Prevalence of malnutrition and its determinants in an elderly people in South India

Satyanarayana Konda, Ravi Kumar B. P., Purushottam A Giri


Background: The population of elderly people aged ≥60 years is increasing worldwide and is projected to reach 1.5 billion by 2050. In India, the elderly people constitute 8.1% of the total population. Malnutrition is highly prevalent in the elderly population due to various diseases and impairments.

Methods: A cross-sectional study was carried out amongst 209 elderly people from February 2018 to April 2018. A questionnaire was used to collect data related to socio-demographic characteristics, Mini Nutritional Assessment (MNA) and regarding medication use, comorbidity, use of a walking aid, smoking and alcohol consumption. The MNA tool was used for the assessment of nutrition status. For an assessment of functional status, the activities of daily living scale and instrumental activities of daily living scale were used. Descriptive analysis and Chi-square test were used to present the data.

Results: The average MNA score was 23.5 (SD=4.3, range: 7-30) and that of BMI was 23.8 (SD=3.9, range: 15.6-38.9). Of 209 study participants, 9.1% were malnourished, 32.5% were at risk of malnutrition and remaining 58.4% were having normal nutritional status. The possible predictors of malnutrition were older age, lower education level, staying single, unemployed, low income and less than three meals daily.

Conclusions: The overall prevalence of malnutrition was found to be 9.1% but the proportion of elderly people at risk of malnutrition was relatively high. Diagnosis and treatment of elderly people at high risk for malnutrition based on the findings of this study may improve functional status and prognosis of elderly people.


Malnutrition, Elderly, Mini nutritional assessment, Risk factors, South India

Full Text:



National Institute on Aging, National Institutes of Health. United States: NIH Publication. Global Health and Ageing. 2011. Available at: Accessed on 10 April 2018.

Census of India. Registrar General of India office, Government of India, India; 2011.

International Food Policy Research Institute. 2016. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030.Washington, DC: IFPRI, 2016.

Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, et al. Mini Nutritional Assessment International Group. Frequency of malnutrition in older adults: a multinational perspective using the Mini Nutritional Assessment. J Am GeriatrSoc. 2010;58:1734-8.

Favaro-Moreira NC, Hofmann SK, Matthys C, Vereecken C, Vanhauwaert E, Declercq A, et al. Risk Factors for Malnutrition in Older Adults: A Systematic Review of the Literature Based on Longitudinal Data. Adv Nutr. 2016;7:507-22

Bostrom AM, Van Soest D, Kolewaski B, Milke DL, Estabrooks CA. Nutrition Status Among Residents Living in a Veterans’ Long-Term Care Facility in Western Canada: A Pilot Study. J Am Med DirAssoc. 2011;12:217-25.

Boulos C, Salameh P, Barberger-Gateau P. Factors associated with poor nutritional status among community dwelling lebanese elderly subjects living in rural areas: results of the AMEL study. J Nutr Health Aging. 2013:1-8.

Guigoz Y, Vellas B, Garry PJ. Mini Nutritional Assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol. 1994;4(2):15-59.

Vellas B, Sieber C. The MNA revisited. What does the data tell us? Paris, France: Scientific Symposium Proceedings XIXth IAGG World Congress of Gerontology and Geriatrics; 2009.

Vedantam A, Subramanian V, Rao NV, John KR. Malnutrition in free-living elderly in rural south India: prevalence and risk factors. Public Health Nutr. 2009:13(9);1328-32.

Mathew AC, Das D, Sampath S, Vijayakumar M, Ramakrishnan N, Ravishankar SL. Prevalence and correlates of malnutrition among elderly in an urban area in Coimbatore. Indian J Public Health. 2016;60:112-17.

Majumder M, Saha I, Chaudhuri D. Assessment of Nutritional Risk in Community-Dwelling Older Adults (65 to 75 Years) in Kolkata, India, J Nutr Gerontol Geriatr. 2014;33(2):126-34.

Agarwalla R, Saikia AM, Baruah R. Assessment of the nutritional status of the elderly and its correlates. J Fam Community Med. 2015;22:39-43.

