{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:43:44Z","timestamp":1791002624817,"version":"4.1.0"},"reference-count":150,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Aging is associated with physiological, biochemical, and psychosocial changes that can significantly affect nutritional status and overall health. In Sub-Saharan Africa (SSA), older adults face unique age-related challenges that may compromise healthy aging, yet evidence remains fragmented. This systematic review synthesized the existing literature on the nutritional status, age-related challenges, and strategies to promote healthy aging of older adults in SSA. Methods: A systematic literature search was conducted on PubMed, Scopus, ScienceDirect, and Cochrane Library to identify relevant studies published up to 10 December 2025. Results: Fifty-five studies met the inclusion criteria, with most of the studies coming from South Africa, Ghana, and Nigeria. Amongst community-dwelling populations, approximately 30\u201365% of the older adults were either malnourished or at risk of malnutrition, while hospital-based studies reported markedly higher burdens, with malnutrition prevalence exceeding 70% in some settings. Undernutrition, micronutrient deficiencies, and the coexistence of overweight and obesity were frequently observed, reflecting the region\u2019s ongoing nutrition transition. Frailty emerged as the predominant age-related challenge, with prevalence ranging around 10\u201360%. Other common challenges included sarcopenia, reduced muscle strength, functional disability, cognitive impairment, and dysphagia, all of which were closely related to poor nutritional status, food insecurity, multimorbidity, and reduced quality of life. Few studies reported on healthy aging strategies, with the limited evidence suggesting that nutrition education, physical activity, and psychosocial interventions may enhance nutritional and functional outcomes. Conclusions: The need for context-specific, nutrition-sensitive interventions, and stronger health and social support systems is warranted to promote healthy aging in SSA older adults.<\/jats:p>","DOI":"10.3390\/nu18091346","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T12:29:11Z","timestamp":1777033751000},"page":"1346","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nutritional and Age-Related Challenges in Older Adults from Sub-Saharan Africa and Potential Strategies to Promote Healthy Aging Amongst Them: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6696-1212","authenticated-orcid":false,"given":"Vanessa","family":"Adu Sarpong","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5342-5825","authenticated-orcid":false,"given":"Isaac","family":"Amoah","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7509-5487","authenticated-orcid":false,"given":"Mauro","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Department for the Promotion of Human Science and Quality of Life, San Raffaele Open University, Via di Val Cannuta, 247, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2641-8865","authenticated-orcid":false,"given":"Phyllis","family":"Tawiah","sequence":"additional","affiliation":[{"name":"Department of Medicine, School of Medicine and Dentistry, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9571-694X","authenticated-orcid":false,"given":"Wenze","family":"Wu","sequence":"additional","affiliation":[{"name":"Inner Mongolia Key Laboratory of Life Health and Bioinformatics, School of Life Science and Technology, Inner Mongolia University of Science and Technology, Baotou 014010, China"},{"name":"College of Life and Health Sciences, Northeastern University, Shenyang 110819, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate Ampomah","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1098\/rstb.2009.0137","article-title":"Human population growth and the demographic transition","volume":"364","author":"Bongaarts","year":"2009","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.46234\/ccdcw2021.160","article-title":"Major trends in population growth around the world","volume":"3","author":"Gu","year":"2021","journal-title":"China CDC Wkly."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/padr.170","article-title":"The challenges posed by demographic change in sub-Saharan Africa: A concise overview","volume":"43","author":"Cleland","year":"2017","journal-title":"Popul. Dev. Rev."},{"key":"ref_4","unstructured":"He, W., Aboderin, I., and Adjaye-Gbewonyo, D. (2020). Africa Aging: 2020."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pillay, N.K., and Maharaj, P. (2012). Population ageing in Africa. Aging and Health in Africa, Springer.","DOI":"10.1007\/978-1-4419-8357-2_2"},{"key":"ref_6","unstructured":"WorldBankGroup (2026, February 17). Life Expectancy at Birth, Total (Years). Available online: https:\/\/data.worldbank.org\/indicator\/SP.DYN.LE00.IN."