The rising incidence of osteoporosis is well established especially among
institutionalized residents. The aim of the study was to determine the association of
nutritional status, functional status and lifestyle habits with bone health status among
institutionalized elderly. Bone health status was assessed using Quantitative Ultrasound
Sonometry (QUS-2), which measures Broadband Ultrasound Attenuation (BUA,
dB/MHz) at the calcaneus. Body weight, height and body fat were assessed using SECA
767 and body fat analyzer (HBF-302 Omron). Sociodemographic background,
reproductive history, history of bone fracture, lifestyle habits, dietary intake and
functional status (Elderly Mobility Scale-EMS and Instrumental Activity Daily Living-
IADL) of the subjects were assessed using appropriate instruments. Data were analyzed
using SPSS software version 13.0 and Malaysian food composition database A total of
363 subjects comprising of 158 males (43.5%) and 205 females (56.5%) were recruited
from 33 old folk’s homes and nursing homes in the Klang Valley. The subjects
comprised of 79.3% Chinese, 11.6% Indians, 5.5% Malays and other races (3.6%). The mean age of the subjects was 75.8 ± 9.1 years old. The mean weight, height and body
fat mass for male and female were 56.7 ± 11.9 and 50.6 ± 13.8, 161.9 ± 7.7 and 149.5 ±
11.7, 15.6 ± 7.0 and 16.7 ± 11.8, respectively. Mean Body Mass Index (BMI) for male
and female were 21.6 ± 4.3kg/m
2
and 22.4 ± 5.6 kg/m
2
. Based on BMI classification,
23.3% of the subjects were underweight, 52.9% with normal weight and 23.8% were
overweight and obese. The mean BUA was 61.4 ± 19.8 dB/MHz. Majority of the
subjects had second tertile of BUA and there was only 10.0% of subject with third
tertile of BUA. The mean energy intake was 1311 ± 312 Kcal. The mean calcium intake
was low, with 428 ± 277 mg in males and 454 ± 281 mg in females. More than 50% of
the subjects had daily calcium intake less than RNI for Malaysian. Approximately half
of the subjects achieved 75
th
percentile for EMS. However, score for IADL was low,
with a mean of 8.6 ± 4.6. There were 61.7% of subjects who exercised currently with a
majority of them practicing brisk walking. The results revealed significant correlation
between BUA and weight (r=0.390, p<0.01), fat mass (r=0.156, p<0.01), phosphorus
intake (r=-0.148, p<0.05), protein intake (r=-0.121, p<0.05), vitamin C (0.120, p<0.05),
EMS (r=0.241, p<0.01) and IADL (r=0.250, p<0.01), duration exercise per session
(r=0.138, p<0.05). Body weight, IADL score, and vitamin C intake were the main
contributors for bone health status among the subjects, which explain 21.5% of the
variation in the BUA significantly (p<0.001). As a conclusion, institutionalized elderly
should be given better care or intervention in achieving optimal body weight and dietary
intakes through providence of better nutrition and rehabilitation efforts to improve
functional status
