Nutritional status and physical function of older adults living in sub-Saharan Africa: a systematic review

Background Adequate nutrition is a cornerstone of healthy ageing, yet malnutrition is an escalating concern among older adults in sub-Saharan Africa (SSA). Despite its impact on independence and chronic disease risk, empirical syntheses of the relationship between nutritional status and physical function in this region remain scarce.

Objective To systematically review the prevalence of malnutrition among older adults in sub-Saharan Africa and its relationship with physical function.

Methods A systematic search was conducted across five electronic databases for peer-reviewed studies published in English between 2000 and 2025. Study selection, data extraction, and quality assessment were performed independently by two reviewers. The review targeted studies that assessed nutritional status (e.g., body mass index, Mini Nutritional Assessment) and physical function (e.g., activities of daily living, handgrip strength) in SSA populations aged 60+. Narrative synthesis was used to synthesise and report data outcomes.

Results Fifteen studies met the inclusion criteria. The prevalence of undernutrition (malnutrition) varied widely, ranging from 1.7% to 75%. Functional impairment was significant: dependency in activities of daily living (ADL) ranged from 9% to 76.5%, while instrumental ADL dependency ranged from 29% to 72.7%. Notably, low to moderate handgrip strength (< 16 kg; ≤27 kg) was also reported.

Conclusion The included studies reported associations between nutritional status and physical function among older adults in SSA. However, the predominantly cross-sectional nature of the included studies precludes establishing a causal relationship. Furthermore, the high variation in prevalence observed across studies may arise from true population differences and methodological differences. A geographical bias toward urban settings was identified, underscoring the need for longitudinal research and data from rural populations to inform targeted healthy ageing interventions.