Medical BACKGROUND......................................................................................................................5

Best Practice & Research Clinical Obstetrics & Gynaecology, 2013

Over the past century, the world has seen unprecedented declines in mortality rates, leading to an accelerated increase in the world population. This century will realise falling fertility rates alongside ageing populations. The 20th century was the century of population growth; the 21st century will be remembered as the century of ageing. Increase in life expectancy is one of the highest achievements of humankind; however, ageing and age-related disease is a mounting challenge for individuals, families, and for social, economic, and healthcare systems. Since healthy life expectancy has lagged behind the increase in life expectancy, the rise in morbidity will increase the burden on healthcare systems. Implementation of preventive health strategies to decrease, delay or prevent frailty, lung, breast and colon cancer, cardiovascular disease, metabolic syndrome, osteoporosis and osteopaenia, may increase health expectancy, and permit women to age gracefully and maintain independent living, without disability, for as long as possible.

2015

The elderly are one of the most vulnerable and high risk groups in terms of morbidity and health status. For this study Global Ageing and Adult Health (SAGE) survey data (2007-2010) have been used. Results show, that prevalen ce of morbidities is significantly higher (58 %) in Russia Federation followed by India and Gh ana (53.8& 40.7 %). Furthermore, the prevalence of Vision problem is remarkab le higher in India and Russia Federation (31.2 & 20.4 %) than in other selected countrie s. The elderly were 12.6 % having hearing problem in Russia Federation while lees contr ibution of Ghana about 3.3 %.Wealth of the respondent are statically associated with morbidity across selected countries. Regression results depicts higher educated elderl y are less likely (0.451, p>0.001) to have morbidity than their counterpart. Furthe rmore, urban respondent have significantly high morbidity as compare to their counterpar t. The intergenerational support has been drastically changed due to the ...

Aging Cell

Aging is a strong risk factor for many chronic diseases. However, the impact of an aging population on the prevalence of chronic diseases and related healthcare costs are not known. We used a prevalence-based approach that combines accurate clinical and drug prescription data from Health Search CSD-LPD. This is a longitudinal observational data set containing computer-based patient records collected by Italian general practitioners (GP) and up-to-date healthcare expenditures data from the SiSSI Project. The analysis is based on data collected by 900 GP on an unbalanced sample of more than 1 million patients aged 35+, observed in different time periods between 2005 and 2014. In 2014, 86% of the Italian adults older than 65 had at least one chronic condition, and 56.7% had two or more. Prevalence of multiple chronic diseases and healthcare utilization increased among older and younger adults between 2004 and 2014. Indeed, in the last 10 years, average number of prescriptions increased by approximately 26%, while laboratory and diagnostic tests by 27%. The average number of DDD prescribed increased with age in all the observed years (from 114 in 2005 to 119.9 in 2014 for the 35-50 age group and from 774.9 to 1,178.1 for the 81+ patients). The alarming rising trends in the prevalence of chronic disease and associated healthcare costs in Italy, as well as in many other developed countries, call for an urgent implementation of interventions that prevent or slow the accumulation of metabolic and molecular damage associated with multiple chronic disease. K E Y W O R D S aging, cancer, cardiovascular disease, chronic disease, diabetes, disease burden, healthcare expenditure, hypertension 1 | INTRODUCTION Many of the developed and developing countries are facing an unprecedented and rapid rise in the number of elderly people that has far-reaching health and economic implications (Fontana, Kennedy, Longo, Seals & Melov, 2014). Life expectancy has almost doubled in the last 150 years, increasing from~45 years in 1,850 tõ 80 years in many industrialized countries today (Christensen, Doblhammer, Rau & Vaupel, 2009). About 10% of the population was 65 or older in the mid-1950s, with only 1%-3% being older than 80 All authors have worked on this project on a voluntary base as part of their standard research activity.

23% of the total global burden of disease is attributable to disorders in people aged 60 years and older. Although the proportion of the burden arising from older people (≥60 years) is highest in high-income regions, disability-adjusted life years (DALYs) per head are 40% higher in low-income and middle-income regions, accounted for by the increased burden per head of population arising from cardiovascular diseases, and sensory, respiratory, and infectious disorders. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%). A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people. Primary prevention in adults aged younger than 60 years will improve health in successive cohorts of older people, but much of the potential to reduce disease burden will come from more eff ective primary, secondary, and tertiary prevention targeting older people. Obstacles include misplaced global health priorities, ageism, the poor preparedness of health systems to deliver age-appropriate care for chronic diseases, and the complexity of integrating care for complex multimorbidities. Although population ageing is driving the worldwide epidemic of chronic diseases, substantial untapped potential exists to modify the relation between chronological age and health. This objective is especially important for the most age-dependent disorders (ie, dementia, stroke, chronic obstructive pulmonary disease, and vision impairment), for which the burden of disease arises more from disability than from mortality, and for which long-term care costs outweigh health expenditure. The societal cost of these disorders is enormous.

