Nutritional and Age-Related Challenges in Older Adults from Sub-Saharan Africa and Potential Strategies to Promote Healthy Aging Amongst Them: A Systematic Review

Abstract

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 30–65% 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’s ongoing nutrition transition. Frailty emerged as the predominant age-related challenge, with prevalence ranging around 10–60%. 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.