The National Programme for Health Care of the Elderly: A Review of its Achievements and Challenges in India

Self-Care Practices and Health-Seeking Behaviors Among Older Adults in Urban Indian Slums: A Mixed Methods Study

Background Effective self-care is crucial for maintaining health among older adults in resource-constrained communities. This study examined self-care practices, health-seeking behaviors, and associated factors among older adults in urban slums in India. Materials and methods A mixed methods study was conducted among 432 adults aged ≥65 years. Participants were selected through multistage random sampling from five slum areas. Self-care practices, health-seeking behaviors, demographic information, chronic conditions, self-efficacy, and health literacy were assessed through interviews. The qualitative data was explored through in-depth interviews with 30 participants. Results Inadequate health literacy (194, 45%) and low self-efficacy (162, 37.5%) were common. While 324 (75%) had an adequate diet and 378 (87.5%) took medications properly, only 86 (20%) monitored diabetes complications. Only 194 (45%) of the patients underwent recommended cancer screening, and 324 (75%) of the patients saw doctors ≥twice a year. Age, sex, education, income, comorbidities, self-efficacy, and health literacy had significant associations. Alongside facilitators such as social support, barriers such as limited healthcare access and suboptimal prevention orientation emerged. Conclusion Suboptimal prevention orientation and overreliance on secondary care instead of self-care among elderly people are problematic given the limited use of geriatric services. Grassroots health workers can improve health literacy and self-efficacy through home visits to enable self-care. Healthcare access inequities for vulnerable groups merit policy attention.

Aging in Place for Community-Dwelling Older Adults in India: A Qualitative Exploration of Prospects and Challenges

As global population ages, "Aging in Place" is prioritized as the top aging strategy for many of the older adults worldwide. India, being a nation that is expected to hold the maximum share of the older adult population in the near future, has a huge responsibility vested in it to take care of the needs of older adults. The social structure of the nation has emphasized the importance of older adults to age in place, experiencing all the independence and autonomy at their own dwelling places for as long as possible. This study aims to provide a profound understanding of the meaning, attitude, and perceptions of older adults toward aging in place. Using a qualitative research design, in-depth interviews were conducted among 15 community-dwelling older adults who chose aging in place in Kerala, India. Following the interviews, thematic network analysis was done, inspired by Jennifer Attride-Stirling. Three global themes were derived, which include the older adults' perspectives on (1) determinants of aging in place, (2) challenges of aging in place, and (3) strategies for successful aging in place. The study evokes in-depth exploration of the experiences of older adults aging in place, which inform future evidence-based practices and policy-level implications.

Impact of first eye cataract surgery on falls among patients of advanced age: a comparative study

OBJECTIVE

To compare the incidence of falls between patients with visually significant cataracts in both eyes and those who have undergone first-eye cataract surgery.

METHODS

This retrospective case-control study involved patients with a history of cataracts in both eyes who had undergone first-eye cataract surgery within the past 9 to 12 months (pseudophakic group). The control group comprised patients with cataracts in both eyes (cataract group). We assessed best-corrected visual acuity (BCVA), systemic comorbidities and medications (using the Charlson comorbidity index), and independent daily activities (using the Lawton Instrumental Activities of Daily Living scale). The patients were questioned about experiencing two or more falls in the last 6 months.

RESULTS

Each group comprised 50 patients. Binocular BCVA was significantly better in the pseudophakic group (0.05 ± 0.06 logMAR) than in the cataract group (0.77 ± 0.34 logMAR). Of all participants, 22% reported experiencing two or more falls in the last 6 months. Multivariate analysis demonstrated significantly better BCVA in participants with less than two falls.

CONCLUSIONS

Patients of advanced age with visually significant cataracts in both eyes are at a higher risk of falling. First-eye cataract surgery may mitigate the occurrence of falls by improving binocular BCVA.

Prevalence of Non-Communicable Diseases and Its Associated Factors Among Urban Elderly of Six Indian States

Aims

The aim of this study is to investigate the prevalence, impact of health determinants on non-communicable diseases (NCDs), and multimorbidity among urban elderly in India.

Methods

This is a cross-sectional study involving a total of 1,671 (870 male and 801 female) respondents aged 60-80 years. Multistage sampling was used for the recruitment of the participants. A total of 12 sample areas from 12 cities of six southern states of south India were selected. Through survey form, information regarding demographic characteristics, health-influencing lifestyle factors, and history of nine NCDs was collected.

Results

The mean age of participants was 68.5 ± 6.01 years.. The prevalence of hypertension was 40.4%, followed by diabetes (31.2%), arthritis (22.1%), sensory impairment (10.1%), heart diseases (7.8%), and dyslipidemia (7.0%). 74.1% of participants had at least one morbidity, and 40.0% of people had multimorbidity. Being overweight is the highest risk health determinant for hypertension, diabetes, heart disease, high cholesterol, stroke, and joint pain. Obese people have 64% more risk of hypertension than people with normal BMI. People with disturbed sleep have increased risk of hypertension, high cholesterol, and joint pain by more than 80% compared to people with proper sleep. Among the modifiable health determinants of obesity, disturbed sleep, constipation, and physical activity up to 30 minutes were positively associated with multimorbidity. Those in the age group of 70 to 80 years have a high risk for NCDs and multimorbidity compared to those in the age group of 60 to 70 years.

Conclusions

A healthy lifestyle is necessary to reduce the burden of NCDs among the elderly. Developing holistic health policies seems an urgent need.