Table of Content - Volume 8 Issue 1 - October 2017
Morbidity pattern in geriatric population attending medicine outpatient department in a tertiary care center
Karthik N1, K V Giriraja2*
1Assistant Professor, 2Professor, Department of Internal Medicine, Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru, Karnataka-560090 INDIA. Email: drgiriraja@gmail.com
Abstract Background: Population aging is a global phenomenon. In India, the size of the elderly population is growing fast. Many older adults have multiple medical conditions. Objectives: Study was done to assess the morbidity patterns in elderly population attending OPD in medicine department. Material and Methods: Study was conducted over a period of three months. All geriatric patients, 60 years or above, were included in the study. Morbidity affecting specific organ systems was classified based on the outpatient department case papers. Results: Respiratory diseases (46%) were commonest morbidity followed by cataract (38%), cardiovascular (36%) and hearing impairment (34%).As the age increases chances of getting morbidities were significantly higher. Conclusions: A high prevalence of morbidity among elderly highlights the urgent need to provide geriatric health care services in the developing country like India. Elderly persons should be motivated and policy makers must focus on rural elderly and their beliefs which prevent them from seeking healthcare. Key Words: Elderly people, Hypertension, Morbidity, Respiratory diseases. INTRODUCTION Worldwide increase in longevity has shifted the age distribution toward older populations.1In India the size of the elderly population, that is, persons above the age of 60 years is growing fast. The absolute number in India increased from 76 million in 2001 to 100 million in 2011.1,2 By 2025, the number of elderly people is expected to rise more than billion with about 840 million of these in developing countries. In India, elderly population is likely to rise to 19% by 2050.3 Most people, when they reach old age, are not free of disease and advanced age in itself is a risk factor for many diseases like cardiovascular and degenerative diseases.4As elderly people are vulnerable to long term diseases of insidious onset such as cardiovascular illness, CVA, cancers, diabetes, musculoskeletal and mental illnesses along with this, there is absence of facilities for medical treatment and of providing economic and social support, hence information on morbidity profile of this population is essential for planning their health care facilities.5This study is therefore aimed at reviewing the pattern of geriatric morbidity presenting in the General outpatient clinic of this tertiary health institution.
MATERIAL AND METHODS This was a cross sectional, observational study done in Department of Internal Medicine, Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru. 250 patients of 60 years and above, attending medical OPD or admitted in medicine ward, were included by convenient sampling after obtaining written informed consent. Sociodemographic details were taken. Diagnosis made on the basis of past records and present examination was taken as final. Data was entered in the Microsoft excel and analyzed with appropriate statistics. RESULTS Table 1: Distribution of geriatric patients according to age
Majority subjects (48%) belonged to age group of 60-69.
Table 2: Morbidity pattern among geriatric patients
Commonest morbidity was respiratory diseases counting for 46%, cataract counted for 38%, cardiovascular diseases formed 36%, hearing impairment counted 34% of study population. Out of 116 cases of respiratory diseases, COPD (33%) was the commonest respiratory disease followed by Koch’s chest (19%). While in cardiovascular morbidities hypertension was most common disorder (58%).
Table 4: Effect of sociodemographic factors on frequency of morbidities among geriatric population
There was statistically significant difference observed in the distribution of morbidity with age. Sex differentiation was also seems to be significant in occurrence of diseases. Multiple morbidities were significantly more in working persons. Subjects belonging to nuclear families shown significant association with multiple morbidities.
DISCUSSION Total of 250 were selected attending outpatient Department of Internal Medicine, Sapthagiri Institute of Medical Sciences and Research Center, Bengaluru regarding various health problems. In our study 60-69 age group formed majority 48% of subjects, similar was seen in Sharma MK et al6 study with 65% of elderly patients were in the age group of 60-69 years. In this study 46% study population had respiratory disorder while Prakash R et al7study found slightly a lower incidence of respiratory diseases 36%, while in Bava MM et al8 study it was 37%. In this study hypertension was commonest cardiovascular disease observed in 58% cases of cardiovascular disease, this observation is consistent with other studies by Sharma D et al940.5% in Shimla, Prakash R et al748% in Udaipur and Kaplan MS et al1053.8 % in United States and 48% in Canada. While lower hypertension morbidity(26%) was reported by Putty AJ et al.11In our study Cataract was seen in 38% of the elderly persons. Similar was seen with Sharma D et al9 study 30% of the older persons in our study. Occurrence of cataract ranged from 21% to 37% in Kishore S et al12, Goswami A et al13, Liu Z et al14studies.In this study Anemia was present in 19% of patients. Putty AJ et al11 reported 52.5% prevalence of anaemia while Niranjan GV et al15 reported a high prevalence of anaemia as high as 82.9%, these findings were much higher than ours, this may be due to different geography and diet pattern. While Sharma D et al9 reported almost similar prevalence of anaemia at (16.5%).Osteoarthritis was seen in 32% elderly. Shankar R et al16 reported a high prevalence of arthritis (57.08%) in their study. Osteoarthritis was observed slightly more in females than in males. Our findings were consistent with Shankar R et al16 and Graciani A et al17studies. While it was only in 5.6% patients in Sharma MK et al6 study. Out of 250 patients studied, the overall prevalence of diabetes was found to be 10%. Out of 25 patients (57%) were males and (43%) were females. This result was similar to the study done by Puri S et al18but the prevalence of DM was slightly more (27.1%) in their study. The psychiatric disorder acounted for 8% comorbidities, while Tiwari et al19 (23.7%). In our study the male to female distribution of psychiatric illnesses was similar to Tiwari et al19 study. A significantly higher proportion of women suffered from osteoarthritis, anaemia, hypothyroidism similar was seen in Sharma D et al9 study. Contrary to previous findings respiratory diseases like chronic obstructive pulmonary disease, cardiovascular, malignancies were observed more in men. Similar sex differences in morbidity pattern were observed by Sharma D et al9 study in their study. The present study observed that with advancing age number of morbidities increased. This is in agreement with Shankar Ret al16 and Niranjan GV et al15studies which observed that the prevalence of old age-related morbidities increased with advancing age significantly. Joshi et al20 reported age was significant factor in occurrence of morbidities. In our study, single illness was observes in 41%, two illnesses in 36% and three or more illnesses.
CONCLUSION In our study common medical problems identified were respiratory diseases, hypertension, diabetes, osteoarthritis, cataract, hearing problems. A high prevalence of morbidity among elderly highlights the urgent need to provide geriatric health care services in the developing country like India. The high morbidity load among elderly in the present study stresses for efforts to provide specialized healthcare to them, and thus ensure that they remain active members of our society.
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