Multimorbidity and multi-disability among the elderly in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)

Abstract

We report prevalence and risk factors for multimorbidity and multi-disability among elderly people in residential care in the Hyderabad region in South India. In total, 1182 elderly (aged ≥ 60) participants were examined in 41 homes for the aged centres. Detailed interviews were conducted by trained personnel to collect personal and demographic information. A questionnaire was used to assess the history of non-communicable diseases and Washington Disability Questionnaire (WDQ) was administered to assess disabilities. The mean age of the participants was 75.0 years (SD 8.8 years; range: 60–108 years), 35.4% were men, 20.3% had no formal education, 60.7% had school education and 19% had higher education. The prevalence of multimorbidity was 37.6% (95% CI: 34.8–40.4). Prevalence of multi-disability was 23.6% (95% CI: 21.2–26.3; n = 270). In total, 857 (72.5%) participants reported using at least one medication for NCDs. Over a third of the elderly in residential care had multimorbidity, and a quarter of them had multi-disability. A holistic health care system that comprises health and wellness coupled with rehabilitation to address disabilities is needed to achieve healthy aging in elderly in homes for the aged in India.

Risk factors of multimorbidity among older adults in India: A systematic review and meta‐analysis

“…Finally, 16 studies were included in this systematic review 1,18,19,50‐62 . Out of these 16 studies, 15 were included in the meta‐analysis 1,18,19,50,52‐62 . Figure 1 shows the process of study selection and inclusion.…”

“…The critical appraisal scores varied from 38% to 88%. Ten studies obtained a score of more than 70%, that is, answered ‘yes’ to at least six questions on the JBI checklist for analytical cross‐sectional studies 1,19,50,51,56‐59,61,62 . The inclusion criteria were clearly defined in all the studies except for one 52 .…”

“…55 In nine studies, exposure was not measured using a valid and reliable method. 18,19,50,52,54,56,[60][61][62] The definition of multimorbidity was unclear in three studies, 53,55,60 and one had not defined it. 50 Two studies did not identify the confounders, 53,54 and four had not stated strategies to deal with them.…”

“…62 The same definition of multimorbidity (i.e., the coexistence of two or more chronic health conditions in an individual) was reported in 12 studies, whereas it was unclear in three studies, 53,55,60 and in one study, no definition was provided. 50 Nine studies used self-reported data on multimorbidity, 1,19,51,52,[56][57][58][59]61 one used medical records, 62 four used both self-reported data and medical records, 18,[53][54][55] one screened selected chronic health conditions, 60 and one had not reported the details. 50…”

“…| 3 of 20 included in this systematic review. 1,18,19,[50][51][52][53][54][55][56][57][58][59][60][61][62] Out of these 16 studies, 15 were included in the meta-analysis. 1,18,19,50,[52][53][54][55][56][57][58][59][60][61][62] Figure 1 shows the process of study selection and inclusion.…”