Abstract
ObjectivesLow socioeconomic position (SEP) is related to many health-related conditions in older adults. However, there is a lack of knowledge on the association between SEP and malnutrition, a condition with serious consequences for older people in terms of quality of life and adverse health events. In the current study, we investigated socioeconomic inequalities in malnutrition and sub-domains of malnutrition in a sample of Spanish older adults.DesignCross-sectional population-based study.SettingUrban area of Albacete, Spain. Participants: 836 participants over age 70 from the first measurement wave (2007-2009) of the Frailty and Dependence in Albacete (FRADEA) study, a population-based cohort study.MeasurementsEducational level and occupational level were the indicators of SEP. Nutritional risk was measured with the Mini Nutrition Assessment® Short Form (MNA®-SF). Logistic regression analyses were performed.ResultsFor both socioeconomic indicators there was a statistically significant association with nutritional risk (OR low education=1.99, 95% CI=1.18-3.35; OR low occupational level=1.71, 95% CI=1.08-2.72). However, these associations disappeared after adjusting for age and sex (OR low education=1.51, 95% CI=0.88-2.60; OR low occupational level=1.32, 95% CI=0.80-2.17). In adjusted models, statistically significant associations between SEP and sub-domains of the MNA®-SF were observed, but these associations were not consistent across socioeconomic indicators.ConclusionsThis study found that malnutrition is a condition that can appear in any older adult, regardless of their socioeconomic group. These findings suggest that interventions to prevent malnutrition in older adults can be targeted at a general older population, and do not have to be SEP specific.
Highlights
Older people with a low socioeconomic position (SEP) have a higher risk of various geriatric conditions, and adverse outcomes related to these conditions
Nutritional status differed by occupational level (21.3% with nutritional risk or malnutrition among older adults with a high occupational level versus 31.7% among those with a low occupational level)
For both educational level and occupational level socioeconomic inequalities in nutritional risk were observed in the unadjusted model, with a higher risk for malnutrition among lower socioeconomic groups (OR = 1.99, 95% CI = 1.183.35, and OR = 1.71, 95% CI = 1.08-2.27, respectively)
Summary
Older people with a low socioeconomic position (SEP) have a higher risk of various geriatric conditions, and adverse outcomes related to these conditions This includes, for example, frailty and polypharmacy, which have shown to be more prevalent in older adults with low education or low levels of income [1,2,3]. An Italian study found an association between low educational level and nutritional risk [14], yet, on the other hand, a recent Polish study concluded that low educational level was not an independent risk factor of malnutrition [15] Both studies made use of the Mini Nutritional Assessment® Short Form (MNA®-SF), a well-validated multidimensional measurement instrument [16], and the recommended instrument by the European Society of Clinical Nutrition (ESPEN) for malnutrition screening of community-dwelling older people [17]. Knowledge of the relationship between SEP and these sub-domains of malnutrition will build evidence regarding nutritional care for older people, and better position healthcare practitioners to identify and manage malnutrition
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