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"165","DOI":"10.3917\/popu.2002.0169","article-title":"The demography of Sub-Saharan Africa in the 21st century","volume":"75","author":"Tabutin","year":"2020","journal-title":"Population"},{"key":"ref_8","unstructured":"WHO (2015). World Report on Ageing and Health, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0140-6736(14)61347-7","article-title":"The burden of disease in older people and implications for health policy and practice","volume":"385","author":"Prince","year":"2015","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1080\/03007995.2024.2380007","article-title":"Nutritional care in older adults: Are we doing everything? An expert opinion review","volume":"40","author":"Ravasco","year":"2024","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3945\/an.116.013474","article-title":"Nutritional considerations for healthy aging and reduction in age-related chronic disease","volume":"8","author":"Shlisky","year":"2017","journal-title":"Adv. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1016\/j.clnu.2024.06.020","article-title":"Nutrition for the older adult\u2013Current concepts. Report from an ESPEN symposium","volume":"43","author":"Volkert","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Castelli, S., Aiello, G., Aiello, V., Massimino, E., Pieri, M., Amoah, I., Lombardo, M., Tripodi, G., and Baldelli, S. (2026). Nutritional Strategies and Aging: Current Evidence and Future Directions. Molecules, 31.","DOI":"10.3390\/molecules31050756"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0261-5614(03)00127-4","article-title":"An investigation into the relationships between quality of life, nutritional status and physical function","volume":"23","author":"Hickson","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1017\/jns.2020.26","article-title":"From lifespan to healthspan: The role of nutrition in healthy ageing","volume":"9","author":"Wickramasinghe","year":"2020","journal-title":"J. Nutr. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Obeng, P., Kyereh, H.K., Sarfo, J.O., Ansah, E.W., and Attafuah, P.Y.A. (2022). Nutritional status and associated factors of older persons in sub-Saharan Africa: A scoping review. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-03062-y"},{"key":"ref_17","unstructured":"Crush, J., Frayne, B., and McLachlan, M. (2011). Rapid Urbanization and the Nutrition Transition in Southern Africa, Idasa Publishing."},{"key":"ref_18","first-page":"9","article-title":"Vulnerability of urban poor women and children to the triple. Burden of malnutrition: A scoping review of the sub-Saharan Africa Environment","volume":"17","author":"Mudogo","year":"2017","journal-title":"Glob. J. Med. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1753-4887.2011.00456.x","article-title":"Global nutrition transition and the pandemic of obesity in developing countries","volume":"70","author":"Popkin","year":"2012","journal-title":"Nutr. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/ije\/dyl306","article-title":"Trends of under-and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh","volume":"36","author":"Shafique","year":"2007","journal-title":"Int. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1432.E1","DOI":"10.1016\/j.jamda.2022.01.065","article-title":"Food Insecurity and Functional Disability Among Older Adults in Ghana: The Role of Sex and Physical Activity","volume":"23","author":"Amoah","year":"2022","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e12644","DOI":"10.1111\/opn.12644","article-title":"On the relationship between frailty, nutritional status, depression and quality of life among older people","volume":"19","author":"Kasa","year":"2024","journal-title":"Int. J. Older People Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1111\/j.1753-4887.2008.00113.x","article-title":"Nutrition, health, and aging in sub-Saharan Africa","volume":"66","author":"Kimokoti","year":"2008","journal-title":"Nutr. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/S0140-6736(14)61602-0","article-title":"Older people\u2019s health in sub-Saharan Africa","volume":"385","author":"Aboderin","year":"2015","journal-title":"Lancet"},{"key":"ref_25","unstructured":"WHO (2019). Sustainable Healthy Diets: Guiding Principles, Food & Agriculture Org."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Mussa, E.C., Agegnehu, D., and Nshakira-Rukundo, E. (2024). Combining social protection interventions for better food security: Evidence from female-headed households in Amhara region, Ethiopia. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0283812"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"107452","DOI":"10.1016\/j.cdnut.2025.107452","article-title":"Social Protection Programmes and their support for promoting access to Nutrient-Dense Foods for vulnerable communities in South Africa","volume":"9","author":"Berejena","year":"2025","journal-title":"Curr. Dev. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/BF03391607","article-title":"Understanding and advancing the health of older populations in sub-Saharan Africa: Policy perspectives and evidence needs","volume":"32","author":"Aboderin","year":"2010","journal-title":"Public Health Rev."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Dableh, S., Frazer, K., Stokes, D., and Kroll, T. (2024). Access of older people to primary health care in low and middle-income countries: A systematic scoping review. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0298973"},{"key":"ref_30","unstructured":"WHO (2018). Integrated Care for Older People (ICOPE) Implementation Framework: Guidance for Systems and Services, World Health Organization."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Bardon, L.A., Corish, C.A., Lane, M., Bizzaro, M.G., Villarroel, K.L., Clarke, M., Power, L.C., Gibney, E.R., and Castro, P.D. (2021). Ageing rate of older adults affects the factors associated with, and the determinants of malnutrition in the community: A systematic review and narrative synthesis. