Nutrition & Health Status, Quality of Life, and Associated Factors among Non-Institutionalized Older Ghanaians

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The ageing process with its attendant physiologic changes increase the risk for a host of diseases and disabilities, such as hypertension, diabetes mellitus, oral conditions, arthritis, stroke, angina, and malnutrition. In Ghana, very little data upon which appropriate interventions can be implemented exists on the nutrition and quality of life of older people. The study aimed to assess nutrition, health status and quality of life (QOL) of older Ghanaians. A cross-sectional study was conducted on 400 older adults. Data was collected on QOL of the elderly population using the Older People Quality of Life (OPQOL) questionnaire which has been validated. Patterns of dietary intake were assessed with a food frequency questionnaire. A 3-day repeated 24-hour food recall was done to assess nutrients intake of the participants. Anthropometric data including weight, height, body mass index, body fat, visceral fat, blood pressure was measured and biochemical indices such as fasting blood glucose, lipids profile were determined using standard procedures. Majority of the participants (66.3%) were female. Total calorie, macronutrients and calcium intakes were inadequate compared with RDA. Males had 39.3% deficits while female participants had 29.6% deficit for total calorie intake. Carbohydrate, protein and fat were in deficit for both males (41%, 46.6%, and 35.6%) and females (26.6%, 73%, 27.5%) respectively. Vitamin A and Calcium intake were inadequate by 39.4% and 48.1% for males and 39.2% and 66.1% for females. However, intakes of vitamin A, folic acid and phosphorus were found to be in excess for male and female participants by between 15% to 40%. Prevalence of hyperglycaemia, overweight and obesity were 21.2%, 30.5% and 16.0% respectively. Among the three grades of high SBP and DBP, the number of participants with grade 1 systolic hypertension was higher (30.2%) than those with grade 2 (16%) and 3 (8%). Same was found for grade 1 diastolic hypertension (22.8%), grade 2 (11.2%) and grade 3(8.8%). Dyslipidaemias including high total cholesterol (TC), low high-density lipoprotein cholesterol (HDL-C) and high low-density lipoprotein cholesterol (LDL-C) was at a prevalence of 0.2%, 98.2% and 1.5% respectively. An increasing body mass index among the elderly population was strongly associated with increasing total energy (r=0.73, p=0.00), carbohydrate (r=0.62, p=0.00), protein (r=0.52, p=0.00), and fat (0.50, p=0.00) intakes. Most (79%) participants reported a good QOL. Among the parameters of QOL, 44.0%, 65.8%, 62.5%, 93.5% and 48.0% of the participants were rated to have good health-related QOL, social QOL, independence and control QOL, v home and neighbourhood QOL and financial QOL respectively. However, more than half (59.0%) of the participants reported poor psychological QOL. Quality of life had very weak, significant correlation with phosphorus intake (r= 0.11, p= 0.04). Other nutrients intake measures did not show significant correlation with QOL (p > 0.05). In conclusion, the elderly population had inadequate intakes for total calorie and macronutrients. Intake of calcium and vitamin A was found to be inadequate. The prevalence of non-communicable disease risk factors such as overweight (30.5%) and obesity (16.0%) were high among the elderly population. Among the dyslipidaemia parameters, low levels of high-density lipoprotein cholesterol (98.2%) was observed higher among the elderly population.
A thesis submitted to the Department of Biochemistry and Biotechnology in partial fulfillment of the requirements for the award of a Master of Philosophy Degree in Human Nutrition and Dietetics