Health and social problems of the elderly: a cross-sectional study in udupi taluk, karnataka

Global Prevalence of Obstructive Sleep Apnea in the Elderly and Related Factors: A Systematic Review and Meta-Analysis Study

PURPOSE

The aims of current meta-analysis was to combine data and statistics on the global prevalence of OSA and related factors in older adults.

DESIGN

A systematic review and meta-analysis.

METHODS

To find related studies, various databases were searched including Embase, PubMed, Scopus, Web of Science (WoS), MagIran, and SID (two local databases) using appropriate keywords, MeSH and controlled vocabulary, with no time limitation up to June, 2021. Heterogeneity of studies was evaluated using I2, and Egger's regression intercept was used to detect publication bias.

FINDINGS

39 studies with a total sample size of 33,353 people were included. The pooled prevalence of OSA in older adults was 35.9% (95% confidence interval: 28.7%-43.8%; I2 = 98.81%). Considering the high heterogeneity of included studies, subgroup analysis was conducted and yielded the most prevalent in Asia continent with 37.0% (95% CI: 22.4%-54.5%; I2 = 97.32%). However, heterogeneity was remained at high level. In the majority of studies, OSA was significantly and positively related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness.

CONCLUSIONS

Results of this study showed that global prevalence of OSA in older adults is high and is significantly related to obesity, increased BMI, age, cardiovascular diseases, diabetes, and daytime sleepiness. These findings can be used by experts working on the diagnosis and management of OSA in the geriatric population. These findings can be used by experts on the diagnosis and treatment of OSA in the older adults. Due to high heterogeneity, findings should be interpreted with great caution.

Oral health and self-rated health in community-dwelling older adults in Colombia

BACKGROUND

The relationship between oral health and specific health conditions, such as cardiovascular disease or cognitive impairment, has been extensively studied. However, the effect of oral health status on self-rated health has not been assessed. This could be relevant in older people considering that poor self-rated health status and oral diseases are highly prevalent in this population. The aim of this study was to determine the association between different parameters of oral health and self-rated health status (SRHS) in Colombian community-dwelling older adults.

METHODS

This is a secondary analysis of the SABE-Colombia study performed in 2015. The dependent variable was defined as the SRHS status assessed by the question "Compared with other people, your age: Do you consider your health status to be better, equal, or worse?" We considered four independent variables: total edentulism considering the high prevalence in older people, the GOHAI score to assess self-rated oral health, and the use of fixed and removable dental prostheses as potential modifiers of oral health. An adjusted ordinal logistic regression was performed by each independent variable.

RESULTS

After the exclusion of missing data, 17,945 persons were included in the final analysis. A total of 10.6% reported worse SRHS, 37.6% reported equal SRHS, and 51.6% reported better SRHS. The worse SRHS group was older and had a higher proportion of dependence, cognitive impairment, and depressive symptoms. The frequency of total edentulism and the lower mean score of GOHAI were significant in the worse SHRS group. An ordinal logistic regression for each independent variable was performed, finding that edentulism increases the probability of worse SHRS, while the GOHAI and use of removable or fixed dental prostheses increase the probability of better SRHS.

CONCLUSION

We found an association between total edentulism, GOHAI Index, the use of dental prostheses (both removable and fixed), and self-rated health status, showing the relevance of oral health status to self-rated health status independent of comorbidities and geriatric syndromes. This result supports the inclusion of oral health evaluation in comprehensive geriatric assessment.

Effects of Service Quality Characteristics of Neighborhood Sports Facilities on User Satisfaction and Reuse Intention of the Elderly during the COVID-19 Pandemic

PURPOSE

this study aimed to examine the user satisfaction and reuse intention of the elderly for neighborhood sports facilities in South Korea during the COVID-19 pandemic.

METHODS

this study surveyed 386 Korean elderly individuals aged ≥ 65 years, who were users of neighborhood sports facilities, from 1 May to 31 August 2022. A total of 386 questionnaires were used for data analysis, which was carried out using SPSS 23.0 statistical software. Descriptive statistics of the mean, standard deviation, and frequency distribution were used at the descriptive level. Moreover, one-way analysis of variance (ANOVA), Scheffe's post hoc pair-wise comparison analysis, Pearson's correlation coefficient, and multiple regression analysis were used at the inferential level. The significance level of these tests was considered for less than 0.05.

