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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Life satisfaction among elderly patients in Nepal: associations with nutritional and mental well-being

Authors: Saruna Ghimire, Binaya Kumar Baral, Isha Karmacharya, Karen Callahan, Shiva Raj Mishra

Published in: Health and Quality of Life Outcomes | Issue 1/2018

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Abstract

Background

Nepal’s demography is aging rapidly, yet few studies to date have examined how this has affected the health and well-being of the elderly, defined as those above 60 years in Nepal’s Senior Citizen Act (2006). Our study, abbreviated NepEldQOLII, aims to assess perceived life satisfaction, and evaluate its relationship with nutritional health and mental well-being among the burgeoning Nepalese elderly population.

Methods

A cross-sectional survey among 289 Nepalese elderly, aged ≥60 years, attending an outpatient clinic of a hospital in Kathmandu, Nepal was conducted. Nutritional status, depression, and life satisfaction were assessed by a mini-nutritional assessment scale (range: 0–14), a geriatric depression scale (range: 0–15), and a satisfaction with life scale (range: 5–35), respectively. Mediation analyses, adjusted for age, sex, marital status, and family type, were used to assess mediating relationships between nutritional and mental wellbeing with life satisfaction as the outcome.

Results

Approximately 21% of the participants were dissatisfied with their life. Life satisfaction was positively associated with being married, high family income, involvement in active earning, and a high nutritional score. Conversely, life satisfaction was inversely associated with living in a nuclear (as opposed to joint) family, the perception of having worse health than peers, the perception of being ignored/hated due to old age, and a higher depression score. In mediation analyses, both nutrition (β = 0.48, bias-corrected and accelerated (BCa) 95% CI: 0.27, 0.69) and depression (β = − 0.87, BCa 95% CI: -1.01, − 0.74) had significant direct associations with life satisfaction. Furthermore, both nutrition (β = 0.30, BCa 95% CI: 0.13, 0.49) and depression (β = − 0.07, BCa 95% CI: -0.14, − 0.03) mediate each other’s association with life satisfaction. Nutritional score mediated 7% of the total association between depression and life satisfaction; depression mediated 38% of the total association between nutrition and life satisfaction.

