COMPARISON OF LIFESTYLE, NUTRITIONAL STATUS AND VULNERABILITY AMONG THE ELDERLY IN RURAL AND URBAN AREAS OF IBADAN, NIGERIA

Abstract

The proportion of the elderly (≥65 years) is increasing in Nigeria and presently constitute 3.2% of the population. Although adequate nutrition is essential for healthy ageing, many elderly become vulnerable to nutritional deficiencies and associated risks. Information on rural/urban differentials in nutritional vulnerability is essential to designing programmes that promote healthy ageing and quality of life. This study was aimed at investigating rural/urban differences in lifestyle, nutritional status and vulnerability of the elderly in Ibadan. Using a comparative cross-sectional survey, stratified sampling technique was used to select two urban and two rural Local Government Areas. Cluster and simple random sampling were used to select wards/communities and respondents respectively. A total of 168 (Urban) and 178 (Rural) respondents were chosen for the study. A semi-structured questionnaire was used to collect information on socio-demographic and lifestyle profile of the respondents. Socio-Economic Status (SES) was categorised as low (6-13), moderate (14-21) and high (22-29) using education, income, employment status, property ownership, housing type and source of drinking water. Lifestyle was assessed using three indices: smoking, levels of alcohol intake and physical activity. Direct weighing method was used for dietary assessment while energy and nutrient intake were determined using the Total Dietary Assessment software. Weight and armspan were assessed to calculate Body Mass Index (BMI) categorised as underweight (<16.5 Kg/m2), normal-weight (16.5-22.9 Kg/m2) and overweight (≥23.0 Kg/m2). Nutritional vulnerability was evaluated using HelpAge-International checklist, categorised as non-vulnerable (0-5), moderately (6-14) and highly (15-38) vulnerable. Data were analysed using descriptive statistics, Chi-square test and logistic regression at 5% level of significance. Respondents‘ ages were 68.9±4.7 years (urban) and 69.7±4.4 years (rural). Men constituted 58.9% and 60.1% in urban and rural areas respectively. Married respondents were 79.8% in urban and 75.8% in rural. Respondents in low SES were more (6.7%) in rural than urban areas (2.4%). Prevalence of heavy alcohol intake (>1 drink/day) (16.1%, 16.9%) and irregular physical activity (1.8%, 9.6%) were lower in urban than rural areas. Current smokers were about three times more (13.5%) in rural than urban areas (4.8%). Inadequate intakes of energy (61.3%, 52.2%), calcium (98.8%, 97.8%), zinc (82.7%, 71.9%) and vitamin B1 (51.2%, 44.9%) were higher while protein (17.9%, 19.7%) and iron (5.4%, 7.9%) were lower in urban than rural areas respectively. Underweight was significantly higher in rural (24.2%) than urban (16.7%) while overweight was higher in urban (8.3%) than rural (7.3%) iii areas. In urban, 5.4% were moderately vulnerable whereas in rural area, 29.2% and 21.3% were moderately and highly vulnerable respectively. Smoking and alcohol intake had no significant relationship with nutritional vulnerability in both areas. The likelihood of being underweight was one and half times higher in rural than urban areas (OR: 1.58; CI: 0.66-3.79). Having at least moderate SES reduced the odds of being underweight four times in urban (OR: 4.22; CI: 1.41-7.76) and two times in rural areas (OR: 1.8; CI: 1.21-5.58) among other results. Unhealthy lifestyle, undernutrition and nutritional vulnerability were higher in rural than urban areas. Nutritional intervention programmes should target the elderly in rural areas.