake (p< 0.005) and QOL (p< 0.001) had negative correlation with malnutrition. Conclusion: Malnutrition among HD elderly had correlation with BMI, dietary intake (energy and protein) and QOL. An intervention towards diet and lifestyle is recommended to improve the nutritional status and the QOL of the HD elderly

Assessment of health-related quality of life in the elderly on maintenance hemodialysis

Introduction: Health-related quality of life (HRQOL) is one of the main indicators of health and wellbeing among dialysis patients which has attracted mounting interest in recent years in the initiation of intervention measures. Thus, this study aimed to determine the correlations between socio-demographic factors and medical characteristics with HRQOL among elderly on maintenance hemodialysis (HD). Methods: A cross-sectional study was conducted in nine HD centers in Selangor. Socio-demographic data and HRQOL were assessed using structured questionnaire and Kidney Disease Quality of Life Instrument (KDQOL-36), respectively whilst medical profile and laboratory data were collected from subjects’ medical record. Results: The mean age of subjects was 67±6 years where majority (57%) of the subjects was on maintenance HD for less than 5 years. The mean physical component summary and mental component summary scores were 33.89±11.83 and 50.23±8.88, respectively. Symptoms/problems subscale, effects of kidney disease on daily life subscale and burden of kidney disease subscale scores were 73.37±17.01, 72.63±19.74 and 54.62±30.42, respectively. There was a significant correlation between serum sodium with physical component summary (r=0.237, p<0.01) and symptoms/problems subscale (r= 0.245, p<0.01). Conclusion: Subjects perceived their mental health better than physical health but felt burdened by kidney disease the most. Serum sodium was found to be positively associated with physical functioning and symptoms/problems subscales. There is a need for routine assessment on HRQOL and appropriate intervention to enhance the quality of life among elderly on HD

Factors associated with food choice values among older hemodialysis patients in selected dialysis centres in Selangor, Malaysia

Hemodialysis (HD) among the elderly has unique clinical features, where these patients have more co-morbidity, require more frequent hospitalization and use more drugs and health services compared to the younger populations. In addition, poor nutritional status may impede their appetite, food accessibility, and preparation. With individual’s social lives mainly focused around food, the foodrelated activities (e.g., shopping, cooking and dining out) become of greater significance to the elderly but are more difficult to achieve. Thus, this study aimed to determine the factors associated with food choice values (FCVs) among HD elderly in selected dialysis centres. A cross-sectional study was conducted among 119 elderly, aged 60 years and above on maintenance HD. By using simple random sampling, nine HD centres were selected from Petaling and Hulu Langat districts, Selangor as the study locations. Socio-demographic, dietary intake, malnutrition risk, depression, health-related quality of life (HRQOL) and FCVs were assessed via interview session. Dialysis Malnutrition Score (DMS) was used to evaluate nutritional status while Patient Health Questionnaire-9 (PHQ-9) used to assess the severity of depressive symptoms. HRQOL was assessed by using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire. The medical profile and dry weight were obtained from the subjects' medical records. Anthropometric assessments such as height, pre-dialysis weight, and post-dialysis weight were also conducted. The variables associated with FCVs were tested with Pearson Correlation and Multiple Linear Regression (MLR). The mean age of the subjects was 67±6 years. The subjects comprised of approximately equal number of males (50.4%) and females (49.6%). Majority of the subjects were Malay (60.5%). Hypertension (87.4%) and diabetes mellitus (71.4%) were the major co-morbidities among subjects. There were 49.6% of the subjects who did not achieve the desirable serum albumin of ≥40 g/L, 58.0% had high serum phosphate (>1.6 mmol/L) while 61.3% of the subjects had low hemoglobin level. About 6.7% of the subjects were underweight. Majority of the subjects had inadequate energy and protein intakes (91.6%), were moderately malnourished (71.4%), non-depressed (84.0%) and obtained better HRQOL score in terms of symptoms/problems (73.37±17.01) and effects of kidney disease (72.63±19.74) subscales. Safety, sensory appeal, and organic factors were the strongest perceived of FCVs. There was a significant negative correlation between age (p<0.05), energy intake (p<0.05), protein intake (p<0.01) and fat intake (p<0.01) with total FCVs score. The MLR model suggested that 12.1% of the variance in the FCVs was explained by age and fat intake. In conclusion, this research found that health was not the main factor in determining the FCVs among HD elderly. Instead, safety, sensory appeal, and organic factors were deemed to be more important when assessed by FCVs questionnaire. Subject who experienced aging and increased in total energy, protein and fat intakes felt that food choice was no longer important. Age and fat intake also had an impact on FCVs of HD elderly. Thus, these findings could be taken into account for dietitians to understand the factors associated with FCVs when designing and delivering nutritional intervention regarding healthy choices of fat intake targeting HD elderly

Factors associated with food choices among elderly: a scoping review

Introduction: The aging population is a matter of global concern. Age-related physiological, pathological, psychosocial, economic, cultural and environmental changes are common and may greatly influence the quality of life of the elderly. The aim of this review was to explore the determinants and motivations that drive the elderly in making food choices. Methods: The search strategy of this literature review used the PRISMA protocol. Potential literature that was related to food choices was identified using two different combinations of keywords and two major electronic search engines, namely Pubmed and Science Direct. The articles that were selected for this review had to be in the English language, open-accessed and published between January 2007 and December 2017. Results: From a search of 1398 articles, 15 articles (seven quantitative and eight qualitative) were identified that were related to food choices among the elderly. The key factor that determined food choices among the elderly population was identified to be health. Others included convenience, sensory appeal, price, early food experience and more. The limitations of these studies that were reported were the small sample size and the reliance on self-reporting. The conclusions that were drawn were for specific groups that were studied in this review should be extrapolated or generalised with caution. Conclusion: Strategies for intervention programmes should be undertaken in collaboration with health professionals, researchers, policymakers, and the food industry. Future research is needed in the elderly who have chronic diseases, are dependent or who have disabilities