What is the recent scenario of Morbidity patterns among Geriatric population?

The NSS (National sample survey) 75th round (2017-2018), provides information on the prevalence rate at the state and national level of general morbidity by age group and gender, as well as of specific categories, of ailments, was a major objective of the survey.

0
What is the recent scenario of Morbidity patterns among Geriatric population?

In a developing country like India, the elderly population is exposed to double burden of communicable and non-communicable diseases. Documented evidences have shown that elderly adult population is more vulnerable to various non-communicable diseases. Along with age-related degenerations, a larger chunk of the population is expected to be affected by mobility-related impairments due to chronic diseases. Impaired mobility has been shown to be an early predictor of physical disability and, ultimately, to be associated with falling, loss of independence, institutionalization, and death. India’s Ageing Population 2012, reported that nearly half (45%) of India’s disease burden is projected to be borne by older adults by 2030 when the population age groups with high levels of chronic conditions will represent a much greater share of the total. These parallel transitions have led to the development process and simultaneous creation of appropriate and adequate healthcare infrastructure.

The NSS (National sample survey) 75th round (2017-2018), provides information on the prevalence rate at state and national level of general morbidity by age group and gender, as well as of specific categories, of ailments was a major objectives of the survey. This article investigated the morbidity pattern and health seeking behavior of the elderly inpatient in India.

An overview of morbidity of elderly in-patients by selected background characteristics (Table 1) shows that, the prevalence of NCDs (9.6) and CVDs (7.2) was higher among elderly male and elderly female have the higher prevalence of Communicable disaeses (5.9) , disability (5.7) and otherdiseasess (3.3). Prevalence of communicable (6.3), Non-communicable (11.2), CVDs (11) disability (7.3) and other diseases (4.4) was higher among oldest old. The prevalence of Communicable (6.8), Non-communicable (8.6), disabilities (6.4) and other diseases (3.7) was higher among elderly living in the rural areas. In urban areas aged people were more likely to suffer from CVDs (6.4). The prevalence of communicable (6.5), non-communicable (12.3), CVDs (7.7), disabilities (6) and other diseases (3.7) was higher among elderly up to primary education. The prevalence of Communicable disease (7.8), Non communicable disease (10.6), CVDs (7.7), disability (7.7) and other diseases (4.1) were higher among the elderly of the 1st quintile class of household expenditure. The prevalence of all diseases was higher in southern region.

Table 1: Prevalence (per 1000) of different morbidities of elderly in India by its background characteristics for in-patients during the last one year (NSSO 2017-2018, N=12642)

Background

characteristics

CD NCD CVD Disability Others P-value
Sex
Male 4.9 9.6 7.2 5.4 3.1
Female 5.9 6.6 5.4 5.7 3.3 <0.05
Place of Residence
Rural 6.8 8.6 6.3 6.4 3.7
Urban 3.6 7.5 6.4 4.5 2.6 <0.05
Education
Illiterate 5.7 1.6 5.1 5.7 3
Up to primary 6.5 12.3 7.7 6 3.7
Up to secondary 4.4 8 7.3 5.1 3.2 <0.05
Graduate & Above 3.2 6.7 6.7 4.6 2.6
Age group
60-69 (Younger old) 4.9 6.7 5.5 4.7 3.1
70-79 (Older old) 6.2 10.6 6.8 6.9 2.9 <0.05
80+ (Oldest old) 6.3 11.2 10.6 7.3 4.4
Social group
SC/ST 5.4 7.2 3.9 4.5 2.5
OBC 5.3 8.6 7.1 5.8 3.5 <0.05
Others 5.4 8.2 7 5.9 3.3
Religion
Hindu 5.5 8.4 6.3 5.7 3.2
Muslim 5 8 7.8 5.3 3.3
Christianity 6.4 6.7 5.3 5.6 3.4 <0.05
Others* 3.3 5.4 4.6 3.2 2
Marital Status
Never Married 7.2 11.1 5.2 7.7 0.7
Currently married 4.8 8.1 6 5 3.2
Widowed 6.6 8.1 7.2 6.6 3.3 <0.05
Divorced/ separated 10.5 6.1 0.7 7.2 1.9
MPCE
1st quintile 7.8 10.6 7.4 7.7 4.1
2nd quintile 6.4 7.9 6 6.6 3.1
3rd quintile 4.7 7.1 5.3 5.1 3.2 <0.05
4th quintile 4.3 7.2 6.2 4 2.9
5th quintile 3.1 7.6 6.7 3.7 2.7
Region
North 2.8 6.1 4.8 2.9 2.2
Central 6.5 7.5 5.7 6.3 3.1
East 5.5 9.4 6.7 5.4 3.9
North-east 1.2 1 1 0.9 0.8 <0.05
West 5.2 8.8 7.5 6.3 3.3
South 8.5 11.4 8.9 8.6 4.4