Shi R, Duan J, Deng Y, Tu Q, Cao Y, Zhang M, Zhu Q, Lu Y. Nutritional status of an elderly population in southwest China: a cross-sectional study based on comprehensive geriatric assessment. J Nutr Health Aging 2015;19(1):26-32.

Winter J, Flanagan D, Mcnaughton SA, Nowson C. Nutrition screening of older people in a community General practice, using the MNA-SF. J Nutr Health Aging. 2013;17(4):322-5.

Lin WQ, Wang HHX, Yuan LX, Li B, Jing MJ, Luo JL, et al. The unhealthy lifestyle factors associated with an increased risk of poor nutrition among the elderly population in China. J Nutr Health Aging. 2017;21(9):943-53.

Schueren M, Monasch SL, Vries OJ, Danner SA, Kramer MHH, Muller M. Prevalence and determinants for malnutrition in geriatric outpatients. Clinical Nutrition. 2013;32:1007-11.

Ghimire S, Baral BK, Callahan K. Nutritional assessment of community-dwelling older adults in rural Nepal. PLoS ONE. 2017;12(2):1-15.

Gunduz E, Eskin F, Gunduz M, Bentli R, Zengin Y, Dursun R, Icer M, Durgun HM, Gurbuz H, Ekinci M, Yesil Y, Guloglub C. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study. Med Sci Monit. 2015;21:2750-6.

Krzyminska-Siemaszko R, Chudek J, Suwalska A, Lewandowicz M, Mossakowska M, Kroll-Balcerzak R, et al. Health status correlates of malnutrition in the polish elderly population-results of the Polsenior study. Eur Rev Med Pharma Sci. 2016;20:4565-73.

Mitri R, Boulos C, Adib SM. Determinants of the nutritional status of older adults in urban Lebanon. Geriatr Gerontol Int. 2017;17:424-32.

Maseda A, Diego-Diez C, Lorenzo-Lopez L, Lopez-Lopez R, Regueiro-Folgueira L, Millan-Calenti JC. Quality of life, functional impairment and social factors as determinants of nutritional status in older adults: The VERISAÚDE study. Clin Nutr. 2017;37(3):993-9.

Chen CC, Chang CK, Chyun DA, McCorkle R. Dynamics of nutritional health in a community sample of American elders: a multidimensional approach using roy adaptation model. Adv Nurs Sci. 2005;28(4):376-89.

Han Y, Li S, Zheng Y. Predictors of nutritional status among community-dwelling older adults in Wuhan, China. Public Health Nutr 2009;12(8):1189-96.

Tsai AC, Chang TL, Yang TW, Chang-Lee SN, Tsay SF. A modified mini nutritional assessment without BMI predicts nutritional status of community-living elderly in Taiwan. J Nutr Health Aging. 2010;14(3):183-9.

Kagansky N, Berner Y, Koren-Morag N, Perelman L, Knobler H, Levy S. Poor nutritional habits are predictors of poor outcome in very old hospitalized patients. Am J Clin Nutr. 2005;82(4):784-91.

Van der Pols-Vijlbrief R, Wijnhoven HA, Schaap LA, Terwee CB, Visser M. Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies. Ageing Res Rev. 2014;18:112-31.

Chavarro-Carvajal D, Reyes-Ortiz C, Samper-Ternent R, Arciniegas AJ, Gutierrez CC. Nutritional Assessment and Factors Associated to Malnutrition in Older Adults: A Cross-Sectional Study in Bogota, Colombia. J Aging Health. 2015;27(2):304-19.

Agarwal E, Miller M, Yaxley A, Isenring E. Malnutrition in the elderly: A narrative review. Maturitas. 2013;76:296-302.

Nykanen I, Lonnroos E, Kautiainen H, Sulkava R, Hartikainen S. Nutritional screening in a population-based cohort of community-dwelling older people. Eur J Public Health. 2012;23(3):405-9.

Flodin L, Svensson S, Cederholm T. Body mass index as a predictor of 1 year mortality in geriatric patients. Clin Nutr. 2000;19:121-5.