Conclusions

Life satisfaction shows a pattern of decline as nutritional and mental health status decrease. Both depression and under-nutrition had a significant association with life satisfaction. The pathway by which nutrition affects life satisfaction is influenced by depression as a mediator. Moreover, nutritional status explained a small portion of the relationship between depression and life satisfaction. These observed preliminary findings should be confirmed in future longitudinal studies.
Literature
1.
Nepal Demographic and Health Survey 2016 : Key indicators. Ministry of Health, New ERA Kathmandu, Nepal, The DHS Program, ICF, Maryland, USA 2017.
2.
World health statistics 2017. monitoring health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization; 2017.
3.
4.
Central Bureau of Statistics. National Population and Housing Census 2011 (National Report). Government of Nepal, National Planning Commission Secretariat. Kathmandu: Central Bureau of Statistics; 2012.
5.
Diener E. Assessing well-being: the collected works of Ed Diener. New York: Springer; 2009.CrossRef
6.
An JY, An K, O'Connor L, Wexler S. Life satisfaction, self-esteem, and perceived health status among elder Korean women: focus on living arrangements. J Transcult Nurs. 2008;19(2):151–60.CrossRefPubMed
7.
Koivumaa-Honkanen H, Honkanen R, Viinamaki H, Heikkila K, Kaprio J, Koskenvuo M. Self-reported life satisfaction and 20-year mortality in healthy Finnish adults. Am J Epidemiol. 2000;152(10):983–91.CrossRefPubMed
8.
Beutell N: Life satisfaction in relation to work and family; 2006.
9.
Tate RB, Lah L, Cuddy TE. Definition of successful aging by elderly Canadian males: the Manitoba follow-up study. Gerontologist. 2003;43(5):735–44.CrossRefPubMed
10.
Strine TW, Chapman DP, Balluz LS, Moriarty DG, Mokdad AH. The associations between life satisfaction and health-related quality of life, chronic illness, and health behaviors among U.S. community-dwelling adults. J Community Health. 2008;33(1):40–50.CrossRefPubMed
11.
Beyaztas FY, Kurt G, Bolayir E. Life satisfaction level of elderly people: a field study in Sivas, Turkey. J Pak Med Assoc. 2012;62(3):221–5.PubMed
12.
Gautam R, Saito T, Kai I. Correlates of life satisfaction among older Nepalese adults living with a son. Bioscience Trends. 2008;2(5):187–92.PubMed
13.
Schimmack U, Radhakrishnan P, Oishi S, Dzokoto V, Ahadi S. Culture, personality, and subjective well-being: integrating process models of life satisfaction. J Pers Soc Psychol. 2002;82(4):582–93.CrossRefPubMed
14.
Ahmadi SM, Mohammadi MR, Mostafavi SA, Keshavarzi S, Kooshesh SM, Joulaei H, Sarikhani Y, Peimani P, Heydari ST, Lankarani KB. Dependence of the geriatric depression on nutritional status and anthropometric indices in elderly population. Iran J Psychiatry. 2013;8(2):92–6.PubMedPubMedCentral
15.
Vafaei Z, Mokhtari H, Sadooghi Z, Meamar R, Chitsaz A, Moeini M. Malnutrition is associated with depression in rural elderly population. J Res Med Sci. 2013;18(Suppl 1):S15–9.PubMedPubMedCentral
16.
German L, Feldblum I, Bilenko N, Castel H, Harman-Boehm I, Shahar DR. Depressive symptoms and risk for malnutrition among hospitalized elderly people. J Nutr Health Aging. 2008;12(5):313–8.CrossRefPubMed
17.
Bhat RS, Chiu E, Jeste DV. Nutrition and geriatric psychiatry: a neglected field. Curr Opin Psychiatry. 2005;18(6):609–14.CrossRefPubMed
18.
19.
20.
Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5.CrossRefPubMed
21.
Pavot W, Diener E. Review of the satisfaction with life scale. Psychol Assess. 1993;5(2):164.CrossRef
22.
Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, et al. Validation of the mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging. 2009;13(9):782–8.CrossRefPubMed
23.
24.
Yesavage JA, Sheikh JI. 9/geriatric depression scale (GDS) recent evidence and development of a shorter version. Clin Gerontol. 1986;5(1–2):165–73.CrossRef
25.
Gautam R, Houde S. Geriatric depression scale for community-dwelling older adults in Nepal. Asian J Gerontol Geriatr. 2011;6(2):93–9.
26.
Wancata J, Alexandrowicz R, Marquart B, Weiss M, Friedrich F. The criterion validity of the geriatric depression scale: a systematic review. Acta Psychiatr Scand. 2006;114(6):398–410.CrossRefPubMed
27.
McDowell I, Newell C, Brink TL, Yesavage JA, Lum O, Heersema P, Adey MB, Rose TL. Geriatric depression scale [GDS] in measuring health: a guide to rating scales and questionnaires. New York: Oxford University Press, USA; 1996.
28.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.CrossRef
29.
Hayes AF. Beyond baron and Kenny: statistical mediation analysis in the new millennium. Commun Monogr. 2009;76(4):408–20.CrossRef
30.
31.
Vohs KD, Finkel EJ. Self and relationships: connecting intrapersonal and interpersonal processes. New York: Guilford Press; 2006.
32.
Banjare P, Dwivedi R, Pradhan J. Factors associated with the life satisfaction amongst the rural elderly in Odisha, India. Health Qual Life Outcomes. 2015;13:201.CrossRefPubMedPubMedCentral
33.
Şener A, Oztop H, Doğan N, Guven S. Family, Close Relatives, Friends: Life Satisfaction Among Older People, vol. 34; 2008.
34.
Braveman P, Egerter S, Barclay C. Issue brief series: exploring the social determinants of health: income, wealth, and health. Princeton: Robert Wood Johnson Foundation; 2011.
35.
DeNavas-Walt C, Bernadette DP, Cheryl HL. Income, Poverty, and Health Insurance Coverage in the United States: 2005, U.S. Census Bureau, Current Population Reports. Washington: U.S. Government Printing Office; 2006. p. 60-231.
36.
Umberson D, Williams K. Family status and mental health. In: Handbook of the sociology of mental health Springer; 1999. p. 225–53.
37.
DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207–18.CrossRefPubMed
38.
Tsai AC, Yang SF, Wang JY. Validation of population-specific mini-nutritional assessment with its long-term mortality-predicting ability: results of a population-based longitudinal 4-year study in Taiwan. Br J Nutr. 2010;104(1):93–9.CrossRefPubMed
39.
Johnson CS. Psychosocial correlates of nutritional risk in older adults. Can J Diet Pract Res. 2005;66(2):95–7.CrossRefPubMed
40.
Amarantos E, Martinez A, Dwyer J. Nutrition and quality of life in older adults. J Gerontol A Biol Sci Med Sci. 2001. 56 2:54–64.
41.
Lengyel CO, Tate RB, Obirek Blatz AK. The relationships between food group consumption, self-rated health, and life satisfaction of community-dwelling Canadian older men: the Manitoba follow-up study. J Nutr Elder. 2009;28(2):158–73.CrossRefPubMed
42.
Koivumaa-Honkanen H, Kaprio J, Honkanen R, Viinamaki H, Koskenvuo M. Life satisfaction and depression in a 15-year follow-up of healthy adults. Soc Psychiatry Psychiatr Epidemiol. 2004;39(12):994–9.CrossRefPubMed
43.
44.
Brown KM, Arthur JR. Selenium, selenoproteins and human health: a review. Public Health Nutr. 2001;4(2B):593–9.CrossRefPubMed
45.
Van Cauwenbergh R, Robberecht H, Van Vlaslaer V, Deelstra H. Comparison of the serum selenium content of healthy adults living in the Antwerp region (Belgium) with recent literature data. J Trace Elem Med Biol. 2004;18(1):99–112.CrossRefPubMed
46.
Maes M, Galecki P, Chang YS, Berk M. A review on the oxidative and nitrosative stress (O&NS) pathways in major depression and their possible contribution to the (neuro)degenerative processes in that illness. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35(3):676–92.CrossRef
47.
Gibson EL. Emotional influences on food choice: sensory, physiological and psychological pathways. Physiol Behav. 2006;89(1):53–61.CrossRefPubMed
Metadata
Title
Life satisfaction among elderly patients in Nepal: associations with nutritional and mental well-being
Authors
Saruna Ghimire
Binaya Kumar Baral
Isha Karmacharya
Karen Callahan
Shiva Raj Mishra
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-0947-2

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