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02583-2"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_33","unstructured":"World Health Organization (2026, March 19). WHO Study on Global AGEing and Adult Health (SAGE). Available online: https:\/\/www.who.int\/data\/data-collection-tools\/study-on-global-ageing-and-adult-health."},{"key":"ref_34","unstructured":"JBI (2026, April 17). JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Available online: https:\/\/jbi.global\/sites\/default\/files\/2020-08\/Checklist_for_Analytical_Cross_Sectional_Studies.pdf."},{"key":"ref_35","unstructured":"JBI (2026, April 17). JBI Checklist for Cohort Studies. Available online: https:\/\/jbi.global\/sites\/default\/files\/2020-08\/Checklist_for_Cohort_Studies.pdf."},{"key":"ref_36","unstructured":"JBI (2026, April 17). JBI Critical Appraisal Checklist for Quasi-Experimental Studies (Non-Randomized Experimental Studies). Available online: https:\/\/jbi.global\/sites\/default\/files\/2020-08\/Checklist_for_Quasi-Experimental_Appraisal_Tool.pdf."},{"key":"ref_37","unstructured":"JBI (2026, April 17). JBI Critical Appraisal Checklist for Qualitative Research. Available online: https:\/\/jbi.global\/sites\/default\/files\/2019-05\/JBI_Critical_Appraisal-Checklist_for_Qualitative_Research2017_0.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Abdu, A., Yimamu, I., and Kahsay, A. (2020). Predictors of malnutrition among older adults aged above 65\u2009years in eastern Ethiopia: Neglected public health concern. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01911-2"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Ahmed, H., Tadesse, A., Alemu, H., Abebe, A., and Tadesse, M. (2022). Undernutrition was a prevalent clinical problem among older adult patients with heart failure in a hospital setting in Northwest Ethiopia. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.962497"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"112798","DOI":"10.1016\/j.nut.2025.112798","article-title":"Nutritional status is associated with cognition and grip strength among older adults: A 10-y longitudinal study in Ghana and South Africa","volume":"136","author":"Corso","year":"2025","journal-title":"Nutrition"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1177\/02601060221082368","article-title":"The nutritional status of community-dwelling elderly in Lesotho and factors associated with malnutrition","volume":"29","author":"Turkson","year":"2023","journal-title":"Nutr. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"163","DOI":"10.11604\/pamj.2024.48.163.42544","article-title":"Malnutrition and micronutrient deficiencies among elderly persons attending University College Hospital, Ibadan: A pilot study","volume":"48","author":"Farombi","year":"2024","journal-title":"Pan Afr. Med. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"18097","DOI":"10.1038\/s41598-025-03291-2","article-title":"Protein intake and muscle mass of community-dwelling older adults: A cross-sectional study in Kigali, Rwanda","volume":"15","author":"Habumugisha","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23337214241279636","DOI":"10.1177\/23337214241279636","article-title":"Assessment of Subnutritional Indices and Associated Risk Factors of Malnutrition Among Older Adults","volume":"10","author":"Isong","year":"2024","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.clnesp.2017.05.007","article-title":"Undernutrition and obesity among elderly people living in two cities of developing countries: Prevalence and associated factors in the EDAC study","volume":"21","author":"Guerchet","year":"2017","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"100030","DOI":"10.1016\/j.dialog.2022.100030","article-title":"Malnutrition in elderly patients with type 2 diabetes mellitus in a Nigerian tertiary hospital: A cross-sectional study","volume":"1","author":"Junaid","year":"2022","journal-title":"Dialogues Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.clnesp.2021.08.021","article-title":"Nutritional status and associated factors among community-dwelling elderly","volume":"45","author":"Mabiama","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Mendham, A.E., Goedecke, J.H., Micklesfield, L.K., Brooks, N.E., Faber, M., Christensen, D.L., Gallagher, I.J., Lundin-Olsson, L., Myburgh, K.H., and Odunitan-Wayas, F.A. (2021). Understanding factors associated with sarcopenic obesity in older African women from a low-income setting: A cross-sectional analysis. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02132-x"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Mphwanthe, G., Reynolds, C., Corish, C., Mndoliro, L., Columbus, T., Misolo, J., Mtande, F., and Browne, S. (2025). Risk of malnutrition, food insecurity, dietary quality, and associated factors among Malawian older adults at hospital admission: A cross-sectional study. BMC Geriatr., 25.","DOI":"10.1186\/s12877-025-06463-x"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s41043-015-0030-0","article-title":"High risk of malnutrition associated with depressive symptoms in older South Africans living in KwaZulu-Natal, South Africa: A cross-sectional survey","volume":"33","author":"Naidoo","year":"2015","journal-title":"J. Health Popul. Nutr."