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Determinants of disability among the elderly population in a rural south Indian community: the need to study local issues and contexts

Published online by Cambridge University Press:  21 September 2011

A. S. Duba ,
A. P. Rajkumar ,
M. Prince  and
K. S. Jacob
A. S. Duba
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
A. P. Rajkumar
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
M. Prince
Affiliation:
Institute of Psychiatry, London. UK
K. S. Jacob*
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
*
Correspondence should be addressed to: K.S. Jacob, Professor of Psychiatry, Christian Medical College, Vellore-632002, Tamil Nadu, India. Phone: +91 416 228 4513; Fax: +91 416 226 2268. Email: ksjacob@cmcvellore.ac.in.
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Abstract

Background: Disability among the elderly is a cause of significant burden. There is dearth of relevant research from low- and middle-income countries. We aimed to establish the nature and factors associated with disability among the elderly in a rural south Indian community.

Methods: We recruited 1000 participants aged over 65 years from Kaniyambadi block, Vellore, India. We assessed their disability status, sociodemographic profile, psychiatric morbidity, cognitive functioning and anthropometrics using the following structured instruments: WHO Disability Assessment Scale II, Geriatric Mental State, Community Screening Instrument for Dementia, and Neuropsychiatric Inventory. We employed appropriate multivariate statistics to study the factors associated with a higher level of disability and to determine the population attributable fractions for various modifiable risk factors.

Results: Advanced age, illiteracy, hunger, poor nutrition, arthritis, hearing impairment, gastro-intestinal and respiratory diseases, dementia and travel costs to primary health facilities increased the risk of disability significantly. Hypertension, diabetes and depression were not associated with disability. Modifiable social determinants and medical diseases together contributed to disability in this population.

Conclusion: Locally relevant social determinants combine with prevalent medical diseases to produce the disability burden among elderly. There is a need to focus on local contexts and modifiable risk factors to design locally appropriate public health policies and interventions.

Keywords

disability evaluationdepressiondementiaincidence rate ratiopopulation attributable prevalence fraction
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 333 - 341
Copyright
Copyright © International Psychogeriatric Association 2011

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