CHAPTER I

THE PROBLEM

Introduction

Every stage of an individual’s life is profoundly influenced and affected by his

physical health condition. This is true to a great extent although generally given not much

concern. It may only become obvious to be noticed when one gets older and starts

experiencing the toll of paying less attention to his physical health.

In the complex and fast changing world, life is one’s own making. A person’s

health condition so with his activity and performance is very much affected by the food

he eats. Research has shown that nutritional intake produces a variety of correlates and

consequences. There are numerous varied physical health effects and consequences of the

food one eats which can either increase or decrease one’s level of performance, in turn,

bound to reinforce one’s existing physical health status, as the saying goes “You are what

you eat.”

Although nutrition and nutritional intake are much associated with infants and

children in their growing stage, the awareness of proper nutritional intake rises up to the

level of adulthood when one gets conscious of his or her diet and figure, thus, the

proliferation of health and massage clinics, food supplements, and fitness gyms.

But never to be taken for granted are the older people who deserve equal if not

more attention especially that they are past the prime of their life. The more they need

whatever nutritional boost or support his family can provide because it is sometimes

overlooked by the society.

It is worth noting the fact that older people are more prone to illness and diseases.
Staying physically strong and healthy becomes a problem for a person as he gets older

even more. It even gets more complicated and difficult for him to cope with it when the

issue of economic condition comes in. Lucky is the older person who need not spend for

any single medication or food supplement to meet his daily nutritional needs.

The most recent Social Weather survey pointed out that the number of Filipino
families experiencing problems on foods and nutritional intakes rose to 7.1 million
equivalent to 40 % of Filipino households. A significant number of these households
include the older people. In some provinces, the older people below poverty line number
as high as 50%.
While there are a number of bills pending in both Houses to increase discounts on
transportation, medicines and other services, the urgency of the present time is a program
for appropriate nutritional intakes for these older people especially the poorest of the poor
among them. Although every country in Asia has a social pension for the poor older
people to take care of these concerns, the Philippines does not have any of this kind.
With the present data of 7 million over 60 years old, around 2 million who are the
poorest among them is a significant number that should be given attention not only by the
government but also by the private sectors.

Lucky is the older person who can afford to spend for the food he wants and

needs plus the nutritional food supplements that are affordable to him. But this may not

be true to one who in the later stage of his life is not able to save and prepare himself

physically, emotionally and even more financially to sustain his needs for the rest of his

life.

In this context, the study which follows is an attempt to expound on the topic

nutritional intake and its relationship to physical health status among older people. The

relevance of the study lies in the fact that its purpose is to determine a correlation

between the nutritional intake and physical health among older people from which, the

results will be used as a bases in coming up with a nutritional program that will fit and

benefit them.
Older people make up an increasing proportion of our population. The blurring of the

various stages in our lifecycle mean that older people are as varied as any other group in

our society. Many older people lead active and healthy lives for many years over the age

of 50. Employment rates for people in their fifties have risen in the past decade, and it is

this age group who are most likely to be providing unpaid care. However, for those at

older ages, there may be barriers which prevent them from participating in a wide variety

of activities. These may be financial, or related to health or lack of transport.

Introduction

The number of elderly persons is increasing in the developed countries and, moreover,
improvements in health care have led to an increase in life expectancy. As a consequence,
cognitive impairment and age-related disability have become a huge and increasingly
important medical and social problem (Schneider & Guralnik, 1990). Disability is
defined in the International Classification of Impairments, Disabilities, and Handicaps
(ICIDH) developed by the World Health Organization as 'a restriction or lack of ability to
perform an activity in normal manner'. In addition to physiological health, an important
issue for older people is maintenance of cognitive functions. Moreover, cognitive decline
is one of the major determinants of disability in elderly people (Barberger-Gateau &
Fabrigoule, 1997). There is heightened interest today in achieving better
acknowledgement of the factors associated with cognitive decline and functional
disability in order to improve the quality of life of older persons.

Many environmental factors may influence the functional balance of the elderly. The role
played by food, for example, in the development or worsening of some illness has been
proven (American Dietetic Association, 2000). The role that an inadequate nutrition plays
in inducing mortality and morbidity is well accepted, as seen in the effect from
malnutrition or specific dietary deficiencies (Garry et al, 1982).

