Nutritional status, tobacco use and alcohol consumption of older persons in Botswana

Aim: To describe body mass index (BMI) distribution according to patterns of tobacco use, alcohol consumption and sociodemographic factors of older persons in Botswana. Material and methods: Data were collected in 1998 as part of a national household survey of 1085 subjects aged 60 years and older. For the purpose of this analysis, data are utilised from a representative 50 % sub-sample (n=393; response rate = 72 %), in which weight and height were measured as pan of a medical examination in the Subjects' homes. Results: A high prevalence of underweight (BMI <18.5) was found in men (20.1%), while overweight (BMI = 25-29.9) and obesity (BMI ! 30) were common in women (21.3 % and 27.9 %, respectively). Thirty-four percent of the subjects reported alcohol consumption and 39 % reported tobacco use. Half of the sample used either one or both of the stimulants. Underweight was significantly associated with low socioeconomic status (OR=3.3 95 % CI=1.3-8.2) and the use of a combination of alcohol and tobacco (OR=2.2; 95 % CI=1.1-4.4). Obesity was significantly associated with female gender (OR=4.9, 95 % CI=2.5-9.7) and younger age (60-69 years, compared to older groups', OR=3.2; 95 % CI=1.3-7.7). A higher than expected clustering of the three health-related risk factors (underweight, tobacco use and alcohol consumption) was found at 6.7 % (observed: expected ratio = 2.9). Conclusion: A double burden of undernutrition and overnutrition was found in this sample of older persons in an African country. A Clustering of the three risk factors for increased morbidity (tobacco use, alcohol consumption and underweight) was evident. These findings indicate a need for health education to effect lifestyle behavioural change in older adults in the subregion.