Improving the diets of old people

Abstract

Despite the recognised importance of diet for health in older age and how common poor diet quality and nutritional status are at this stage of the life course, little is known about the complexity of influences on diet quality at this age, particularly in community-living people. Furthermore, there is limited understanding of how a transition between relatively good quality diets in early old age, to poorer quality diets and greater risk of malnutrition observed at older ages, might occur.

In this project, participants were recruited from the Hertfordshire Cohort Study (HCS) and focus groups were run to explore influences on diet among community-dwelling older people living in the county of Hertfordshire, UK. Drawing upon the qualitative findings, a secondary data analysis of previously collected HCS data was carried out to identify psychosocial correlates of diet quality in older community-dwelling men and women, and determine their associations with change in diet quality over 10 years. This was followed by a mapping study in the local context of the city of Southampton, to describe services or interventions available to local community-dwelling older people that might support their diets. This study formed part of the process evaluation of the GENIE (Generating Engagement in Network Involvement) pilot intervention study. The last piece of work was a pilot study of the GENIE social network intervention, which was carried out in a group of older community-dwelling adults in the Southampton area. In this pilot study, the potential of improving social networks to promote diet quality was evaluated.

The findings from the qualitative study suggested that social and psychological factors were important influences on diet and that they may mediate some of the effects of age-related factors on the diets of older people. Findings from the quantitative study showed that a range of social factors, including greater participation in social and cognitive leisure activities, were associated with diets of better quality in cross-sectional analyses. The mapping study identified a range of services that could support the diets of community-living older people in Southampton, however these did not appear to be adequately joined-up. The results of the pilot study suggest that a social network intervention of this kind may hold promise for the promotion of diet quality of community-based older adults.

This thesis has added to the evidence-base on influences on older people’s diets, particularly in a UK context. It has especially highlighted modifiable factors, such as social isolation, that could be targeted in interventions and public health strategies to promote the diets and health of community-living older adults. Further larger intervention studies, with appropriate evaluation, are needed to establish the effectiveness of such interventions. In addition, psychological factors such as resilience, self-efficacy and outcome expectancies, should also be considered as a part of such strategies. It may be crucial for these interventions to be put in place early on to prevent decline in diet quality and associated poor health outcomes.

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Identifiers

ORCID for Sian Robinson: orcid.org/0000-0003-1766-7269

ORCID for Janis Baird: orcid.org/0000-0002-4039-4361

ORCID for Cyrus Cooper: orcid.org/0000-0003-3510-0709

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