Health Problems and Disability of Elderly Individuals in Two Population Groups from Same

© JAPI • VOL. 54 • JULY 2006 www.japi.org 539

Original Article

Health Problems and Disability of Elderly Individuals

in Two Population Groups from Same Geographical

Location

GK Medhi*, NC Hazarika**, PK Borah*, J Mahanta***

Abstract

Objective : To compare morbidity, disability (ADL-IADL disability) along with behavioral and biological

correlates of diseases and disability of two elderly population groups (tea garden workers and urban dwellers)

living in same geographical location.

Methods : Two hundred and ninety three and 230 elderly from urban setting and tea garden respectively aged

> 60 years were included in the study. Subjects were physical examined and activity of daily living instrumental

activity of daily living (ADL-IADL) was assessed. Diagnosis of diseases was made on the basis of clinical

evaluation, diagnosis and/or treatment of diseases done earlier elsewhere, available investigation reports,

and electrocardiography. Hypertension was defined according to JNC-VI classification. BMI (weight/height2

)

was calculated. Logistic regression analysis was performed to see the impact of important background

characteristics on non-communicable diseases (NCD) and disability.

Results : Hypertension (urban - 68% and tea garden - 81.4%), musculoskeletal diseases (urban - 62.5% and

teagarden - 67.5%), COPD and other respiratory problems (urban - 30.4% and tea garden - 32.2%), cataract

(urban 40.3% and tea garden - 33%), gastro-intestinal problems (urban - 13% and tea garden - 6.5%) were

more commonly observed health problems among community dwellings elderly across both the groups.

However in contrast to urban group, serious NCDs like Ischaemic Heart Disease (IHD), diabetes were yet to

emerge as health problems among tea garden dwellers. Infectious morbidities, undernutrition and disability

(ADL-IADL disability) were more pronounced among tea garden dwellers. Utilization of health service by tea

garden elderly was very low in comparison to the urban elderly. Both tea garden men and women had very

high rates of risk factors like use of non-smoked tobacco and consumption of alcohol. On the other hand,

smoking and obesity was more common in urban group. Most morbidities and disabilities were associated

with identifiable risk factors, such as obesity, tobacco (smoked and non-smoked) and alcohol consumption.

Educational status was also found to be an important determinant of diseases and disability of elderly

population. Age showed a J-shaped relationship with disability and morbidity. Sex difference in health

status was also detected.

Conclusion : This study highlights the physical dimension of health problems of elderly individuals. Social

circumstances and health risk behaviours play important role in the variation of health and functional status

between the two groups. Life-style modification is warranted to prevent onset of chronic diseases. To improve

quality of life, rectification of poor health status through affordable health service for disease screening and

better management of illness, nutritional improvement and greater health awareness are necessary particularly

among low socio-economic group. Low-cost intervention like cataract surgery could make a difference in the

quality of life of elderly Indian. ©

ahead for health care in coming years is to ensure the

quality of life to a large group of elderly population.

However, to address the healthcare needs of this

growing numbers of vulnerable and heterogeneous

population, reliable information about their health

problems from different social settings is still lacking in

India. Functional health status greatly influences quality

of life at old age. Population based data on health

*Research Officer,; **Deputy Director; ***Director, Research

Officer, Regional Medical Research Centre, NE Region, ICMR,

Dibrugarh. Received : 19.5.2004; Accepted : 20.4.2006

INTRODUCTION

Population around the world is growing old at high

rate with increasing life-expectancy. The challenge