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Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study.

ABSTRACT: BACKGROUND:The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life (QOL). However, the factors accelerating this poor QOL have not been fully examined in Nepal. Therefore, this study examined the factors associated with the QOL of older adults residing in the rural setting of Nepal. METHODS:Data from a previous cross-sectional study conducted among older adults between January and April 2018 in in rural Nepal was used in this study. The analytical sample included 794 older adults aged ?60 years, selected by a multi-stage cluster sampling approach. QOL was measured using the Older People's Quality of Life tool; dichotomized as poor and good QOL. Other measures used included age, gender, ethnicity, religion, marital status, physical activity, and chronic diseases such as osteoarthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and depression. The factors associated with QOL were examined using mixed-effects logistic regression. RESULTS:Seven in ten respondents (70.4%) reported a poor QOL. At the bivariate level, increasing age, unemployment, intake of alcohol, lack of physical activity as well as osteoarthritis, COPD and depression were significantly associated with a lower likelihood of a good QOL. The adjusted model showed that older age (AOR = 0.50, 95% CI: 0.28-0.90), the Christian religion (AOR = 0.38, 95% CI: 0.20-0.70), and of an Indigenous (AOR: 0.25; 95% CI: 0.14-0.47), Dalit (AOR: 0.23; 95% CI: 0.10-0.56), and Madheshi (AOR: 0.29; 95% CI: 0.14-0.60) ethnic background were associated with lower odds of good QOL. However, higher income of >NRs 10,000 (AOR = 3.34, 95% CI: 1.43-3.99), daily physical activity (AOR: 3.33; 95% CI: 2.55-4.34), and the absence of osteoarthritis (AOR: 1.9; 95% CI: 1.09-3.49) and depression (AOR: 3.34; 95% CI: 2.14-5.22) were associated with higher odds of good QOL. CONCLUSION:The findings of this study reinforce the need of improving QOL of older adults through implementing programs aimed at addressing the identified biosocial and disease conditions that catalyse poor QOL in this older population residing in rural parts of Nepal.

SUBMITTER: Yadav UN

PROVIDER: S-EPMC7704002 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study.

Yadav Uday Narayan UN Thapa Tarka Bahadur TB Mistry Sabuj Kanti SK Ghimire Saruna S Yadav Krishna Kumar KK Boateng Godfred O GO O'Callaghan Cathy C

PloS one 20201130 11

<h4>Background</h4>The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life (QOL). However, the factors accelerating this poor QOL have not been fully examined in Nepal. Therefore, this study examined the factors associated with the QOL of older adults residing in the rural setting of Nepal.<h4>Methods</h4>Data from a previous cross-sectional study conducted among older adults between Janu ...[more]

PMID: 33253232

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Project description:BackgroundThe high burden of chronic conditions, coupled with various physical, mental, and psychosocial changes that accompany the phenomenon of aging, may limit the functional ability of older adults. This study aims to assess the prevalence of poor functional status and investigate factors associated with poor functional status among community-dwelling older adults in rural communities of eastern Nepal.MethodsData on 794 older adults aged ≥ 60 years from a previous community-based cross-sectional study was used. Participants were recruited from rural municipalities of Morang and Sunsari districts of eastern Nepal using multi-stage cluster sampling. Functional status was assessed in terms of participants' ability to perform activities of daily living using the Barthel Index. Covariates included sociodemographic characteristics, lifestyle factors, and self-reported chronic conditions. A binary logistic regression model was used to investigate factors associated with poor functional status.ResultsThe overall prevalence of poor functional status was 8.3 % (male: 7.0 % and female: 9.6 %), with most dependence noted for using stairs (17.3 %), followed by dressing (21.9 %) on Barthel Index. In the adjusted model, oldest age group (odds ratio [OR] = 2.83, 95 %CI: 1.46, 5.50), those unemployed (OR = 2.41, 95 %CI: 1.26, 4.65), having memory/concentration problems (OR = 2.32, 95 %CI: 1.30, 4.13), depressive symptoms (OR = 2.52, 95 %CI: 1.28, 4.95), and hypertension (OR = 1.78, 95 %CI: 1.03, 3.06) had almost or more than two times poor functioning.ConclusionsOne in 12 older adults had poor functional status as indicated by their dependency on the items of the Barthel Index; those in the oldest age bracket were more likely to exhibit poor functional status. We suggest future studies from other geographies of the country to supplement our study from the rural setting for comprehensive identification of the problem, which could guide the development of prevention strategies and comprehensive interventions for addressing the unmet needs of the older adults for improving functional status.

Project description:BackgroundDemographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal's health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in Nuwakot District, Nepal; and concurrently, to validate the Mini Nutritional Assessment (MNA) tool.MethodsA cross-sectional field study was conducted with a sample of 242 elderly people in Okharpauwa, Nepal to obtain prevalence of malnutrition. Differences in demographic and lifestyle factors between these who were malnourished, those at risk of malnourishment, and those who had adequate nutritional status were analyzed. The MNA tool was evaluated using receiver operating characteristic (ROC) curve analysis; sensitivity, specificity, and diagnostic accuracy were calculated.Results111 males and 131 females, with a mean age of 69.8±7.4 years, participated in this study. The mean BMI of the participants was 21.4±3.9 kg/m2; the mean MNA score was 19.3±4.2. BMI was significantly correlated with the total MNA score (r = 0.58; p<0.001). The diagnostic accuracy, sensitivity and specificity of MNA were 81%, 86% and 67% respectively. Of the 242 elderly sampled, 24% were malnourished and 65% were at risk of malnutrition. Malnutrition was more prevalent among females (29%) than males (18%), and most prevalent among the marginalized Dalit ethnic group (40%). Elderly persons who were married and literate had better nutritional health than their counterparts.ConclusionsThe MNA appears to be a valid and sensitive tool for rapid nutritional screening of the elderly in Nepal. The prevalence of malnutrition was high among Nepalese elderly in the Okharpauwa VDC, which requires urgent health monitoring and management attention.

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Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study.

Publications

Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study.

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