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Geriatrics
STUDY ON HEALTH PATTERNS & AWARENESS

2nd Proff. | Social & Preventive Medicine | 22- November

Project Made by: -
SARVPREET SINGH
SHUBHAM MITTAL
SONIT KAUSHAL
SULABH MALHOTRA
SURAJ KUMAR
 Index
Sr. Title Page No.
No.
1. Introduction 2
2. Aims & Objectives 4
3. Review of Literature 5
4. Materials & Methods 10
5. Observations & Discussions 11
6. Summary & Conclusions 24
7. Recommendations 25
8. Bibliography 26
9. Annexure I 27
10. Annexure II 28

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 Introduction
Geriatrics, or Geriatric Medicine, is a specialty that focusses on
healthcare of elderly people. It aims to promote health by treating
diseases & disabilities in older adults. A doctor who specializes in
treatment of elderly people is called a Geriatrician. The term
Geriatrics comes from “geron” meaning old & “iatros” meaning
“healer”. However, geriatrics is sometimes called Medical
Gerontology.
Geriatrics differ from standard adult medicine because it focusses on
the unique needs of elderly person. The aged body is different
physiologically from the younger adult body, & during old age, the
decline of various organs becomes manifest. The appearance of
symptoms depends on the remaining healthy reserves in the organs.
Geriatrics may be defined as
“The branch of medicine concerned with the diagnosis, treatment
& prevention of disease in older people & the problems specific to
aging”
Another aspect of gerontology is social gerontology which was born
on the hands out of the instincts of humanitarian & social attitudes
& on the other out of the problems set by the increasing number of
old people.
Experimental Gerontology is concerned with research into the basic
biological problems of ageing into its physiology, biochemistry,
pathology & psychology.
India is in a phase of demographic transition. As per the 1991 census,
the population of the elderly in India was 57 million as compared to
20 million in 1951. There has been a sharp rise in the number of
elderly persons between 1991 & 2001 & it has been estimated that
by the year 2050, the number of elderly people would rise to about
324 million.

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India has acquired the name of “Ageing Nation “since 7.7 % of its
population is more than 60 years old.
This demographic transition is attribute to the decreasing fertility &
mortality rates due to the availability of better health care services.
It has been observed that reduction in mortality is higher than
reduction in fertility, resulting in more individuals reaching the
senior citizens tag.
There has been a sharp decrease in the crude death rate from 28.5
during 1951-1961 to 84 in 1996. On the other hand, the crude birth
rate for the same time period for the same time fell from 47.3 in1951
to 22.8 in 1996.
The current statistics for the elderly in India gives a prelude to a new
set of medical, social & economic problems that could arise if a
timely initiative in this direction is not taken by the program
managers & the policy makers.

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 Aims & Objectives

1. To collect data regarding social, financial & medical status of

geriatric population in the region.
2. To analyze the data in form of master charts, pie charts, bar
graphs etc. & give recommendations on the basis of data so
obtained.

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 Review of Literature
Ageing is a natural process. Sir James Sterling Ross once quoted, “You do not
heal old age, you protect it, promote it & extend it”. Old age should be
regarded as a normal, inevitable biological phenomenon. The study of the
physical and psychological changes which are incident to old age is called
gerontology. The care of the aged is called clinical gerontology or geriatrics.
Experimental gerontology is concerned with research into the basic biological
problems of ageing, into its physiology, biochemistry, pathology and
psychology. There is ample scope for research into the degenerative and other
diseases of old age; their treatment in hospital and general practice; and finally
into preventive geriatrics and the epidemiology of conditions affecting the
aged.
Discoveries in medical science and improved social conditions during past
few decades have increased the life span of man. The expectation of life at
birth in developed countries is over 70 years. The age structure of the
population in the developed countries has so evolved that the numbers of old
people is continually on the increase. These trends are appearing in all
countries where medical and social services are well developed and the
standard of living is high. In the year 2002, there were an estimated 605
million old persons in the world, of which 400 million were living in low-
income countries. Italy and Japan have the highest proportion of older persons
(about 16. 7 per cent and 16 per cent respectively in the year 2003). By 2025,
the number of elderly people is expected to rise more than 1.2 billion with
about 840 million of these in low-income countries. In India, although the
percentage of aged persons to the total population is low in comparison to the
developed countries, nevertheless, the absolute size of aged population is
considerable. For the year 2010 the estimates are 8 per cent of total population
were above the age of 60 years, and is likely to rise to 19% by 2050. This
profound shift in the share of older Indians, brings with it a variety of social,
economic and healthcare policy challenges.
No one knows when old age begins. The "biological age “of a person is not
identical with his "chronological age". It is said that nobody grows old merely
by living a certain number of years. Years wrinkle the skin, but worry, doubt,
fear, anxiety and self-distrust wrinkle the soul. While ageing merely stands for
growing old, senescence is an expression used for the deterioration in the
vitality or the lowering of the biological efficiency that accompanies ageing.

