Influence Of Social Networks On Nutrition And Physical Function Of Ethnic Older Minorities Over Time

Abstract

BACKGROUND: Social networks (SN) are consistently shown to influence health outcomes in later life. However, relatively little is known about SN of ethnic older minorities, and how they impact on health outcomes over time. PURPOSE: To explore SN and their impact on nutritional intake and status, and physical function in ethnic older minorities (≥60 years) living in Birmingham, United Kingdom. METHODS: SN were assessed using the Wenger Practitioner Assessment of Network Types (PANT). Multiple-pass 24-hour dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Correlation and regression analyses examined relationships between SN, physical function, nutrient intake and nutritional status. The influences of SN were captured through semi-structured interviews at baseline (N=92) and follow-up (N=81). Interviews were transcribed verbatim and analysed using directed content analysis. RESULTS: Of the 100 participants measured at baseline, 81 were followed up 8-months later. Mean age =70.9±8.1 years (62% male) comprising African/Caribbean (65%), South Asian (28%), and other ethnicities (7%). Five SN were identified and grouped into two broad categories: integrated SN (locally integrated (44%) and wider community (8%)); and non-integrated SN (family dependent (25%), locally self-contained (17%), and private restricted (6%)). At follow-up, SN declined in 19% and improved in 11%. There was an overall decrease in physical function (F(1))=9.73, P=0.03) and nutritional status (F(1))=6.04, P=0.016) over time. Participants in integrated SN compared with non-integrated SN at baseline were less likely to experience a decline in physical function at follow-up (OR: 0.17; 95% CI:0.04-0.63). Qualitative results indicate that participants with declines in SN perceived this as causing poorer physical function and eating behaviours. CONCLUSION: Changes in SN occurred over a relatively brief period in this sample, with integrated SN associated with better physical function, nutritional intake and status. These findings can inform interventions and community outreach programmes designed to enhance SN and the health status of this population.