Influence of family and social detachment on city-dwelling elderly demographic’s risk factors for malnutrition in South Korea: Social detachment and elderly’ malnutrition

Objective. This study investigated the influence of social detachment and its associated factors on the prevalence of malnutrition in elderly residents of South Korean cities. Methods. We performed secondary analysis using the results of the 2020 Survey of Living Conditions and Welfare Needs of Older Persons in Korea conducted on the elderly population, aged 65 or older, in 969 survey districts, totalling 10,097 people. Hierarchical linear regression modelling was performed to identify the step-by-step influences on the risk for malnutrition. Results. Based on the baseline survey, two-sevenths of elderly people living alone (ELA), one-fifth living with only their spouse (ELS), and one-fortieth living with children (ELC) were classified as at moderate risk of malnutrition, according to the criteria in the NSI (Nutrition Screening Initiative) Checklist. Physical (ΔR2 = 0.017 of ELA, ΔR2 = 0.026 of ELS, ΔR2 = 0.012 of ELC, p < 0.001) and cognitive impairment (ΔR2 = 0.002 of ELA, ΔR2 = 0.002 of ELS, p < 0.01) appeared to increase the risk for malnutrition in all living arrangements with age. Noticeably, contact with separately living children, as another factor of family social capital, appeared to be associated with a decreased risk for malnutrition in the order of ELA, ELC and ELS, as confirmed in the cross-validated estimates of ΔR2 (ΔR2 = 0.043 of ELA, ΔR2 = 0.01 of ELC, ΔR2 = 0.009 of ELS, p < 0.001). Conjugal relationships appeared to be more important than parent-child relations for nutritional care of the elderly population. Conclusions. The demographic of elderly people living alone was the most vulnerable, as two-fifths of the ELA population is at double or triple the risk of malnutrition than those living with a spouse or with children. In all groups, social detachment, excluding conjugal relationships, was found to be a significant underlying determining factor connected to malnutrition in the elderly groups investigated in this study.