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With the passage of time, certain changes take place in an organism. These
changes are, for the most part deleterious and eventually lead to the death of
the organism. Our knowledge about the ageing process is incomplete. We do
not know much about the disabilities incident to the ageing process. However,
the following are some of the disabilities considered as incident to it; (a) senile
cataract, (b) glaucoma, (c) nerve deafness, (d) osteoporosis affecting mobility,
(e) emphysema, (f) failure of special senses, (g) changes in mental outlook.
This list is not exhaustive; we need to know a lot more about the disabilities
incident to the ageing process.
Cardiovascular diseases are the major causes of death in the developed
countries. A reduction of body weight and modification of the habits of life
are needed to decrease the strain on heart and blood vessels. By these, it is
possible to lead a longer and more useful life.
The danger of cancer looms large past middle life. In the developed countries,
cancer is a leading cause of death. The incidence of cancer rises rapidly after
the age of 40. Cancer of the prostate is common after the age of 65.
Accidents are a health problem in the elderly. The bones become fragile due
to a certain amount of decalcification as a result of which they break easily.
Accidents are more common in the home than outside. Fracture neck of femur
is a very common geriatric problem.
Diabetes is a long-term illness due to faulty carbohydrate metabolism. It is a
leading cause of death as the population grows older. About 75 per cent of the
diabetics are over 50 years of age.
A wide range of articular and non-articular disorders affect the aged fibrositis,
myositis, neuritis, gout, rheumatoid arthritis, osteoarthritis, spondylitis of
spine, etc. These conditions cause more discomfort and disability than any
other chronic disease in the elderly.
In the upper decades of life, respiratory diseases such as chronic bronchitis,
asthma, emphysema are of major importance.
Enlargement of the prostate, dysuria, nocturia, frequent and urgency of
micturition are the common complaints.
Impaired memory, rigidity of outlook and dislike of change are some of the
mental changes in the aged. Reduced income leads to a fall in the living
standards of the elderly; it does have mental and social consequences.

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Between 40 and 50, there is cessation of reproduction by women and
diminution of sexual activity on the part of men. During this phase, physical
and emotional disturbances may occur. Irritability, jealousy and despondency
are very frequent.
Emotional disorders result from social maladjustment. The degree of
adaptation to the fact of ageing is crucial to a man's happiness in this phase of
life. Failure to adapt can result in bitterness, inner withdrawal, depression,
weariness of life, and even suicide.
People can do a great deal to influence their individual risk of developing
many of the diseases of later life by paying careful attention to lifestyle factors.
By adopting a healthier lifestyle, the risk of a whole range of diseases can be
reduced.
A good diet reduces the chances of developing the diseases of old age. As
countries rapidly develop economically, diets and lifestyles change
considerably and over nutrition replaces undernutrition. One of the problem is
excessive fat intake. Saturated fats and trans-fatty acids, have been linked to
raised cholesterol levels in the blood, leading to increased risk of
cardiovascular diseases. People should eat healthy diet since very early age to
avoid or delay diseases. The diet should be balanced with less saturated fats
and oils; should contain lots of fruits and vegetables; salt and sugar should be
less; include plenty of calcium rich food; eat high fibre diet.
Exercise helps maintain good health, as it helps to control weight, improves
emotional well-being and relieves stress, improves blood circulation,
increases flexibility, lowers blood pressure, increases energy levels, improves
balance and thus reduces the dangers of falls, lowers blood sugar levels thus
helps in diabetes, improves bone density and thus helps prevent osteoporosis.
Overweight and obesity have become major problem worldwide and it
contributes to many diseases of later life. Obesity is an important factor in
heart disease, stroke, hypertension, diabetes, arthritis (especially in the knees),
and breast cancer.
It is estimated that 22 per cent of men and 18 per cent of women aged 65 to
74 years in developed countries are smokers. Though this figure is lower than
among younger adults, older people have usually smoked for longer, have
been and continue to be heavy smokers, and are likely to have chronic
diseases, with smoking causing further deterioration. Former smokers live
longer than continuing smokers; smoking cessation at the age of 50 years