},{"key":"ref_51","first-page":"403","article-title":"Assessment of Nutritional Status Among Elderly Hospitalized Patients in Enugu, Nigeria: A Hospital-Based Study","volume":"65","author":"Okoro","year":"2024","journal-title":"Niger. Med. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"160","DOI":"10.4103\/npmj.npmj_545_21","article-title":"Nutritional status and morbidity patterns of the elderly in a Northwestern Nigerian hospital: A cross-sectional study","volume":"28","author":"Olawumi","year":"2021","journal-title":"Niger. Postgrad. Med. J."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Tesfaye, B.T., Yizengaw, M.A., Etefa, T.E., and Bosho, D.D. (2023). Nutritional status of hospitalized elderly patients in Ethiopia: A cross-sectional study of an important yet neglected problem in clinical practice. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1227840"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"443","DOI":"10.4103\/njcp.njcp_374_17","article-title":"Factors associated with sarcopenia among older patients attending a geriatric clinic in Nigeria","volume":"21","author":"Adebusoye","year":"2018","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"102349","DOI":"10.1016\/j.healthplace.2020.102349","article-title":"Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults","volume":"63","author":"Rebok","year":"2020","journal-title":"Health Place"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Ambagtsheer, R.C., and Moussa, R.K. (2021). Association of frailty with health service utilisation and health care expenditure in sub-Saharan Africa: Evidence from C\u00f4te d\u2019Ivoire. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02377-6"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Asiamah, N., Danquah, E., Vieira, E.R., Hjorth, P., Jnr, R.A., Agyemang, S.M., Khan, H.T.A., Yarfi, C., and Muhonja, F. (2024). Association of frailty with functional difficulty in older Ghanaians: Stability between women and men in two samples with different income levels. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-05534-9"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"100090","DOI":"10.1016\/j.inpsyc.2025.100090","article-title":"Dementia, cognitive impairment in Nigerians aged 90 years or older: A 20-year follow up of survivors of Ibadan study of aging cohort","volume":"38","author":"Baiyewu","year":"2025","journal-title":"Int. Psychogeriatr."},{"key":"ref_59","first-page":"1078","article-title":"Self-perception and clinical presentation of eating and swallowing difficulties within elderly care","volume":"72","author":"Bell","year":"2025","journal-title":"S. Afr. J. Commun. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.maturitas.2016.05.012","article-title":"Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa","volume":"91","author":"Biritwum","year":"2016","journal-title":"Maturitas"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00223-019-00609-x","article-title":"Functional Measures of Sarcopenia: Prevalence, and Associations with Functional Disability in 10,892 Adults Aged 65 Years and Over from Six Lower- and Middle-Income Countries","volume":"105","author":"Bowe","year":"2019","journal-title":"Calcif. Tissue Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s13365-020-00915-3","article-title":"Low levels of frailty in HIV-positive older adults on antiretroviral therapy in northern Tanzania","volume":"27","author":"Bristow","year":"2021","journal-title":"J. Neurovirol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Davidson, S.L., Emmence, L., Motraghi-Nobes, S.M., Bickerstaff, E., Rayers, G., Lyimo, G., Kilasara, J., Chuwa, M., Kisheo, F., and Kisaruni, E. (2024). Assessing frailty amongst older people admitted to hospital in a low-income setting: A multicentre study in northern Tanzania. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-04789-6"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"105757","DOI":"10.1016\/j.archger.2025.105757","article-title":"Association between frailty and subjective life expectancy in Sub-Saharan Africa: Evidence from C\u00f4te D\u2019Ivoire","volume":"131","author":"Dzando","year":"2025","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Dzando, G., and Moussa, R.K. (2025). Assessing the contributions of health deficits to frailty among older people in Sub-Saharan Africa: Evidence from C\u00f4te d\u2019Ivoire. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-25373-6"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1111\/hiv.70111","article-title":"Multidimensional frailty, sex differences, and quality of life among older Ugandans affected by HIV","volume":"26","author":"Dzando","year":"2025","journal-title":"HIV Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1007\/s12119-023-10076-0","article-title":"Changes and Forms of Sexual Behaviour in Old Age: A Qualitative Study of Older People in Southeastern Nigeria","volume":"27","author":"Ede","year":"2023","journal-title":"Sex. Cult."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Gatimu, S.M., Milimo, B.W., and Sebastian, M.S. (2016). Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3845-8"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1080\/0361073X.2017.1298957","article-title":"Identifying Frailty and Its Outcomes in Older People in Rural Tanzania","volume":"43","author":"Gray","year":"2017","journal-title":"Exp. Aging Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"112062","DOI":"10.1016\/j.jpsychores.2025.112062","article-title":"Bodily pain severity and emotional pain experience in old age: Analyses of potential mediators from representative Ghanaian aging survey","volume":"190","author":"Gyasi","year":"2025","journal-title":"J. Psychosom. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.gerinurse.2024.10.067","article-title":"Sleep problems, pain interference, and global subjective health outcome: Findings from a representative aging study in Ghana","volume":"61","author":"Gyasi","year":"2025","journal-title":"Geriatr. Nurs."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"111481","DOI":"10.1016\/j.jpsychores.2023.111481","article-title":"Diabetes mellitus and functional limitations among older adults: Evidence from a large, representative Ghanaian aging study","volume":"174","author":"Gyasi","year":"2023","journal-title":"J. Psychosom. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.archger.2018.05.010","article-title":"Gender, self-rated health and functional decline among community-dwelling older adults","volume":"77","author":"Gyasi","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1017\/S1041610217002861","article-title":"A longitudinal study of cognitive decline in rural Tanzania: Rates and potentially modifiable risk factors","volume":"30","author":"Heward","year":"2018","journal-title":"Int. Psychogeriatr."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Lewis, E., Coles, S., Howorth, K., Kissima, J., Gray, W., Urasa, S., Walker, R., and Dotchin, C. (2018). The prevalence and characteristics of frailty by frailty phenotype in rural Tanzania. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0967-0"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"iii6","DOI":"10.1093\/ageing\/afy134.01","article-title":"The prevalence of frailty in older community welling Tanzanians by comprehensive geriatric assessment","volume":"47","author":"Lewis","year":"2018","journal-title":"Age Ageing"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Breasail, M.\u00d3., Zengin, A., Pearse, C., Drammeh, I., Janha, R., Jarjou, L., Ebeling, P.R., Prentice, A., and Ward, K.A. (2025). Rural-urban differences in osteoporosis and sarcopenia prevalence among Gambian older adults: A pilot study. J. Bone Miner. Res., zjaf130.","DOI":"10.1093\/jbmr\/zjaf130"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"100209","DOI":"10.1016\/j.ahr.2024.100209","article-title":"Depressive syndrome, cognitive impairment, and associated factors among community-dwelling aged persons in Cameroon","volume":"4","author":"Mabiama","year":"2024","journal-title":"Aging Health Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12981-025-00824-7","article-title":"Prevalence and factors associated with frailty among older adults with and without HIV in Kampala, Uganda","volume":"23","author":"Mbabazi","year":"2025","journal-title":"AIDS Res. Ther."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Mwangala, P.N., Nasambu, C., Wagner, R.G., Newton, C.R., and Abubakar, A. (2024). Prevalence and Factors Associated with Frailty Among Older Adults Living with HIV Compared to Their Uninfected Peers from the Kenyan Coast. Int. J. Public Health, 69.","DOI":"10.3389\/ijph.2024.1606284"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1159\/000527341","article-title":"Physical Multimorbidity and Sarcopenia Among Adults Aged \u226565 Years in Low- and Middle-Income Countries","volume":"69","author":"Smith","year":"2023","journal-title":"Gerontology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1007\/s40520-022-02074-3","article-title":"Sleep duration and sarcopenia in adults aged\u2009 \u2265\u200965 years from low and middle-income countries","volume":"34","author":"Smith","year":"2022","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1007\/s12603-015-0664-z","article-title":"Prevalence of falls in an urban community-dwelling older population of Cape Town, South Africa","volume":"19","author":"Kalula","year":"2015","journal-title":"J. Nutr. Health Aging"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1007\/s13337-025-00938-6","article-title":"Perceived quality of life and associated lifestyle practices among older people living with HIV in Uganda. A cross-sectional study","volume":"36","author":"Atuhairwe","year":"2025","journal-title":"VirusDisease"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"113659","DOI":"10.1016\/j.socscimed.2020.113659","article-title":"Quality of life of older adults in two contrasting neighbourhoods in Accra, Ghana","volume":"270","author":"Alaazi","year":"2021","journal-title":"Soc. Sci. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1177\/08982643241273137","article-title":"Prevalence and Factors Associated with Healthy Aging in a Large Representative Community Sample of Older Ethiopians","volume":"37","author":"Belachew","year":"2025","journal-title":"J. Aging Health"},{"key":"ref_87","first-page":"788","article-title":"Identifying hearing impairment and the associated impact on the quality of life among the elderly residing in retirement homes in Pretoria, South Africa","volume":"68","author":"Govender","year":"2021","journal-title":"S. Afr. J. Commun. Disord."