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ORIGINAL ARTICLE
Year : 2012  |  Volume : 34  |  Issue : 4  |  Page : 360-364  

Prevalence of Psycho-Social Problems Among Elderly in Urban Population of Mysore City, Karnataka, India


1 Department of Community Medicine, JSS Medical College, Mysore, Karnataka, India
2 Programme Associate, State Health Resource Center, Chhattisgarh, India

Date of Web Publication7-Mar-2013

Correspondence Address:
Prashantha Bettappa
Department of Community Medicine, JSS Medical College, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7176.108221

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   Abstract 

Background: The reduction in fertility level, reinforced by steady increase in the life expectancy has produced fundamental changes in the age structure of the population, which in turn leads to the aging population. Objectives: To know the psycho-social problems of the elderly in urban population of Mysore; to determine the extent of functional impairment among the elderly and to know the psychological distress of the elderly using GHQ score. Materials and Methods: This community-based cross-sectional study was carried out at the field practice area of Urban Health Center , JSS Medical College, Mysore . The study population comprises of all geriatric population aged 60 years or above who were residing in the study area for atleast one year. 526 study subjects were recruited for the study. Data collection was done from May 2011 to December 2011 using a preformed semi-structured schedule. Data was entered into Microsoft Excel and statistical analysis is carried out using SPSS-17 version. Results: 162 out of 207 elderly men (78.3%) were more functional than 240 out of 319 aged women (75.2%). Severe functional impairment was almost same in both gender (4%) while moderate imparement was noted slightly more among aged women. The functional score was significantly higher for young old, for literates, for middle class and for employed. Anxiety and insomnia were found in 3.4% of the aged (males 2.4% and females 4.1%) followed by somatic symptoms 2.9%, social dysfunction 1.5% and severe depression 1.1%. All psychological distress were found more among elderly women. The prevalence of mental illnesses were found to be significantly higher for age more than 75 years. Conclusions: Awareness among the elderly population should be created for regular medical check-ups to ensure prevention and early detection of the chronic diseases. There is a need to have geriatric wards having specialized professionals with psychiatric and medical social workers along with subsidized health care services.

Keywords: Elderly, functional impairment, psychological distress


How to cite this article:
Boralingaiah P, Bettappa P, Kashyap S. Prevalence of Psycho-Social Problems Among Elderly in Urban Population of Mysore City, Karnataka, India. Indian J Psychol Med 2012;34:360-4

How to cite this URL:
Boralingaiah P, Bettappa P, Kashyap S. Prevalence of Psycho-Social Problems Among Elderly in Urban Population of Mysore City, Karnataka, India. Indian J Psychol Med [serial online] 2012 [cited 2019 Nov 15];34:360-4. Available from: http://www.ijpm.info/text.asp?2012/34/4/360/108221


   Introduction Top


Elderly or old age consists of ages nearing or surpassing the average life span of human beings. The boundary of old age cannot be defined exactly because it does not have the same meaning in all societies. Government of India adopted 'National Policy on Older Persons' in January, 1999. The policy defines 'senior citizen' or 'elderly' as a person who is of age 60 years or above. The elderly population (aged 60 years or above) account for 7.4% of total population in 2001. Both the share and size of elderly population is increasing over time. From 5.6% in 1961 it is projected to rise to 12.4% of population by the year 2026.

The reduction in fertility level, reinforced by steady increase in the life expectancy has produced fundamental changes in the age structure of the population, which in turn leads to the aging population. The needs and problems of the elderly vary significantly according to their age, socio-economic status, health, living status and other such background characteristics. Various studies have been conducted to analyze the health and related issues associated with old age, which needs further exploration, so the present study was focused on various socio-demographic profile and its association with psycho-social problems.


   Materials and Methods Top


Objectives of the study

  1. To know the psycho-social problems of the elderly in urban population of Mysore
  2. To determine the extent of functional impairment among the elderly
  3. To know the psychological distress of the elderly using GHQ score.


