A. N. Khan**,,
The word ‘age’ has been used by physiologists to express certain natural divisions in human development and decay. These are known as infancy, lasting to the 7th year;childhood to the 14th; youth to the 21st; and adult till 50th; and then old age. The two great factors influencing the length of life are heredity and environment. One way in which environmental conditions affect longevity is through diseases contracted in the course of life.
The topic of this year’s World Health Day, marked on 7th April 2012, was devoted to“Ageing and Health“ with the theme “Good health adds life to years”. Life expectancy is going up in most countries, meaning more and more people live longer and enter an age when they may need health care.
Healthcare is the diagnosis, treatment and prevention of disease, illness, injury and other physical and mental impairments in humans. Healthcare is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers. Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. According to WHO, a well functioning healthcare system requires a robust financing mechanism, reliable information on which to base decisions and policies; and well maintained facilities and logistics to deliver quality medicines and technologies.
Healthcare can form a significant part of a country’s economy. In 2008, the healthcare industry consumed an average of 9.0% of the GDP across the most developed OECD countries. The United States 16.0%, France 11.2% and Switzerland 10.7% of GDP, were the three top spenders.
Healthy or normal old age is attended by diminution in functional activity which corresponds with the characteristic changes of atrophy and involution in the structure of organs and tissues and of a diminished area of the capillary blood vessels. Fatigue is more readily produced; memory, especially for names, becomes less agile; and willpower, like the gait, becomes less certain. The mental outlook is largely determined by that of the individual in the past, happy and kindly, or pessimistic and uncharitable.
It is hard to draw a sharp line of demarcation between normal old age, with its limitations due to atrophic changes in the body, on the one hand and on the other hand the manifestations in the elderly resulting from past infections and diseases. Physiological old age, that is freedom from any pathological change, is agreed to be rare and it has been said that often the ‘old age itself a disease’.
Some diseases especially prone to attack the aged are diabetes, cancer, and the cardiovascular – renal group. The last is closely related to arteriosclerosis, which may affect various parts of the body, such as the kidneys, the brain and the heart.
The number of elderly in the developing countries has been growing at a phenomenal rate; in 1990 the population of 60 years and above in the developing countries exceeded that of the developed countries. According to present indications, most of this growth will take place in developing countries and over half of it will be in Asia, namely India and China contributing a significant proportion of this growing elderly.
The 2001 census has shown that the elderly population of India accounted for 77 million, while the elderly constituted only 24 million in 1961, it increased to 43 million in 1981 and to 57 million in 1991. The proportion of elderly persons in the population of India rose from 5.63% in 1961 to 7.5% in 2001 and expected to increase by 12% in 2025. The elderly population aged 70 and above which was only 8 million in 1961 rose to 29 million in 2001. The Indian population census reported 99,000 centenarians in 1961 which rose to 1,38,000 in 1991.
To assess the emerging ageing scenario of India in the first half of the 21st century, the elderly population of India has been projected for the next 50 years. The size of India’s elderly population aged 60 and above is expected to increase from 77 million in 2001 to 179 million in 2031 and further to 301 million in 2051. The number of elderly persons above 70 years are projected to increase five-fold between 2001 – 2051.
Health problems are supposed to be the major concern of a society as older people are more prone to suffer from ill health than younger age groups. Besides physical illness the aged are more likely to be victims of poor mental health, which arise from senility, neurosis and extent of life satisfaction. The study found a majority of the elderly suffering from diseases like cough (cough includes tuberculosis of lungs, bronchitis, asthama, and whooping cough as per the International Classification of Diseases), poor eyesight, anaemia and dental problems. The proportion of the sick and the bedridden among the elderly is found to be increasing with advancing age; the major physical disabilities being blindness and deafness.
The First National Sample Survey (NSS) indicated that 45% of the elderly suffered from some chronic illness like pain in the joints and cough. Other diseases noted in NSS included blood pressure, heart disease, urinary problems and diabetes. The major killers among the elderly consisted of respiratory disorders in rural areas and circulatory disorders in urban areas. Rural survey reported that around 5% of the elderly were bedridden and another 18.5% had only limited mobility. Given the prevalence of ill health and disability, it was found that dissatisfaction existed among the elderly with regard to the provision of medical aid. The sick elderly lacked proper familiar care while public health services were insufficient to meet their needs.
Among the eight chronic diseases canvassed in the NSS, close to 1/3rd of elderly reported suffering from pain in joints, followed by cough 20%, and blood pressure 10%. Less than 5% reported as suffering from piles, diabetics and cancer.
One out of two elderly in India suffers from at least one chronic disease which requires long-term medication.
*******
** Write of this Article Mr.A. N. Khan
Scientist & Former Asst. Director, NEERI, Nagpur
Disclaimer: The views expressed by the author in this feature are entirely his own and do not necessarily reflect the views of INVC.
