CHAPTER 5

SUMMARY AND CONCLUSION

Aging can be defined as “Regression of physiological function

accompanied by advancement of age”. People above age 60 years are usually
considered as elderly population. Old age is characterised by several
physiological and biochemical changes resulting in an impaired functioning of
body tissue and organs which ultimately causes several health problems. These
are aggravated by inadequate utilization and absorption of nutrients causing
specific nutrition related diseases. Further several non nutritional factors namely
area, age, sex, education, income and occupation also profoundly influences the
nutritional status of elderly.

The present study was aimed at assessing the nutritional status of selected
elderly population from urban, rural and tribal area of Nanded District. A total
sample of 600 elderly (200 urban, 200 rural and 200 tribal) were selected for the
present research study. The anthropometric status of selected elderly was
determined by recording height (cm.), weight (kg.), hip circumference (cm.),
waist circumference (cm.) and waist hip ratio and Body mass index was
calculated using values of height and weight. On the basis of BMI, selected
subjects were categorised in different grades of undernutrition. Daily food intake
of each selected elderly was recorded with the help of two day dietary recall
method and weighment method. Nutrient intake was calculated by using
Nutritive value of Indian foods book (Gopalan C. 2010). Percent adequacy of
food intake was calculated using balanced diet table for elderly and percent
adequacy of nutrient intake was done by using RDA table. Further, 10 percent
elderly each from urban (20) and rural area (20) were screened for serum
calcium, phosphorus and blood haemoglobin level. Two health check up camps
were organised each in urban and rural area with the help of professional doctors
for the record of nutritional inadequacy. Total 200 elderly (100 urban and 100
rural) were screened in health check up camp. Information regarding health
problems, bone problems and psychological problems by using predesigned
questionnaire with checklist of problems.

Results of the study is summarized as below. Socio economic status

revealed that, out of total 600 elderly subjects 279 (46.5%) were male and 321
(53.5%) were female. However, 75 percent elderly were belonging to 60 to 70
years age group and vegetarian (62.5 %). Majority were having monthly income
Rs. 10000/- (40.16 %) and were involved in farming occupation. Almost all
(91.16 %) elderly subjects were living with their family.

Anthropometric measurements of selected elderly subjects reported a

mean height 155.96 ± 12.07 cm. with range of 122 to 182 cm and mean weight
52.67 ±11.31 kg. with range of 28 to 87 kg and mean body mass index was 21.22
± 3.43 with range of 13.88 to 34.63. However, hip waist ratio ranged from 0.75
to 1.08 with mean 0.92 ± 0.04. Highest anthropometric values were recorded by
elderly male, 60 to 70 years of age, having income Rs. > 10000/-, having
vegetarian diet pattern, and government servant. Further data on prevalence of
undernutrition revealed that, majority of tribal, elderly of more than 70 years,
female elderly, non vegetarian elderly and elderly belongs to high income group
and female were found to be under weight as compared to their counterparts.
However, 56 to 71.21 percent of elderly subjects were found to be normal while
remaining were either in the category of underweight or overweight.

Information on mean food intake of elderly shows that, intake of cereals,

pulses, green leafy vegetables, fats and oil, milk and milk products and sugar and
jagerry by elderly from urban area was found to be more than rural and tribal
elderly. The recorded values by urban elderly were 266.52±72.27gm,
33.23±12.15 gm, 27.42±32.15 gm, 48.05±34.48 gm, 33.82±34.72 gm,
13.92±5.59 gm, 104.37±50.79 gm and 16.66±7.46 gm respectively. Except fruits
consumption, all other food stuffs was consumed significantly more among
urban elderly, while lower consumption was noted among tribal elderly. Elderly
male recorded more intake of almost all food stuffs but less than recommended
dietary allowances. Except sugar, all other food stuffs consumption was observed
significantly low by elderly having monthly income Rs. < 5000/- as compared to
other two income groups. Elderly having vegetarian dietary pattern shows
maximum intake. Elderly who were retired as government servant were reported
maximum intake as compared to others. Percent adequacy of food intake was
ranged from 15.39 (fruits) to 97.88 (cereals) among urban eldely subjects. Except
sugar and jagerry, percent adequacy of all other food stuffs was recorded more
among urban elderly than rural and tribal. However, lowest values was recorded
among tribal elderly. Further, it was reported from the table that, elderly
belonging to 60 to 70 years of age group, elderly male, vegetarian elderly,
elderly belonging to high income group and government elderly showed highest
percent adequacy of food intake almost for all food stuffs.

