WHO Definition of Elderly老年人的定义Word格式文档下载.docx

WHO Definition of Elderly老年人的定义Word格式文档下载.docx

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Abstract:

Across-sectionalstudywasconductedtodeterminemorbidityprofileandpredictorsofincreasednumberofmorbiditiesamong2264elderlyattended/admittedinJeddahhealthfacilities.Results:

Aboutone-fourthofelderlyreportedpoorself-perceivedhealth,37.3%weredependentonothersintheiractivitiesand32.1%utilized>

3drugs/day.Diminishedvisionwasthecommonestcomplaintwhilethemostprevalentdiseaseswerediabetesmellitus,arthritisandhypertension.Thenumberofmorbiditiesrangedfrom1-6withameanof2.11±

1.16.Inmultivariateanalysis,thepredictorsofincreasedmorbiditieswereobesity（OR=;

95%CI=1.37-2.44）,feelingdepressed（OR=1.64;

95%CI=1.26-2.13）,advancedage,stopworkingandfemalegender.Itisrecommendedthatthereisagreatneedforincreasingelderlymedicalandsocialcare.

INTRODUCTION

Inrecentyears,therehasbeenasharpincreaseinthenumberofolderpersonsworldwide

（1）andmoreoldpeoplearealivenowadaysthanatanytimeinhistory.

（2）Theproportionofthepopulationaged60andover,isalsogrowingeachyear.Bytheyear2025,theworldwillhost1.2billionpeopleaged60andoverandrisingto1.9billionin2050.（3）ThesametrendisalsopredictedintheEMR;

whiletheproportionoftheelderlypopulationtototalpopulationwas5.8%in2000itexpectedtoreach8.7%byyear2025and15.0%by2050.（4）

Thedemographictransitionwithageingofthepopulationisaglobalphenomenonwhichdemandsinternational,national,regionalandlocalaction.（4,5）Inrecentyearstherehasbeenanincreasinginternationalawarenessofhealthissuesrelatingtoagingpopulations.（6）.Traditionalperceptionsofoldagehavebeenchallengedduringthepastfewyearsanditisimportantthatelderlypeoplearenottakenasaburdenonsociety,butratherasanasset.（5,6）

Thehealthproblemsoftheelderlyarecomplicatedbysocial,economicandpsychologicalinteractionstoagreaterdegreethanyoungerpeople.Moreover,theseproblemsareusuallymultipleandareoftenmaskedbysensoryandcognitiveimpairmentssothatspecialskillsarerequiredtodetectthem.Thesefactorscontributetoaworseningofmorbidityandmortality.（7）

Morbidityamongelderlypeoplehasanimportantinfluenceontheirphysicalfunctioningandpsychologicalwell-being.Manyelderlyhaveseveraldisordersatthesametime.Theincidenceofdiseasesincreaseswithage.（8）Theimportanceofearlysurveillanceofthehealthneedsofelderlypeoplehasbeenemphasized,Knowledgeofthesituationandcircumstancesoftheelderlypopulationisessentialtotheprovisionofcost-effectiveservicesandtheplanningofstrategiesforinterventionandcare.（7）

Littleisknownaboutthehealthneedsofelderlypopulation.（9）Assessmentofthemorbidityprofilewillhelpintheapplicationofinterventions,toimprovethehealthstatusandthequalityoflifeoftheelderly.Theobjectiveofthisstudywastoevaluatethemorbidityprofileandpredictorsofincreasednumberofmorbiditiesamongtheelderlypatientsattended/admittedinJeddahhealthfacilities.

MATERIAL&

METHODS

Acrosssectionalstudywasconductedamongallelderly（aged60yearsandabove）attended/admittedinhealthfacilitieswhichdeliverhealthcareforelderlyinJeddahgovernorate,duringthestudyperiodoftheyear2005.Allhospitalseithergovernmental（7hospitals）orprivate（25hospitals）inadditionto17randomlyselectedprimaryhealthcarefacilitiesfromthetotalof38primaryfacilitieswereincludedinthestudy.Thedatawerecollectedthroughinterviewingquestionnaire,reviewingofrecords,andtakingsomemeasurements.

Interviewingquestionnaire:

Allelderlyattended/admittedintheselectedhealthfacilitiesonthedayofinterviewwererecruited.Apre-designedquestionnairewasusedtocollectinformationaboutpersonalandsocio-demographicdata,presenceofacaregiver,personalhabitsandperceivedhealth.Functionalcapacityofelderlywasinquiredbyaskingabouttheabilityofelderlytoconductthebasicactivitiesaswalking,bathing,usingthetoilet,dressing,eating,andgettinginandoutofhomewithoutneedofhelp.Themainphysical&

psychologicalcomplaintswereinquired.Inaddition,diagnosedchronicdiseaseswereinquiredbyaskingaboutthepresenceofchronicdiseasesdiagnosedbyphysicians&

/diseaseswritteninthepatients'

record.

Reviewingofrecords:

Across-checkingofmedicalrecordsofinterviewedpatientswasdone.Theclinicaldiagnosiswastakingaccordingtophysicianbasedreport.Themaindiagnosis,associateddiagnosiswerereviewed.Allinvestigationswerealsoreviewed.Thetotalnumbersofmorbiditieswerecalculatedaccordingtothemainandassociateddiagnoses.