Methodology

This community-based cross-sectional study was carried out at the field practice area of Urban Health Center, located at Medar's block of Mysore city, which comes under the Department of community medicine, JSS medical college, Mysore and it was covering a population of 8000. The study population comprises of all geriatric population aged 60 years or above in the study area, who were residing in the study area for atleast one year. The survey was done by house to house visit. After excluding the non-respondents and locked homes after atleast 3 visits, 526 respondents were recruited for the study. Approval from the Human Ethical Committee, JSS Medical College, Mysore, was obtained to conduct the study. The study subjects were subjected for personal interview using a pre-tested and semi-structured proforma and clinical examinations and checking of individual records were also used as study tools in order to collect data on demographic, socio-economic, environmental and morbidity conditions. Informed consent was taken from the study subjects.

Data collection was done from May to December 2011. Contents of proforma were as following; general outline (age, sex, marital status, occupation, education, religion, type of family, duration of stay at the present address, family composition etc), medical information (chief complaint, past history, personal history and family history), general physical examination (built, nutrition, general mental status, height, weight, pulse rate, respiratory rate, BP, pallor, pedal edema etc), systemic examination (RS, CVS, CNS, GI, musculoskeletal, renal, skin, oral and special senses), personal hygiene, functional status, social problems and activities, environmental data, questionnaire on non-psychotic psychiatric disorders.

The study subjects were divided into young-old and old-old as elderly ≤75 and >75 respectively. Socio-economic status of the family was assessed using Modified Kuppuswamy's Method of Socio-economic Scale. Katz Index of Independence in activities of daily living scoring method was used in order to assess functional status of the elderly. Assessment of non-psychotic psychiatric disorders was based on questionnaire of General Health Questionnaire (GHQ 28).

Microsoft Excel software was used to enter the data. To estimate the prevalence of various health conditions of geriatric population, appropriate proportion (%) is worked out and to test the association of morbidity conditions with socio-economic parameters, statistical tests such as Chi-square test, t-test is applied at 5% level of significance. Statistical analysis is carried out using SPSS-17 version.


   Results Top


[Table 1] shows that majority of the elderly (34.6%) belongs to age group 60-64 years followed by age group 75 years and above (25.9%). The majority of study population belonged to Hindu religion (94.7%). About half of the elderly were illiterate, 39.7% of the aged were widow and 5.7% were widower. Nuclear family was found in 48.9% of the elderly followed by three generation 34.8% and joint family 16.3%. About 48.6% of the elderly were receiving pension (16.9% male and 29.8% female).
Table 1: Distribution of the elderly by their bio‑social characteristics

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The percentage of illiterate elderly was found to be 50.4%, and 49.6% of the elderly were literate. Only 2% of the elderly have done study till graduation or post-graduation or professional. 68.8% of the respondents were unemployed, followed by 16.2% unskilled worker, 5.9% semiskilled worker, 5.7% semi-professional and 3.4% skilled worker. None of the elderly belongs to professional occupation and semi professional was mainly comprised of businessmen. Above table indicates that about 1/3 rd of the female and 58% of the male population were unemployed. In all category of occupation, proportion of male respondent was higher than female respondent except in the category of skilled worker which was found to be 4.7% among both genders. Socio-economic status revealed that there were mainly three classes from where elderly belongs to; upper middle, upper lower, lower and lower middle. Most of the elderly (64.8%) belongs to class IV. None of the elderly belongs to upper socio-economic group. 27.6% of the aged female and 10.6% of aged male belongs to lower socio-economic class according to Modified Kuppuswamy's Socio-economic Scale [Table 2].
Table 2: Distribution of elderly according to their socio‑economic position

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[Table 3] reveals that 81.7% of the family were sympathetic and helpful at the time of illness of the elderly against 10.6% of the family who were apathetic and negative towards the health of the elderly. 50.8% of the family had financial problems. Intra familial relation was found to be cordial in about 77.6% of the family and 10.6% reported conflict in the family. For the health problem of the elderly, the psychological impact on family found were: anxiety 33.5%, 18.4% worried, 15.6% stress and fear 5.3%.
Table 3: Distribution of psycho-social problems among elderly

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Most of elderly men (78.3%) were more functional than aged women (75.2%). Severe functional impairment was almost same in both gender (4%) while moderate imparement was noted slightly more among aged women [Table 4]. The functional score was significantly higher for young old than very old, for literates than illiterates, for middle class elderly than lower class elderly and for employed than unemployed as per Katz Index of Independence of activities of daily living scoring method [Table 5].
Table 4: Distribution of study population based on functional status