RESULTS

the mechanistic and humanistic service factors of neighborhood sports facilities affected user satisfaction and reuse intention. Furthermore, user satisfaction of the elderly during the COVID-19 pandemic had a positive effect on reuse intention.

CONCLUSION

this study confirmed that the service quality characteristics of neighborhood sports facilities during the COVID-19 pandemic had a positive effect on user satisfaction and intention to continue to exercise among the elderly.

The National Programme for Health Care of the Elderly: A Review of its Achievements and Challenges in India

Aging care is critical. Projections for 2020 indicate that India’s older population will comprise 6.57% of the overall population. The best-known newly developed technologies must be provided to the older population. Non-governmental organizations and private institutions are increasingly providing more door-to-door guidance and help. This study evaluated the impact of the National Programme for Health Care of the Elderly (NPHCE) in India and analyzed its achievements and challenges. The program’s key strategies include providing preventive and promotional care and sickness management, empowering geriatric services, and guaranteeing optimal rehabilitation. The NPHCE is an excellent project for caring for a rapidly aging population. This study described the existing programs and schemes related to older people in India, with a focus on the NPHCE and an analysis of the program’s achievements and challenges.

Morbidities, health problems, health care seeking and utilization behaviour among elderly residing on urban areas of eastern Nepal: A cross-sectional study

Background

Morbidity increases with age and enhances the burden of health problems that result in new challenges to meet additional demands. In the ageing population, health problems, and health care utilization should be assessed carefully and addressed. This study aimed to identify chronic morbidities, health problems, health care seeking behaviour and health care utilization among the elderly.

Methods

We conducted a community based, cross-sectional study in urban areas of the Sunsari district using face-to-face interviews. A total of 530 elderly participants were interviewed and selected by a simple proportionate random sampling technique.

Results

About half, 48.3%, elderly were suffering from pre-existing chronic morbidities, of which, 30.9% had single morbidity, and 17.4% had multi-morbidities. This study unfurled more than 50.0% prevalence of health ailments like circulatory, digestive, eye, musculoskeletal and psychological problems each representing the burden of 68.7%, 68.3%, 66.2%, 65.8% and 55.7% respectively. Our study also found that 58.7% preferred hospitals as their first contact facility. Despite the preferences, 46.0% reported visiting traditional healers for treatment of their ailments. About 68.1% reported having difficulty seeking health care and 51.1% reported visits to a health care facility within the last 6 months period. The participants with pre-existing morbidity, health insurance, and an economic status above the poverty line were more likely to visit health care facilities.

Conclusion

Elderly people had a higher prevalence of health ailments, but unsatisfactory health care seeking and health care utilization behaviour. These need further investigation and attention by the public health system in order to provide appropriate curative and preventive health care to the elderly. There is an urgent need to promote geriatric health services and make them available at the primary health care level, the first level of contact with a national health system.

Multimorbidity and multi-disability among the elderly in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60-108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8-40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2-26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.

Utilization of health care services by elderly for respiratory diseases including TB - Challenges

Progressive functional decline of all body organ systems in association with decreased immunity makes elderly vulnerable to all types of diseases including respiratory diseases. Advances in medical fields have resulted in increasing proportion of elderly globally. Healthcare demands of elderly population are complex. Provision of healthcare services for this continuously increasing population subgroup & ensuring their adequate utilization is full of challenges. These are demographic, socioeconomic, financial, physical accessibility, quality of healthcare services, attitudinal & transportation related. Large size of this subgroup with special healthcare needs in context of limited available resources of middle income country like India is the biggest challenge. Poor educational status & socioeconomic condition of Indian elderly, dependence on family, absence of formal social security & healthcare security complicates situation further. Condition of elderly females is particularly worse. In view of poor physical ability with often associated physical disability makes accessibility of healthcare services also significant factor. Overcoming negative attitudinal factors prevalent in Indian elderly & make them utilize available healthcare services is another huge challenge. Quality of healthcare services in form of availability of required expertise & equipments, attitude of healthcare providers towards elderly patients & convenience in utilization of these services also play an important role. Special provisions in TB control program for elderly in view of their complex needs, high prevalence, morbidity & mortality are also required.

An epidemiological study on quality of life among elderly in an urban area of Thirumazhisai, Tamilnadu

Introduction:

One of the most important indicators of health and well being of the elderly is the quality of life they live in. Owing to the rise in elderly population due to the demographic transition, there is growing need to address the health concerns of this population.

