Nearly 75% Elderly in India Suffer From Chronic Disease: Survey

Health Minister Dr Harsh Vardhan released the findings from the Longitudinal Ageing Study of India (LASI) Wave-1 on Wednesday, 6 January, saying, “75 per cent of the elderly people suffer from one or the other chronic disease. 40 per cent of the elderly people have one or the other disability and 20 per cent have issues related to mental health. This report will provide base for national and state level programmes and policies for elderly population.”

Launched in 2016, the Longitudinal Ageing Study in India (LASI) is a full–scale national survey of scientific investigation of the health, economic, and social determinants and consequences of population ageing in India. It is a biennial panel survey representative of the older and elderly population age 45 and above for India and its states and Union Territories.

The importance of the report stems from the increasing life expectancy around the globe. The UN Population Division (2019) projects global life expectancy toreach 74.5 years for males and 79.1 years for females in 2050. With approximately 1.36 billion inhabitants in 2019, India is projected to become the world’s mostpopulous country in the next six years.

“In 2011 census, the 60+ population accounted for 8.6 per cent of India’s population, accounting for 103 million elderly people. Growing at around 3 per cent annually, the number of elderly age population will rise to 319 million in 2050,” Vardhan said.

“These alarming population projections and the dramatic shift in age-structure call for robust and internationally harmonized data on ageing. Although adult health and ageing is being increasingly investigated, there are currently no comprehensive and internationally comparable national survey data in India that encompass the full range of topics necessary to understand the health, economic, social, and psychological aspects of the ageing process. The LASI is designed to fill this gap,” the report states.

Population Studied

The National Programme for Health Care of Elderly, Ministry of Health & Family Welfare conducted the Longitudinal Ageing Study of India, through International Institute for Population Sciences, (IIPS), Mumbai in collaboration with Harvard T.H Chan School of Public Health, and the University of Southern California.

The LASI, wave 1 covered a panel sample of 72,250 individuals age 45 and above and their spouses, including 31,464 elderly persons age 60 and above and 6,749 oldest-old persons age 75 and above from 35 states and union territories (UTs) from April 2017 to December 2018.

Health Findings

The assessment of the burden of chronic health conditions such as cardiovascular diseases, diabetes, chronic respiratory diseases, bone diseases, and cancers, as well as their risk factors, are important for promoting appropriate and effective health care policies for the prevention and control of noncommunicable diseases (NCDs), the report notes.

Self-rated health (SRF) captures the full range of illnesses a person has and the possible symptoms of diseases that are yet undiagnosed. Some findings are:

• Overall, in India, the prevalence of poor SRH is two times among the elderly age 60 and above (24%) than older adults age 45-59 (12%)
• Elderly women, the elderly with no education and those who are not currently working, are more likely to report poor SRH.
• More than half of elderly age 60 and above reported poor SRH in the states of Kerala (53%) and Tamil Nadu (53%).

Chronic Health Conditions

• Overall, in India the self-reported prevalence of diagnosed cardiovascular diseases (CVDs) is 28% among older adults age 45 and above.
• The prevalence of CVDs increases with age from 22% among those in age 45-59 to 34% among those in age 60-74, and further to 37% among those age 75 and above.
• About a third (32%) of elderly age 60 and above have been diagnosed with hypertension, 5.2% were diagnosed with chronic heart disease and 2.7% with stroke.
• The self-reported prevalence of diagnosed CVDs is higher among the elderly residing in urban areas (50%), elderly women (38%), elderly residing with children and others (39%), those with 10 or more years of schooling (50%) and those in the richest MPCE quintile (45%).
• In India, the self-reported prevalence of diabetes mellitus among older adults age 45-59 is 9% and among the elderly age 60 and above is 14%.
• A little less than a third (30%) of elderly age 60 and above with 10 or more years of schooling reported having been diagnosed with diabetes mellitus compared with 8% among the elderly with no education.
• More than a quarter of the elderly age 60 and above reported that they have been diagnosed with diabetes in the demographically advanced states/UTs of Kerala (35%), Puducherry (28%), Lakshadweep (28%), Goa (27%), Delhi (26%), Tamil Nadu (26%), and Chandigarh (25%).
• Overall in India, the prevalence of asthma, bronchitis, and COPD is higher among elderly age 60 and above (5.9%, 1.6%, and 2.8%, respectively) than in older adults age 45-59 (3.1%, 0.7%, and 1.6%, respectively)
• Eight percent of elderly age 60 and above reported chronic lung diseases (Figure 17). Chronic lung diseases are more prevalent in the states/UTs of Rajasthan (15%), Puducherry (13%), Kerala (12%), West Bengal (11%) and Karnataka (10%).

Mental Health:

• Overall, the self-reported prevalence of diagnosed neurological/psychiatric problems among the elderly age 60 and above in India is 2.6% (Figure 17) and that of depression is 0.8%.
• The elderly living with others (1.3%) and divorced/deserted/separated (1%) are more likely to be diagnosed with depression
• The prevalence of neurological or psychiatric problems among the elderly is more than 5% in the states/UTs of West Bengal (8.1%), Telangana (7%), Puducherry (6.9%), and Jammu & Kashmir (5.3%).

Treatment Rates for Chronic Diseases:

• Overall in India, around three quarters of the elderly age 60 and above who were diagnosed with chronic conditions have been treated for hypertension (77%), chronic heart diseases (74%), diabetes mellitus (83%), chronic lung diseases (72%) and cancer (75%)
• More than half of elderly have been treated for stroke (58%) and bone/joint diseases (56%)
• The treatment rate for neurological & psychiatric diseases among the elderly is the lowest (41%)
• The treatment rate for all chronic health conditions is higher among the elderly in urban areas, those with higher education, and those in the richest MPCE quintile than their counterparts