Determinants of nutrition risk among older adults in Fiji
Main Article Content
Keywords
nutrition risk, ageing, depressive symptoms, muscle strength, gait speed, rural, Fiji.
Abstract
Introduction: Malnutrition is prevalent yet under-recognised among community-dwelling older adults. This study investigates determinants of nutrition risk in older Fijians to inform targeted interventions.
Methods: Face-to-face interviews gathered socio-demographic, health, and physical characteristics from older adults in Fiji. Nutrition risk and depressive symptoms were assessed using the Mini Nutritional Assessment-Short Form (MNA-SF) and the Geriatric Depression Scale (GDS-15). Muscle strength (handgrip) and physical performance (gait speed) were measured. Independent t-tests and multivariate regression identified factors associated with nutrition risk.
Findings measure: Among 299 older adults (mean age 69.68 ± 9.29 years), 66% were Fijians of iTaukei (Indigenous) and 33% were Fijians of Indian descent, with 56% living in rural and 44% in urban areas. 25% of participants were at nutrition risk. In the fully adjusted model, increasing age was independently associated with higher nutrition risk, with each additional year corresponding to a 4.8% increase in odds (Adjusted Odds Ratio, aOR 1.05, 95% Confidence Interval, CI 1.01–1.09). Suggestive but non-significant trends were observed for ethnicity (lower odds for Fijian Indian vs iTaukei; aOR 0.53, 95% CI 0.27–1.03), rural locality (higher odds vs urban; aOR 1.69, 95% CI 0.93–3.05), and number of comorbidities (aOR 1.22 per condition, 95% CI 0.97–1.54). Sex, medication count, depressive symptoms, muscle strength, gait speed, and BMI showed no significant associations with nutrition risk after adjustment. Participants with lower mean muscle strength (26.19 ±12.98 kg) and slower gait speed (6.21±2.26 m/s) were at higher risk of depressive symptoms. Higher depressive symptom scores were associated with increased nutrition risk (β = -0.124, p = 0.033).
Conclusions: In this study, those at greater risk for malnutrition were older, of indigenous descent, rural living, having >1 comorbidities, were at higher risk of depression, and had lower physical performance. Routine screening is essential for early identification of individuals at nutrition risk to enable targeted interventions.
References
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20. van Beek JHGM, Kirkwood TBL, Bassingthwaighte JB. Understanding the physiology of the ageing individual: computational modelling of changes in metabolism and endurance. Interface Focus. 2016;6(2):20150079. doi:10.1098/rsfs.2015.0079
21. Mühlberg W, Weidemann G, Stedtfeld HW, Sieber C. Low total protein increase injury in the elderly. J Am Geriatr Soc. 2004;52(2):324–325.
22. Bohannon RW. Grip strength: sn indispensable biomarker for older adults. Clin Interv Aging. 2019;14:1681–1691. doi:10.2147/cia.S194543
23. Plange N-K. Aspects of ageing in Fiji. Fiji :University of the South Pacific; 1987.
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28. Volkert D, Kiesswetter E, Cederholm T, et al.Development of a model on determinants of malnutrition in aged persons. Gerontol Geriatr Med. 2019;5 doi:10.1177/2333721419858438
29. de Boer A, Ter Horst GJ, Lorist MM. Physiological and psychosocial age-related changes associated with reduced food intake in older persons. Review Article. Ageing Res Rev. 2013;12(1):316-328. doi:10.1016/j.arr.2012.08.002
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31. Ohara Y, Motokawa K, Watanabe Y, et al. Association of eating alone with oral frailty among community-dwelling older adults in Japan. Arch Gerontol Geriatr. 2020;87:104014. doi:10.1016/j.archger.2020.104014
32. Minagawa-Watanabe Y, Ukawa S, Fukumura T, et al. Association of dining companionship with energy and nutrient intake among older adults. Nutrients. 2025;17(1):37.
33. Noritake K, Fujii K, Kubo Y, et al. Appetite and social networks among community-dwelling older adults. Nutrition. 2024;119:112321. doi:10.1016/j.nut.2023.112321
34. Lin W-Q, Xiao T, Fang Y-Y, et al. Association of malnutrition and health-related factors among older adults in China. Nutrients. 2024;16(9):1338.
35. Takehara S, Hirani V, Wright FAC, et al. Appetite, oral health and weight loss in older men. BMC Geriatr. 2021;21(1) doi:10.1186/s12877-021-02169-y
36. Ministry of Health and Medical Services. National oral health survey report 2004. 2004.
37. Naduva A. Geriatric Assessment during health promotional home visits in Fiji. Health Promot Pac. 2007;14(2):23-28.
38. Asian Development Bank. Fiji country gender assessment 2015. 2015.
39. Dodd R, Shanthosh J, Lung T, et al. Gender, health and ageing in Fiji. Int J Equity Health. 2021;20(1):1-12. doi:10.1186/s12939-021-01529-9
40. Krishnamoorthy Y, Rajaa S, Rehman T. Diagnostic accuracy of geriatric depression scale. Arch Gerontol Geriatr. 2020;87:104002. doi:10.1016/j.archger.2019.104002
41. Islam MZ, Disu TR, Farjana S, Rahman MM. Malnutrition and risk factors of geriatric depression. BMC Geriatr 2021;21(1):572. doi:10.1186/s12877-021-02535-w
42. Kim J, Kang S, Hong H, et al. Muscle strength moderates nutritional health and depression. Nutrients. 2022;14(3):665.
43. Zasadzka E, Pieczyńska A, Trzmiel T, et al. Handgrip strength and depression: systematic review. Int J Environ Res Public Health 2021;18(9):4823.
44. Miller ME, Magaziner J, Marsh AP, et al. Gait speed and mobility disability. J Am Geriatr Soc. 2018;66(5):954-961. doi:10.1111/jgs.15331
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Determinants of nutrition risk among older adults in Fiji. PacHealthDialog [Internet]. 2026 Apr. 29 [cited 2026 Apr. 29];26(2). Available from: https://www.pacifichealthdialog.nz/index.php/phd/article/view/223
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Determinants of nutrition risk among older adults in Fiji. PacHealthDialog [Internet]. 2026 Apr. 29 [cited 2026 Apr. 29];26(2). Available from: https://www.pacifichealthdialog.nz/index.php/phd/article/view/223