Aims:

The study was undertaken to find out the Quality of Life among the elderly and the associated factors.

Methodology:

This is a descriptive cross sectional study done in urban area of Thiruvallur district Tamil Nadu. To arrive at the required sample of 199, elderly people above 60 years were selected by probability proportionate to size sampling. Semi-structured pre-tested questionnaire was used for data collection regarding sociodemographic details and related factors. Katz scale was used to assess activities of daily living and Quality of life (QOL) was assessed using WHO quality of life BREF (WHOQOL BREF) questionnaire.

Results:

Moderate score in QOL was obtained in all the 4 domains with highest in Psychological and environmental domains. Nearly 99% of had full activity in Katz scale. All the three QOL domains were found to have statistical significant association with age and education. Gender and marital status were found to be associated with psychological domain, and employment/pensioner status with physical domain.

Conclusion:

Measures like Health education have to be targeted for the elderly in ways to improve their physical and psychological wellbeing which can imporove the quality of life they live in. Primary care and family physicians have to be made aware and empowered to identify the various domains of QOL in elderly and to identify in which domain the person needs to take care the most.

Determinants of rural-urban differential in healthcare utilization among the elderly population in India

Background

Population aging poses a demographic burden on a country such as India with inadequate social security systems and very low public investment in health sector. This challenge of accelerated demographic transition is coupled by the rural-urban disparity in access to healthcare services among the elderly people in India. An important objective of India’s National Health Policy (2017) is to “progressively achieve universal health coverage” which is posited upon mitigating the sub-national disparity that necessitates identifying the drivers of the disparity for targeted policy intervention. This study, therefore, makes an attempt towards the exploration of the prominent contributory factors behind the rural-urban gap in utilisation of healthcare among the older population in India.

Methods

The analysis has been done by using the unit level data of Social Consumption: Health (Schedule number 25.0) of the 75th round of the National sample Survey conducted during July 2017–June 2018. Two binary logistic models have been proposed to capture the crude and the adjusted association between health seeking behaviour and place of residence (rural/ urban). To compute the group differences (between rural and urban) in the rate of healthcare utilization among the elderly population in India and to decompose these differences into the major contributing factors, Fairlie’s decomposition method has been employed.

Results

The logistic regression models established a strong association between place of residence and likelihood of healthcare utilisation among the Indian elderly people. The results of the Fairlie’s decomposition analysis revealed considerable rural-urban inequality disfavouring the rural residents and health care utilisation was found to be 7 percentage points higher among the older population residing in urban India than their rural counterparts. Level of education and economic status, both of which are indicators of a person’s Socio-Economic Status, were the two major determinants of the existing rural-urban differential in healthcare utilisation, together explaining 41% of the existing rural-urban differential.

Conclusion

Public health care provisions need to be strengthened both in terms of quality and outreach by way of greater public investments in the health sector and by building advanced health infrastructure in the rural areas. Implementation of poverty alleviation programmes and ensuring social-security of the elderly are also indispensable in bringing about equity in healthcare utilisation.

Geriatric population in India: Demography, vulnerabilities, and healthcare challenges

Global pandemic due to corona virus disease (COVID-19) has exposed vulnerabilities of the geriatric population all over the world. India has been adding progressively increasing number of elderly to its population. This is happening with increasing life expectancy and decreasing mortality. In comparison to children, the population as well as deaths in elderly are rising with changing demography. The elderly population has its own vulnerabilities based on education, socioeconomic condition, gender, place of residence etc. They are affected by various non-communicable diseases which form predominant cause of morbidity and mortality like cardiovascular diseases, stroke, cancer, respiratory illnesses etc. The elderly also contribute to various kinds of disabilities like movement, vision, hearing and in many cases multiple disabilities. They are also more vulnerable to mental health problems and cognitive impairment. The article also suggests a way forward in dealing with rising geriatric age group and its associated problems. The programs supporting this population are largely scattered which needs to be consolidated to include social security, pension and food security along with health benefits. The approach to health care of the elderly needs a comprehensive strategy instead of the present fragmented approach where different disease based programs for non-communicable diseases, cancer and mental health cater to specific health issues of the elderly. Greater awareness, training and skill building in geriatric health for primary care physicians need focus and energy. Prioritizing training and research in this field including the need for more geriatricians has been highlighted.