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reduces the risk of dying within the next 15 years by 50 per cent. For some,
but not for all former smokers, the risk of developing smoking-related diseases
reverts to that of lifelong non-smokers. Drinking beyond a specified amount
contributes to a number of later life diseases. Research suggests that sensitivity
to the effect of alcohol increases with age. Older people achieve a higher blood
alcohol concentration, than younger people after consuming an equal amount
of alcohol. This is largely as a result of the age-related decrease in the amount
of body water which dilutes alcohol. While younger people are likely to
develop tolerance to increasing amount of alcohol, older people have a
decreased ability to develop this tolerance . Drinking is linked to liver
diseases, stomach ulcers, gout, depression, osteoporosis, heart disease, breast
cancer, diabetes and hypertension.
People who become socially isolated who rarely go out, do not join in the
community activities, have few friends. or do not see much of their family -
are less healthy. Getting out and keeping involved with others creates a sense
of belonging. Mixing with other people of similar age, at similar stage of life
or perhaps with similar health concerns, can help people realize that they are
not alone. The support gained from others can be important in recovering from
illness. The main causes of illness are arthritis, cataract, bronchitis,
avitaminosis, ear diseases, hypertension, diabetes, rheumatism, helminthic
infestations, accidents, etc. The findings of an ICMR survey conducted in
1984-85 of elderly persons over 60 years of age attending geriatric clinics in
rural areas in which visual impairment topped getting major share of 88%.
Next was locomotive disorder, joints , muscles sharing 40% of the occurrence.
Neurological Complaints have a share of 18.7%.
The government of India announced a National Policy on older persons
in January 1999. This policy identifies principal areas of intervention as
financial security, health care, nutrition, shelter, education, welfare, protection
of life and property of older citizens. The policy provides for a broad
framework for collaboration and cooperation, both within as well as between
governmental and nongovernmental agencies. An important thrust in the
policy is on active and productive involvement of older persons, and not just
their care. A national council for older persons (NCOP) was constituted to
operationalize the policy. An integrated programme for older persons has been
formulated by revising the earlier scheme of assistance to voluntary
organizations for programmes relating to the welfare of the aged. The
objective is to promote a society for all ages, to empower and improve the
quality of life of older persons. The programme for the first time recognizes

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formation of self-help groups, association of older persons for advancement
of their rights and utilization of their experience and services.
Potential for disease prevention in the elderly for older individuals, a great
proportion of the disease burden derives from existing conditions, whether this
burden is measured by prevalence rates, indicators of morbidity, disability,
mortality, or by health and long term care utilization. In addition, older people
with disability, resulting from chronic diseases, appear at high risk of acute
illness and injuries. The evidence arrayed of the role of existing and often
immutable disease argues for the importance of secondary and tertiary
prevention, in combination with primary screening or prevention for this
population. Among older individuals, categories of conditions, occurrences,
and illnesses exist in a variety of combinations, and risk factors as well as
disease sequelae often overlap.

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 Methods & Materials
A demographic study was conducted in the urban slum area of Mustafabad
on prescribed 2 days visit by the department. A preformed questionnaire was
distributed among 40 students. Each student was allotted 5 houses by the
department for the purpose of data collection. The data so collected from
houses where Geriatric people were there was compiled. Houses which were
locked or there was no geriatric person to be questioned will not be
considered in final data entry. The data so collected was arranged in tables,
pie charts, bar graphs etc.

10 | P A G E
 Observation & Discussions
Distribution of Geriatric Population on the Basis
of Working Status
Table 1
Working Status Frequency Percentage
Working 54 38%
Not Working 88 62%
Total 142 100%

38% of the geriatric population surveyed was working whereas 62% didn’t.

