| Objectives:To investigate the status of nutrition knowledge-attitude and dietary habits and thehealthy related quality of life, analysis the relationship between dietary habits and healthstatus among elderly community-dwelling in Xi’an. Furthermore, the case-control studywas adopted to explore the influencing factors of poor dietary habits.Methods:1. The cross-sectional studyA sample of826elderly which aged60years and above were collected from elevencommunities of six administrative districts in Xi’an city, by a stratified cluster randomsampling method. They were surveyed by a semi-structured questionnaires included theChina Health and Nutrition Surveys (CHNS), the Medical Outcomes Study36-ItemShort-Form Health Survey (MOS SF-36), dietary nutrition knowledge-attitude-practice(KAP), chronic diseases and the demographic information. The study were gathered between July12,2012and November12,2012. Database was constructed using EpiDate3.1software and data was analyzed with SPSS17.0software, besides descriptive statistics,the chi-square test, Wilcoxon’s rank sum test and Spearman’s correlation.2. The matched case-control studyBased on the results of cross-sectional study, the1:1matched case-control study wasdesigned to explore influencing factors of poor dietary habits. Case group was included150elderly who has poor dietary habits. The control group was consisted of150olderpeople lived in the same or nearly community. Both the same gender and the difference inage less than three years as the matched conditional for the cases and the control groups.Data were analyzed with SPSS17.0software and then using1:1univariate factor Logisticregression and multivariate conditional Logistic regression analysis.Results:1. Generally demographics characteristicsA total of826the questionnaires in this study were sent out, and there were806effective Questionnaires were took back, the effective rate was97.6%. In this sample, malewere262(32.5%), female were544(67.5%); The range of age from60to88years old,average age was71.4(SD=6.8) years; Ethnic: Han were787(97.6%), the others were19(2.4%); Education level: illiteracy116(14.4%), elementary school190(23.6%), middleschool255(31.6%), secondary school/middle technique school165(20.5%), junior colleges38(4.7%), university or above42(5.2%); Marriage status: married were538(66.7%), lossspouse were263(32.6%), unmarried or divorce were5(0.7%); living arrangement: alonewere126(15.6%), with family were680(84.4%); Occupation currently: having jobs or workwere29(3.6%), retired at home were777(96.4%); medical insurance: participants were737(91.4%), none were69(8.6%); interesting: yes538(66.7%), no268(33.3%); religion:haswere122(15.1%), no were684(84.9%); income(RMB): less than1000yuan were170(21.1%),1001～2000yuan were438(54.3%),2001～3000yuan were146(18.1%); morethan3001yuan were52(6.5%); The occupation before retirement: Leaders were125(15.5%),workers were401(49.8%), farmers were84(10.4%), the others were196(24.3%).2The current status of nutrition knowledge, attitude, dietary habits, chronic diseases andthe healthy related quality of life among elderly community-dwelling in Xi’an city2.1The present situation about nutrition knowledge-attitude and dietary habits of elderlycommunity-dwelling The percent of correctly reply to the common nutrition knowledge was much higher,but to some special nutrition knowledge was worse generally. Overall, there were79.7%among elderly’s proper rate of nutrition knowledge was middle and above level. Morethan half of the elderly has powerful aspiration to get nutrition knowledge, and beenwilling to change some unreasonable dietary habits. However, the consciousness of healthcare was light. The fairly good attitude rate of elderly was63.1%.72.7%of theparticipants were middle over level of dietary habits, and the meal regular was better.Comparing with the Dietary Guidelines for Chinese, dietary composition of elderlycommunity-dwelling in Xi’an was unreasonable, though remains traditional dietarycharacteristics of China, the dietary construction has changed, main traits which includedfood from plants was more, the intake of cereal and products were higher, but meal’ andpulses’ products, fruits, vegetables, dietary fiber was lower, meat was unbalance. Theconsumption of poultry meat and eggs was more, seafood was obviously insufficient,dietary sodium and seed oils were exceed to the provided standard.2.2The incidence of chronic diseases among elderly in communityThe incidence of chronic diseases among elderly community-dwelling in Xi’an was83.3%, the rate of single chronic disease was23.8%, two or above chronic diseases was59.4%; The prevalence of hypertension was highest and more than40.0%; rank in thesystematic, circulate-system was first, the rate was54.1%. Otherwise, the health protectionof oral cavity was shortcoming, more than half(62.8%) of elderly has different levels ofteeth defect.2.3The health related quality of life among elderly in communityMost of the elderly the quality of life with middle and above level, the prevalencerate of good, middle was62.8%,37.1%respectively.2.4The relationship among dietary habits, chronic disease and health related quality of lifeDietary habits was better, the prevalence rate of chronic disease was lower, and theprevalence rate of heart disease was statistical significance between Dietary habits.otherwise, there were relationship between dietary habits, chronic disease and healthrelated quality of life. Just as the better health related quality of life of the elderly, thedietary habits was better, the prevalence rate of chronic disease was lower.2.5Influencing factors of poor dietary habits among elderly by1:1matched case-controlstudyBy single factor logistic analysis, the results showed that educational level, the occupation before retirement, income, Marriage status,age, nutrition knowledge andattitude, PF, RP, RE, SF, BP,GH, MH and VT were significantly associated with poordietary habits(P＜0.05).In a multivariate factor conditional logistic regression analysis demonstrated thatpoor nutrition knowledge, shorting consciousness of health care, SF and Marriage statuspoor were major influencing factors on poor dietary habits. Their Odds and95%Confidence Interval ware as following:0.278（95%CI=0.123～0.627）、0.224（95%CI=0.081～0.618）、0.046（95%CI=0.012～0.164）、2.784（95%CI=1.260～6.154）、2.507（95%CI=1.203～5.228）。Conclusion:1. The status of nutrition knowledge, attitude and dietary habits among elderlycommunity-dwelling in Xi’an were good relatively, but the consciousness of health carewas shortcoming, the consumption of dietary unreasonable.2. The incidence of chronic diseases in community-dwelling elderly was much higher,more than half the population among sample have at least two kinds of chronic diseases.In short, health status of the elderly community-dwelling in Xi’an was not optimistic.3. The subjective health status was optimistic among the elderly, more than half elderlythe quality of life was better level.4. There are relationship among dietary habits, the prevalence rate of chronic disease aswell as health-related quality of life among elderly. The better health related quality of lifeamong elderly community, the better of the dietary habits, or the lower prevalence rate ofchronic disease. Furthermore, there was the relationship between the dietary habits and theprevalence rate of chronic disease such as heart disease.5. Common influencing factors to poor dietary habits were poor nutrition knowledge,shorting consciousness of health care and relatively poor SF as well as marriage status.6. Recommendations of prevention and invention: holistic social should be pay moreattention to the current status and potential problems to the poor nutrition knowledge,shorting consciousness of health care and relatively poor SF as well as marriage statusamong elderly community-dwelling. Relative governments and healthy departments mustoffer support and provide help in policy and safeguard, especially communities healthyservice department, ought to take effective measures aimed to existing problems whichrelated to health at present, such as opening nutrition-related knowledge education in community, taking advantage of medium included TV and broadcast, by spreading DietaryGuidelines for Chinese and giving publicity to the elderly about the dangerous of poordietary habits, in order to improving nutrition-related knowledge and the perception ofhealth care. At the same time, building service facilities step by step, strengthening thesocial supports to enriching spirits of elderly. Finally improving the development ofelderly both physiological and psychological health, enhancing the quality of life, ultimatecome true the healthy aging. |
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