An Investigation to Identify Potential Risk Factors Associated with Common Chronic Diseases Among the Older Population in India

Informal sector employment and the health outcomes of older workers in India

A large proportion of the older population in India constitutes an undeniable share of workforce after the retirement age. This stresses the need to understand the implications of working at older ages on health outcomes. The main objective of this study is to examine the variations in health outcomes by formal/informal sector of employment of older workers using the first wave of the Longitudinal Ageing Study in India. Using binary logistic regression models, the results of this study affirm that type of work does play a significant role in determining health outcomes even after controlling socio-economic, demographic, life-style behaviour, childhood health and work characteristics. The risk of Poor Cognitive Functioning (PCF) is high among informal workers, while formal workers suffer greatly from Chronic Health Conditions (CHC) and Functional Limitations (FL). Moreover, the risk of PCF and/or FL among formal workers increases with the increase in risk of CHC. Therefore, the present research study underscores the relevance of policies focusing on providing health and healthcare benefits by respective economic activity and socio-economic position of older workers.

Self-Care and Its Predictive Factors in Hemodialysis Patients

Introduction: Chronic kidney disease is a serious problem and patients need active self-care. This study focuses on the relationship between self-care and its predictive factors in hemodialysis (HD) patients.

Methods: This multicenter correlational study was conducted on 201 HD patients referring to HD centers in the west of Tehran, Iran. A multi-stage sampling method was used to select the samples. Data were collected using self-care Scale, Paloutzian-Ellison Spiritual Well-Being Scale, and Connor Davidson Resilience Questionnaires. Data were analyzed using SPSS software version 13 and descriptive statistics and linear regression with stepwise method.

Results: The mean (SD) scores of self-care, resilience, and spiritual well-being were 35.5 (5.69), 53.4 (12.94), and 97.4 (17.9), respectively. Univariate analysis showed that self-care had a statistically significant relationship with gender, occupation, education, being diabetic, and hyperlipidemia. Self-care positively correlated with the resilience and negatively correlated with age. Multivariate regression indicated that the resilience (β = 0.78, P = 0.001), being diabetic (β = -0.09, P = 0.01), and age (β = -0.11, P = 0.005) could be predictors of self-care. These variables accounted for 78% of variance in self-care in HD patients.

Conclusion: Our results showed that resilience was positively correlated with self–care, but being diabetic and age were negatively correlated with self-care in HD patients. Therefore, the health care providers should pay more attention to HD patients who are diabetic and older, as they are at a higher risk of having impaired self-care.

Evaluation of anti-arthritic and anti-inflammatory activities of Martynia annua L. Ethanolic extract

Background

Arthritis is a disorder of change in joint architecture and ligament degeneration. Rheumatoid arthritis is an autoimmune disorder in which body’s immune system targets own cells and degrade them.Martynia annuaL. has been used in Indian traditional therapies for the treatment of epilepsy, many types of inflammations, respiratory infection, sore throat and wound. The objective of the present study was to determine anti-inflammatory and anti-arthritic activities ofM. annuaethanolic fruit extract.

Methods

The extraction was performed using ethanol as a solvent followed by phytochemical investigation ofM. annuaethanolic fruit extract. Antioxidant and anti-hyaluronidase enzyme inhibition activities was performed for the fruit extract. In vivo anti-inflammatory of fruit extract was performed onCalotropis proceralatex (CPL) induced paw edema in rats using ibuprofen as standard. Inflammation was observed at 0, 1, 2, 4 and 6 h. In vivo anti-arthritic of fruit extract was performed on Complete Freund’s adjuvant (CFA) induced arthritis in rats. Arthritis was observed at 0, 7, 14 and 21 day. X-Ray study was also performed for inflammatory and arthritic paw of rats.

Results

The qualitative phytochemical screening of fruit extract showed presence of flavonoids, terpenoids, saponins, tannins, steroids, glycosides, proteins, carbohydrates, amino acids and polysaccharides. The antioxidant activity of fruit extract was 49.1 as compared to standard 45.73 at 100 μl dose. The anti-hyaluronidase enzyme inhibition activity of fruit extract was 84.60 as compared to standard 94.21 at 100 μl dose.

