|Year : 2020 | Volume
| Issue : 3 | Page : 267-270
Morbidity status and quality of life among elderly population in rural Bengaluru
Pradeep Tarikere Satyanarayana, Jatin Krishna Reddy
Department of Community Medicine, SDUAHER, SDUMC, Kolar, Karnataka, India
|Date of Submission||26-Feb-2020|
|Date of Decision||15-May-2020|
|Date of Acceptance||11-Jun-2020|
|Date of Web Publication||28-Jul-2020|
Dr. Jatin Krishna Reddy
Department of Community Medicine, SDUAHER, SDUMC, Kolar, Karnataka
Source of Support: None, Conflict of Interest: None
BACKGROUND: Elderly people may suffer from the multiple health disorders and are vulnerable for many physical and mental disturbances. Quality of life (QOL) in elderly population can be affected by many health factors.
AIMS: The aim of the study is to identify the morbidity pattern and to assess the QOL among elderly.
MATERIALS AND METHODS: The sample size calculated was rounded off to 230. Elderly participants aged above 60 years were interviewed after taking informed written consent. A pretested semi-structured questionnaire was used to assess sociodemographic profile morbidity pattern and to assess QOL, the questionnaire is called WHO Quality of Life -Old (WHO QOL-OLD) questionnaire was used for the data collection. Settings and Design: This was a community-based cross-sectional study done in rural health training center of MVJ Medical College and Research Hospital, Hoskote, Bengaluru. Statistical Analysis Used: Descriptive statistics such as percentage were used, and independent t-test was used to compare the between various groups.
RESULTS: Among 231 study participants, 122 (52.8%) belonged to 60–65 years' age group, 126 (54.5%) were female, 130 (56.3%) were illiterate, and 119 (51.6%) were completely dependent financially on family members. The mean score and transformed facet score (TFS) of facet VI (Intimacy) were the highest, and the lowest mean score and lowest TFS were observed in facet IV (social participation).
CONCLUSIONS: Among elderly, QOL is hampered because of senescence, chronic diseases, social displacement, and financial or physical dependence. Promotion of QOL among elderly at primary health-care level needs to be planned by the policy makers.
Keywords: Elderly, quality of life, sensory abilities
|How to cite this article:|
Satyanarayana PT, Reddy JK. Morbidity status and quality of life among elderly population in rural Bengaluru. Int J Health Allied Sci 2020;9:267-70
|How to cite this URL:|
Satyanarayana PT, Reddy JK. Morbidity status and quality of life among elderly population in rural Bengaluru. Int J Health Allied Sci [serial online] 2020 [cited 2022 Aug 20];9:267-70. Available from: https://www.ijhas.in/text.asp?2020/9/3/267/290712
| Introduction|| |
Aging is an inescapable natural phenomenon of humanity. With better hospital facilities and better control of communicable diseases, the World Health Organization (WHO) expects many people can live into their sixties and beyond with ease. Because of the unbridled population aging, it is estimated that 2050 will have more than 22% of elderly as global population. Aging of the world population is about to dawn the phase of acceleration, and consequently, significant changes occur in the structure of population aging in the developing countries. It is estimated that nearly two-thirds of the total population aged 60 years and more are living in the developing countries. Old age often goes hand in hand with increasingly complex and often interrelated problems, encompassing physical, psychological, and social health. According to the WHO, the biggest killers among old age are heart disease and stroke with greatest cause of morbidity being sensory abilities (SAB), diabetes, and depression. The WHO defines quality of life (QOL) as individual's perception of their position in life in context of the culture and value systems, in which they live and in relation to their goals, expectations, standards, and concerns.”
QOL for elder person has become increasingly important to design interventions to promote healthy aging process and also identifying the factors which are relevant to the QOL in older adults. Several aspects of life are included in the term QOL as it merges social, physical, psychological, spiritual, economical, cognitional, and sexual dimensions of life. In most of the developing countries, the health-care systems are allocated with a meager fragment of the total budget for treating older adult illness having a limited access to antecedence health care and do not have a policy priority. A great number of short comings are perceived in elderly care. A very few to list are snag in coordination and continuation of care appended with the delayed detection and diagnosis of problem. Individual approach is much needed as not all older people are responsive to the care offered to them with a wide variety in the effectiveness of different health care and promotion activities. With this background, the study was started among elderly population with objectives to identify morbidity pattern and assess the QOL among elderly.
