1.5cr elderly in Bangladesh suffer from malnutrition

Around 25% of 1.5 crore elderly people in Bangladesh suffer from malnutrition, and 52% suffer from arthritis. Home-based palliative care is also needed for the elderly with incurable diseases.

This information became clear at a programme organised to reveal the findings of three separate studies conducted by Bangabandhu Sheikh Mujib Medical University (BSMMU).

The programme was organised on Thursday marking the International Day of Older Persons which will be observed across the country and elsewhere in the globe today.

In Bangladesh, 7.5% of the total population belongs to the older age group. Of them, 26% are malnourished, and 62% are at risk of malnutrition.

The Department of Public Health & Informatics of BSMMU conducted a study from October 2019 to February 2020, to identify the causes of malnutrition in the country's elderly people. The study was conducted among 125 older individuals living in three villages of Uttarkhan in Dhaka.

The study, "Factors associated with the nutritional status of the older population in a selected area of ​​Dhaka, Bangladesh", said, "More than two-thirds of the older population are malnourished or at risk of malnutrition. The female respondents are more vulnerable, with 22% male and 28.8% female [study participants] being malnourished."

The study said depression, inadequate oral health, and lack of education are negatively associated with the nutritional status of the older population. The proportion of malnourished and at risk of malnutrition, among respondents living without a partner, were 28.6% and 65.3% respectively.

A higher proportion of malnutrition was observed among  respondents who had depression (39.3%) than those with normal mental health (12.5%). Furthermore, about one-third of the elderly who suffer from poor oral and dental health, also suffer from malnutrition.

Doctors said malnourished older people are at risk of developing different nutrition-related complications, leading to the inability to live on their own and making them dependent on others. Various comorbidities and the nutritional status of older individuals are interlinked, making them more prone to chronic diseases, which leads to further malnutrition, making it all a vicious cycle.

Dr KM Touhidur Rahman, lead researcher of the study, told The Business Standard, "Malnutrition reduces human immunity. If the elderly are malnourished, their infectious diseases increase a lot and the rate of recovery from such diseases decreases, resulting in increased dependence on others."

Dr Touhid thinks it is necessary to institute nutrition programmes to eliminate malnutrition among the elderly. "Women need to be given more importance in this regard due to the higher rate of malnutrition among them. Besides, emphasis should be given to improving the mental and oral health of the elderly, because they cannot eat as they do not have good teeth and a healthy mouth," he said.

Dr Rahman said, "One of our interesting findings is that those who eat less eggs, milk, and meat for fear of high blood pressure or other diseases are suffering from malnutrition [more]. Instead of doing well, this is worsening the condition of their hearts. By avoiding food to stay well, they are getting worse. That is why a proper diet needs to be ensured for older persons."

In addition to malnutrition, the rate of suffering from arthritis is much higher among the elderly. Another study by the Department of Internal Medicine of BSMMU, found that 52% of the elderly in rural Bangladesh suffer from arthritis and more than half of whom are moderately physically disabled.

The study, "Prevalence of Musculoskeletal Disorders in the Elderly Population in a Rural Community of Bangladesh", said 43.4% male and 56.6% female elderly people suffer from arthritis. Lower back pain and knee pain are the most common sites of pain for elderly people. Prevalence of knee osteoarthritis is 26.3%.

The study was conducted, from April 2017 to March 2018, on 380 elderly persons in Mokshedpur Union of Dohar upazila in Dhaka.

The study said, about 60% of patients went to local doctors for their rheumatic pain management.

Palliative care is a special service for critical and incurable patients and is required for six lakh patients suffering from incurable or long term diseases in Bangladesh every year.

The Department of Palliative Medicine of BSMMU is providing home-based palliative care to incurable patients living within 20km of the medical university.

The Department of Public Health & Informatics of BSMMU, conducted a study from October 2020 to June 2021 to evaluate home based palliative services in Bangladesh.

The study, "Home based palliative care for ill patients: opportunities in Bangladesh", said, "more than 80% of cancer patients avail palliative care. Mental problems and anxiety symptoms are most common in patients."

The study recommends developing specific protocols for home-based palliative care, educating doctors on the need for palliative care, and more publicity to raise public awareness.

BSMMU Vice-Chancellor, Professor Dr Sharfuddin Ahmed, said the number of senior citizens in the country will increase to 3.5 crore by 2050. The young have to hold the hands of the elderly. The government of Bangladesh is maintaining equity and has taken steps to reduce illness among both children and the elderly. He said all at the university want to serve patients of all ages equally.

This year's slogan for International Day of Older Persons is – Digital Equity for All Ages.

Mentioning old age as a major challenge of human life, the United Nations has been observing 1 October as the "International Day of Older Persons" every year since 1991.