Exploring nutritional challenges and health risks in older women in rural primary health care setting in Western India

With demographic shift, there has been an increase in the proportion of the geriatric female population, resulting in an increased demand for healthcare systems in low resource settings. Evidence on nutritional status and associated morbidities exclusively among geriatric women in rural India remains limited. The current study was conducted to examine the association between Nutritional status and Morbidities among Geriatric women. This analytical cross-sectional study was conducted among 195 geriatric women attending outpatient departments of rural health centres attached to the Institute of National Importance in Western India. Consecutive sampling was used for the study. Nutritional status was assessed using the Mini Nutritional Assessment (MNA®) scale. Comprehensive geriatric assessment was performed using the WHO 10-minute Age-Friendly Primary Care Toolkit along with standardised scales for depression (Geriatric Depression Scale, GDS-15), cognitive impairment (Dementia Assessment Rapid Test, DART), functional ability (Katz Index for Activities of Daily Living, ADL), dependence (Lawton & Brody Instrumental Activities of Daily Living, IADL). Haemoglobin and glycated haemoglobin (HbA1c) were estimated for all participants to assess anaemia status and glycaemic control respectively. Among 195 participants, 12 (6.15%) were malnourished and 83 (42.57%) were at risk of malnutrition. WHO 10- minute comprehensive identified urinary incontinence in 21(10.77%), depression positive in 16(8.21%) using single question screening, falls in 3(1.54%) and inability to recall any items on delayed recall in 6 (3.08%). Further assessment using standardised scales showed that 80 (41.03%) were positive for depression, 62 (31.79%) had high dependence, 34 (17.44%) were highly likely to develop cognitive impairment and 21 (10.76%) had severe functional impairment. Out of all the 195 participants, more than half 102 (52.3%) had anemia. There was a statistically significant association between nutritional status and morbidities among geriatric women. Increasing age (aOR 1.256; 95% CI 1.101–1.433; p = 0.001), financial independence (aOR 0.341; 95% CI 0.121–0.958; p = 0.041) and anemia (aOR 3.451; 95% CI 1.805–6.598; p < 0.001) were found to be factors significantly associated with higher odds of being malnourished or at risk of malnutrition. Geriatric women attending rural outpatient departments had a high proportion at risk of malnutrition, which was significantly associated with anaemia, depression, cognitive impairment, functional impairment. These findings are cross-sectional and do not permit causal inference. Opportunistic comprehensive geriatric screening at the primary care level using validated tools is feasible and can facilitate early identification and referral of at-risk older women.