Southeast Asian Journal of Tropical Medicine and Public Health, 2021

A systematic review was carried out to assess prevalence of noncommunicable disease morbidity and comorbidity in relationship to socioeconomic, behavioural health and environmental risk factors for among elderly people globally. Observational studies were culled from public databases, such as PubMed, SCOPUS, Science Direct, and Google Scholar from January 2015 to December 2020, and a Newcastle-Ottawa Quality Assessment Scale tool and PRISMA 2009 checklist were used to assess risk of bias in selected material. Analysis was performed using a weighted mean of morbidity prevalence and disease subgroup together with an R program for data analysis. Among 16 eligible studies and 14 cross-sectional studies weighted mean of morbidity and comorbidity prevalence was 75.1 and 60.6% respectively. NCDs constituted mainly coronary heart disease, diabetes mellitus, hypercholesterolemia, hypertension, and stroke, with hypertension having the highest prevalence among all subjects (62.2%), both females (65.9%) and males (65.4%). In the elderly population individual and behavioural risk factors were the main categories related to morbidity, with behavioral risk factors contributing to comorbidities. In conclusion, morbidity and comorbidity prevalence are high among the elderly population worldwide. Diabetes mellitus and hypertension are the most common illnesses. Age, socioeconomic status, environmental settings and behavioral risk factors influenced comorbidity occurrence.

The BMJ, 2022

Objectives To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors. Design Systematic analysis. setting Participants were aged ≥70 from 204 countries and territories, 1990-2019. Main OutcOMes Measures Years of life lost, years lived with disability, disability adjusted life years, life expectancy at age 70 (LE-70), healthy life expectancy at age 70 (HALE-70), proportion of years in ill health at age 70 (PYIH-70), risk factors, and data coverage index were estimated based on standardised GBD methods. results Globally the population of older adults has increased since 1990 and all cause death rates have decreased for men and women. However, mortality rates due to falls increased between 1990 and 2019. The probability of death among people aged 70-90 decreased, mainly because of reductions in noncommunicable diseases. Globally disability burden was largely driven by functional decline, vision and hearing loss, and symptoms of pain. LE-70 and HALE-70 showed continuous increases since 1990 globally, with certain regional disparities. Globally higher LE-70 resulted in higher HALE-70 and slightly increased PYIH-70. Sociodemographic and healthcare access and quality indices were positively correlated with HALE-70 and LE-70. For high exposure risk factors, data coverage was moderate, while limited data were available for various dietary, environmental or occupational, and metabolic risks. cOnclusiOns Life expectancy at age 70 has continued to rise globally, mostly because of decreases in chronic diseases. Adults aged ≥70 living in high income countries and regions with better healthcare access and quality were found to experience the highest life expectancy and healthy life expectancy. Disability burden, however, remained constant, suggesting the need to enhance public health and intervention programmes to improve wellbeing among older adults.

Mechanisms of Ageing and Development, 2020

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Experimental Gerontology, 2005

Purpose: Multiple factors contribute to mortality in the elderly, but the extent to which traditional factors contribute independently to mortality in different countries is not known. Our objective is to determine the differential impact of socio-demographic variables, selected diseases, health habits and disability on all-cause mortality, among older people living in five European countries and Israel.

Journal of Aging and Health, 2006

The study evaluated the health impact of specific diseases. Method: Life tables and health survey data are combined to estimate expected lifetime with and without long-standing illness. We compared estimates based on observed rates of mortality and prevalence of illness with those based on hypothetical rates from which a specific disease has been eliminated. Results: Life expectancy would increase by 4.0 years for 65-year-olds if circulatory diseases are eliminated, and the proportion of expected lifetime without long-standing, limiting illness would increase from 59.2% to 66.5% for men and from 52.2% to 55.6% for women. Elimination of musculoskeletal diseases would not change life expectancy but would increase the proportion of expected lifetime without long-standing illness. Conclusions: Because of comorbidity, more years of illness are to be expected if lethal diseases are to be eliminated. Elimination of nonfatal diseases would mainly transfer years with long-standing illness to years without illness.

Ciência & Saúde Coletiva

This article aims to estimate the prevalence of chronic diseases/conditions in octogenarians according to sex, age groups and private health insurance, and its relationship with difficulty in performing usual activities. Cross-sectional population-based study with elderly data (n = 6,098) from the National Health Survey (PNS) 2019. Prevalences and 95% confidence intervals were estimated. The prevalences were: hypertension 61.7%, chronic back problem 30.0%, hypercholesterolemia 22.0%, diabetes 20.3%; arthritis/rheumatism 19.4%, heart disease 19.3%, depression 9.4%, cancer 8.9%, cerebrovascular accident (CA) 7.5%, asthma 4.9%, lung disease (LD) 4.2% and kidney failure (KF) 3.0%. Hypertension, chronic back problem, hypercholesterolemia, major arthritis/rheumatism and depression in women, and cancer in men. Major heart disease, hypercholesterolemia, arthritis/rheumatism, KF, cancer and depression in those with private health insurance. Restriction of usual activities 14.8%, more frequen...