At the end of this session, the student shall be able to What is gerontology and it’s branches? Describe the growing burden of geriatric age group. Classify and Enumerate the Health problems of the aged. What are the lifestyle factors which helps the aged? Describe the health status of the aged in India. Describe the Schemes & Policy for Older Person in India Explain the Implication of the ageing population in India How are these diseases prevented in the elderly?

1. Preventive Medicine in
Obstetrics, Paediatrics and
Geriatrics
Dr. Jayaramachandran S
Associate Professor
Department of Community Medicine
06.05.2020

2. At the end of this session, you will be able to
ü What is gerontology and it’s branches?
ü Describe the growing burden of geriatric age group.
ü Classify and Enumerate the Health problems of the aged.
ü What are the lifestyle factors which helps the aged?
ü Describe the health status of the aged in India.

3. At the end of this session, you will be able to
ü Describe the Schemes & Policy for Older Person in India
ü Explain the Implication of the ageing population in India
ü What are the disease prevention in the elderly?

4. Gerontology and Geriatrics

5. Definitions
• 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.
• Social gerontology which was born on the one hand out of the
instincts of humanitarian and social attitudes and on the other out of
the problems set by the increasing number of old people.
• Experimental gerontology is concerned with research into the basic
biological problems of ageing, into its physiology, biochemistry,
pathology and psychology.

6. Definitions
• Geriatric gynaecology: More patients are coming for repair of
prolapse of varying degrees, non- specific vaginitis, ovarian tumours,
psychic aberrations and sexual problems.
• There is ample scope for research into the degenerative and other
diseases of old age; their treatment in hospital and general practice;
and finally into preventive geriatrics and the epidemiology of
conditions affecting the aged.

7. Burden of the problem

8. Burden of the problem – Globally
• In general, “elderly” age group is defined as persons aged 65 years
and above.
• By 2025, the number of elderly people is expected to rise more than
1.2 billion with about 840 million of these in low-income countries.
• The expectation of life at birth in developed countries is over 70
years.
• These trends are appearing in all countries where medical and social
services are well developed and the standard of living is high.

9. Burden of the problem – India
• 53 million females and 51 million males are elderly
• Males – 8.2%
• Females – 9.0%
• rural – 71%
• Urban – 29%

10. Burden of the problem – India
• In India, although the percentage of aged persons to the total
population is low in comparison to the developed countries,
nevertheless, the absolute size of aged population is considerable.
• For the year 2010 the estimates are 8 per cent of total population
were above the age of 60 years, and is likely to rise to 19% by 2050.
• This profound shift in the share of older Indians, brings with it a
variety of social, economic and healthcare policy challenges

11. Health problems of the aged

12. Health problems of the aged
A. Problems due to the ageing process
B. Problems associated with long term illness
C. Psychological problems

13. A.Problems due to the ageing process
• The "biological age" of a person
is not identical with his
"chronological age".
• Our knowledge about the ageing
process is incomplete.
• This list is not exhaustive
1. Senile cataract
2. Glaucoma
3. Nerve deafness
4. Osteoporosis affecting mobility
5. Emphysema
6. Failure of special senses
7. Changes in mental outlook

14. B. Problems associated with long term illness
• Certain chronic diseases are
more frequent among the older
people than in the younger
people
• Degenerative diseases of heart
and blood vessels
• Cancer
• Accidents
• Diabetes
• Diseases of the locomotor
system
• Respiratory illnesses
• Genitourinary system problems

15. C. Psychological problems
• Mental changes – Impaired memory, rigidity of outlook and dislike of
change
• Sexual adjustments – Irritability, jealousy and despondency are very
frequent
• Emotional disorders – The degree of adaptation to the fact of ageing
is crucial to a man's happiness in this phase of life. Failure to adapt
can result in bitterness, inner withdrawal, depression, weariness of
life, and even suicide.

