Prevalence and Patterns of Multimorbidity Among Rural Elderly: Findings of the AHSETS Study.

Jaya Singh Kshatri,Shakti Ranjan Barik,Subrata Kumar Palo,Sanghamitra Pati,Trilochan Bhoi

doi:10.3389/fpubh.2020.582663

Jaya Singh Kshatri, Shakti Ranjan Barik + Show 3 more

Open Access

https://doi.org/10.3389/fpubh.2020.582663

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Abstract

Introduction: In India, the proportion of older population is projected to increase from 8% in 2015 to 19% in 2050 and a third of the country's population will be older adults by end of the century. Multimorbidity is common among the elderly and the prevalence increases with age. Chronic conditions are most often present as clusters and it's critical to explore the prevalent pattern of clustering for better public health strategies.Method: A cross-sectional study was conducted among 725 rural older adults (>60 years) in Tigiria block of Odisha, India. Multimorbidity status was assessed using the prior validated MAQ-PC tool. Survey was conducted using android tablets installed with open data kit software. While Euclidean distances using K-means clustering algorithm were used to estimate the similarity or dissimilarity of observations. The optimum numbers of clusters were determined using silhouette method. Data were analyzed using multiple open source packages of R statistical programming software ver-3.6.3.Result: The overall prevalence of multimorbidity was 48.8% of which dyads (25%) were the most common form, followed by triads (15.2%). The prevalence of multimorbidity was higher in females (50.4%) than males (47.4%). The optimal number of clusters was found to be 3. While arthritis alone was a separate cluster, hypertension and acid peptic disease were in another cluster and all the rest conditions were included in the third cluster.Conclusion: The cluster analysis to measure of proximity suggested arthritis, hypertension, and acid peptic disease are the diseases that occur mostly in isolation with the other chronic conditions in the rural elderly.

Highlights

In India, the proportion of older population is projected to increase from 8% in 2015 to 19% in 2050 and a third of the country’s population will be older adults by end of the century
We present the findings of the primary objective of this study which was to estimate the prevalence of multimorbidity among the rural older adults population in Tigiria block, Odisha, India, and explore the clustering and patterns of multiple chronic diseases among them
The study included a total of 725 rural older adults

Summary

Introduction

In India, the proportion of older population is projected to increase from 8% in 2015 to 19% in 2050 and a third of the country’s population will be older adults by end of the century. Multimorbidity is common among the elderly and the prevalence increases with age. Chronic conditions are most often present as clusters and it’s critical to explore the prevalent pattern of clustering for better public health strategies. A disease is said to be chronic (or long term chronic condition) when it lasts for more than 1 year and needs ongoing health care. The term multimorbidity refers to a condition where there is co-occurrence of multiple chronic conditions without taking any of the disease as the index condition [1]. Some chronic conditions are more likely to cluster than others. This may be due to biological, behavioral, or environmental factors [2]

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