Abstract
BackgroundEighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. We studied these among people aged 65 years and over living in urban catchment areas in Chennai, south India.MethodsIn a prospective population cohort study, 1005 participants were followed-up after three years. Baseline assessment included sociodemographic and socioeconomic characteristics, health behaviours, physical, mental and cognitive disorders, disability and subjective global health.ResultsAt follow-up, 257 (25.6%) were not traced. Baseline characteristics were similar to the 748 whose vital status was ascertained; 154 (20.6%) had died. The mortality rate was 92.5/1000 per annum for men and 51.0/1000 per annum for women. Adjusting for age and sex, mortality was associated with older age, male sex, having no friends, physical inactivity, smaller arm circumference, dementia, depression, poor self-rated health and disability. A parsimonious model included, in order of aetiologic force, male sex, smaller arm circumference, age, disability, and dementia. The total population attributable risk fraction was 0.90.ConclusionA balanced approach to prevention of chronic disease deaths requires some attention to proximal risk factors in older people. Smoking and obesity seem much less relevant than in younger people. Undernutrition is preventable. While dementia makes the largest contribution to disability and dependency, comorbidity is the rule, and more attention should be given to the chronic care needs of those affected, and their carers.
Highlights
Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause
Almost 80% of the world's deaths occur in low and middle income countries (LMIC), where estimation of cause of death is difficult, since most die at home without prior contact with health care professionals [1]
In a cohort study of socioeconomically disadvantaged older people in and around Asan City in South Korea, male gender and poor self-rated health were the main predictors of mortality [7]
Summary
Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. Mortality rates were stable among older people in contrast to the secular decline in younger age groups Those with better education and higher socioeconomic status experienced lower mortality, as did those living with children. In a cohort study of socioeconomically disadvantaged older people in and around Asan City in South Korea (a recently developed country), male gender and poor self-rated health were the main predictors of mortality [7]. Ischaemic heart disease and stroke predicted mortality in men only
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