16. Lifestyle and healthy ageing

17. Lifestyle and healthy ageing
• People can do a great deal to
influence their individual
risk of developing many of the
diseases of later life by
paying careful attention to
lifestyle factors
• By adopting a healthier lifestyle,
the risk of a whole range of
diseases can be reduced.
1. Diet and nutrition
2. Exercise
3. Weight
4. Smoking
5. Alcohol
6. Social activities

18. Health status of the aged in India

19. Health status of the aged in India
• Few hospital based studies
• Partial view of the spectrum of
diseases
• Overall data on aged is scarce
• Hypertension / diabetes
• Cataract
• Arthritis
• Bronchitis
• Ear diseases
• Avitaminosis
• Rheumatism
• Accidents

20. Schemes & Policy for Older Person

21. National Policy for Older Persons in 1999
• This policy identifies principal areas of intervention as financial
security, health care, nutrition, shelter, education, welfare, protection
of life and property of older citizens.
• The policy provides for a broad framework for collaboration and
cooperation, both within as well as between governmental and non-
governmental agencies.
• An important thrust in the policy is on active and productive
involvement of older persons, and not just their care.

22. National Policy for Older Persons in 1999
• A national council for older persons (NCOP) was constituted to
operationalize the policy.
• An integrated programme for older persons has been formulated by
revising the earlier scheme of assistance to voluntary organizations
for programmes relating to the welfare of the aged.
• The objective is to promote a society for all ages, to empower and
improve the quality of life of older persons.

23. National Policy for Older Persons in 1999
• Recognises the formation of self help groups
• Association of older people and advancement of their rights and
utilization of their experience and services.
• 234 Old age homes, 398 day care centres and 40 mobile medical units
are operational.
• Scheme of assistance to Panchayat Raj Institutions, Voluntary
Organizations / Self Help Groups, for construction of old age homes to
encourage Multi Service Centres for older persons.

24. Schemes for Older Persons
• National Social Assistance Programme, old age pension is being
provided to more than 4 million destitute elderly all over the country.
• An Old Age Social and Income Security (OASIS) project was launched
to comprehensively examine policy questions, connected with Old
Age Income Security.
• Travel related concessions I facilities are provided to the older people
by Indian Railways, Indian Airlines and State Transport Corporations.

25. Schemes for Older Persons
• Health care is being provided to the older persons through Bhavishya
Arogya Mediclaim, and Rural Group Life Insurance Schemes.
• Income Tax Concessions are also available to the elderly citizens.
• On 19th Nov. 2007, the Indira Gandhi National Old Age Pension
Scheme was launched to provide monthly pension to people over 65
years and living below poverty line.

26. Help Age India
• Largest voluntary organization working for the cause and care of the
disadvantaged older people.
• In the 26 years since its inception, it has made an impact on the lives
of nearly 6 million senior citizens, through 3,084 projects.
• Supports for (a) Free cataract operations; (b) Mobile medicare units;
(c) Income generation and micro-credit; (d) Old-age homes and day-
care centres; (e) Adopt-a-Gran (grand parent); and (f) Disaster
mitigation.

27. Implication of the ageing population

28. Implication of the ageing population
• The ageing population is both a medical and sociological problem.
• Leads to human and social costs unless preventive action is taken.
• The alteration of the age pyramid
• Ageing developing countries are slated to face a heavy double burden
of infectious and non-communicable diseases

29. Potential for disease prevention in the elderly
• The evidence arrayed of the role of existing and often immutable
disease argues for the importance of secondary and tertiary
prevention, in combination with primary screening or prevention for
this population

32. National Programme for the Health Care of
the Elderly
• Department of Geriatric at 8 Super Specialized Institutions.
• Geriatric Unit at 100 District Hospitals.
• Rehabilitation Units at CHCs Falling Under 100 Identified Districts.
• Activity at PHCs under 100 Identified Districts.
• Activity at Sub-centre under 100 Districts

33. Thank You
Ageing is a natural process.
The modern philosophy is that the old
must continue to take their share in the
responsibilities and in the enjoyment of
the privileges, which are an essential
feature of remaining an active member of
the community.
The community must assist the aged to
fight the triple evils of poverty, loneliness
and ill- health.