A STUDY OF THE MORBIDITY PATTERN AMONG THE GERIATRIC POPULATION IN A RURAL AREA OF WEST BENGAL 1) AIMS AND OBJECTIVES

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Ageing is a global and an irreversible phenomenon intricately woven to the inherent cycle of life. The world’s elderly population – people 60 years of age or older, is the fastest growing age group. While population ageing is a triumph of modern society and bears testimony to the unmistakeable advances of modern medicine and healthcare, and is a reflection of the overall improvement in global health but it also raises special challenges in the 21st century both in developed and developing countries – the challenge of adequately understanding the needs and requirements of this special population group and realigning the existing healthcare infrastructure to cater to their needs. Given the fact that by 2050 about 80% of the elderly will be living in developing countries 3 , it is time that we gather more knowledge and skills to make ourselves prepared to meet this challenge. This special group of population has certain unique socio-demographic qualities which necessitates realignment of healthcare and other health promotive services to suit their needs. Firstly, there persists vast health inequalities , as the existing healthcare services are not adequate both in focus and expertise to cater to the elderly population . Most of the initiatives and programmes aim at other vulnerable population groups like children, pregnant mothers etc. However, it will be increasingly necessary to spend the resources for this section of the population. Secondly, accessibility of healthcare services may be disrupted as a significant proportion of the elderly population are bed ridden or have restricted mobility arising out of different morbidities, or simply because of frailty. Thirdly, disasters and emergencies severely impact the most vulnerable including the older people eg. highest percentage of fatalities in Indonesia caused by the 2004 Indian Ocean tsunami was in people aged 60 years and older – this necessitates urgent planning to protect the elderly from emergencies. Finally, lack of earning power , dependence on family members , lack of emotional support and psycho-social factors further overwhelm the vulnerability of the older people.

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The area comprises a total population of 165. the field practice area is in the Amdanga Community Development block of North 24 Parganas district of West Bengal. prevent disease and manage chronic illnesses in dependent and frail patients. To study the quality of life and attitude towards life of the elderly D. we should . To suggest measures to mitigate their problems .771 (2001) and is catered by the 2 . the less costs are concentrated in that period. promote it and extend it” . Health expenditure increases with age and is concentrated in the last year of life . Postponing the age of death through healthy ageing combined with appropriate end-oflife policies could lead to major health care savings.G. try to “protect it.Effective. More venture has to be undertaken to formulate guidelines for a comprehensive geriatric healthcare approach. To assess the physical and psycho-social morbidity pattern affecting the elderly population B. Now that we have achieved longevity of life. To know about the health care-seeking behavior of the elderly in different morbid conditions C. close to 80% of all deaths are expected to occur in people older than 60. STUDY AREA : The study is proposed to be conducted in the rural field practice area of the Dept. 2) SPECIFIC OBJECTIVES OF THE STUDY : A. of Community Medicine of R. as Sir James Sterling Ross has put it . By 2050. as will be found in this study 3) MATERIALS AND METHODS: 1. Hence this study is taken up with the objective to assess the health status and morbidity pattern of the rural elderly with a view of providing data that will help in reorienting the health services to reduce their problems. It is time that preventive healthcare strategies specific to the elderly are clearly formulated and tested.Kar Medical College . community-level primary health care for older people is crucial to promote health.but the older a person dies. The challenge of 21st century healthcare is to delay the onset of disability and ensure optimal quality of life for the elderly.

