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      Prevalence of malnutrition and associated factors among community-dwelling older persons in Sri Lanka: a cross-sectional study

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          Abstract

          Background

          Malnutrition in older persons is a public health concern. This study aimed to estimate the prevalence of malnutrition and its associated factors among community-dwelling older persons in Sri Lanka.

          Methods

          A cross-sectional study was conducted in the Kandy district, Sri Lanka. The nutritional status of older persons was assessed using the Mini Nutritional Assessment –Short Form (MNA­SF). A standardised questionnaire was used to record factors associated with malnutrition: demographic characteristics, financial characteristics, food and appetite, lifestyle, psychological characteristics, physical characteristics, disease and care, oral health, and social factors. Complex sample multinomial logistic regression analysis was performed.

          Results

          Among the 999 participants included in the study, 748 (69.3%) were females and 251 (25.1%) were males. The mean age was 70.80 years (95% CI: 70.13, 71.47). The prevalence of malnutrition, risk of malnutrition and well-nutrition was 12.5%, 52.4% and 35.1% respectively. In the multivariate model, hypertension (adjusted OR = 1.71; 95% CI: 1.02, 2.89), alcohol consumption (aOR = 4.06; 95% CI: 1.17, 14.07), and increased age (aOR = 1.06; 95% CI: 1.01, 1.11) were positively associated with malnutrition. An increased number of people living with the older person (aOR: 0.91; 95% CI: 0.85, 0.97) was a protective factor among those at risk for malnutrition.

          Conclusion

          Both the prevalence of malnutrition and risk of malnutrition were commonly observed among community-dwelling older persons in Sri Lanka. The associated factors identified in this study might help public health professionals to implement necessary interventions that improve the nutritional status of this population.

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          Most cited references41

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          The impact of non-response bias due to sampling in public health studies: A comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health

          Background In public health monitoring of young people it is critical to understand the effects of selective non-response, in particular when a controversial topic is involved like substance abuse or sexual behaviour. Research that is dependent upon voluntary subject participation is particularly vulnerable to sampling bias. As respondents whose participation is hardest to elicit on a voluntary basis are also more likely to report risk behaviour, this potentially leads to underestimation of risk factor prevalence. Inviting adolescents to participate in a home-sent postal survey is a typical voluntary recruitment strategy with high non-response, as opposed to mandatory participation during school time. This study examines the extent to which prevalence estimates of adolescent health-related characteristics are biased due to different sampling methods, and whether this also biases within-subject analyses. Methods Cross-sectional datasets collected in 2011 in Twente and IJsselland, two similar and adjacent regions in the Netherlands, were used. In total, 9360 youngsters in a mandatory sample (Twente) and 1952 youngsters in a voluntary sample (IJsselland) participated in the study. To test whether the samples differed on health-related variables, we conducted both univariate and multivariable logistic regression analyses controlling for any demographic difference between the samples. Additional multivariable logistic regressions were conducted to examine moderating effects of sampling method on associations between health-related variables. Results As expected, females, older individuals, as well as individuals with higher education levels, were over-represented in the voluntary sample, compared to the mandatory sample. Respondents in the voluntary sample tended to smoke less, consume less alcohol (ever, lifetime, and past four weeks), have better mental health, have better subjective health status, have more positive school experiences and have less sexual intercourse than respondents in the mandatory sample. No moderating effects were found for sampling method on associations between variables. Conclusions This is one of first studies to provide strong evidence that voluntary recruitment may lead to a strong non-response bias in health-related prevalence estimates in adolescents, as compared to mandatory recruitment. The resulting underestimation in prevalence of health behaviours and well-being measures appeared large, up to a four-fold lower proportion for self-reported alcohol consumption. Correlations between variables, though, appeared to be insensitive to sampling bias.
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            Reliability and Validity of the International Physical Activity Questionnaire (IPAQ) in Elderly Adults: The Fujiwara-kyo Study

            Background The International Physical Activity Questionnaire (IPAQ) is a self-reported questionnaire for assessing physical activity and has been tested in 12 countries among adults aged 18 to 65 years. The present study evaluated the reliability and validity of the IPAQ among adults aged 65 years and older. Methods The study included 164 men and 161 women selected from participants of the Fujiwara-kyo Study, a prospective cohort of elderly Japanese adults. To examine test–retest reliability, the participants were asked to complete the IPAQ twice, 2 weeks apart. The criterion validity of the IPAQ was tested by using an accelerometer. Results Based on intraclass correlation coefficients, the reliability of the total IPAQ was 0.65 and 0.57 for men and women, respectively, aged 65 to 74 years and 0.50 and 0.56 for those aged 75 to 89 years. The Spearman correlation coefficients between total IPAQ score and total physical activity measured by accelerometer (TPA-AC) were 0.42 and 0.49 for men and women, respectively, aged 65 to 74 and 0.53 and 0.49 for those aged 75 to 89. Weighted kappa coefficients between total IPAQ score and TPA-AC were 0.49 and 0.39 for men and women, respectively, aged 65 to 74 and 0.46 and 0.47 for those aged 75 to 89. Conclusions The reliability of the IPAQ was not sufficient, but the validity was adequate. Although there were some limitations with regard to repeatability and agreement in classification, the IPAQ was a useful tool for assessing physical activity among elderly adults.
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              Changes during aging and their association with malnutrition

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                Author and article information

                Contributors
                +94717293827 , trbaasu@yahoo.com
                moyfm@ummc.edu.my
                katlim@um.edu.my
                Samath.Dharmaratne@BBS.MD
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                30 August 2018
                30 August 2018
                2018
                : 18
                : 199
                Affiliations
                [1 ]ISNI 0000 0001 2308 5949, GRID grid.10347.31, Department of Nursing Sciences, Faculty of Medicine, , University of Malaya, ; Kuala Lumpur, Malaysia
                [2 ]ISNI 0000 0000 9816 8637, GRID grid.11139.3b, Department of Nursing, Faculty of Allied Health Sciences, , University of Peradeniya, ; Peradeniya, Sri Lanka
                [3 ]ISNI 0000 0001 2308 5949, GRID grid.10347.31, Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, , University of Malaya, ; Kuala Lumpur, Malaysia
                [4 ]ISNI 0000 0000 9816 8637, GRID grid.11139.3b, Department of Community Medicine, Faculty of Medicine, , University of Peradeniya, ; Peradeniya, Sri Lanka
                [5 ]ISNI 0000 0004 1936 8438, GRID grid.266539.d, Department of Family and Community Medicine, College of Medicine, , University of Kentucky, ; Kentucky, USA
                [6 ]ISNI 0000000122986657, GRID grid.34477.33, Department of Health Metric Sciences, School of Medicine, , University of Washington, ; Seattle, USA
                Author information
                http://orcid.org/0000-0002-5362-0751
                Article
                892
                10.1186/s12877-018-0892-2
                6117936
                30165826
                2d046746-be57-4c5d-bbb2-c2556ce2631a
                © The Author(s). 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 October 2017
                : 24 August 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Geriatric medicine
                elderly persons,malnutrition,mini nutritional assessment,prevalence,sri lanka
                Geriatric medicine
                elderly persons, malnutrition, mini nutritional assessment, prevalence, sri lanka

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