Experience of Elderly People Regarding the Effect of Yoga/Light Exercise on Sedentary Behavior: A Longitudinal Qualitative Study in Madhya Pradesh, India

This study is set on the background of a randomized control trial (RCT) in which intervention was carried to observe the effects of yoga/light exercise on the improvement in health and well-being among the elderly population. A longitudinal qualitative study was conducted as part of RCT interventions to explore the experience of the elderly practicing yoga/light exercise in relation to sedentary behavior in the Ujjain district of Madhya Pradesh, India. Participants of the RCT were selected for this study. Eighteen focus group discussions were conducted—six during each phase of RCT interventions (before, during, and after). The findings regarding motivating and demotivating factors in various phases of intervention were presented in three categories: experience and perception of the effects of yoga/light exercise on sedentary behavior (1) before, (2) during, and (3) after intervention. This study explores the positive effect of yoga/light exercise on sedentary behavior and subjective well-being on the elderly population. They were recognized to have undergone changes in their physical and emotional well-being by consistently practicing yoga/light exercise. The main driving factors were periodic health check-ups and the encouragement of qualified trainers without any cost. This study concludes with the notion that these interventions should be encouraged in the community to use physical exercise as a method to better control the physical and social effects of aging.

Gender prevalence of cardiovascular diseases in the geriatric population of India: A meta-analysis using R

BACKGROUND

Population ageing is an important challenge for developed as well as developing countries due to the downward trends in mortality rates. The elderly population is increasing worldwide. Cardiovascular diseases (CVDs) are one of the most common diseases in the geriatric population. These diseases involve the heart or blood vessels and include hypertension, rheumatic heart disease, heart failure, and heart attack. An estimated 17.7 million people in India will die from CVDs representing 31% of all global deaths.

AIM

To perform a systematic review and meta-analysis of the gender prevalence of CVDs in the geriatric population of India.

METHODS

In the present study, we searched databases such as Google Scholar, PubMed and MEDLINE from the year 2003 to 2019 to identify the prevalence of CVDs in the Indian geriatric population. A meta-analysis was conducted using the statistical software R version 3.4.3 and the random effect model was used to determine the pooled estimate of the prevalence of CVDs in the geriatric population of India along with the 95% confidence interval rather than using the fixed effect model. The random effect model takes into consideration the heterogeneity across the various studies.

RESULTS

The prevalence of CVDs in the Indian geriatric population was determined in 6586 male subjects from 32 studies and 8164 female subjects from 32 studies, respectively. The overall prevalence of CVDs in the Indian geriatric population was 36.6% (95%CI: 31.9%-41.3%). In addition, calculation of the various heterogeneity statistics (Cochran’s Q = 3836.85, I² = 98.6%, P < 0.0001) indicated heterogeneity in the prevalence of CVDs in the elderly Indian population in these studies. The prevalence of CVDs in elderly males was 38.0% (95%CI: 33.0%-43.0%) and the prevalence of CVDs in elderly females was 40.9% (95%CI: 35.5%-46.2%).

CONCLUSION

The results indicate that the prevalence of CVDs in the female geriatric population was relatively higher than that in the male geriatric population. Policy makers must take immediate steps to prevent CVDs and improve geriatric health care services in India.

Morbidity pattern, social safety net, and drug adherence level among geriatric patients attending in a health-care facility: A cross-sectional study

INTRODUCTION

Financial support system available to geriatric populations affects their adherence level to the prescribed treatment leading to a rise in chronic disease burden.

OBJECTIVE

The aim of this study was to ascertain the disease pattern, health expenditure, and adherence to the prescriptions among geriatric patients reporting to a hospital in North India.

METHODOLOGY

This descriptive, cross-sectional study was conducted from July 2017 to June 2018. Patients who were 60 or above years in age, already diagnosed and were on treatment for more than 3 months were included in the study. A total of 310 patients were selected using convenient sampling method. Data were collected by a pretested and validated questionnaire.

