Malnutrition, low diet quality and its risk factors among older adults with low socio-economic status: a scoping review

Low socio-economic status (SES) is often associated with various health-related problems. Therefore, the present paper aims to review the available literature to identify the prevalence of malnutrition, prevalence of poor diet quality and its associated risk factors among older adults with low SES. A literature search was performed using four databases, namely PubMed, Google Scholar, Springer and Science Direct. The search terms used were 'diet quality', 'nutritional status', 'dietary intake', 'overweight', 'obesity', 'underweight', 'older people' and 'low socioeconomic status (SES)'. The overall prevalence of undernutrition among older adults with low SES worldwide was in the range of 28·9 to 48 %, while overnutrition was reported to be between 8·1 to 28·2 %. In Asia, the prevalence of undernourished older adults ranged from 3 to 64·9 %, while 2·5 to 32·8 % were overnourished. Most of the studies (60 %) included in the present review used BMI as the tool to identify malnutrition, but none of the nutritional screening tools were considered to be the 'gold standard'. For dietary assessment, FFQ and multiple 24 h dietary recall improved the estimation of individual dietary intake. Risk factors for poor diet quality included financial hardship, functional limitation, sex, place of residence, smoking and oral health. Poor nutritional status, especially lack of good-quality diet, and thinness are prevalent among older adults with low SES. Hence, it is important to establish nutrition-related programmes and intervention studies among this group of individuals for improving their health status and quality of life.