Presenter(s):

Finn Hartwell-Kinnear; Leon Geffen, Samson Institute for Ageing Research; University of Cape Town, South Africa

Abstract

Ageing in Africa continues at a comparatively rapid pace. Nevertheless, welfare and healthcare systems on the continent remain, generally, limited. Older Africans experience heterogenous challenges in securing adequate nutrition. However, there remains limited analysis of these challenges across multiple countries. In response, this work sought to determine predictors of nutritional issues among older persons in South Africa, Benin, Egypt, Ethiopia, Kenya, Malawi, Nigeria, Rwanda, Sudan, Tanzania and Uganda. The project was undertaken by the Pan-African Utilization of Lay Assessment Systems (PAULAS): an international consortium of practitioners and researchers concerned with the wellbeing of older Africans. Data was collected via a cross-sectional survey of 7,196 persons aged 50 years and older. The interRAI Check Up Self-Report (CUSR) was employed and included scales such as the Cognitive Performance Scale (CPS), Activities of Daily Living Hierarchy (ADLH), Instrumental Activities of Daily Living, and the Changes in Health, End-Stage Disease, Signs, and Symptoms Scale (CHESS) among others. Malnutrition was proxied by the presence of weight loss and reduction in food intake. Potential indicators of malnutrition were analysed by means of logistic regression. Alongside sociodemographic variables, mood, pain, cognitive performance, activities of daily living, health and disease diagnoses, and economic trade-offs were considered. These were selected from review of the existing literature, significance at the bivariable level, and clinical experience. Descriptive statistics showed frequency of malnutrition differed considerably across countries; the mean rate of malnutrition was 41.8% overall. Using the Statistical Analysis System (SAS) version 9.4, findings from logistic regression inferred that disease, fatigue, functional ability, impaired vision and hearing, incontinence, and psychosocial factors like loneliness, mood, financial trade-offs and substance use influenced odds of nutritional issues. Clearly therefore, nutritional issues among older persons is a complex problem involving physical, environmental, and psychosocial factors. Disparate sample size and the use of convenience sampling limited the generalisability of these findings. However, identification of the above predictors of malnutrition may inform further research and the clinical detection of older persons at risk of nutritional issues.

Bio(s):

Dr. Leon Geffen is a Family Physician and Director of the Samson Institute For Ageing Research. He is a Fellow of interRAI, he serves as an expert to the World Health Organisation’s Clinical Consortium For Healthy Ageing & Global Network for Long-term Care. He holds an Honorary Senior Lectureship at the University of Cape Town’s Institute of Ageing in Africa. Dr. Geffen chairs the Ageing & Health Special Interest Group of the World Organisation of Family Doctors (WONCA) and serves on the International Advisory Board of Age & Ageing Journal. His research focuses on health systems, particularly innovative approaches to assessment and management of patients over 60 in primary care settings. In September 2022, the WHO recognized him among 50 global leaders transforming the world to better accommodate aging populations.

Finn Hartwell-Kinnear, MSocSci., BA Hons., BSocSci., NCIF. Finn is a doctoral candidate in the Department of Sociology at the University of Cape Town and associate researcher at the Samson Institute for Ageing Research. He received his BSocSci, BA Honours, and MSocSci Cum Laude from the University of KwaZulu-Natal. Finn’s PhD research considers the nature of food, family and welfare systems; how they intersect to influence deprivation amongst older persons and their households. He engages with a wide range of theoretical and methodological approaches across fields of sociology, agri-food studies, social gerontology, political economy, and public health and policy.