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Psycho-Social, Nutritional Status and Meal Service Utility Patterns by Living Arrangements of the Elderly Participated in Meal Service
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Kyung Hee Han, Mee Sook Choi, Jung Sook Park
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Korean J Community Nutr 2004;9(5):615-628. Published online October 31, 2004
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- This study is designed to examine influences of living arrangements on psycho-social factors, health and nutritional status, dietary adequacy and meal service utility patterns of the elderly. Nutritional status was evaluated by Mini Nutritional Assessment (MNA). Three hundred and nine elderly (110 men and 199 women) who participated in meal service in the Chung-buk province were investigated. Proportion of the elderly living alone, couples only, living with spouse and family, living with family without spouse, and living with other than family were 30.7%, 25.9%, 14.2%, 24.3% and 4.9% respectively. The mean age of the elderly was 74.1 years and the elderly who are living couples only and living with spouse and family were younger than those with other living status. Living arrangements seem to be related to psycho-social factors, health and nutritional status, and dietary quality. Those who live alone and live with other than family were mostly women and they have lower socio-economic status, psycho-social, health and nutritional status and dietary patterns compared with those of the elderly who are living with spouse or family. It was found that the elderly who live a couple only and live with spouse and family had better emotional, health and nutritional index than those of the elderly who live with family without spouse, especially in case of females. Most of elderly perceived that participation of meal service programs had a positive effect on their daily life and satisfied with meals. The elderly living alone and living with other than family were more frequently using meal service but had a negative attitude about the charged meal service for better quality than the elderly with other living status. The most important reason for all the elderly to participate in meal service was to meet their friends and then to get other services. Particularly those who are living alone and living with other than family showed lack of moivation to prepare and set the meal, and for them the economic reason is also important. They also replied that the poor health and lack of other help were the most difficult problems for them to prepare meals. It would be effective to provide nutritional services that meet specific needs of the elderly according to their characteristics and living environment.
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Serum Osmolality and Its Association with Health-Related Factors and Biochemical Parameters in the Elderly
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Kyung Hee Han
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Korean J Community Nutr 2001;6(1):76-83. Published online February 28, 2001
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- This study was designed to determine serum osmolality and to investigate the association among serum osmolality, health-related factors and biochemical indices. Two hundred thirty seven elderly(86 male, 151 female : mean age 73.8) residing in the chungbuk area participated. Sociodemographic data and self-perceived health status were obtained by interview, and biochemical parameters were measured. The mean serum osmolaity was 301.2+/-10.1 mOsm/ kg(range 240.8~328.9 mOsm/ kg) and serum osmolality of the females(302.4 mOsm/ kg) was significantly(p<0.05) higher than that of the males(299.0 mOsm/ kg). Only 11.0% of the elderly were within the accepted normal range(280~295 mOsm/ kg) and the majority of the subjects were in a hyperosmolar state(60.8% : 296~307 mOsm/ kg). It was observed that serum osmolality was reduced with increasing age but not statistically significant. There was no significant difference in serum osmolality according to marital status. Serum osmolality was significantly lower(p<0.05) in the elderly with higher self-perceived health scores than the elderly with lower self-perceived health scores, however no significant difference was observed between the presence or absence of disease. Serum osmolality tended to be higher(p=0.06) in the elderly with difficulty in mobility than the elderly who have no problem in mobility. Serum osmolality tended to be higher(p=0.06) among drug users compared to that of non-users. There was a significant association between serum osmolality and serum albumin in females but not in males. Significant associations were shown between serum osmolality and serum transferrin in both sexes. However, there was no significant correlation between serum osmolality and hemoglobin or hematocrit except with hematocrit in females only. The results of this study indicated that the elderly were dehydrated and hydration state seems to influence health status and, the elderly should be encouraged to drink an adequate amount of fluids. Also, the hydration state is required to be assessed and considered for the interpretation of biochemical parameters.
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Drug Use and Nutritional status of the Elderly in chungbuk area: IV. effects of drug Use & Health-Related Habits (Alcohol drinking, cigarette smoking & exercise) on Nutritional status
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Kyung Hee Han, Ki Nam Kim, Dong Yean Park
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Korean J Community Nutr 1998;3(3):397-409. Published online August 31, 1998
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- The purposes of this study were to investigate the effects of drug use & the health-related habits(alcohol drinking, smoking and exercise) on the nutritional status of elderly. subjects were 362 free-living elderly aged over 65(male 131, female 231) in Chungbuk area. Interviews with questionaire on drug use, health-related habits, and nutrient intakes, anthropometric measurement and biochemical blood test were carried out from August to October in 1996. Energy intakes of the males who used drug were lower than those of males who did not use any drug, while energy intakes of the females who used drug were higher than those of females who did not. In biochemical indices, LDL-cholesterol level of the males who used drug was higher than that of males who did not have drug. serum triglycerides, VLDL-cholesterol and obesity degree(BMI & TS) of the females who used drug were higher than those of females who did not have drug. Alcohol drinking, smoking and exercise habits of the elderly who used drug had little effects on the nutrient intakes while those habits had considerable effects on biochemical indices and obesity degree. Among drug users, male drinkers showed higher triglycerides & HDL-cholesterol level, and female drinkers showed higher triglycerides and lower total cholesterol and LDL-cholesterol level, compared to non drinkers. Among female drug users, smokers showed lower body mass index(BMI) compared to non smokers. Males and females who had both drinking and smoking habits showed higher serum triglycerides and VLDL-cholesterol level. Especially females who had both drinking and smoking habits showed lower BMI & Tricep skinfold thickness compared to those who had netiher drinking nor smoking habits.