abuse. subsequent analysis. and their attitude towards old age . found relevant during the study STUDY TOOLS: Predesigned . sadness etc. one subcentre will be selected from each one of the PHCs by simple random sampling. To ascertain the prevalence of the common mental morbidities plaguing the elderly like depression.coronary artery diseases etc ). PHCs consist of 6 subcentres. which has four PHCs under it viz. pretested schedule Cross-sectional design. 3. Secondly. STUDY POPULATION : The study population comprises of the individuals aged 60 STUDY PERIOD : One year which includes the period for data collection and SAMPLE SIZE : All the individuals who are aged 60 years and above and are SAMPLE DESIGN : The Amdanga block comprises of four PHCs. Amdanga. To assess the lifestyle factors like smoking. alongwith their notion of their quality of life . • STUDY DESIGN : Community based descriptive epidemiological study with a PARAMETERS TO BE STUDIED : Prevalence of morbidity among the geriatric population including cardiovascular ailments (viz. residing permanently at the four selected villages will be taken as the study population. Berberia. 7. Factors. Adhata and Maricha. musculo-skeletal disorders. if any . • • • 8. • To know their health care seeking behavior . lonelinesss. Each of the 4 years and above . alcoholism. who are permanent residents of the selected villages of the Amdanga block. neurological ailments. 3 . dementia etc. Firstly. one village will be randomly selected from each of the chosen subcentres again by the method of simple random sampling. 4. hypertension . 5. Effort is made such that the study population is representative of the whole Amdanga block.Amdanga BPHC. 2. 6. For ethical reasons it is proposed that all the individuals aged 60 years and above residing in these 4 selected villages will be included as the study population . ocular diseases and other disorders • Prevalence of psycho-social problems amongst the elderly like feeling of neglect.

it showed pains and joint aches to be the most prevalent morbidity (43. percussion hammer Torchlight. STUDY TECHNIQUE : The purpose of the study will be explained to each subject and an verbal informed consent will be sought from the subjects included in the study. various studies have been conducted with the aim to assess the morbidity pattern amongst the elderly people . This is in contrast to another study set in urban Udaipur. measuring tape ( both steel & tailor’s tape) Stethoscope. though ocular morbidity (70%) accounted for the most common group of systemic diseases. laboratory reports etc. The study subjects will be interviewed with the help of the predesigned and pretested schedule. A year long study was conducted in rural Tamil Nadu in 2002-03 by Purty AJ et al of the Dept.4%) followed by chewing and dental problems . Significantly. so that appropriate measures to cater to their specific health needs can be put to place. 10. sphygmomanometer. where available will be done. 512 Hz tuning fork Psychological scales like Geriatric depression scale. Clinical Dementia Rating Scale etc. PLAN FOR ANALYSIS OF DATA : Analysis of the data will be done with the help of appropriate statistical methods. Review of the secondary data.77 per person. conducted by Prakash R et al which revealed hypertension (48%) as the most prevalent disease. 4) REVIEW OF LITERATURE: As an assertion of the growing socio-demographic importance of the geriatric population both in developed and developing countries. Secondary data like doctors’ prescriptions. ADL scale. of Community Medicine of Pondicherry Institute of Medical Sciences. will be examined clinically for any detectable morbidity and psychological evaluation will be done with the help of appropriate psychological questionnaire and scales.• • • • • 9. Digital weighing machine. This was followed by psycho-social problems (42%) in 4 . This study revealed the quantum of diseases in an elderly person to be about 2. hospitalisation records.

Mangalore.This is in contrast to the findings by Prakash R et al which reported that 17. The unfavourable attitude was more prominent among females than in males. 5) REFERENCES: 1.3% of the respondents felt neglected by their family.3%).both sexes. Noticeably only about 35. 5 .4% thought that they were a burden to the family. welfare schemes while only a meager 14. The study by Lena A et al also focused on the psycho-social problems faced by the elderly and their attitude towards old age . Also this study showed the sex-wise distribution of the morbidity pattern and expectedly females accounted for a higher percentage in both the two most prevalent morbidities at 54% (hypertension) and 49% (psycho-social problems).7% of the elderly individuals were aware of the Govt. Prakash R et al in their study found that loneliness (20%) was the main cause for feeling sad in the elderly. While the study by Lena A et al reported that poverty and financial constratints was the principal cause of sadness (48%) amongst the elderly .6% in both sexes combined. showed corroborative data . followed by a feeling of neglect by the family members. Significantly nearly half of the subjects felt neglected by their family members while 36.6% actually utilized the geriatric welfare services. with hypertension (59. In comparison to the study by Purty AJ et al the prevalence of musculo skeletal disorders was only 14. Another study conducted by Lena A et al in the field practice area of Kasturba Medical College .1%) as the most prevalent disease followed by osteoarthritis (41.

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