A lot of studies have analyzed the role of malnutrition on mortality (Sullivan et al, 1999),
morbidity (Sullivan, 1995b) and time of hospitalization (Ryan, 1990). Poor nutrition in
elderly persons is associated with more doctors visits, more emergency room visits, more
hospitalizations, more nursing home placement, more health costs, reduced survival rates,
and reduced perception of health and well-being (Delhey et al, 1989). However, the
impact of poor nutritional status on functional and cognitive declines is not well known in
elderly people.

Malnutrition is a common problem in older people which has been mostly studied on
hospitalized subjects (Mowe & Bohmer, 1991). It can adversely affect prognosis, delay
recovery from disease, reduce immune function, and increase the susceptibility to
infections (Sullivan, 1995a). There is a lack of longitudinal studies conducted in free-
living elderly persons to analyze the association between their nutritional status and
evolution in terms of mortality, cognitive and functional capacity. Such studies could
enable the identification of subjects who are apparently healthy but at risk of adverse
outcomes, based on simple indicators of nutritional status. Good candidates for such
indicators are general markers of nutritional status such as anthropometric measurements
and overall levels of protein and energy intakes (Reuben et al, 1995).

In this paper, we examined the association of general indicators of nutritional status with
the evolution of health status in terms of cognitive decline, disability and mortality in a
population of healthy elderly persons living at home.

POOR OLDER PEOPLE IN THE PHILIPPINES

UNITE TO DEMAND 1,000 A MONTH FOR
SOCIAL PENSION
Posted on November 6, 2008 by cosephil
News release Tuesday 30 September 2008
 Older people in Philippines have joined together on Tuesday 30 September, the

inauguration of the UN International Day of Older People which is October 1, under the

banner of Age Demands Action – a global campaign calling for recognition and support

of older people’s vital contribution to society.

They joined groups and organisations of older people in 33 countries worldwide to press
the government officials and legislators to take action on the issues and concerns
affecting older people and in the Philippines to pass the bill for social pension.

In Quezon City a delegation of older people from Coalition of older persons

Association of the Philippines (COPAP) composed of 70 organizations in Metro
Manila and the nearby provinces and Coalition of Services of the Elderly mobilized
a walk for social pension to demand for a social pension for poor older people in the
Philippines. This is the appropriate time to allocate a budget for social pension
while budget hearings are still on-going in Congress.

This measure will help to deliver better economic and physical security to older people
and their families.

A Social Weather survey for the first quarter of the year pointed out that the number of
families that considered themselves food poor rose from 6.1 million to 7.1 million,
equivalent to 40 percent of Filipino households. A significant number of the households
include the elderly. In some provinces, the elderly below the poverty line number as
high as 50%

While there are a number of bills pending in both houses to increase discounts on
transportation, restaurants, entertainment and health care, the urgency of the moment
is for a social pension for the poorest of the poor among the elderly. Every
country in ASIA (including Bangladesh) has a social pension for poor older
people. Only the Philippines has no social pension.

Recent news release from the World Bank and Asian Development Bank have
emphasized the priority of cash transfer over stop-gap measures to directly fight poverty
and inequality.

Nanay Inday, President of a group in Bagong Silang remarks “are they trying to
kill off the old people by making us stand in long lines so that we can purchase
the only rice we can afford… and for how long will it be like this?”

There are presently 7 million over 60, more women than men who are the most
vulnerable. Since 1995, Congress has appropriated 1% of the budget for the elderly and
disabled. The 1% would be more than adequate to provide a social pension for the
poorest among the elderly who number around 2 million. The Philippine government is
also signatory to the Millennium Development Goals (MDG) to halve (rather than
increase) poverty by 2015.
“Now is the time for change. By 2050 one in five of the world’s population will be over the
age of 60. Governments must start investing in and supporting older people now or their
huge potential to build a better future for families and communities will not be realised.”

Age Demands Action is the first worldwide campaign of its kind, launched in 2007 by
HelpAge International, the global network striving for the rights of older people.

—- end —

Filed under: Uncategorized

Population: 77 725 862 (July 1998 est.)

Age structure:

0-14 years: 38% (male 14 867 972; female 14 379 722)

15-64 years: 59% (male 22 582 178; female 23 136 055)

65 years and over: 3% (male 1 232 813; female 1 527 122) (July 1998 est.)

Almost half of the Philippine population is under 25 years old.

Population growth rate: 2.09% (1998 est.)