Public health aspect of geriatrics

1. GERIATRIC
HEALTH
health of the aged

2. “The test of civilization is
the measure of consideration
and care which gives to its
weaker members”

3. Objective of the session:
After the end of the session the
participants will be able to answer the
following –
 What is geriatric and ageing
 Who are elderly people and Statistics
of elderly people
 Situation of elderly people in
Bangladesh

4.  Magnitudes of the problems of the
elderly people
 Statistics of elderly diseases
 Major chronic conditions and common
age related disabilities affecting older
people worldwide

5. What is geriatrics?
 The study of the physical and
psychological changes which are incident
to old age is called gerontology.
 The care of the aged is called clinical
gerontology or geriatrics. It is the
branch of medicine that focuses on
health care of the elderly to promote
health and to prevent and treat
diseases and disabilities in old adults.

6. CONTD
 Social geriatrics deals with social
attitude towards old people.
 Experimental gerontology is concerned
with research into the basic biological
problems of ageing, into its physiology,
biochemistry, pathology and psychology.

7. Defining health and ageing
 Health is a cumulative state, to be
promoted throughout life in order to
ensure that the full benefits are
enjoyed in later years. Good health is
vital to maintain an acceptable quality of
life in older individuals and to ensure
the continued contributions of older
persons to society.

8. AGING
 A normal biological process which is a
slow perceptible progressive
degenerative process advancing with
age leading to functional deterioration,
vulnerability and ultimately cumulating
to extinction of life
 Story of life : Birth , Growth , Decay and
Death

9. ageing process & process of ageing.
 The ageing process (‘normal ageing’)
represents the universal biological
changes that occur with age and are
unaffected by disease and
environmental influences. Not all of
these age-related changes have adverse
clinical impacts.

10.  the process of ageing is strongly
influenced effects of environmental
and disease states that, in turn, are
related to or change with ageing but
are not due to ageing itself.
 The active-ageing concept, now
promoted by WHO, encourages the
‘process of growing older without grow
in old through the maintenance of
physical, social, and spiritual activities
throughout a lifetime’

11.  AGEING PROCESS :
are due to mutation of DNA, damage to the
tissues by formation of free radicals, end
result of non – enzymatic combinations of
glucose with amino acids, bio chemical
mechanism of cellular metabolism which
affects physiology of tissues of the body or
organs. Different theories are :
 · Genetic
 · Immunological
 · Nutritional
 · Neurological
 · Endocrine and metabolic
 · Hypothalamus causes ageing via
hormonal or other pathways.

12.  The old are placed in three categories:
(1) Recent old who are still active and
undertake normal activities without
support;
(2) Old who work with difficulty and
hence have reduced activities;
(3) Very old who work with difficulty in
the home or not at all.

13.  World health organization defined
elderly people with age 65 years and
above. But the growing number of active
and healthy older people has caused
that definition to expand to "young old"
(65 to 75), "old old" (75 to 85), and
"oldest old" (85 and beyond). The over-
85 age group is the one that is growing
most rapidly.

14. Category) Age Group (years
Elderly (Older
persons)
Oldest-old
65+ (sometimes 60+)
80+

15. World population (millions) of
elderly and oldest-old
Year
Population Total
(millions)
2000
6055
2025
7823
2050
8900
Elderly 65+ ( % )
Oldest old 80+ ( % )
6.9
1.1
10.4
1.9
16.4
4.2

16. Dependent populations of the world (%)
Age Group 1950 1975 2000 2025 2050
Younger than 34 37 30 24 21
15 years
Older than 05 06 07 10 16
65 years
Total 39 43 37 35 37

17. HEALTH PROBLEMS OF THE AGED
 Problems due to the aging process
 Problems associated with long term
illness
 Psychological Problems

18. Health problems of the aged
 Problems due to the aging process:
The biological age is not identical with
chronological age .
 Disabilities incident to the aging process
a. Senile cataract
b. Glaucoma
c. Nerve deafness
d. Bony Changes affecting mobility
e. Emphysema
f. Failure of special senses
g. Changes in mental outlook

