Factors associated with poor socioeconomic status among Malaysian older adults: an analysis according to urban and rural settings

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Abstract

Background

Poverty at old age is associated with poor dietary habit, nutritional status and higher rates of chronic diseases and psychosocial problems. However, there is limited information about this matter according to urban and rural settings. The aim of this study was to identify dietary, nutritional, physical and cognitive factors associated with poor socioeconomic status (SES) among older adults according to urban and rural settings in Malaysia.

Methods

An analysis was conducted among 2237 older adults who participated in a longitudinal study on aging (LRGS TUA). This study involved four states in Malaysia, with 49.4% from urban areas. Respondents were divided into three categories of SES based on percentile, stratified according to urban and rural settings. SES was measured using household income.

Results

The prevalence of low SES was higher among older adults in the rural area (50.6%) as compared to the urban area (49.4%). Factors associated with low SES among older adults in an urban setting were low dietary fibre intake (Adj OR:0.91),longer time for the Timed up and Go Test (Adj OR:1.09), greater disability (Adj OR:1.02), less frequent practice of caloric restriction (Adj OR:1.65), lower cognitive processing speed score (Adj OR:0.94) and lower protein intake (Adj OR:0.94). Whilst, among respondents from rural area, the factors associated with low SES were lack of dietary fibre intake (Adj OR:0.79), lower calf circumference (Adj OR: 0.91), lesser fresh fruits intake (Adj OR:0.91), greater disability (Adj OR:1.02) and having lower score in instrumental activities of daily living (Adj OR: 0.92).

Conclusion

Lower SES ismore prevalent in rural areas. Poor dietary intake, lower fitness and disability were common factors associated with low in SES, regardless of settings. Factors associated with low SES identifiedin both the urban and rural areas in our study may be useful inplanning strategies to combat low SES and its related problems among older adults.

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Most cited references 37

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The Lawton instrumental activities of daily living scale.

C. Gräf (2008)

By detecting early functional decline, the scale can help nurses with discharge planning. Acute illness or a worsening chronic condition can hasten functional decline in older adults. During hospitalization, reduced mobility and other factors may rapidly decrease an older patient's ability to perform activities crucial for independent living, and the effects might be permanent. The Lawton Instrumental Activities of Daily Living (IADL) Scale assesses a person's ability to perform tasks such as using a telephone, doing laundry, and handling finances. Measuring eight domains, it can be administered in 10 to 15 minutes. The scale may provide an early warning of functional decline or signal the need for further assessment. For a free online video demonstrating use of this assessment, go to http://links.lww.com/A246.

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Poverty and disability in low- and middle-income countries: A systematic review

Lena Morgon Banks, Hannah Kuper, Sarah Polack (2017)

Introduction Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Methods Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. Results From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of upper-middle income countries finding a positive relationship. By age group, the proportion of studies reporting a positive association between disability and poverty was lowest for older adults and highest for working-age adults (69% vs. 86%). Conclusions There is strong evidence for a link between disability and poverty in LMICs and an urgent need for further research and programmatic/policy action to break the cycle.

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Changes during aging and their association with malnutrition

Shilpa Amarya, Kalyani Singh, Manisha Sabharwal (2015)

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Author and article information

Contributors

Suzana Shahar: suzana.shahar@ukm.edu.my

Divya Vanoh: vanohdivya@gmail.com

Arimi Fitri Mat Ludin: arimifitri@ukm.edu.my

Devinder Kaur Ajit Singh: devinder@ukm.edu.my

Tengku Aizan Hamid: aizan@upm.edu.my

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 13 June 2019

Publication date PMC-release: 13 June 2019

Publication date Collection: 2019

Volume: 19

Issue : Suppl 4 Issue sponsor : Publication of this supplement has not been supported by sponsorship. Information about the source of funding for publication charges can be found in the individual articles. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.

Electronic Location Identifier: 549

Affiliations

[1 ]ISNI 0000 0004 1937 1557, GRID grid.412113.4, Centre for Healthy Aging and Wellness, Faculty of Health Sciences, , Universiti Kebangsaan Malaysia, ; Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

[2 ]ISNI 0000 0001 2294 3534, GRID grid.11875.3a, Nutrition and Dietetics Programme, School of Health Sciences, Health Campus, , Universiti Sains Malaysia, ; 16150 Kubang Kerian, Kelantan Malaysia

[3 ]ISNI 0000 0004 1937 1557, GRID grid.412113.4, Biomedical Science Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, , Universiti Kebangsaan Malaysia, ; Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

[4 ]ISNI 0000 0004 1937 1557, GRID grid.412113.4, Physiotherapy Programme, School of Rehabilitation Science, Faculty of Health Sciences, , Universiti Kebangsaan Malaysia, ; Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

[5 ]ISNI 0000 0001 2231 800X, GRID grid.11142.37, Malaysian Research Institute on Ageing (MyAgeing), , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

Article

Publisher ID: 6866

DOI: 10.1186/s12889-019-6866-2

PMC ID: 6565532

PubMed ID: 31196023

SO-VID: 76b968d0-42c2-4179-a3f3-130d8b1470ac

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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ScienceOpen disciplines: Public health

Keywords: socioeconomic status,urban,rural,older adults,disability

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ScienceOpen disciplines: Public health

Keywords: socioeconomic status, urban, rural, older adults, disability

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Factors associated with poor socioeconomic status among Malaysian older adults: an analysis according to urban and rural settings

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Most cited references 37

The Lawton instrumental activities of daily living scale.

Poverty and disability in low- and middle-income countries: A systematic review

Changes during aging and their association with malnutrition

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Cited by 16

Most referenced authors 1,524