Morbidity pattern in geriatric population attending medicine outpatient department in a tertiary care center

 

Karthik N¹, K V Giriraja^2*

 

 

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.

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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