Volume 13, Issue 5 (Special Issue 2019)
Salmand: Iranian Journal of Ageing 2019, 13(5): 652-665 |
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Ghasemi S, Keshavarz Mohammadi N, Mohammadi Shahboulaghi F, Ramezankhani A, Mehrabi Y. Physical Health Status and Frailty Index in Community Dwelling Older Adults in Tehran. Salmand: Iranian Journal of Ageing 2019; 13 (5) :652-665
URL: http://salmandj.uswr.ac.ir/article-1-1580-en.html
URL: http://salmandj.uswr.ac.ir/article-1-1580-en.html
Sima Ghasemi1 
, Nastaran Keshavarz Mohammadi * 2, Farahnaz Mohammadi Shahboulaghi3 , Ali Ramezankhani4 , Yadollah Mehrabi4
, Nastaran Keshavarz Mohammadi * 2, Farahnaz Mohammadi Shahboulaghi3 , Ali Ramezankhani4 , Yadollah Mehrabi4
1- Department of Basic Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,n_keshavars@yahoo.com
3- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. ,
3- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Extended Abstract
1. Objectives
lthough we are facing a growing population of elderly people in Iran, our knowledge of their health status is not sufficient. The aging population creates opportunities and challenges, including an increase in primary health care and in other services. Because of the increased prevalence of chronic diseases, these people need more health and social care than other citizens [1]. A comprehensive understanding of the health problems of this vulnerable group can help health planners in implementing effective interventions. To our knowledge, there is no comprehensive study in Tehran City, Iran on all dimensions of health and vulnerability of the elderly [2-12]. This study aimed to investigate the physical health status and assess the Frailty Index (FI) of the elderly people in Tehran, Iran.
2. Methods and Materials
In this cross-sectional study, 480 old people were selected using a stratified cluster sampling method from District 5 in Tehran in 2016. They met the study inclusion criteria. For collecting study data, we used the Elderly Need Assessment Questionnaire (ENAQ) which has been designed for the Iranian population with acceptable validity and reliability [13-15]. After approval of the University Ethics Committee and obtaining informed consent from the participants, the questionnaires were completed through a door-to-door interview with the subjects.
To determine the score of the physical health status, the total score of ENAQ under physical health subscale was calculated. The scores less than 1 shows poor status and scores higher than 0 indicate favorable status. The score of the FI under physical health subscale was also measured [16-19]. For this purpose, first, 30 diseases and disorders were considered. Each “yes” answer received 1 point. By dividing the overall score of disorders by 30, FI was calculated for each subject. To measure their health care needs, an open-ended question was drafted whose answer was analyzed quantitatively through content analysis. In this regard, first, the answers that had similar concepts were put in one group, then, to get the percentage of responses, the number of groups was divided into the total number of the elders. The obtained data were analyzed using logistic regression analysis in SPSS V.16. The significance level was considered less than 0.05.
3. Results
The Mean±SD age of the study subjects was 70.1±7.3 years. Of 480 participants, 74.2% were in the age group of below 75 years; 30% were widowed, divorced, or single; a little more than half of them had elementary education or were illiterate; 42.45% were unemployed; only a very small percentage (5%) had voluntary activities; 13% of them were living alone; about half of them (54.1%) were not satisfied with their income; majority of them were receiving pension for retirement or had old age pension; most of them had health insurance, and 16.2% were under financial support.
Regarding the general opinion of the elderly about their health status; 50% and 21.8% of them reported it as “moderate” and “good”, respectively; while one-fourth of them reported it “poor” and “very poor”. The majority of the elderly (90.9%) had at least one disease with special treatment. About 30.9% of them were multi-drug users (taking four or more drugs at the same time). Moreover, 22.7% of them had a history of falling in the past 12 months. The most commonly reported diseases were joint inflammation (62.4%), hypertension (48.2%), and heart disease (31.1%), while the most common disorders and health problems were anxiety (57.6%) and fatigue (56.4%). With regard to the accumulation of deficits which is the total number of diseases, disorders, signs, symptoms, and functional deficiencies existing in an elderly person, 28% of seniors had 8-11 disease or disorders at the same time. Regarding the health care needs, most of them (83%) reported no health insurance coverage and half of them reported problems in medication supply.
A logistic regression model was used to determine the relationship of demographic variables with the physical health of the elders. By adjusting the underlying factors of age, gender, marital status, education, lifestyle, and FI, it was found out that only FI had a significant association with physical health (OR=4.4, CI=3.5-3.9; P<0.001). That is, for every 0.01 increase in FI, subjects with the same demographic status, will have a four-fold decrease in their physical health status.
4. Conclusion
The majority of the studied seniors had at least one chronic disease with special treatment. This figure has increased compared to the studies conducted in the past 10 years. Given the findings and frequency of chronic diseases (joint inflammation, hypertension, and heart disease), preventive services, screening and managing common diseases seem to be necessary. It is also advisable to prepare comprehensive self-care programs to actively protect the health of the elderly. It seems that stress management, insurance coverage, and effective access to health care services are the most important physical health needs of the elderly in Tehran. Planning and delivery of health services should be in line with the current situation of the elderly and their changing needs. Health authorities and family members should be aware of the real needs and health demands of elderly people. This is an important step in preventing the elderlies’ common diseases and disorders and protecting and promoting their health.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences under code No: 286-SBMU.REC.1393.
