Abstract
BackgroundChile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a nutritional supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the supplementation programme.AimThe aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing nutrition supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile.MethodsThe study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of nutrition for older people based on sound science-base and evidence for cost-effectiveness.Trial registrationISRCTN48153354
Highlights
Chile has undergone a period of rapid demographic transition which has led to an increase in the proportion of older people in the population: the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005
It was agreed that rather than making the nutritional supplement available to all eligible individuals in the selected clusters, a sample would be defined that would enable the detection of the proposed primary outcome regarding pneumonia incidence
Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population
Summary
Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. The population of individuals aged 80 years or older is projected to more than triple in the period 2000–2050, from 1.2% to 4.3% of the world's population, or about 73 million to 400 million people [1]. These changes will be most dramatic in the less developed countries in Asia and Latin America, where the population age structure will change rapidly from one that is predominantly young, with relatively low proportions of older people, to one with more balanced numbers across age groups. Emphasis was placed on adequate nutrition throughout the life course and national food policies designed to recognise older people as potentially vulnerable
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