The aging of the population will undoubtedly result in higher levels of physical and cognitive disabilities that result from the aging process and chronic disease conditions of older adults. Table 2 shows the change in physical mobility decreased as the age increased. Oldest old were reported higher percentage of confined to home and confined to bed.

Table 2: Percentage distribution of Age at different level of physical mobility

Physical mobility 60-69 70-79 80+ Total (60+)
Physically mobile 95.4 90.6 71.8 92.2
Confined to bed 0.8 1.5 7.2 1.5
Confined to home 3.3 7.4 18.7 5.6
Able to move only in

wheelchair

0.5 0.5 2.4 0.7


The prevalence of different type of communicable disease among the elderly population in last 12 months preceding the survey. Prevalence of Others communicable disease (Typhoid, Hookworm infection, filariasis, tuberculosis) was higher among elderly followed by viral Hepatitis/jaundice and Malaria (Figure 1). Prevalence of other Non communicable disease (under nutrition, Goitre and other diseasesof the thyroid, obesity, any difficulty or abnormality in urination, pain the pelvic region, earache with discharge /bleeding from ear, decreased hearing or loss of hearing, disorders of eye movements- strabismus, nystagmus, ptosis, adnexa) is higher among elderly (19.8%) followed by cataract (14.3%), Diabetes (13.6%) and Bronchial asthma (13.6%).

What is the recent scenario of Morbidity patterns among Geriatric population?Figure 1: Prevalence of Communicable and Non-Communicable Diseases

The analysis infers as age increased, the morbidity too increased and this difference in the prevalence of morbidity among different age groups was found to be statistically significant (P < 0.05). The results shows that the prevalence of all type of diseases like communicable, noncommunicable, CVDs, disabilities and other morbidities were higher among the in-patients of elderly (60+) in Kerala and other progressive states and union territories such as Delhi, Tamil Nadu, West Bengal, Maharashtra and Andhra Pradesh, which supporting the fact that the lifestyle of the socio- economically well-off population in general is one of the important factors responsible for morbidity especially, NCDs and CVDs. The study reveals that oldest people (80+) were less physically mobile, they were Able to move only in wheel chair corroborating the fact that With advancing age, however, maintaining mobility and walking capability may be jeopardized by the increasing risk of physical and sensory impairments.

The government should effectively plan health care services for the elderly and prepare a feasible implementation design relevant to the needs of the country. These policy changes comprise a positive step in the right direction. However, the problems of elderly population need to be tackled from both the supply and the demand side. From the supply side, there is a greater need to provide facilities, infrastructure and sensitive handling, to cater to the health of the elderly. But to ensure that treatment reaches those who need it, there is also a need to focus on the demand side of the problem by generating the demand: this would entail focusing on vulnerability factors and giving special attention to the most vulnerable group.

By,
Jhumki Kundu,
International Institute for Population Sciences,
Mumbai

Sampurna Kundu,
Centre of Social Medicine and Community Health, Jawaharlal Nehru
Univerisity,
New Delhi

Summary
Article Name
What is the recent scenario of Morbidity patterns among Geriatric population?
Description
The NSS (National sample survey) 75th round (2017-2018), provides information on the prevalence rate at the state and national level of general morbidity by age group and gender, as well as of specific categories, of ailments, was a major objective of the survey.
Author
Publisher Name
THE POLICY TIMES
Publisher Logo