Measurements:

Theweight&

heightweretaken.Thebodymassindex（BMI）wascalculated.（BMI=Weightinkg/heightinmetersquare）.

Statisticalanalysis:

Thestatisticalanalysiswasconductedusingtwostatisticalpackages;

SPSSversion13andEpi-Infoversion6.04.Chi-square,independentsamplet-testandANOVAtestswereperformed.Multivariateregressionanalysisusingstepwiseregressionmodelwasdoneforcontrollingandadjustingofallconfoundingfactors.

RESULTS

Thetotalnumberofelderlyinthestudyamountedto2246persons.Two-thirdsofelderlywererecruitedfromgovernmentalhealthfacilities（hospitalsandprimarycarefacilities）whileonethirdofthesamplewasrecruitedfromprivatehospitals.Aboutone-fifthoftheelderly（21.6%）wereinpatientswhiletherestwererecruitedfromoutpatientclinics.

Table

（1）portrayspersonalandsocioeconomiccharacteristicsofelderly.Malesrepresented62.7%ofthesample.Theageofelderlyrangedfrom60-104yearswithameanof67.9±

7.71years,abouttwofifthsofthesampleaged70years&

above.Aboutthree-fourthswereSaudi.Widowedelderlyrepresentedaboutone-fifth（21.8%）ofthesample.Themajorityofelderly（78.4%）hadlessthansecondaryeducation.Almostallgeriatricsubjectsinthepresentstudylivedwiththeirfamiliesandwerecaredforbyfamilymembers（93.6%）,whileonly6.4%livedalone

Table

（2）showsthat39.0%ofelderlyperceivedtheirhealthasgood,whileaboutonefourth（23.5%）ofthesampleratedtheirhealthaspoor.Thepercentageoffemaleswhoperceivedtheirhealthaspoorwashigher（31.2%）thanmales（19.0%）.Thedifferencesbetweenbothsexeshasahighlystatisticalsignificantdifference（X2=66.8,p=0.0000）.Thetablealsoshowsthatabouttwo-fifths（37.3%）ofelderlyweredependentonothersintheirusualdailyactivities;

23.5%weredependentin1-3ofdailyactivitiesand13.8%formorethan3oftheiractivities.Thenumberofutilizeddrugsbyelderlypatientsrangedfrom0-10drugswithameanof2.98±

.Aboutonethird（32.1%）ofelderlywereonmorethanthreemedications.Femalesutilizedexcessivenumberofdrugscomparedtomaleswithahighstatisticalsignificantdifference（X2=,p=0.000）.Thenumberofelderlymorbidconditionsrangedfrom1-6diseases.Abouttwo-fifths（39.4%）oftheelderlyhadonediseasewhile60.6%hadtwoormoremorbidconditions.

Table（3）demonstratesphysicalandpsychologicalcomplaintsofelderly.Diminishedvisionwasthemostfrequentphysicalcomplaint（61.5%）whilediminishedhearingwasencounteredamong30.6%and25.6%ofelderlycomplainedfromdementia.Regardingpsychologicalcomplaints;

rapidlyangrywasthecommonestone（61.4%）.Thetablealsoportraysthatfemalesshowedhigherpercentagesofallphysicalandpsychologicalsymptomsthanmales.Regardingphysicalcomplaints,theyweremoresusceptibletorepeatedfalling（OR=2.10;

95%CI:

1.66-2.64）,urinaryincontinence（OR=1.74;

1.34-2.26）.Regardingpsychologicalcomplaintsfemalesweremorethantwotimesmorepronetofeelingofdepression（OR=2.31;

1.93-2.77）andinsomnia（OR=2.00;

1.67-2.77）.

Table（4）showsthemorbidityprofileoftheelderly,itisapparentfromthetablethatdiabetesmellituswasthecommonestelderlydisease（53.6%）,followedbyarthritis（52.12%）andhypertension（50.4%）.Femaleswereathigherrisksofhavingmanytypes23-5.93）,followedbyarthritis61-）andpsychologicalproblems（OR=2.14;

95%CI=1.58-2.90）.Inaddition,femaleswerealsoathigherrisksofhavingbronchialasthma,cancer,COPDandeyediseases.Ontheotherhand,theywereslightlylesssusceptibletodiabetesmellitusandrenaldiseases.

Table（5）illustratestherelationshipbetweenthenumbersmorbiditiesandthestudiedvariable.Highernumberofmorbiditieswasobservedamongfemalescomparedtomaleswithahighlystatisticalsignificantdifference（t=5.41,p=0.000）.Age-wise,highermeanmorbiditieswasnoticedwithadvancingageandahighlystatisticalsignificantdifferencewaspresent（F=12.53,p=0.000）.Lowermorbidconditionswereobservedamongmarriedelderlycomparedtoothers.BasedonBMI,lowermorbiditywasfoundamongnonobeseelderly.Nonpracticingexercisewasassociatedwithhighernumbersofmorbiditiescomparedtothosewhopracticingexercise.Basedonpsychologicalconditionofelderly,thosewhowerestillworking,thosehavingnofamilyorsocialproblemsandwhodidn’tfeellonelinessordepressionencounteredlessnumberofmorbidconditionscomparedtoothers.（p<

0.0000）

Multivariateregressionanalysis（Table6）showsthatthefirstpredictorofincreasenumberofmorbiditywasobesity;

obeseelderlywereat3timesincreasedrisk