| Subjects and Methods|| |
It was community-based cross-sectional study carried in Rural Health Training Center (RHTC), field practice area of MVJ Medical College and Research Hospital, Hoskote, rural Bengaluru, from June to December 2017 for 6 months. RHTC Field practice area covers around eight villages which were included in the study. The study participants who were elderly, who were aged 60 years and above, and who were permanent residents of village were included in the study, and elderly participants who were bedridden and who were already diagnosed with any mental illness were excluded from the study. Considering the expected standard deviation (SD) of QOL score in the elderly population  to be 10.88 and tolerable error 1.5% at 95% confidence interval, the minimum sample size came out to be 201 by the formula (1.962σ2l2/), where “σ” is SD and “l” is allowable error. Taking 10% as nonresponse rate, the final sample size was calculated as 230. Snowball technique was applied to identify households having elderly population. Data regarding sociodemographic profile and morbidity status were collected using semi-structured questionnaire. For morbidity pattern, elderly participants with already diagnosed illness who are on treatment were taken into consideration, and no new attempt was made to diagnose any illness. QOL was assessed using the WHOQOL-OLD Questionnaire. Permission was taken from Information, Evidence and Research Department of WHO, Geneva, prior to the start of the study. The WHOQOL-OLD module consists of 24 Likert-scaled items assigned to six facets which are SAB, autonomy (AUT), past, present and future activities, social participation, death and dying (DAD), and intimacy. Basically, high scores represent high QOL and low scores represent low QOL. Summing the items belonging to a facet yields the raw facet score (RFS). Transferring a raw score to a transformed scale score transformed facet score (TFS) between 0 and 100 makes it possible to express the scale score in percent between the lowest (0) and highest (100) possible value. To obtain the TFS (0–100), the transformation rule applied is TFS = 6.25 × (RFS - 4). The data were collected by interview technique which lasted not more than 15 min after getting written informed consent from the participants. The data were entered into Windows Microsoft Excel and analyzed using SPSS v22 (IBM Corp), USA. Level of significance was defined with P < 0.05. To compare between various groups, independent t-test was applied. Institutional Ethics committee clearance was obtained before the start of the study.
| Results|| |
Among 231 study participants, 122 (52.8%) belonged to 60–65 years' age group, 126 (54.5%) were female, 130 (56.3%) were illiterate, and 119 (51.6%) were completely dependent financially on family members [Table 1].
|Table 1: Distribution of study participants according to Sociodemographic profile (n=231)|
Click here to view
Of 231 study participants, 157 (67.9%) had one or other chronic illness. Ninety-seven (41.9%) elderly participants had hypertension, 89 (38.5%) had Type II diabetes mellitus, 12 (5.1%) had suffered stroke, 24 (10.2%) had hypothyroidism, 6 (2.5%) had suffered congestive heart disease, 42 (18.1%) had arthritis, and 34 (14.7%) had chronic obstructive pulmonary disease [Table 2].
|Table 2: Distribution of elderly participants according to morbidity pattern|
Click here to view
[Table 3] shows the RFS and the TFSs among the study population. The mean score and TFS of facet VI were the highest (73.6) and the lowest mean score and lowest TFS were observed in facet IV (44.8) [Table 3].
|Table 3: Distribution of elderly participants according to quality of life|
Click here to view
[Table 4] shows the six facets of QOL among the study population with those with any illness and those without illness. Statistically significant difference was found in SAB, AUT, and DAD domain where those without any illness had higher scores [Table 4].
|Table 4: Comparison of quality of life among those with illness and those without illness|
Click here to view
| Discussion|| |
This was a cross-sectional community-based study carried out in RHTC area of MVJ Medical College and Research Hospital for a period of 6 months from June to December by house-to-house interview. Among 231 study participants, 122 (52.8%) belonged to 60–65 years' age group, 126 (54.5%) were female, 130 (56.3%) were illiterate, and 119 (51.6%) were completely dependent financially on family members.
Of 231 study participants, 157 (67.9%) had one or other chronic illness, 97 (41.9%) were diagnosed hypertensive, and 89 (38.5%) were diagnosed with diabetes mellitus. Among the study population, the mean score and TFS of facet VI were the highest (73.6) and the lowest mean score and lowest TFS were observed in facet IV (44.83).
The present study showed that the prevalence of 67.9% of elderly has chronic illness. A study done by George et al. showed a higher prevalence of 91% with chronic illness among elderly study participants in rural villages of Raichur. A study done by Kumar et al. in Rajasthan also showed 71% prevalence of morbidity in elderly which was similar to the present study. Various studies show similar prevalence of hypertension among elderly.,,, The current study showed higher prevalence of Type II diabetes as 89 (38.5%), which is similar to many studies., Few studies also showed lower prevalence of diabetes., The study showed overall lesser scores in all domains. The presence of any chronic illness in elderly participants showed lesser scores compared with those participants who had no illness. However, statistically significant difference was seen in three domains such as SAB, AUT, and DAD domain where those without any illness had higher scores signifying that the presence of chronic illness decreases the QOL. Various studies done to assess QOL among elderly irrespective of using standardized validated questionnaires showed that QOL scores were less in elderly and decrease as age progresses with various factors such as financial dependence, marital status, age playing a role, and presence of chronic illness also being strong determinant influencing QOL.,,,,,
The strengths of the present study were that validated WHO tool was used to assess QOL among elderly and the data were collected using interview technique. Limitations of the present study would be poor generalizability and prior mental health status assessment was not done among elderly participants as cognitive abilities start declining as age progresses.