RESULTS

The mean age of the patients was 66.16 years ± 5.37 years (54.8% males). Monthly average family income was Rs. 15202.97 ± 1134.63. Overall, 25% of the treatment cost was met through various social schemes (52% = pension scheme, 32% of patients had no such schemes and only 2% through health insurance schemes). Rest was out-of-pocket expenditure. Common diseases were hypertension (60.64%), diabetes mellitus (35.8%), cancer (28.38%), and coronary artery disease (22.58%). More than half (52.9%) of the patients had two or more illnesses; about 35.8% of them were taking treatment for 1-5 years. Moderate adherence was observed among the majority of the patients. Statistically significant (P < 0.05) difference in treatment adherence to the prescriptions was observed.

CONCLUSION

Geriatric patients had many chronic morbidities. They had high out-of-pocket expenditure and suboptimal financial support affecting their level of adherence to the prescriptions.

Assessment of functional status and daily life problems faced by elderly in a North Indian city

BACKGROUND

The increase in proportion of elderly implies that their problems demand more attention of the administrators. The current study was carried out to assess the functional status of the elderly and to explore the extent and pattern of routine daily life problems faced by them.

METHODS

An integrated qualitative and quantitative research design was employed. A stratified multistage random sampling technique was used to select the respondents from various areas of Chandigarh. The houses were selected randomly from where elderly persons (> 60 years) were identified. Katz Index of Independence in activities of daily living (ADL) was used to evaluate functional ability of the respondents. Instrumental ADLs (IADLs) were assessed using Lawton and Brody scale. Focus group discussions and in-depth interviews were conducted among the elderly to explore their problems using an interview guide.

RESULTS

One thousand and eighty elderly were enrolled in the study. Their mean age was 67.22 ± 7.54 years. (range 60-102 years). The majority (70%) were independent in carrying out their daily life activities. Financially, around one-third were completely dependent and around half were partially dependent. Major dependence was in food preparation, housekeeping and laundry. From the qualitative data, four main themes were formulated, that is general personal problems of elderly; family problems; problems faced by elderly in hospitals and at public places. A feeling of purposelessness, financial insecurity, physical dependency, problems in hospitals and so on, emerged as the main problems.

CONCLUSIONS

Majority of the elderly considered their lives as problematic because they were dependent physically as well as financially. The main domains of dependency were problems related to bowel continence, food preparation, housekeeping and laundry.

Effectiveness of Color Coded Diabetic Control Monitoring Charts among Elderly Diabetics Attending Outreach Primary Care Geriatric Clinics in Rural Karnataka: An Open Label Randomized Control Trial

INTRODUCTION

Type 2 diabetes mellitus problem is progressively rising every day. The adherence to the treatment approaches and health-seeking make major difference in case of diabetics particularly elderly. Visual tools improve the involvement of patients in their care, especially among populations with low health literacy.

OBJECTIVE

To evaluate the effectiveness of color-coded diabetic control monitoring charts on glycemic control among elderly diabetics.

METHODOLOGY

144 elderly diabetic patients attending rural primary care geriatric clinics were randomized into two groups. Those randomized to the intervention group received the color-coded diabetic monitoring chart and a health education package in addition to the usual consultation services. Baseline and 1-year follow-up glycated hemoglobin (HbA1C) values were used to assess the effectiveness of the intervention.

RESULTS

The results of multivariate linear regression analysis showed that there was an average reduction of 0.265% in HbA1C value in the intervention group when compared to the nonintervention group when adjusted for baseline HbA1C and number of visits during the intervention period (β coefficient = 0.265, P < 0.05).

CONCLUSION

Color-coded diabetes charts are effective in achieving glycemic control among elderly diabetics, and steps should be made to inculcate visually appealing management approaches in case of elderly diabetic patients.

Psychosocial Status and Economic Dependence for Healthcare and Nonhealthcare among Elderly Population in Rural Coastal Karnataka

Introduction:

The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients.

Materials and Methods:

The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September–December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent.

Results:

Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%), whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them.

Conclusion:

The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.

Study of pruritus vulvae in geriatric age group in tertiary hospital

BACKGROUND

According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.

METHODS

We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.

RESULTS

Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.

CONCLUSION

Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.

Study of pruritus vulvae in geriatric age group in tertiary hospital

BACKGROUND

According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.

METHODS

We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.

RESULTS

Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and Candida was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.

CONCLUSION

Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.

Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (U.P), India

INTRODUCTION

The health of the elderly will be an important issue defining the health status of a population. With the rise in aged population, there is a greater need to look into their physical disability aspects, which is otherwise neglected. The rationale behind the study is to assess the physical disability of the elderly living in rural area of Jhansi. The aims of the study were to study the prevalence of physical disability among the elderly of rural area, and to find out the factors and association affecting the physical disability.