Information on nutrient intake of selected elderly shows that, intake of

protein (gm), carbohydrate (gm), fats (gm), energy (kcal), iron (mg), calcium
(mg), phosphorus (mg) and vitamin c (mg) were found to be more by urban
elderly than rural and tribal. The values for respective nutrients were 42.21±9.74,
252.94±57.15, 28.51±7.94, 1455.26±314.80, 15.20±6.30, 440.88±152.65,
964.22±265.40 and 37.65±27.96. Nutrient intake by elderly of 60 to 70 years of
age, elderly male, vegetarian, elderly having high income and government job
elderly recorded highest values for almost all nutrients. Percent adequacy of
nutrient intake was also recorded the same pattern with range of 52.41 percent
(iron) to 142.59 (carbohydrate) in urban area, where intake of was found to be
more than rural and tribal elderly.

Further it was noted that, serum calcium of selected elderly subjects,

ranged from 8.6 ± 00 to 9.45 ± 0.83. the range of serum phosphorus was 2.78 ±
0.39 to 3.70 ± 0.90. while haemoglobin content of blood of selected elderly
ranged from 7.9 ± 00 to 9.73 ± 2.52. it was noted from the data that, serum
calcium, phosphorus content of selected elderly was significantly higher among
urban elderly as compared to rural elderly. The values were also noted more
among elderly aged 60 to 70 years, elderly male, elderly belonging to high
income group and elderly retired ass government servant. Further it was noted
that, vegetarian and non vegetarian elderly recorded non significant difference
for serum calcium, phosphorus and blood haemoglobin content. On the basis of
haemoglobin content elderly were catagorised under different grades of anaemia
which shows that, equal percent of urban (22.50 %) and rural elderly (25 %)
were suffering with mild and moderate grade of anaemia. However, 2.5 to 42.50
percent elderly were suffering with mild or moderate grade of anaemia among
different socio economic background. Out of 40 elderly, only two elderly were
found to be normal and non of the elderly were found under sever category of
anaemia.

Nutritional inadequacy identified by doctors in health check up camp

showed that, elderly living in rural area were more susceptible for various
problems occurred due to nutritional inadequacy (i.e. underweight, overweight,
decreased activity level, ease of pluking of hair, lack of hair curl, dull and ulterd
hair texture, xerosis, edima, general dermatitis of skin, moon face, diffuse
dipigmentation, decreased or increased subcutaneous tissue, spoon shaped nails,
dry conjunctiva and bitot spot of eyes, angular stomatitis and cheilosis of lips,
swollen and bleeding gums, teeth carries and stained teeth and decreased muscle
mass etc.)

Prevalence of different health, bone and psychological problems in elderly

population (Table 50 to 52) revealed that, health problems like leg pain, eye
problem, headache and aneroxia (ranged from 5.5 to 86.80 %) bone problems
like joint pain, backache and knee pain ( ranged from 22.41 to 91 %) while
psychological problems like burst of anger, irritability, nervousness and loss of
memory (ranged from 5.50 to 79.69 %) were more prevalent among elderly
subjects. Prevalence of various problems were higher among tribal elderly. It
was also noted more among female elderly and elderly above age 70 years.
Elderly who were suffering with various psychological problems expressed the
reasons behind it as, aging, family problems, health problems, aloneness and
economic problems. Further it was also recorded the health diseases among
elderly like diabetes mellituss, heart diseases, hyper tension, cancer and liver
problems in less percent.

Based on above findings, it can be concluded that,

1. Anthropometric measurements were better among elderly living in

urban area and elderly male.
2. As age advances, anthropometric measurements like weight, body
mass index, waist and hip circumference reduced.
3. Maximum number of elderly were under normal category of BMI.
Percent of normal elderly decreased with advancement of age.
4. Area, age, income, occupation significantly influenced on food and
nutrient intake among elderly subjects.
5. Area of living affects serum calcium, phosphorus and haemoglobin
content. Rural elderly reported lower values for all biochemical
examination.
6. Advancement of age leads to prevalence of various health, bone and
psychological problems which decreased in high income group.
7. Maximum elderly suffered with mild degree of anemia
8. Bone and psychological problems aggravated with advancement of
age.

As it is commonly observed that, the elderly are the commonly

neglected segment of the population in family and society too. As either they
are retired from their job, lacking in the social activity, feeling burdened in the
family, less resources like money and one or other associated health problems,
loss of spouse, feeling of boredom and uselessness are the associated
ingredients which directly and indirectly affects on their food consumption,
health problems, psychological problems. Instead of considering them as
useless and burden, to the family, their knowledge, experience, thought
fullness, values and culture deeply penetrated by them must be valued and
used for upcoming further generation. So, there will not be any need of to join
any value (moral) tradition classes. It is strongly recommended that, the
families and society should treat them as they are important and valuable
segment of population. Which definitely useful to impart the training to the
generation.