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Drug Consumption and Nutritional Status of the Elderly in Chung-buk Area: II. Nutritional Status of Urban and Rural Elderly
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Kyung Hee Han, dong Yean Park, Ki Nam Kim
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Korean J Community Nutr 1998;3(2):228-244. Published online May 31, 1998
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- The nutritional status of 362 elderly men and women in Chung-bud area was evaluated in terms of their nutrient intakes, biochemical and anthrophometric measurements by interviews with questionnaires from August to October 1996. Mean intake of all nutrients except ascorbic acid did not meet the RDA for this sample. Protein, vit A, reboflavin, calcium were the most likely to be deficient on the basis of propotions of elderly consuming less than 75% of the RDA. The subjects nutrient intake was significantly affected by gender, marital status, number of family, family composition, educational level, pocket money, and region. Men in rural areas and women over 75 in urban areas were the most vulnerable groups with nutritional deficiency. According to serum biochemical indices, mean level of cholesterol, triglycerides, LDL, total protein, albumin and iron belonged to normal range but mean level of HDL showed below the normal range. More elderly men and women in urban areas showed a higher percentage of abormal level of cholesterol, triglycerides, LDL and HDL than those in rural areas. More elderly men and women in rural areas had abnormal levels of RBC, Hematocrit and hemoglobin compared to those in urban areas. Mean height and weight of elderly men was 161.4cm and 56.2Kg, respectively and 149.1cm and 50.5kg for women. The elderly in rural areas were taller than those in urban areas but had less weight, MAC, TSF, MAMC. Mean BMI of this sample belonged to normal range. However, the elderly in rural areas had a higher rate of underweight and lower for overweight than those in urban areas. The elderly in urban areas had higher blood pressure than those in rural areas.
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Drug Consumption and Nutritional Status of the Elderly in Chung-Buk Area: I. Diseades and Drug Consumption
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Kyung Hee Han, Ki Nam Kim, Dong Yean Park
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Korean J Community Nutr 1998;3(1):76-93. Published online February 28, 1998
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- Three hundred sixty-two(male 131, female 231) elderly aged over 65 in Chungbuk area were interviewed to determine the disease states and drug usage patterns. The prebalence of disease was 78% and women reported more chronic diseases(83%) than men(71%). Elderly who live with spouse and have an occupation have a lower rate of disease. Average number of diseases of the elderly was 1.8+/-1.1, and women(2.1+/-1.3) have significantly higher average number of diseases than that of men(1.4+/-0.7). Also the elderly in urban areas(2.1+/-1.4) have significantly higher number of diseases than that of the elderly in rural areas(1.6+/-0.9). Arthritis, hypertension, cardiovascular and gastric diseases were the most frequently listed chronic diseases in order for both men and women. Anemia and fracture of bone were relatively higher in women than in men. Particularly, the arthritis of the urban elderly have a rate of 1.5 times higher than that of the rural elderly. Fifty-two percent of the elderly were currently using drugs ; among drug users 71.2% used prescription drugs and 20.5% used nonprescription drugs. The average number taken per person was 2.1+/-1.4 and there was no sex or age difference. However, the elderly in rural areas (2.7+/-1.7) consumed a significantly higher number of drugs than those in urban areas(1.7+/-0.7). The average number of prescription drugs taken was 2.0+/-1.4 while the average of nonprescription drugs taken was 1.3+/-0.6. Analgesics and antihypertensive drugs were most commonly used. Vitamin and analgesics were the most frequently used self-prescribed drugs. It was noted that potential adverse drug interaction by concominant drug consumption for arthritis and antihypensive drug, abuse of digestants and antiacid without treatment of the underlying disease, and misuse of quick-acting bowel medications were problematic for the elderly. In addition drugs used for the elderly have some adverse effect on the digestive system. The types and composition of drugs used by the elderly were identified and presented. Medication compliance was poor and 13.5% reported adverse reactions such as edema, heartburn, nausea, and difficulty with eating. Seventeen percent of the elderly obtained drugs arranged by those other than medical staff. Also, even among those elderly who obtained drugs prescribed by a doctor, 69.1% of subjects had not receive instruction about potential adverse reactions. These results suggest that nutritional problems related to drug usage might exist and so dietitians, either individually or as members of health teams, need to have a better understanding of drug-nutrient interaction and closer supervision, and drug information/education service should therefore be provided to prevent or minimize adverse drug reaction in elderly users of medication.
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The Effectiveness and Preferences of Nutritional Supplementary Drinks for the Elderly
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Kyung Hee Han, Eun Hee Jung, Sook Ja Cho
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Korean J Community Nutr 1997;2(3):366-375. Published online August 31, 1997
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- This study was conducted to evaluate the effectiveness and preferences of supplementary drinks for very old subjects who are likely to be malnourished. Twenty-five elderly subjects were divided into two groups. The supplemented group(N=15) received 500mls of nutrient supplement(New Care) two times daily for 4 weeks. This resulted in a significant increase in the total calories, protein, minerals and vitamins. Nutritional status was assessed both anthropometrically and biochemically, before and after the study period. A significant improvement in mid arm circumference, triceps skinfold thickness and serum albumin were observed in the supplemented group but not in the control group. There is a possibility that most of the elderly were in an anemic state at the beginning of the study since their mean hematologic parameters were within the lower normal range while their mean serum osmolarities was slightly higher than normal,. Although mean serum hemoglobin and hematocrit were not increased significantly, th percentage of the recovery rate from anemia in the supplemented group was higher than in the control group. Total lymphocyte count also showed similar tendency. Sensory evaluation of nutritional supplementary drinks were relatively good and the elderly showed great interest in nutrient supplements. This study suggests that a nutritional status of poorly nourished elderly subjects can be improved by providing them with nutritional supplementations.
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