The investigation of medical and psychosocial problems of geriatric population in the urban area of Madhya Pradesh in India ()
1. INTRODUCTION
Ageing is a natural, inevitable biological phenomenon. Community must learn to respect their grand elderly, understand them and treat them with honour, dignity and abundant love.
Globally, there are an estimated 605 million people aged 60 years and above. Improvements in health care facilities have brought longevity, which is considered to be one of the greatest achievements of the 20th century. The ratio of older persons has changed dramatically from approximately one in fourteen in the fifties to about one in four at present. From 1990 to 2025, the elderly population in Asia will rise from 50 percent of world elderly to 58 percent, in Africa and Latin America from 5 - 7 percent, but in Europe the figure will drop from 19 to 12 percent of the world elderly [2-4]. The life span has increased in India from 32 years in 1947 to more than 62 years at present. From the morbidity point of view almost 50 percent of the Indian elderly have chronic diseases and 5% suffer from immobility [5]. There are several vulnerable groups and a large disadvantaged group are elderly females, who are one of fastest growing segments and which will increase to become 4 times the current figure, by 2025 [6,7]. The challenge in the 21st century is to delay the onset of disability and ensure optimal quality of life for older people.
A major component of the burden of illness for the elderly derives from prevalent chronic diseases. India in the epidemiological transition is facing a double burden of diseases both communicable and non communicable diseases where nutrition plays an important role. For the substantial impact on this burden, preventive health care strategies specific to the elderly need to be clearly formulated and tested. Current recommendations for periodic health examination and for preventive health care for the elderly include only minimal components for a geriatric preventive health care approach. Hence, this study was taken up with the objective of medical and psychosocial problems of geriatric among the urban area with a view to improve over health care services for them.
2. OBJECTIVES
1) To study the morbidity pattern among geriatrics;
2) To assess various psychosocial factors in geriatric population;
3) To recommend measures to improve condition of geriatric population.
3. MATERIAL AND METHOD
It is a community based cross sectional study was carried out during the period of Oct. 2002 to Oct. 2003. This study was conducted in the urban health and family welfare centre (Lady Bhore centre) catchment area of Bhopal city. The cater area comprised of Fategarh, Saheed Nagar, Sazida Nagar, Idgah Hill, wards. In each area/ward 52 persons of geriatric age group were interviewed at home by using predesigned and pretested proforma. The reference population of universe for this study was geriatrics population of Catchment area of Lady Bhore centre, Bhopal. The urban family welfare centre covering the population of 65,978 with 5.09% (3358) of geriatric population (census 2001, [8,9]). 6% of geriatric population were taken as a sample size for the study 208 (>60 years of age).
Eligibility criteria for selection of subject were those who had completed 60 years of age and above. Selection of the study subjects (208) were done by the systemic random sampling method by selecting every third house, first house was selected by random method (using currency note) in that way we were covered 5090 houses and got 208 geriatric people.
4. DATA COLLECTION TOOL AND METHOD
A study team comprised of post graduate student, interns, medical social worker, public health nurses, and attendants. Team was trained in the department of Community Medicine, Gandhi Medical College Bhopal, to collect uniform information regarding various parameters from the study subjects. The information was collected on a predesigned and pretested proforma though personal interview and general examination, data was collected by house to house visit. Each individual was told about the purpose of the study, and confidentiality of the information was assured. A detailed history was taken regarding present and past illness. The post graduate student and interns did a general physical examination. Body weight was measured in kilograms using a spring weighing machine to the nearest 0.5 kg with light cloths on. Blood pressure was measured twice using a mercury sphygmomanometer from the right arm with the elderly in the sitting position.
If high BP was detected, two more reading were taken on difference occasions to confirm hypertension. They were subsequently graded as normo-tensive. Systolic BP < 140, diastolic < 90 mm of Hg, Hypertensive systolic BP > 140 and diastolic 90 mm of Hg (WHO 1996) [9].
5. DATA ANALYSIS
The data was analyzed by computer using EPI-Info7 & SPSS-9 software with the help of computer expert.
6. OBSERVATIONS
Two hundred and eight elderly people were studied from the study area. Out of 208 aged 91 (43.7%) were males, 117 (56.25%) were females. Maximum number of males and females were from the age group 60 - 64 years. In the age group of 80 years and above more number of males 9 (9.9%) then females 8 (6.8%). The mean age of the study group in male 68.8 years & females was 67.4 years (Table 1).
Table 1. Distribution of respondents according to socio-demographic profile.
Table 2 shows that out of 208 aged in the study area, 40.7% males were care by their spouse during illness, while only 14.5% females were care by their spouses during illness.
1.7% females stated that there was no one to look after them during illness.
Table 3 shows that out of 208 aged 117 (56.25%) had chronic problems and 15 (7.2%) acute, while rest of them was having no problem.