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Maniragaba, F., Nzabona, A., Asiimwe, J.B., Bizimungu, E., Mushomi, J., Ntozi, J., and Kwagala, B. (2019). Factors associated with older persons\u2019 physical health in rural Uganda. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0209262"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"6635814","DOI":"10.1155\/2021\/6635814","article-title":"Aged Persons Living with HIV and Nutritional Wellness: Analysis of 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2","volume":"2021","author":"Oduro","year":"2021","journal-title":"J. Aging Res."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Seid, A.M., and Fentahun, N.F. (2023). Behavioral model-guided nutritional counseling could improve the dietary practice and nutritional status of elders in Ethiopia: A quasi-experimental study. BMC Geriatr., 23.","DOI":"10.1186\/s12877-023-04433-9"},{"key":"ref_91","first-page":"IJFMR23057453","article-title":"The State of Gerontological and Geriatric Studies in Sub-Saharan Africa and Ghanaian Studies: Literature Review","volume":"5","author":"Samba","year":"2023","journal-title":"Int. J. Multidiscip. Res."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"5302","DOI":"10.3402\/gha.v3i0.5302","article-title":"Ageing and adult health status in eight lower-income countries: The INDEPTH WHO-SAGE collaboration","volume":"3","author":"Kowal","year":"2010","journal-title":"Glob. Health Action"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Tawiah, P., Mensah, P.B., Gyabaah, S., Adebanji, A.O., Konadu, E., and Amoah, I. (2024). Gait speed and its associated factors among older black adults in Sub-Saharan Africa: Evidence from the WHO study on Global AGEing in older adults (SAGE). PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0295520"},{"key":"ref_94","unstructured":"West African Centre for Cell Biology of Infectious Pathogens, University of Ghana (2026, March 21). Available online: https:\/\/www.waccbip.org."},{"key":"ref_95","unstructured":"Centre for Ageing Studies, University of Ghana (2026, March 21). Available online: https:\/\/cfas.ug.edu.gh\/."},{"key":"ref_96","unstructured":"Research Center for Ageing Cognition and Psychological Health, Nnamdi Azikiwe University Awka (2026, March 21). Available online: https:\/\/rcacph.unizik.edu.ng\/."},{"key":"ref_97","unstructured":"Applied Gerontology Research Group, University of Nigeria (2026, March 21). Available online: https:\/\/www.unn.edu.ng\/research-groups\/applied-gerontology-research-group\/."},{"key":"ref_98","unstructured":"Albertina & Walter Sisulu Institute of Ageing in Africa, University of Cape Town (2026, March 21). Available online: https:\/\/health.uct.ac.za\/institute-ageing."},{"key":"ref_99","unstructured":"ILCSA (2026, March 21). International Longevity Centre South Africa. Available online: https:\/\/ilcsa.org\/."},{"key":"ref_100","unstructured":"Optentia Research Unit (2026, March 21). Ageing and Generational Dynamics. Available online: https:\/\/optentia.co.za\/unit.php?unitid=OQ%3D%3D."},{"key":"ref_101","unstructured":"Kilimanjaro Clinical Research Institute (KCRI), Tanzania (2026, March 21). Available online: https:\/\/www.kcri.ac.tz\/."},{"key":"ref_102","unstructured":"EPHI (2026, March 21). Ethiopian Public Health Institute, Available online: https:\/\/ephi.gov.et\/."},{"key":"ref_103","unstructured":"Association of Ghana\u2019s Elders (2026, March 21). Aide for Ghanaian Elderly. Available online: https:\/\/ageafrica.com."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"igae002","DOI":"10.1093\/geroni\/igae002","article-title":"Longitudinal Studies of Aging in Sub-Saharan Africa: Review, Limitations, and Recommendations in Preparation of Projected Aging Population","volume":"8","author":"Akinrolie","year":"2024","journal-title":"Innov. Aging"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"e003512","DOI":"10.1136\/fmch-2025-003512","article-title":"Frailty, multimorbidity and quality of life in an ageing population in Africa: A cross-sectional, population-based study in rural and urban Rwanda","volume":"13","author":"Boah","year":"2025","journal-title":"Fam. Med. Community Health"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"569","DOI":"10.4314\/ajosi.v8i1.33","article-title":"Social determinants of health and aging in Africa: Structural inequality, vulnerability, and the future of care","volume":"8","author":"Lukman","year":"2025","journal-title":"Afr. J. Soc. Issues"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"i89","DOI":"10.1093\/fampra\/cmr054","article-title":"Undernutrition in older adults","volume":"29","author":"Morley","year":"2012","journal-title":"Fam. Pract."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","article-title":"ESPEN guideline on clinical nutrition and hydration in geriatrics","volume":"38","author":"Volkert","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM criteria for the diagnosis of malnutrition\u2013a consensus report from the global clinical nutrition community","volume":"10","author":"Cederholm","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Kuh, D., and Shlomo, Y.B. (2004). A Life Course Approach to Chronic Disease Epidemiology, Oxford University Press.","DOI":"10.1093\/acprof:oso\/9780198578154.001.0001"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1136\/jech.57.10.778","article-title":"Life course epidemiology","volume":"57","author":"Kuh","year":"2003","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1017\/S0029665117000398","article-title":"Exploring the health status of older persons in Sub-Saharan Africa","volume":"76","author":"Audain","year":"2017","journal-title":"Proc. Nutr. Soc."