Conclusion

It is evident from the study thatMartynia annuaL. extract possess both antioxidant and hyalurinodase inhibition activity at dose dependent manner as well as anti-arthritic and anti-inflammatory potential.

Evaluation of the anti-rheumatic properties of thymol using carbon dots as nanocarriers on FCA induced arthritic rats

Rheumatoid Arthritis (RA) is an autoimmune disease that commences as inflammation and progressively destroys the articular joint. In this study, we assess the anti-rheumatic potential of the monoterpenoid class of thymol conjugated with Carbon Dots (CDs). Waste biomass in the form of dried rose petals was chosen as a precursor for the synthesis of CDs via a one-step hydrothermal bottom-up methodology. The prepared CDs exhibited absorption in the near-visible region, and unique excitation-dependent emission behaviour was confirmed from UV-Visible and fluorescence measurements. The surface morphology of CDs was confirmed by SEM and HR-TEM analysis to be quasi-spherical particles with an average size of ∼5-6 nm. The presence of various functional moieties (hydroxyl, carbonyl, and amino) was confirmed via FT-IR measurement. The graphitization of CDs was confirmed by the D and G bands for sp2 and sp3 hybridization, respectively, through Raman analysis. Esterification methodology was adopted to prepare the CDs-thymol conjugate and confirmed via FT-IR analysis. CDs play the role of a nanocarrier for thymol, an anti-arthritic agent. The bioactive compound of thymol showed potent anti-arthritic activity against RA targets through in silico docking studies. Further, the in vivo studies revealed that CDs-thymol conjugates (10 mg per kg body weight) showed a significant reduction in rat paw volume along with reduced levels of RF and CRP (2.23 ± 0.42 IU ml-1 and 16.96 ± 0.22 mg ml-1) when compared to the disease control rats. X-ray radiography and ultrasonic imaging revealed less bone destruction, joint derangement, and swelling in arthritis-induced Wistar rats. They could also potentially improve the Hb (14.14 ± 0.19), RBC (6.01 ± 0.11), PCV (6.01 ± 0.11) levels and elevate the status of antioxidant enzymes (GPx, SOD, MDA), and the activity was comparable to the standard drug, ibuprofen (10 mg kg-1), suggesting that the CDs-thymol conjugate at 10 mg kg-1 could act as a strong anti-arthritic agent. This work is evidence for the utilization of waste biomass as a value-added product such as a nanocarrier for biomedical applications.

Socioeconomic determinants of chronic health diseases among older Indian adults: a nationally representative cross-sectional multilevel study

OBJECTIVE

Study uses multilevel modelling to examine the effect of individual, household and contextual characteristics on chronic diseases among older Indian adults.

DESIGN

Nationally representative cross-sectional study.

PARTICIPANTS

Data from the nationally representative, India Human Development Survey conducted in 2011-2012 was used in this study. The survey asked information related to the diagnosed chronic illnesses such as cataract, tuberculosis, hypertension, heart disease and others. The sample size of this study comprised 39 493 individuals who belonged to the age group 50 years and above.

MEASURES

Self-reported diagnosed chronic illness.

METHOD

Considering the hierarchal structure of the data multilevel logistic regression analysis was applied to attain the study objective.

RESULTS

Older adults aged 80 years and older were found with three times more chances (OR: 3.99, 95% CI 2.91 to 5.48) of suffering from a chronic ailment than 50-54 years old. Lifestyle risk factors such as alcohol and tobacco (smoked and smokeless) consumption were noted to be significantly associated with the presence of chronic illness whereas older adults who have never consumed smokeless tobacco stood 20% fewer chances (OR: 0.80, 95% CI 0.68 to 0.94) of having any chronic illness. Contextual level variables such as older adults residing in the rural areas were found with 17% fewer chances (OR: 0.83, 95% CI 0.70 to 0.97) of suffering from a chronic illness.

CONCLUSION

Even after controlling for various characteristics at the individual, household and contextual levels, significant variations in chronic illness remain unexplained at the community and state level, respectively. The findings of this study could effectively be utilised to consider more contextual variables to examine the chronic health status among the growing older population of India.