European Journal of Cardiovascular Medicine

The global and Indian demographic trend shows that, with passage of time, countries have experienced ageing of population with increase in proportion of older persons, thus creating a burden on the working age group. Census 2011, Sample Registration System, and other studies, have shown following demographic changes in India.1India’s elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers.

In India, the proportion of the population aged 60 years or more has been increasing consistently over the last century. In 1901 the proportion of the population aged 60 years  or over of India was about 5 percent.²

The population of the elderly is getting older as well as representing a larger percentage of the total population. The elderly group that is expanding the fastest is the "oldest old". The demands of this group are expected to rise significantly in the twenty-first century since their levels of disease and impairment are higher than those of other younger age groups³

OBJECTIVE OF THE STUDY:

1. To assess morbidities amongst the elderly in the study area.
2. To determine the nutritional status of the elderly in the rural areas.
3. To study the socio demographic factors influencing the health care seeking behaviour amongst the elderly

Study Type: Community-based, Cross-sectional study. Study Population: Elderly Population above 60 years of age. Study Area:Villages under Titaguri,Dotma & Balajan, kokrajhar Study Duration: November 2024 to January 2025. Sample Size calculation: Sample size was calculated based on study named Barua K, Borah M, Deka C, Kakati R. Morbidity pattern and health-seeking behavior of elderly in urban slums: A cross-sectional study in Assam, India. J Fam Med Prim Care. 2017;6(2):345–50 ,Taking the prevalence of diabetes mellitus (24%), among the elderly in urban settlements from a study in Assam in 20174, 95% confidence interval, and absolute error as 5%, the sample size is calculated to be 291.84, using the formula n=4pq/ l2 Where p= Prevalance of the study q=(1-p) l=5% The sample size was rounded off to300. This community-based cross-sectional study was conducted among persons aged 60 years and above, in rural areas in the Kokrajhar district, Assam The kokrajhar rural area of Titaguri,Dotma and Balajan will be chosen from where 25 nos of villages shall be randomly selected .From each village, 12 nos of elderly respondent are taken for the study taking into consideration of 10% of non responders. During the study, informed consent has been taken from the respondents and household visits are conducted for completing the study. Ethical Clearance: Ethical clearance has been obtained from the Institutional Ethical Committee Inclusion Criteria: People aged 60 years and above, who were permanent resident of the study place and gave consent and volunteer to participate to be included. in this study, People aged 60 years and above of Kokrajhar District should be residing for more than 6 months . Exclusion Criteria: Subjects not willing to participate in the study 2) Those with known psychiatric illness 3) Individuals having serious morbidity Consent: Informed consent will be taken from all the participants before data collection and confidentiality will be maintained. Data collection: A pretested semi structured questionnaire was administered and required information was obtained from the elderly subjects using the interview method by house to house visit. Morbidity was assessed by history taking, clinical examination, reviewing past medical records and treatment taken by the elderly. For measuring the activities of daily living, the Katz index of ADL shall be used. Activities of daily living are tasks of self maintenance, mobility, communication, home management and community living that enables an individual to achieve personal independence. In the study, the main six basic items of ADL viz. bathing, dressing, going to toilet, transferring, continence and feeding. Data analysis– The data obtained shall be entered in Microsoft Excel. Analysis will be done using SPSS version 16 and descriptive interpretation of data was done in the form of percentages. The Chi square test will be used as test of significance. Data shall be entered in MS excel sheet. Qualitative data will be expressed in proportions and chi-square test shall be applied. Mean and standard deviation will be use for quantitative data. Suitable tests of significance shall be applied wherever necessary.

Table 1 : Distribution of Morbidities amongst the Elderly Population

• Multiple response table

In Table 1 shows the morbidity profile of elderly people in the study area of  Kokrajhar On the basis of their history, clinical assessment, laboratory test reports, and doctors' prescriptions, it had been noted that out of 300 elderly people, 37% had hypertension, 32.33% had diabetes mellitus, 40.33% had musculoskeletal disorders, 36.67% had dental problems, 12.33% had urogenital disorders, 11% had sleep disorders, 10.33% had geriatric depression,8.33%had accidents and injuries and 6.66%had dementia. Ocular disorders(83.67%) were observed to be the most frequent morbidity followed by musculoskeletal disorders (40.33%) and hypertension (37%).