METHODS

A community-based cross-sectional study was carried out in a Baragaon block of rural area of Jhansi, Uttar Pradesh, India, from July 2015 to October 2015. Multistage random sampling was performed. A total of 265 participants of age 60 years and above were selected. Physical disability was assessed using Barthel index. Appropriate data entry and statistical analysis were done in EpiInfo. Frequency tables were used to calculate the prevalence, and Chi-square test was used to find out the association.

RESULTS

The overall prevalence of physical disability was 23.4%. 70% belongs to the age group from 60 to 69 years. Physical disability was significantly higher among age group >80 years. Similarly, women were more affected with physical disability than men.

CONCLUSIONS

High prevalence of physical disability is the major area of concern. More extensive postdischarge health facilities to be provided to elderly.

How healthy is our geriatric population? a community-based cross-sectional study

INTRODUCTION

With the rise in aged population there is a greater need to look into their nutritional and physical disability aspects which is otherwise neglected. The study aimed to assess the prevalence of malnutrition, anemia and physical disability among the community-dwelling aged population.

MATERIALS AND METHODS

A cross-sectional study was carried out in a rural block of north Tamil Nadu. Seventeen villages were selected using cluster sampling based on probability proportional to size. A total of 340 participants of age 60 years and above were selected from these clusters using simple random sampling. Nutritional status and physical disability were assessed using mini nutritional assessment scale and Barthel index. Blood samples were collected for anemia. Appropriate data entry and statistical analysis were done in EPIDATA and SPSS 16.

STATISTICAL ANALYSIS USED

Besides calculating prevalence chi square and logistic regression tests were done to identify associated risk factors.

RESULTS AND CONCLUSIONS

The overall prevalence of "at risk of malnutrition," anemia and physical disability were 10.9%, 38.2% and 20.6%, respectively. None of the community-dwelling aged population was found to be malnourished. Anemia and physical disability were significantly higher among the older age group [(OR 2.29 (1.17-4.89), (OR 2.81 (95% CI 1.31-6.04), respectively]. Similarly women were more affected with physical disability than men (OR 2.27 (1.28-4.02)). Further studies need to be done to explore the reasons for high prevalence of anemia.

Quality of life of older people in an urban slum of India

OBJECTIVES

The aim of this study was to examine different domains of quality of life (QOL) and their relationship to sociodemographic characteristics among older people in an urban slum in India.

MATERIALS AND METHODS

A cross-sectional study was conducted (n = 120). Selected individuals were interviewed, and their QOL was assessed by the World Health Organization Quality of Life-BREF questionnaire. Statistical analysis was then performed.

RESULTS

Of those included in the study population, 61.7% were men, all were Hindus, 46.7% were members of the general caste, 19.2% were illiterate, 35% were unemployed, and 72.5% lived with their joint family (i.e. extended family). Mean scores in each domain studied did not significantly differ between the sexes, age groups, castes, and family types. Subjects with more education, who were married, and with greater income had significantly better QOL scores. Mean scores were also better in certain domains among persons who had their own income and who resided with their children.

CONCLUSION

Having low education, being single, lacking personal income, and not living with their children significantly reduced QOL in the elderly subjects. Attention should be given to these factors to help elderly individuals age in a healthy manner.

Estimation of lifestyle diseases in elderly from a rural community of guntur district of andhra pradesh

INTRODUCTION

Current statistics for the elderly in India give a prelude to a new set of medical, social, and economic problems that could arise if a timely initiative in this direction is not taken by program managers and policy makers. Aim & Objectives: To identify the burden of lifestyle related disease and its pattern among the elderly in a rural population and to look at socio economic and gender related issues influencing their morbidity.

METHODOLOGY

This cross sectional study was conducted during January to June 2012 in two villages under the Department of Community Medicine, NRI Medical College in Guntur District of Andhra Pradesh. A total of 1960 families with a population of 9067 were enumerated. All people 60 years and above were administered a pretested proforma looking into perceived health status and known disease status. Data was entered in WHO Epi info package and analysed for percentages. Chi square test was applied where appropriate.

