Objective: To examine the relationship between the nutritional status and handgrip strength of older people in rural Malawi. Design: Cross-sectional study. Setting: Lilongwe rural, Malawi, situated approximately 35±50 km from the city. Subjects: Ninety seven males and 199 females participated in this study. Methods: Selected anthropometric measurements were taken and nutrition indices were computed using standard equations. Handgrip strength was measured using an electronic grip strength dynamometer. Results: The mean handgrip strength (in kg) for men was significantly higher than for women 28X0^5X9 vs. 21X7^4X5X In addition, there was a significant decline in handgrip strength with age in both sexes. Furthermore, handgrip strength was positively correlated to the following nutritional status indicators: BMI r 0X40 in males and r 0X34 in females), mid-upper arm circumference (MUAC) r 0X45 in males and r 0X38 in females) and arm-muscle area (AMA) r 0X39 in males and r 0X37 in females). After controlling for potential confounders, namely sex, height and age, the correlations between handgrip strength and the nutrition indices were still significant. Conclusion:The results of this study support the hypothesis that poor nutritional status is associated with poor handgrip strength. Malawian males had both lower handgrip strength and lower arm muscle area than their counterparts from industrialised countries. However, Malawian females had similar handgrip strength despite lower arm muscle area, in comparison with women from industrialised countries, reflecting perhaps their higher level of physical activity. Further studies are required to determine whether by alleviating nutritional problems a concomitant improvement in handgrip strength can be obtained.

Background: Older people are becoming an increasingly important proportion of the populations of developing countries, yet little information exists on their nutritional status or social conditions. Objective: To assess the nutritional status of older people in rural Malawi. Design: Cross-sectional study. Setting: Lilongwe, Malawi. Subjects: A total of 296 respondents (97 males and 199 females) aged from 55±94 y were studied. Methods: Selected anthropometric measurements were taken by trained personnel. Among kyphotic respondents, height was estimated from armspan using regression equations derived from the non-kyphotic respondents. Body mass index (BMI) and corrected arm muscle area (CAMA) were computed using standard equations. Results: The mean age of the respondents was 63.3 y and 68.9 y among females and males, respectively. Kyphosis was seen in 17.3% of all subjects and oedema in 4.1%. Nearly 90% of the subjects were involved in agricultural activities. Men were heavier and taller than women but women had larger MUACs and triceps skinfolds than males. The mean BMIs in kg/m 2 ( AE s.d.) were as follows: 19.7 (2.6) for men and 20.3 (3.0) for women. The prevalence of undernutrition, de®ned as BMI`18.5 kg/m 2 , was 36.1% among males and 27.0% among females. In contrast, using MUAC (cut-offs 23 cm for males and 22 cm for females), 20.4% of the men and only 10% of the women were classi®ed as malnourished. Conclusion: The study demonstrated for the ®rst time that undernutrition is a signi®cant problem among older people in rural Malawi. It highlights the need to incorporate older people into existing and future nutrition and health programmes.

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