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Table 5: Association of functional impairment among elderly with their bio‑social factors

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Based on general health questionnaire 28, overall prevalence of mental illness was found in 7 elderly (1.3%) which was seen more among elderly females (1.9%). Only one male was found to have mental illness [Table 6]. Anxiety and insomnia were found in 3.4% of the aged (males 2.4% and females 4.1%) followed by somatic symptoms 2.9%, social dysfunction 1.5% and severe depression 1.1%. All psychological distress were found more among elderly women [Table 7]. The prevalence of mental illnesses (somatic symptoms, anxiety and insomnia, social dysfunction and severe depression) were found to be significantly higher for age more than 75 years as evident from [Table 8].
Table 6: Distribution of elderly according to mental iIllness as per GHQ 28 scoring

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Table 7: Association of psychological distress observed on GHQ 28 scale with gender of study subjects

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Table 8: Association of psychological distress with the age of the study subjects

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   Discussion Top


In the present study, 10.6% of the family were found to have apathy and negative reaction on illness of elderly, 50.8% of the aged had financial burden, 10.6% of the elderly had conflict. Sonar et al., [1] found significant association between geriatric depression and marital status, living arrangements, type of family, decision making, adjustment with old age, feeling isolation, feeling insecure. Living with children (56.8%) is the most preferred arrangement in the present study followed by living independent (21.5%), spouse (20.2%) and relative (1.5%). A similar finding was reported by Reeta Kumar et al. [2] Among elderly who were widow/widower, loneliness was observed in 33.8%, 6.7% feel deprived in the life and 3% feel not caring. Elderly females had more of this feeling than males. Study done by Bhatia et al., [3] showed very high prevalence of loneliness among persons who lived alone (92.2%) than who lived with their spouse (58.9%).

In the present study moderate and severe functional impairment was found to be 19% and 4.6% respectively. Male respondents were noted to be more functional than female respondent. Functional score was observed significantly higher for younger old than older old, for illiterates than literates, for middle class than lower class and for employed than unemployed. A similar observation was reported by Kammar et al. [4] Prevalence of psychological disorders among elderly population observed were somatic symptoms 2.9%, anxiety and insomnia 3.4%, social dysfunction 1.5% and severe depression was 1.1%. Study done by Gurvinder Pal Singh et al., [5] revealed that 48% of the elderly had mood disorders, 15.4% had neurotic stress and somatoform disorders, 14.3% had organic including symptomatic, mental disorders.


   Conclusion Top


Awareness among the elderly population should be created for regular medical check-ups to ensure prevention and early detection of the chronic diseases. There is a need to have geriatric wards having specialized professionals with psychiatric and medical social workers along with subsidized health care services. There is a need to train both indigenous and allopathic doctor to handle the specific illnesses associated with aging. Awareness about nutrition and health-related issues of the elderly are of great importance. Program focusing on the elderly women and poor need to be formulated and implemented. There is need for an appropriate insurance scheme for enabling the elderly to meet their medical expenses. Health problems of elderly should be tackled with psycho-social intervention. Healthy traditions and values of Indian culture should be protected and promoted by developing good intra-familial and social relationships.

 
   References Top

1.Sonar BG. Old age pensioners: A socio-psychological study. Indian J Gerontol 2004;18:187-200.  Back to cited text no. 1
    
2.Kumar R, Sharma A. Wisdom, cognitive-failure, depression and loneliness among older men. Indian J Gerontol 2009;23:458-77.  Back to cited text no. 2
    
3.Bhatia SP, Swami HM, Thakur JS, Bhatia V. A study of health problems and loneliness among the elderly in Chandigarh. Indian J Community Med 2007;32:239-307.  Back to cited text no. 3
    
4.Kammar MR, Kamath R, Ashalatha KV. Functional abilities of the aged. Indian J Gerontol 2011;25:41-50.  Back to cited text no. 4
    
5.Singh GP, Chavan BS, Arun P, Lobraj, Sidana A. Geriatric out-patients with psychiatric illnesses in a teaching hospital setting - A retrospective study. Indian J Psychiatry 2004;46:140-3.  Back to cited text no. 5
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

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