RESULTS

There were 509 (11.2 percent) elderly female patients and 517 (11.4 percent) male patients (>60 years of age). 52.3 percent of the women and 44.5 percent of the men had some chronic illness. Hypertension was 19 percent and 28 percent in males and females respectively. There was an overall 14 percent of diabetes and 9 percent arthritis. In women, illiteracy, being just a housewife and widowhood were associated with increased lifestyle disease burden.

CONCLUSION

A significant number of elderly are suffering with chronic illnesses even in rural areas. There is a need to highlight the medical and socio-economic problems that are being faced by the elderly people especially the women in India. Rural health programmes need to also put the health problems of the elderly on par with other health related issues.

Prevalence of Dentulism, Partial Edentulism and Complete Edentulism in Rural and Urban Population of Malwa Region of India: A Population-based Study

Background

The objective of this study was to evaluate the prevalence of dentulism, partial edentulism and complete edentulism in rural and urban population of Malwa region of India, who visited at department of prosthodontics for the first time.

Materials and methods

An institution-based, cross-sectional study using the random sampling method was used to select the study sample of 1000 males and females. Data were collected using questionnaires and oral examination. Data were statistically analyzed using Chi-square test.

Results

Nearly, 38.5 and 63.1% of the rural and urban females were dentulous in the age of below 53 and 43 years. 61.4 and 36% of rural and urban males were dentulous in the age of below 53 and 43 years. Nearly, 41.9 and 48.2% of the rural and urban females were partial edentulous in the age of above 53 and 43 years. Fifty-eight and 51.7% of rural and urban males were dentulous in the age of above 53 and 43 years. Nearly, 22.4 and 55.8% of the rural and urban females were completing edentulous in the age of above 43 years in both population. 77.5 and 44.1% of rural and urban males were completing edentulous in the age of above 33 and 53 years.

Limitation

The study was conducted in an institution-based set-up. Hence, any interpretation of the results of this study must bear this limitation in mind.

Conclusion

It is essential to identify feasible strategies to provide primary dental health education and treatment to all rural and urban elderly in the future. We suggest community dental health services to be included in general health of the elderly rather than a special health need of the community.

How to cite this article

Sonkesariya S, Jain D, Shakya P, Agrawal R, Prasad SVS. Prevalence of Dentulism, Partial Edentulism and Complete Edentulism in Rural and Urban Popu- lation of Malwa Region of India: A Population-based Study. Int J Prosthodont Restor Dent 2014;4(4):112-119.

No longer diseases of the wealthy: prevalence and health-seeking for self-reported chronic conditions among urban poor in Southern India

BACKGROUND

The burden of chronic conditions is high in low- and middle-income countries and poses a significant challenge to already weak healthcare delivery systems in these countries. Studies investigating chronic conditions among the urban poor remain few and focused on specific chronic conditions rather than providing overall profile of chronic conditions in a given community, which is critical for planning and managing services within local health systems. We aimed to assess the prevalence and health- seeking behaviour for self-reported chronic conditions in a poor neighbourhood of a metropolitan city in India.

METHODS

We conducted a house-to-house survey covering 9299 households (44514 individuals) using a structured questionnaire. We relied on self-report by respondents to assess presence of any chronic conditions, including diabetes and hypertension. Multivariable logistic regression was used to analyse the prevalence and health-seeking behaviour for self-reported chronic conditions in general as well as for diabetes and hypertension in particular. The predictor variables included age, sex, income, religion, household poverty status, presence of comorbid chronic conditions, and tiers in the local health care system.

RESULTS

Overall, the prevalence of self-reported chronic conditions was 13.8% (95% CI = 13.4, 14.2) among adults, with hypertension (10%) and diabetes (6.4%) being the most commonly reported conditions. Older people and women were more likely to report chronic conditions. We found reversal of socioeconomic gradient with people living below the poverty line at significantly greater odds of reporting chronic conditions than people living above the poverty line (OR = 3, 95% CI = 1.5, 5.8). Private healthcare providers managed over 80% of patients. A majority of patients were managed at the clinic/health centre level (42.9%), followed by the referral hospital (38.9%) and the super-specialty hospital (18.2%) level. An increase in income was positively associated with the use of private facilities. However, elderly people, people below the poverty line, and those seeking care from hospitals were more likely to use government services.

CONCLUSIONS

Our findings provide further evidence of the urgent need to improve care for chronic conditions for urban poor, with a preferential focus on improving service delivery in government health facilities.