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/nutrit\/nuw064","article-title":"Relationship between shifts in food system dynamics and acceleration of the global nutrition transition","volume":"75","author":"Popkin","year":"2017","journal-title":"Nutr. Rev."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S0140-6736(19)32497-3","article-title":"Dynamics of the double burden of malnutrition and the changing nutrition reality","volume":"395","author":"Popkin","year":"2020","journal-title":"Lancet"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1377\/hlthaff.2015.0645","article-title":"Food insecurity and health outcomes","volume":"34","author":"Gundersen","year":"2015","journal-title":"Health Aff."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1111\/jgs.14069","article-title":"Frailty screening in low-and middle-income countries: A systematic review","volume":"64","author":"Gray","year":"2016","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2147\/CIA.S201835","article-title":"Assessment of the relationship between frailty syndrome and the nutritional status of older patients","volume":"14","author":"Muszalik","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1002\/jcsm.12981","article-title":"Roles of nutrition in muscle health of community-dwelling older adults: Evidence-based expert consensus from Asian Working Group for Sarcopenia","volume":"13","author":"Chen","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.clnu.2014.04.007","article-title":"Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group","volume":"33","author":"Deutz","year":"2014","journal-title":"Clin. Nutr."},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Fostinelli, S., De Amicis, R., Leone, A., Giustizieri, V., Binetti, G., Bertoli, S., Battezzati, A., and Cappa, S.F. (2020). Eating behavior in aging and dementia: The need for a comprehensive assessment. Front. Nutr., 7.","DOI":"10.3389\/fnut.2020.604488"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"583","DOI":"10.3233\/JAD-180468","article-title":"Dietary patterns and cognitive health in older adults: A systematic review","volume":"67","author":"Chen","year":"2019","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"De Sire, A., Ferrillo, M., Lippi, L., Agostini, F., De Sire, R., Ferrara, P.E., Raguso, G., Riso, S., Roccuzzo, A., and Ronconi, G. (2022). Sarcopenic dysphagia, malnutrition, and oral frailty in elderly: A comprehensive review. Nutrients, 14.","DOI":"10.3390\/nu14050982"},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Young, A.M., and Byrnes, A. (2022). Malnutrition. Encyclopedia of Gerontology and Population Aging, Springer.","DOI":"10.1007\/978-3-030-22009-9_128"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Norman, K., Ha\u00df, U., and Pirlich, M. (2021). Malnutrition in older adults\u2014Recent advances and remaining challenges. Nutrients, 13.","DOI":"10.3390\/nu13082764"},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"Roberts, S., Collins, P., and Rattray, M. (2021). Identifying and managing malnutrition, frailty and sarcopenia in the community: A narrative review. Nutrients, 13.","DOI":"10.3390\/nu13072316"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Gingrich, A., Volkert, D., Kiesswetter, E., Thomanek, M., Bach, S., Sieber, C.C., and Zopf, Y. (2019). Prevalence and overlap of sarcopenia, frailty, cachexia and malnutrition in older medical inpatients. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1115-1"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.jamda.2017.03.008","article-title":"\u201cHealthy aging\u201d concepts and measures","volume":"18","author":"Michel","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_128","unstructured":"WHO (2017). Global Strategy and Action Plan on Ageing and Health, WHO."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"3233","DOI":"10.1080\/10408398.2020.1793729","article-title":"Breaking the vicious circle of diet, malnutrition and oral health for the independent elderly","volume":"61","author":"Antoniadou","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_130","doi-asserted-by":"crossref","unstructured":"Raheem, D., Carrascosa, C., Ramos, F., Saraiva, A., and Raposo, A. (2021). Texture-modified food for dysphagic patients: A comprehensive review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18105125"},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Cichero, J.A. (2018). Age-related changes to eating and swallowing impact frailty: Aspiration, choking risk, modified food texture and autonomy of choice. Geriatrics, 3.","DOI":"10.3390\/geriatrics3040069"},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Bharathvaj, V., Feleciya, P.J., Abhirami, P., Rawat, S., Sunil, C., and Palanimuthu, V. (2026). Plant-based protein for food enrichment and fortification. Plant-Based Proteins Processing, Elsevier.","DOI":"10.1016\/B978-0-443-33955-4.00011-5"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Lima, M., Costa, R., Rodrigues, I., Lameiras, J., and Botelho, G. (2022). A narrative review of alternative protein sources: Highlights on meat, fish, egg and dairy analogues. Foods, 