Table 2 : Distribution of Nutritional Status  of the Elderly Population

Table 2  shows that 38.7% of the elderly were with normal BMI, 24% were overweight, and 37.33% were obese with a higher prevalence in females (43.18%). Whereas 69.33% of the elderly had central obesity which means had a higher waist-to-hip ratio (WHR).

Table 3 : Distribution of Multimorbidity amongst   the Elderly Population

 Table 3 shows the incidence of multi morbidity in the study population i.e.,(2-3 diseases) is 50%, (4-5 diseases) is 26.7% and >6 diseases is 10.7%.

Regarding morbidity patterns amongst the elderly in this study, the commonest morbidity was ocular disorders (83.67%), followed by musculoskeletal disorders (40.33%), hypertension (37%), and diabetes mellitus (32.33%) (Table 1). The other health problems among them were dental problems (36.67%), hearing disorders (35%),gastrointestinal disorders(17.67%),urogenital disorders(12.33%), sleep Disorders (11%),geriatric depression(10.33%),accidents and injuries(8.33%), respiratory disorders (9.33%)and dementia(6.7%).

Similar observations were made by George LS et al. in Karnataka where alsothe commonest morbidities were musculoskeletal disorders (50.5%) and ocular disorders (50.4%). ⁵

According to the study's description of the nutritional status of the elderly, 38.7% of them were with normal BMI, 24% were overweight, and 37.33% were obese. A higher prevalence of obesity was seen in females (43.18%) than in males (29.03%). Central obesity, or a higher WHR, was present in 69.33% of the elderly. (Table 2)

Daniel et al. conducted a systematic review and meta-analysis in which they reported that the pooled prevalence of overweight/obesity among older Indians was 21.5 %.⁶

Ocular disorders were observed to be the most common morbidity among the 300 elderly (83.67%), followed by musculoskeletal disorders (40.33%), hypertension (37%), and diabetes mellitus (32.33%) in the rural areas of Kokrajhar District. A significant association with increasing age was seen with different morbidities including ocular disorders, hearing disorders, musculoskeletal disorders, urinary system disorders, dementia, dental problems, sleep disorders, and multimorbidity. Regarding the nutritional state of the elderly, it was found that 38.7% were with a normal BMI, 24% were overweight, and 37.33% were obese, with females having a higher prevalence (43.18%). Additionally, central obesity or having a higher WHR was present in 69.33% of the elderly population. Limitations of the study In the present study, all patients were interviewed so there may be subjective variation or conscious falsification regarding sensitive questions like addiction which cannot be verified. Recall bias might be present. Funding: No funding sources Conflict of interest: None declared

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2. Situation Analysis of the Elderly in India. June 2011. Central Statistics Office. Ministry of Statistics &Programme Implementation Government of India. Available from http://www.mospi.nic.in/mospi_new/ upload/elderly_in_india.pdf [accessed on 4 October2012].

3.World NRC(US) Pona RA and ND foran A. The Health of Aging Populations. In:Preparing for an Aging World:TheCase for Cross-Nationa lResearch [Internet]. NationalAcademies Press (US); 2001 [cited 2024Aug25].Available from: https://www.ncbi.nlm.nih.gov/books/NBK98373/

4. Barua K, Borah M, Deka C, Kakati R. Morbidity pattern and health-seeking behavior of elderly in urban slums: A cross-sectional study in Assam, India. J Fam Med Prim Care. 2017;6(2):345–50.

5. Chauhan S, Kumar S, Patel R, Simon DJ, KumariA. Burden of communicable and non-communicable diseases-related inequalities among older adults inIndia: a study based on LASI survey. BMC Geriatr. 2022 Oct 10;22(1):790.

6.Daniel RA, Kalaivani M, Aggarwal P, Gupta SK. Prevalence of Overweight/Obesity among Elderly Persons in India:ASystematic Review and Meta-analysis. J Prim Care Spec. 2024 Apr;5(1):22