Health problems among the elderly: a cross-sectional study

Background:

Estimates of health problems of the elderly in developing countries are required from time to time to predict trends in disease burden and plan health care for the elderly. Developing countries have a poor track record of equitable distribution of health care. Marginalized groups living in urban slums and rural villages have poor penetration of health services.

Aims:

To identify the geriatric health problems in samples drawn from a slum and a village, and also to explore any gender and urban–rural difference morbidity.

Subject and Methods:

A community-based cross-sectional study was carried out by house to house survey of all people aged over 60 years in an urban slum and a village in the field practice area of a teaching hospital. The total elderly population in these two areas was 407, with an almost equal representation from urban slum and rural area. Information (most of them self-reported) was collected in a pre-tested instrument, which has been used earlier in a World Health Organization multicentric study in India. Categorical variables were summarized by percentages. Associations were explored with odds ratio (OR) and 95% confidence intervals (CIs).

Results:

Female elders outnumbered the male elders; widows outnumbered widowers. Tobacco use was very high at 58.97% (240/407). Visual impairment (including uncorrected presbyopia) was the most common handicap with prevalence of 83.29% (339/407), with males more affected than females (OR = 2.52, 95% CI 1.32-4.87). Uncorrected hearing impairment was also common. Urinary complaints were also more common in males (OR = 1.68, 95% CI = 0.93-3.04). More rural elders were living alone than their urban counterpart (OR = 2.87, 95% CI 1.23-6.86). History of weight loss was higher in the rural areas, while tendency to obesity was higher in the urban areas. An appreciable number 29.2% (119/407) had unoperated cataract. Prevalence of hypertension was 30.7% (125/407); 12% (49/407) had diabetes; 7.6% (31/407) gave history of ischemic heart disease, males more than females (OR = 3.75, 95% CI 1.62-8.82). A large proportion, 32.6%, (133/407) had dental problems. Almost half of the population gave history of depression.

Conclusion:

A large number of unmet health needs, such as unoperated cataract, uncontrolled hypertension, uncorrected hearing impairment and tobacco use, exist in marginalized groups. Health interventions for these are needed in developing countries. Preventive services such as tobacco cessation campaigns among the elderly should also get priority.

Effect of Living Arrangement on the Health Status of Elderly in India: Findings from a national cross sectional survey

Epidemiological studies show strong association between lack/inadequate family support with increased mortality and poor health among the elderly. This study examined the effect of living arrangement on elderly health status by analysing the data of 39,694 persons aged 60 and above included in India's second National Family Health Survey conducted in 1998-1999. Results indicate that elderly who are living alone are likely to suffer more from both chronic illnesses, such as asthma and tuberculosis, and acute illnesses, such as malaria and jaundice, than those elderly who are living with their family, even after controlling for the effects of a number of socio-economic, demographic, environmental and behavioural confounders. The findings have important programme and policy implications for countries such as India, which has the second largest elderly population in the world. There is a strong need for the implementation of specific public support systems and health care strategies focused on the elderly population in general and elderly living alone in particular.

Ageing in Puducherry, South India: An overview of morbidity profile

BACKGROUND

The geriatric health problems are related to chronic disease as a result of increasing life expectancy.

OBJECTIVE

This study was undertaken to assess the health problems of the elderly in Puducherry.

MATERIALS AND METHODS

This cross-sectional study was carried out on 214 elderly persons from the age group of 60 years and above using a pre-designed and pre-tested questionnaire that addressed the disease magnitude in comparison with the socioeconomic variables.

RESULTS

Overall, 43% of the participants were diabetic, 47.7% hypertensive, 86% anemic and 68.2% visually impaired. All the morbidities were noted to be higher in the 70-79 years age group. Diabetes was significantly higher in participants from urban areas, with family history and increasing waist-hip ratio, but significantly lower in the below poverty line areas. Hypertension risk was significantly higher among females, among those leading sedentary life, those eating vegetarian food, those addicted to tobacco and with abdominal obesity. Anemia was significantly lower among urban vegetarians. Overweight and obese were noted in 31% of the participants, and were higher in females (87.5%). Rural residence, female sex, living in joint family, literacy, sedentary life style, decreasing per capita income and decreasing body mass index (BMI) were significantly associated with visual impairment.

CONCLUSION

This study highlights the burden of health problems of elderly individuals in South India.