Within the following few decennaries, we will see an extraordinary addition in the figure of older people worldwide. The public wellness benefit of preventative medical specialty in old age comes from the compaction of the clip spent in dependence to a lower limit. This survey was conducted to measure the current state of affairs, intervene and suggest suited recommendations for geriatric wellness attention.
The diminution in birthrate and mortality rates accompanied by an betterment in kid endurance and increased life anticipation has led to a progressive addition in the figure of aged individuals. The ratio of older individuals has changed dramatically from about one in 14 in the 1950ss to about one in four at nowadays. One common myth is that older individuals largely live in industrialised societies. In fact, 60 % are found today in developing states and in 25 old ages this proportion will hold risen to 75 % 1.
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Globally, the figure of individuals aged 60 old ages or over is expected about to treble, increasing from 673 million in 2005 to 2 billion by 20502. India, had 72 million aged individuals above 60 old ages of age as of 2001, compared to China ‘s 127 million. Harmonizing to projections, the aged in the age group 60 and above is expected to increase from 71 million in 2001 to 179 million in 2031, and farther to 301 million in 2051 and 21 % of the Indian population will be 60+ by 2050 as compared to 6.8 % in 19913,4.
The cardinal characteristics of ageing are increased inter-individual variableness, complexness and co-morbidity, which is why indexs of quality of attention based on individual disease theoretical accounts work less good among older than younger people and the attention of the aged is already a major societal and wellness job in flush states. In developing states like India, ripening is besides associated with societal isolation, poorness, evident decrease in household support, unequal lodging, damage of cognitive operation, mental unwellness, widowhood, loss, mourning, limited options for life agreement and dependence towards terminal of life5.
The challenge in the twenty-first century is to detain the oncoming of disablement and guarantee optimum quality of life for older people. At a clip when Governments are measuring ways to bring forth fundss for healing and rehabilitative services for the aged it may be worthwhile to give due importance to preventive and promotive services for the aged at the primary wellness attention degree. Individualized wellness publicity and preventative medical examinations for older people has been shown to be extremely effectual and is likely to be among the grounds for falling disablement among older Americans to the point of stabilising healthcare outgo on older people6, 7. Arthritis is one of the major causes of disablement in the aged age group. It has been estimated that the entire cost of the arthritis measure for the United States, in footings of hospitalization, physician visits, medicines, physical therapies, nursing-home attention, lost rewards, early decease, and household strife is over $ 50 billion dollars yearly. Such statistics are non available for India.
This survey was conducted to measure: the current morbidity profile of older individuals in a rural community ; to supply early intercession if any needed ; to supply informations for planning services for the older individuals in rural countries ; and to piece a cohort to subsequently measure the public-service corporation of preventative medical examination as indispensable component of primary wellness attention in cut downing the overall morbidity. The purpose was to propose recommendations for any alterations in attack towards geriatric wellness attention.
Material and Methods:
A cross-sectional survey of geriatric population was conducted in the rural wellness developing country of our medical college at small town Kasurdi, Taluka Haveli of Maharashtra between 01 Feb 2007 and 31 Mar 2007. All aged individuals in the age group of 60 old ages and above shacking in the small town were included in the survey.
A elaborate demographic profile of the small town was conducted by the occupants of the Dept of Community Medicine over a period of three months ( Nov 2006 to Jan 2007 ) by family study. The entire figure of individuals in the age group of 60 and above were 239 out of which 214 ( 98 males and 116 females ) participated in the survey and rest 25 were either off from the small town or could non be contacted inspite of repeated attempts.
The survey was started with sensitisation of the villagers. Each person aged 60 old ages and above was informed about the study and its aims. They were requested to see Rural Health Training Centre ( RHTC ) as per reciprocally agreed day of the month and clip. Repeated house visits were made and merely after three visits a individual was declared unavailable.
Informed consent was obtained and confidentiality of the information was assured. The agenda of visits along with the intent of the survey was besides displayed on the chalkboards in forepart of the common topographic point and Gram Panchayat office.
Each person in the survey was subjected to personal interview, clinical and laboratory scrutiny. The information was collected on a pre tested standard performa. The interview was carried out in the local linguistic communication. The medical squad consisting of 6 occupants and 2 medical students societal workers were trained and briefed about the aims of survey. The information therefore collected were compiled, tabulated and analysed utilizing SPSS, Ver 14.0.
Clinical scrutiny included a general physical and systemic scrutiny. Height was measured in the standing place with au naturel pes on portable stadiometer and was calculated to the nearest 0.5 centimeter. Body weight was measured in kgs utilizing a spring weighing machine to the nearest 0.5 kilogram with light apparels on. Blood force per unit area was measured twice utilizing a quicksilver sphygmomanometer from the right arm with the aged in the lying place. The Korotkoff phases I and V were recorded for systolic and diastolic force per unit areas severally. If high BP was detected, two more readings were taken early forenoon on different occasions to corroborate high blood pressure. They were later graded as: Normotensive systolic BP & A ; lt ; 140, diastolic & A ; lt ; 90 mmHg ; Hypertensive systolic BP ?140 and diastolic ?90 mmHg8.
Chronic systemic diseases with established diagnosing by a specializer in that field was considered as positive instance whereas ague and chronic systemic diseases found by the research workers were investigated and confirmed by a specializer before considered positive for the survey.