11 | P A G E
Distribution of Population on the basis of Reason
for Working :-
Table 2
Category Frequency Percentage
Financial Burden 29 53.7%
To remain busy 15 27.78%
Others 10 18.5%
Total 54 100%

27.78% of the working population stated they wanted to remain busy, so

were engaged in the job, whereas majority (65.9) work for financial aim.

12 | P A G E
Distribution of Health Problems in Geriatric
Population:-
Table 3
Category Frequency Percentage
Visual 69 48.6%
Locomotory 55 38.7
Neurological 2 1.4%
Cardiovascular 34 23.9%
Respiratory 14 9.9%
Others 40 28.2%
Total 142 100%

Visual problems lead the chart with 48.6% of the prevalence, followed by
Locomotory problems (38.7%). Cardiovascular, Respiratory & Neurological
problems occupy 23.9%, ,9.9% & 1.4% of total.

13 | P A G E
Distribution of Treatment Status in Geriatric
Population:-
Table 4
Category Frequency Percentage
Taking treatment 93 65.5%
Not taking treatment 49 34.5%
Total 142 100%

65.5 % of people were taking treatment for their problems.

14 | P A G E
Distribution of Patients on the basis of preference
to various Healthcare Sectors:-
Table 5
Category Frequency Percentage
Government 51 54.8%
hospital/Dispensary
Private Hospital 31 33.3%
Chemist 11 11.8%
Total 93 100%

Mostly, people are dependent on Government Sector for their medical

treatment.

15 | P A G E
Distribution of Respondents on the basis of
Financial Status :-
Table 5
Category Frequency Percentage
Capable 95 66.69%
Not Capable 47 33.1%
Total 142 100%

More than half of population (66.69%) is financially capable of carrying out

treatment.

16 | P A G E
Distribution of Incidence of General Geriatric
Problems: -
Table 6
Medical Incidence Percentage Percentage
Problem Frequency of those of Total
having Respondents
problem surveyed
Insomnia 44 38.9% 30.9%
Stress 38 33.62% 26.7%
Lack of 27 23.89% 19.01%
Appetite
Substance 4 3.5% 2.8%
Abuse
Others 29 Nil 20.4%
No

Insomnia is the most common problem, followed up by Stress, Lack of

Appetite.

17 | P A G E
Distribution of Geriatric Population based on
Relation with children : -
Table 7
Relation Frequency Percentage
Good 118 83.1%
Not Good 3 2.1%
Satisfactory 19 13.4%
No response 2 1.4%
Total 142 100%

Most of the families enjoy a keen connection between the two generations,
as they respond that they share a good relationship with children.

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Distribution of Respondents on the basis of
Employment Status of Children : -
Table 8
Status Frequency Percentage
Working 132 93%
Not Working 10 7%
Total 142 100%

Nearly all of the people surveyed had their children employed.

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Distribution of Respondents on the basis of Social
Activity : -
Table 9
Social Status Frequency Percentage
Active Socially 9 6.3%
Not Active Socially 133 93.7%
Total 142 100%

Most of the people aren’t active socially.

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Distribution of respondents having unfulfilled
desire.
Table 10
Category Yes No Total
Frequency 51 91 142
Percentage 35.9% 64.1% 100%

Most people are satisfied with the life they are leading.

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Distribution of Respondents on the basis of
Awareness about Health Schemes
Table 11
Aware Frequency Percentage
Aware 23 16%
Not Aware 119 84%
Total 142 100%

Majority of people have no idea of government schemes aimed at “their

benefit”

22 | P A G E
Distribution of Respondents on the basis of awareness of
Government Programs : -
Table 12
Policy Frequency Percentage
NPHCE 2 1.4%
NPOP 3 2.1%
NOAP 15 10.5%
Others 3 2.1%
Don’t Know 119 84%
Total 142 100%

