The project goal is to measure the impact of caregiving and gender on the nutritional status of Luo elders in Kenya. The high mortality rate of adults with HIV/AIDS has produced 11 million orphans, the care of which has largely been left to the elderly. As working-age adults fall ill and die, HIV affected households are likely to experience a decrease in household income and food availability. Several reports suggest that elder caregivers of orphans suffer from insufficient food but few studies have measured the nutritional status of elders or the specific factors which determine nutritional deficiencies. To accomplish the project goal, two groups of elders, caregiving and non-caregiving, will be compared with respect to nutritional status, food intake and activity levels over three years. Based on pilot research, it is expected that female caregivers will have poorer nutritional status than non-caregivers but male caregivers will be advantaged relative to their non-caregiving peers. This project will examine food intake or energy expenditure to determine which is most important in determining these differences. The project will also examine the allocation of food within the family to determine if the distribution of food is responsible for the differential impact of caregiving across genders. Prior to the HIV/AIDS crisis, many African countries made great strides in increasing life expectancy and the 50+ population is rapidly increasing. Now at the peak of the crisis, life expectancy has declined to half that of the pre-AIDS generation. Thus, the current cohort of elderly is unique. As the epidemic progresses, it leaves behind the youngest and the oldest. These survivors of AIDS must adapt to a rapidly changing social world. The scientific merit of this study is that it will add to our understanding of nutritional adaptation during social change. The focus on elder nutrition also allows a greater understanding of the variation in the aging process. The broader impact of the project is the knowledge which will contribute to the solution of the HIV/AIDS orphan crisis. An estimated 30-39% of Luo adults living in Nyanza Province are infected with HIV. Survivors of AIDS live in an environment of social stigma and loss as well as economic, nutritional and physical stress. Relatively little systematic research has been conducted on the impact of the HIV/AIDS crisis on older adults in Africa yet without their role, the survival of the population is in jeopardy. Ultimately, by understanding factors which lead to undernutrition in elder caregivers, interventions can be developed to enable grandparents to more effectively care for orphaned grandchildren.