11.","DOI":"10.3390\/foods11142053"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"4049","DOI":"10.1111\/1541-4337.12771","article-title":"The science of plant-based foods: Constructing next-generation meat, fish, milk, and egg analogs","volume":"20","author":"McClements","year":"2021","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Parle, F., Martinez, M.M., and Roman, L. (2026). Plant-Protein Fortification of Cereal Foods: Market Insights and Nutritional Implications for the Dietary Exposome. Annu. Rev. Food Sci. Technol., 17.","DOI":"10.1146\/annurev-food-052924-062915"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s44187-025-00512-5","article-title":"Food fortification as a sustainable global strategy to mitigate micronutrient deficiencies and improve public health","volume":"5","author":"Ashraf","year":"2025","journal-title":"Discov. Food"},{"key":"ref_137","doi-asserted-by":"crossref","unstructured":"Coelho-Junior, H.J., Calvani, R., Azzolino, D., Picca, A., Tosato, M., Landi, F., Cesari, M., and Marzetti, E. (2022). Protein intake and sarcopenia in older adults: A systematic review and meta-analysis. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19148718"},{"key":"ref_138","doi-asserted-by":"crossref","unstructured":"Rogeri, P.S., Zanella, R., Martins, G.L., Garcia, M.D., Leite, G., Lugaresi, R., Gasparini, S.O., Sperandio, G.A., Ferreira, L.H.B., and Souza-Junior, T.P. (2022). Strategies to prevent sarcopenia in the aging process: Role of protein intake and exercise. Nutrients, 14.","DOI":"10.3390\/nu14010052"},{"key":"ref_139","unstructured":"WHO (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour, World Health Organization."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.4102\/sajp.v81i1.2114","article-title":"Physical activity and ageing: The role of physiotherapy in promoting healthy ageing","volume":"81","author":"Naidoo","year":"2025","journal-title":"S. Afr. J. Physiother."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1007\/s12325-025-03148-0","article-title":"Southeast Asian, African, and Middle East expert consensus on structured physical activity\u2014Dance, exercise, and sports","volume":"42","author":"Bajaj","year":"2025","journal-title":"Adv. Ther."},{"key":"ref_142","doi-asserted-by":"crossref","unstructured":"Balis, L.E., Sowatey, G., Ansong-Gyimah, K., Ofori, E., and Harden, S.M. (2019). Older Ghanaian adults\u2019 perceptions of physical activity: An exploratory, mixed methods study. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1095-1"},{"key":"ref_143","doi-asserted-by":"crossref","unstructured":"Ibekaku, M.C., Nasiri, N., Onyekere, C.P., Friedrich Yap, J.M., MacNinch, S., Adebusoye, L., Weeks, L.E., Ghanouni, P., and McArthur, C. (2025). Physical Activity Interventions for Older Adults with Dementia or Cognitive Impairment in Sub-Saharan Africa: A Scoping Review. Dementia.","DOI":"10.1177\/14713012261425564"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"111791","DOI":"10.1016\/j.exger.2022.111791","article-title":"The effect-modification of physical activity on the association of pain with impaired physical function in aging adults","volume":"163","author":"Gyasi","year":"2022","journal-title":"Exp. Gerontol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.jmpt.2025.10.058","article-title":"Sedentary Time, Light Physical Activity Intensity, and Pain Severity: Findings From the Ghana Study on Aging","volume":"48","author":"Gyasi","year":"2025","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"e079503","DOI":"10.1136\/bmjopen-2023-079503","article-title":"Physical activity interventions implemented for older people in Sub-Saharan Africa: A scoping review","volume":"14","author":"Naidoo","year":"2024","journal-title":"BMJ Open"},{"key":"ref_147","doi-asserted-by":"crossref","unstructured":"Liu, M., and Wang, B. (2025). Integrating natural non-pharmaceutical therapies into medical tourism: A dynamic health portrait-driven model for proactive older adult health and public health services. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1580082"},{"key":"ref_148","first-page":"61","article-title":"Psychosocial-spiritual factors associated with well-being of older population in Africa","volume":"10","author":"Kehinde","year":"2023","journal-title":"J. Educ. Community Health"},{"key":"ref_149","doi-asserted-by":"crossref","unstructured":"Bevilacqua, R., Soraci, L., Stara, V., Riccardi, G.R., Corsonello, A., Pelliccioni, G., Lattanzio, F., Casaccia, S., M\u00f6ller, J., and Wieching, R. (2022). A systematic review of multidomain and lifestyle interventions to support the intrinsic capacity of the older population. Front. Med., 9.","DOI":"10.3389\/fmed.2022.929261"},{"key":"ref_150","doi-asserted-by":"crossref","unstructured":"Cole, S., Hua, C., Peng, S., and Wang, W. (2024). Exploring the relationship of leisure travel with loneliness, depression, and cognitive function in older adults. Int. J. Environ. Res. Public Health, 21.","DOI":"10.3390\/ijerph21040498"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/9\/1346\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T20:18:59Z","timestamp":1778530739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/9\/1346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":150,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["nu18091346"],"URL":"https:\/\/doi.org\/10.3390\/nu18091346","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]}}}