NPHCE:- National Policy for Healthcare of Elderly

NPOP:- National Policy for Old People
NOAP:- National Old Age Pension Scheme

23 | P A G E
 Summary & Conclusions
Among them, 38% of the geriatric population surveyed was working. On
being asked the reason of them working, 53.7 % of them quoted financial
burden. 27.78% of the working population stated they wanted to remain
busy, so were engaged in the job.
Coming to the medical status of population, visual problems tops the chart
with 48.6% occurrence in the region. Locomotory problems followed up
with 38.7% occurrence. Cardiovascular, Respiratory & other problems
occupy 23.9%,9.9% &28.2 % of the total distribution.
On being asked if they were taking any treatment for the problems they were
suffering at that time, 65.5% population positively responded to the question.
54.8% of such treatments are procured in Government Hospitals, 33.3% in
Private Hospitals & 11.8& by Chemists.
Quantitatively, 66.9% of the respondents stated that they were capable of
affording the treatment they procure.
Talking of General problems, most people suffer from Insomnia (38.9%),
33.62% take too much stress & 3.5% of the population was addicted to some
substance abuse.
Satisfactorily, 83.1% of such people share a Good relationship with their off
springs. 93% of the total have their children working to earn a living.
A mere 6.3% of the Geriatric Population was associated with some kind of
social organization, be it religious or others.
35.9% of the individuals stated that they were happy & satisfied with the life
they are leading.
A meagre 16.19% population was known to any Government Schemes
aimed to benefit Geriatric Population.

24 | P A G E
 Recommendations
After analyzing the data so compiled, following
recommendations can be made for the concerned
authorities to look upon: -
1. Government should roll out pension plans & financial
helps to such people effectively.
2. Dedicated Ophthalmic & Orthopedic medical services
should be rolled out & it should be ensured that these
services are reaching such population in an easily
procurable & affordable manner.
3. Awareness camps and door to door counselling should be
carried out to bring them to hospitals & relieve them from
sufferings.
4. The infrastructure & policies of Government hospitals
should be improved to bring an affordable treatment to
the rest of people too.
5. Community Centers, Fitness Clubs for the Elderly should
be opened up to improve the social life.
6. This will be by far the most important recommendation to
the authorities to promote awareness of the policies they
frame in the people for whom they are framing. 83% of
population has no idea of what government is doing for
them which is seriously a shameful number & needs to be
improved.

25 | P A G E
 Bibliography
The data collected in this project is adapted from
1. Park’s Textbook of Preventive & Social Medicine
2. National Council for Biotechnology Information
(www.ncbi.nlm.nih.gov)
3. World Health Organization
(http://www.who.int/ageing/projects/tegeme/en/)
4. Textbook of Community Medicine by Suryakantha
5. Indian Statistical Institute
(mospi.nic.in)
6. Eurekalert.org
https://www.eurekalert.org/pub_releases/2018-11/ags-hpv111918.php

26 | P A G E
 Annexure-I
Demographic Profile:- Geriatrics
Name: -…………………………………………………. (a) Insomnia
(b) Stress
Age:-………… Sex:- M/ F/
(c) Loss of Appetite
Others
(d) Substance of Abuse
Q1.Are you currently working? (e) Others
(a) Yes
(b) No Q6.What kind of relationship do you share
with your children?
If yes, Reason for working (a) Good
(a) Financial burden (b) Not Good
(b) To remain busy (c) Satisfactory
(c) Others (d) No Response
Q2.Are you suffering from any health
problem? Q7.Are your children working?
(a) Visual (a) Yes
(b) Neurological (b) No
(c) Locomotory
(d) Cardiovascular Q8.Are you working for any social
(e) Respiratory organization?
(f) Others (a) Yes
Q3.Are you taking any treatment for your (b) No
health problems?
(a) Yes Q9.Do you have any unfulfilled desire?
(b) No (a) Yes
(b) No
If Yes, which place of procurement of
treatment do you prefer? Q10. Are you aware of any government
(a) Government Dispensary/Hospital health services for elderly?
(b) Private Hospital (a) Yes
(c) Chemist (b) No
(d) Others
Q4.Are you financially capable of carrying If Yes, please state :-
out treatment? (a) National Programme for Health
(a) Yes Care of Elderly (NPHCE)
(b) No (b) National Policy for Older
Persons(NPOP)
Q5.Are you suffering from any of these (c) National Old Age Pension
problems? Scheme(NOAP)
(d) Others

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 Annexure II
1. Master Charts
2. Grand Chart

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