19. PROBLEMS ASSOCIATED WITH LONG
TERM ILLNESS
Certain chronic diseases are
frequent:
a. Degenerative disease of the heart &
blood vessels like atherosclerosis. MI, IHD,
Hypertension etc.
b. Cancer breast, prostate, colon, lung etc
c. Accidents

20. PROBLEMS ASSOCIATED WITH LONG
TERM ILLNESS
d. Diabetes
e. Diseases of the locomotors system
fibrositis, myositis, neuritis, gout,
rheumatoid arthritis, osteoarthritis,
spondilitis of spine, frozen shoulder,
muscle wasting.
f. Respiratory illness. chronic bronchitis,
asthma, emphysema

21. PROBLEMS ASSOCIATED WITH LONG
TERM ILLNESS
 GENITO URINARY SYSTEM
e. g. enlargement of prostate, dysuria, nocturia,,
frequency, urgency of micturation.
 DISEASES OF THE EYE, EAR
 GITRACT,NERVOUS SYSTEM
 GYNAECOLOGICAL DISORDER
 OTHERS like accidental hypothermia,
vulnerable to infection, nutritional diseases…

22. PSYCHOLOGICAL PROBLEMS
Mental changes:
 Impaired memory,
 Rigidity of the outlook,
 Dislike of change causes mental and social
consequences.

23. PSYCHOLOGICAL PROBLEMS
Sexual adjustment :
 Between 40 & 50 - Cessation of
reproduction by females & diminution of
sexual activity of men.
 during this phase physical, sexual and emotional
disturbances, irritability, jealousy and
despondency are very common and frequent.

24. PSYCHOLOGICAL PROBLEMS
Emotional disorders:
 Failure to adapt can result in
 bitterness ,
 inner withdrawal
 depression ,
 weariness of life, and
 even develops suicidal tendency.

25. PSYCHOLOGICAL STRESS IN ELDERLY
Due to
 Change in health and habits
 Change in family environment
 Work and occupation
 Change in social interaction
 Due to economic solvency.

26. Implication of the aging population in
terms of preventive and social medicine
 Medical & social problem
 Greater demand of health services
 Huge economic burden of the community
 Strain on the younger generation
 Old must share responsibility &
previleges
 Community must assist the aged to fight
triple evils of poverty, loneliness &
illhealth.

27. A multidimensional process designed
to assess elderly person’s functional
ability, physical health, cognitive,
mental health and socio-environmental
situation.
Preventive measures on disease,
accidents, iatrogenic complications
and solution of psychological problems
should deal with priority basis and
humanitarian ground.

28. CARE OF THE AGED
 AT PERSONAL LEVEL e.g. Diet, exercise,
regular medical checkup, regular intake of
medicines, healthy life style habits etc.
 AT FAMILY LEVEL needs peaceful environment
and complete family support.
 AT COMMUNITY LEVEL : e.g. Support of the
basic needs, early diagnosis and treatment of
physical and mental illness (At PHC level)

29. CARE OF THE AGED
 AT NATIONAL LEVEL : Development of
geriatric, economical, employment, social and
psychological services.
 AT INTERNATIONAL LEVEL : Resource
allocation for elderly people is global issue for
implementation of HEALTH FOR ALL.

30. LIFE STYLE AND HEALTHY AGEING
 By adopting a healthier life style the risk of a
whole range of diseases can be reduced .
These factors are :
 DIET AND NURTITION
 EXERCISE
 MAINTAING NORMAL WEIGHT
 SMOKING
 ALCOHOL
 SOCIAL ACTIVITIES

31. PROBLEMS/ CHALLENGES OF THE CARE
OF THE ELDERLY
 HEALTH RELATED
 ECONOMIC
 DEVELOPMENTAL
 SOCIAL ASPECT
 GLOBAL ASPECT
 ETHICAL CHALLENGE.

32.  1st October is the international
day of the elderly,
 In Bangladesh it was first observed
in the year 1991
 In the year 1999 UNITED NATION
declared as the international year
for the older persons.
 Who observed the world health day
with the theme active ageing makes
the difference.