Factores asociados al estado nutricional en el adulto mayor, en base a la Encuesta Demográfica y Salud Familiar (ENDES) 2015

Abstract

Objetivo: Determinar los factores asociados al estado nutricional en el adulto mayor peruano. Métodos: Análisis secundario del estudio transversal ENDES 2015 de adultos mayores. El estado nutricional se midió mediante el índice de masa corporal, tomando los puntos de corte para el adulto mayor (bajo peso: ≤23 kg/m², peso normal: 23.1-27.9 kg/m², sobrepeso: 28-31.9 kg/m² y obesidad: >32 kg/m²). Para evaluar factores asociados con el estado nutricional se corrieron dos Modelos Lineales Generalizados independientes (GLM), uno para comparar a los grupos con y sin desnutrición y el otro a los grupos con y sin sobrepeso/obesidad. Se obtuvo la razón de prevalencia cruda (RPc) y ajustada (RPa) a un intervalo de confianza del 95%, utilizando regresión de la familia Poisson con varianza robusta. Resultados: El 30.0% presentó desnutrición aguda, 20.6% sobrepeso y 9.8% obesidad. Los factores asociados a desnutrición aguda fueron: edad (70-79 años: RP: 1,29[1,13-1,48]; 80 a más: RP: 1.54[1.32-1.80] vs 60 a 69 años), en área rural vs urbana (RP: 1.25[1.04- 1.50]), mayor en sierra y selva vs Lima Metropolitana y Callao (Resto de Costa: RP: 1.96 [1.29-2.99], Sierra: RP: 1.74[1.17-2.62]; Selva: RP: 1.96[1.29-2.99]), menor probabilidad a medida que aumenta el quintil de riqueza (Quintil Superior: RP: 0.45[0.31-0.67]), mayor probabilidad de tener presión arterial óptima vs presión arterial alta (RP: 1.40[1.17-1.67]), mayor probabilidad de no tener diabetes (RP: 1.56[1.06- 2.28]), menor probabilidad de consumir frutas y verduras (RP: 0.79[0.66-0.95]). Los factores asociados a sobrepeso/obesidad fueron: sexo femenino (RP: 1.64[1.43-1.88]), menor probabilidad conforme aumenta la edad (RP: 0.62, IC 95%: 0.51-0.75), menor en sierra vs Lima Metropolitana y Callao (RP: 0.79[0.64-0.98]), mayor probabilidad a medida que aumenta el quintil de riqueza: (RP: 3.14[2.39-4.12]), menor probabilidad de tener presión arterial óptima (RP: 0.53[0.43-0.66]), menor en los no diabéticos (RP: 0.81[0.67-0.99]) y aumenta en los que tienen síntomas depresivos (RP: 1.25[0.06-1.48]). Conclusiones: Los factores asociados a desnutrición en los adultos mayores fueron la edad, vivir en área rural, en la sierra y selva, menor quintil de bienestar, presión arterial óptima, no ser diabético y menor consumo frutas y ensalada de verduras. En sobrepeso u obesidad fueron el sexo femenino, edad, vivir en sierra, mayor quintil de bienestar, a mayor medida de presión arterial, diabéticos y con síntomas depresivos.

Objective: Determine the factors associated with nutritional status in the Peruvian elderly. Methods: Secondary analysis of the ENDES 2015 cross-sectional study of older adults. The nutritional status was measured by the BMI, taking the cut-off points for the elderly (low weight: ≤23 kg / m², normal weight: 23.1-27.9 kg / m², overweight: 28-31.9 kg / m² and obesity: > 32 kg / m²). To evaluate factors associated with nutritional status, two independent Generalized Linear Models (GLM) were run, one to compare groups with and without malnutrition and the other to groups with and without overweight / obesity. The raw prevalence ratio (RPc) and adjusted prevalence (RPa) were obtained at a 95% confidence interval, using Poisson family regression with robust variance. Results: 30.0% presented acute malnutrition, 20.6% overweight and 9.8% obesity. The factors associated with acute malnutrition were: age (PR: 70-79 years: 1.29 [1.13-1.48]; 80 plus: PR: 1.54 [1.32-1.80] vs 60 to 69 years), in rural vs. urban area (PR: 1.25 [1.04- 1.50]), higher in sierra and selva vs. Lima Metropolitan and Callao (Rest of Coast: PR: 1.96 [1.29-2.99], Sierra: PR: 1.74 [1.17-2.62]; Jungle: PR: 1.96 [1.29-2.99] ), lower probability as the wealth quintile increases (Upper Quintile: PR: 0.45 [0.31-0.67]), higher probability of having optimal blood pressure vs high blood pressure (PR: 1.40 [1.17-1.67]), higher probability of not having diabetes (PR: 1.56 [1.06-2.28]), lower probability of consuming fruits and vegetables (PR: 0.79 [0.66-0.95]). The factors associated with overweight / obesity were: female sex (PR: 1.64 [1.43-1.88]), lower probability as age increases (PR: 0.62, 95% CI: 0.51-0.75), lower in sierra vs. Metropolitan Lima and Callao (PR: 0.79 [0.64-0.98]), higher probability as the wealth quintile increases: (PR: 3.14 [2.39-4.12]), lower probability of having optimal blood pressure (PR: 0.53 [0.43-0.66]), lower in non-diabetics (RP: 0.81 [0.67-0.99]) and increase in those with depressive symptoms (RP: 1.25 [0.06-1.48]). Conclusions: The factors associated with malnutrition in the elderly were age, living in rural areas, in the mountains and jungle, lower quintile of well-being, optimal blood pressure, not being diabetic and less consumption of fruits and vegetable salad. In overweight or obesity were female sex, age, living in the sierra, greater quintile of well-being, a greater measure of blood pressure, diabetics and with depressive symptoms.