The research lab trials included hemoglobin appraisal by Sahli ‘s method, random blood sugar by electronic glucometer, urine scrutiny for albumen and sugar by Uristic and Diastic. All these probes were conducted at the clip of scrutiny or an assignment was given on following yearss as per the convenience of the persons. Patients found to hold high random blood sugar ( as per WHO standards ) were asked to acquire both fasting and station prandial samples done following twenty-four hours for verification.
Out of 214 aged examined, 24 ( 11.2 % ) were found wholly fit while 190 were found to hold one or more than one morbidity. Detailss have been provided in Table 1. The major morbidities belonged to the Diseases of the Eye, Musculoskeletal, Respiratory system, Hypertension and Dental. Distribution of instances as per of import diseases is given in Table 2.
Distribution of aged as per BMI is shown in Table 3. About 28.6 % males and 17.3 % females were found to be overweight ( BMI ? 25 ) . The overall prevalence of corpulence was found to be 22.5 % . However, 8.4 % were besides found to hold scraggy ( BMI & A ; lt ; 18 ) .
Distribution of aged as per consequences of research lab trials has been shown in Table 4. Taking a cutoff of 12 gram % Hb, the overall prevalence of anaemia was 62.6 % . Random blood sugar degree ( BSL ) was found to be 140 mg/dl or higher in 14 ( 6.5 % ) subjects. Fasting and postprandial BSL were so tested for these 14 persons and 12 were so diagnosed to be enduring from DM by the specializer concerned.
In our survey, mean figure of unwellnesss per individual was found to be 2.61 which is in consonant rhyme with surveies among the aged in South India, 2.429 but higher than elderly in rural North India, 1.9310. The distribution of morbidities found in our survey is besides similar to findings in an urban scene of Gujarat5.
The presenting symptoms of the same disease may change in aged in comparing to younger population11. The taking cause of lessened vision in developing states is cataract, which was besides found in present survey ( 37.3 % ) whereas, amongst all oculus instances cataract was present in 68.3 % . It is about similar to that found in other surveies in urban country of Rajasthan, 44 % 12 and rural countries of Kancheepuram distt, 32.1 % 13. Cataract in the rural population may be due to increased exposure to ultraviolet radiation during long hours of work in unfastened fields14. A affair of concern is the addition in cataract in rural population during last few decennaries.
A high prevalence of arthritis / articulation hurting ( 38.3 % ) in the current survey, particularly among females, has besides been reported in other studies9,13,15. This high prevalence in our and besides in other surveies shows that preventative and promotive attention at Primary wellness attention degree for aged in this facet is an pressing necessity as it would better their quality of life and salvage subsequent morbidity and demand on the wellness attention system for joint replacings and other expensive surgical processs.
Our survey determination of 28 % prevalence of high blood pressure is higher than that found in Varanasi, 11.25 % 10 but much lower than WHO report, 56 % 16 and among the rural aged in Haryana, India17. This low prevalence of high blood pressure can be attributed to uninterrupted wellness instruction and wellness publicity activities being done in the small town by the occupants of this Medical College.
The organic structure mass index ( BMI ) is a utile index of specifying fleshiness and chronic energy lack ( CED ) at the community level18. It was observed that 8.4 % of the aged were thin and 22.5 % were overweight in contrast to the survey done in Tamil Nadu where 49 % of the aged were thin and 9.7 % overweight13.
Anaemia was the commonest morbidity, with over half of population ( 62.6 % ) agony from it. A survey carried out in the Southern portion of India reported a higher prevalence of anemia ( 82.9 % ) in the 60 old ages and above age group9. Anaemia in aged may be multi factorial with etiology every bit varied as nutritionary, physiological and pathological19. The presence of diabetes mellitus in 5.6 % of the aged farther reflects the epidemiological passage and increasing load of life-style diseases in the rural communities.
Randomized surveies in Japan and Taiwan have clearly demonstrated a strong positive correlativity between preventative services for the aged at primary attention degree and subsequent reduced morbidity and mortality20, 21. The international organisations like the World Health Organization have focused on nearing ageing as a portion of the life rhythm and restructured its programme on the wellness of the aged and given it a new name – Ageing and Health. Healthy aged can profit society by doing usage of their accomplishments and abilities which they have acquired during their lives.
In our survey we are urging enterprises including roll uping prevalence/incidence informations ; carry oning public wellness surveillance ; placing best patterns for bar, diagnosing, direction and attention of arthritis ; advancing community-based and patient self-management plans and activities ; developing public information and instruction plans ; spread outing physical activity plans ; and informing the populace about nutrition instruction chances.
The aged deserve better than to be squeezed uncomfortably into a individual disease theoretical account designed to outdo assess the benefits and injuries of intervention in younger populations. Effective preventative and promotive wellness attention at primary degree will assist them take a socially productive and disablement free life.
This survey among the aged in the rural country of Maharashtra, India has highlighted a high prevalence of morbidity and identified common bing medical jobs. Strengthening of geriatric wellness attention services in conformity with the common bing jobs particularly preventative and promotive services in the community are required. Further research, particularly qualitative research, is needed to research the deepness of the jobs of the aged. Attempts in this way and follow up of the aged have already been initiated by the Dept of Community Medicine of our Medical College.