| Conclusion|| |
Constrained economic conditions, strict cultural norms, poor educational qualifications and unutilized health care facilities added with inadequate social interactions with elderly can result in poor quality of life. Chronic diseases such as diabetes mellitus, coronary heart diseases are most common diseases in elderly people affecting the Quality of life. An old age-friendly environment should be established which would enable people of all ages to actively participate in community. Old age friendly environment will help older people to stay connected to all age group people so that it can address many issues faced by elderly population. Promotion of QOL among elderly at Primary Health care level needs to be planned by policy makers.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bartwal J, Rawat CM, Awasthi S. A community based cross-sectional study on self perception of health status and health seeking behaviour among elderly population in Haldwani block, Uttarakhand. Int J Med Sci Public Health 2016;5:1798.
Brett CE, Gow AJ, Corley J, Pattie A, Starr JM, Deary IJ. Psychosocial factors and health as determinants of quality of life in community-dwelling older adults. Qual Life Res 2012;21:505-16.
Fang J, Power M, Lin Y, Zhang J, Hao Y, Chatterji S. Development of short versions for the WHOQOL-OLD module. Gerontologist 2012;52:66-78.
Praveen V, Rani MA. Quality of life among elderly in a rural area. Int J Community Med Public Health 2016;3:754-7.
George LS, Deshpande S, Krishna Kumar MK, Patil RS. Morbidity pattern and its sociodemographic determinants among elderly population of Raichur district, Karnataka, India. J Family Med Prim Care 2017;6:340-4.
] [Full text]
Kumar V, Mital P, Harshith B, Mital P, Shekhawat A, Nawal CL. Morbidity patterns in elderly patients attending medicine department of tertiary care center. Int J Adv Med 2017;4:180-3.
Kalavathy MC, Thankappan KR, Sarma PS, Vasan RS. Prevalence, awareness, treatment and control of hypertension in an elderly community-based sample in Kerala, India. Natl Med J India 2000;13:9-15.
Banegas JR, Rodríguez-Artalejo F, Ruilope LM, Graciani A, Luque M, de la Cruz-Troca JJ, et al
. Hypertension magnitude and management in the elderly population of Spain. J Hypertens 2002;20:2157-64.
Chinnakali P, Mohan B, Upadhyay RP, Singh AK, Srivastava R, Yadav K. Hypertension in the elderly: Prevalence and health seeking behavior. N Am J Med Sci 2012;4:558-62.
Radhakrishnan S, Balamurugan S. Prevalence of diabetes and hypertension among geriatric population in a rural community of Tamilnadu. Indian J Med Sci 2013;67:130-6.
] [Full text]
Singh AK, Mani K, Krishnan A, Aggarwal P, Gupta SK. Prevalence, awareness, treatment and control of diabetes among elderly persons in an urban slum of delhi. Indian J Community Med 2012;37:236-9.
] [Full text]
Shraddha K, Prashantha B, Prakash B. Study on morbidity pattern among elderly in urban population of Mysore, Karnataka, India. Int J Med Biomed Res 2012;1:215-23.
Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, et al
. Prevalence and risk factors of diabetes in a large community-based study in North India: Results from a STEPS survey in Punjab, India. Diabetol Metab Syndr 2017;9:8.
Ravikumar P, Bhansali A, Ravikiran M, Bhansali S, Walia R, Shanmugasundar G, et al
. Prevalence and risk factors of diabetes in a community-based study in North India: The Chandigarh Urban Diabetes Study (CUDS). Diabetes Metab 2011;37:216-21.
Rajeev MM, Ajkumar VJ. Elderly in India: A quality of life of elderly persons in institutional settings. Int J Develop Res 2015;5:2845-51.
Lokare L, Nekar MS, Mahesh V. Quality of life and restricted activity days among the old aged. Int J Biol Med Res 2011;2:1162-4.
Dorji N, Dunne MP, Seib C, Deb S. Quality of life among senior citizens in Bhutan. Asia Pac J Public Health 2017;29:35-46.
Usha VK, Lalitha K. Quality of life of senior citizens: A rural-urban comparison. Indian J Soc Psychiatry 2016;32:158. [Full text]
Ganesh Kumar S, Majumdar A, Pavithra G. Quality of life (QOL) and its associated factors using WHOQOL-BREF among elderly in urban Puducherry, India. Journal of clinical and diagnostic research: JCDR 2014;8:54.
[Table 1], [Table 2], [Table 3], [Table 4]