Prevalence of malnutrition and associated risk of malnutrition among the community-dwelling elderly population in Batticaloa District, Sri Lanka

Abstract

Malnutrition is common issue among elderly population in world as well as Sri Lanka. Several risk factors are contributing for developing this global burden and malnutrition also greatly impact on elderly’s health in several aspects, physical health, mental health & social well-being. Therefore, assessing risk of malnutrition and identifying the risk factors associated with malnutrition are essential to tackle this global issue. The objectives are to assess the prevalence and its associated factors of risk of malnutrition among the community-dwelling elderly population in Batticaloa district, Sri Lanka. Community based descriptive cross-sectional study was conducted by recruiting 844 community dwelling elderly by using multistage sampling method in Batticaloa district, Sri Lanka from October 2024 to July 2025. The nutritional status of elderly was assessed using Malnutrition Universal Screening Tool (MUST). Validated interviewer administered questionnaire was used to collect data on socio-demographic and clinical characteristics. Statistical Package of Social Sciences version 26 (SPSS 26) was used for analyzing the data based on objectives. Majority of the participants were female (n=553, 65.5%), Tamil (n=613, 72.6%), married (n=415, 49.2%) and living in rural areas (n=562, 66.6%). Most participants were aged between 65- 74 years (n=618, 73.2%) and more than half had completed primary education (n=424, 50.2%), three -fourth were unemployed (n= 641, 75.9%) and had a monthly family income of less than LKR 15,000 (n=665, 78.8%). Regarding clinical characteristics more than half of them had loss of appetite (n=445, 52.7%), chronic illness (n=571,67.7%), use of medication (n= 546, 64.7%), physically active (n=541, 64.1%), no food allergies or avoidance of food (n=495, 58.6%), no habit of betel chewing (n=596, 70.06%), no swallowing difficulties (n= 615, 72.9%), 3 frequent meal (n= 635, 75.2%). Nearly the entirety of participants had no eating difficulties (n= 790, 93.6%), no current alcohol consumption (n=759, 89.9%), no cigarette smoking (n=783, 92.8%), tooth loss (n=758, 89,8%), no use of dentures (n=772, 91.5%), self- eating (N= 827, 98.0%), fully independent no assistance need for mobility (n=727, 86%), no vegetarian (n= 821, 97.3%). The findings demonstrated, more than half of the participants exhibited low risk of malnutrition (58.3%), medium and high risk of malnutrition (17.5%, 24.2%) respectively. The findings revealed a significant association between the level of risk of malnutrition and age ( p=0.000), marital status (p=0.021), education level(p=0.001), family monthly income (p=0.007) and history of loss of appetite (p=0.045), eating difficulties (p=0.00), swallowing difficulties (p=0.000), chronic illness (p=0.000) ,diabetes mellitus (p=0.013), hypertension (p=0.000), dyslipidemia (p=0.000) and other chronic illness (p=0.046) like cardiac diseases and gastritis, usage of medication (p=0.000) , English (p=0.000) and ayurvedic (p=0.007) medication, level of physical activity ( p=0.000) and mobility (p=0.000), habit of current alcohol consumption ( p=0.020)and cigarette smoking(p=.001) were found to be significantly associated. This study found that around one- quarter participants had high risk of malnutrition (24.2%). The associated factors which are identified in this study highlighted the need for individualized intervention to improve the nutritional status of community dwelling elderly population.