Funding
This paper was extracted from a research project jointly supported by Research Center on Ageing of University of Social Welfare and Rehabilitation Sciences, and School of Health Safety and Environment of Shahid Beheshti University of Medical Sciences.
Authors' contributions
All authors contributed in designing, running, and writing all parts of the research.
Conflict of interest
The authors declared no conflict of interest.
1. Objectives
lthough we are facing a growing population of elderly people in Iran, our knowledge of their health status is not sufficient. The aging population creates opportunities and challenges, including an increase in primary health care and in other services. Because of the increased prevalence of chronic diseases, these people need more health and social care than other citizens [1]. A comprehensive understanding of the health problems of this vulnerable group can help health planners in implementing effective interventions. To our knowledge, there is no comprehensive study in Tehran City, Iran on all dimensions of health and vulnerability of the elderly [2-12]. This study aimed to investigate the physical health status and assess the Frailty Index (FI) of the elderly people in Tehran, Iran.
2. Methods and Materials
In this cross-sectional study, 480 old people were selected using a stratified cluster sampling method from District 5 in Tehran in 2016. They met the study inclusion criteria. For collecting study data, we used the Elderly Need Assessment Questionnaire (ENAQ) which has been designed for the Iranian population with acceptable validity and reliability [13-15]. After approval of the University Ethics Committee and obtaining informed consent from the participants, the questionnaires were completed through a door-to-door interview with the subjects.
To determine the score of the physical health status, the total score of ENAQ under physical health subscale was calculated. The scores less than 1 shows poor status and scores higher than 0 indicate favorable status. The score of the FI under physical health subscale was also measured [16-19]. For this purpose, first, 30 diseases and disorders were considered. Each “yes” answer received 1 point. By dividing the overall score of disorders by 30, FI was calculated for each subject. To measure their health care needs, an open-ended question was drafted whose answer was analyzed quantitatively through content analysis. In this regard, first, the answers that had similar concepts were put in one group, then, to get the percentage of responses, the number of groups was divided into the total number of the elders. The obtained data were analyzed using logistic regression analysis in SPSS V.16. The significance level was considered less than 0.05.
3. Results
The Mean±SD age of the study subjects was 70.1±7.3 years. Of 480 participants, 74.2% were in the age group of below 75 years; 30% were widowed, divorced, or single; a little more than half of them had elementary education or were illiterate; 42.45% were unemployed; only a very small percentage (5%) had voluntary activities; 13% of them were living alone; about half of them (54.1%) were not satisfied with their income; majority of them were receiving pension for retirement or had old age pension; most of them had health insurance, and 16.2% were under financial support.
Regarding the general opinion of the elderly about their health status; 50% and 21.8% of them reported it as “moderate” and “good”, respectively; while one-fourth of them reported it “poor” and “very poor”. The majority of the elderly (90.9%) had at least one disease with special treatment. About 30.9% of them were multi-drug users (taking four or more drugs at the same time). Moreover, 22.7% of them had a history of falling in the past 12 months. The most commonly reported diseases were joint inflammation (62.4%), hypertension (48.2%), and heart disease (31.1%), while the most common disorders and health problems were anxiety (57.6%) and fatigue (56.4%). With regard to the accumulation of deficits which is the total number of diseases, disorders, signs, symptoms, and functional deficiencies existing in an elderly person, 28% of seniors had 8-11 disease or disorders at the same time. Regarding the health care needs, most of them (83%) reported no health insurance coverage and half of them reported problems in medication supply.
A logistic regression model was used to determine the relationship of demographic variables with the physical health of the elders. By adjusting the underlying factors of age, gender, marital status, education, lifestyle, and FI, it was found out that only FI had a significant association with physical health (OR=4.4, CI=3.5-3.9; P<0.001). That is, for every 0.01 increase in FI, subjects with the same demographic status, will have a four-fold decrease in their physical health status.
4. Conclusion
The majority of the studied seniors had at least one chronic disease with special treatment. This figure has increased compared to the studies conducted in the past 10 years. Given the findings and frequency of chronic diseases (joint inflammation, hypertension, and heart disease), preventive services, screening and managing common diseases seem to be necessary. It is also advisable to prepare comprehensive self-care programs to actively protect the health of the elderly. It seems that stress management, insurance coverage, and effective access to health care services are the most important physical health needs of the elderly in Tehran. Planning and delivery of health services should be in line with the current situation of the elderly and their changing needs. Health authorities and family members should be aware of the real needs and health demands of elderly people. This is an important step in preventing the elderlies’ common diseases and disorders and protecting and promoting their health.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Research Ethics Committee of Shahid Beheshti University of Medical Sciences under code No: 286-SBMU.REC.1393.
Funding
This paper was extracted from a research project jointly supported by Research Center on Ageing of University of Social Welfare and Rehabilitation Sciences, and School of Health Safety and Environment of Shahid Beheshti University of Medical Sciences.
Authors' contributions
All authors contributed in designing, running, and writing all parts of the research.
Conflict of interest
The authors declared no conflict of interest.
Type of Study: Research |
Subject:
Clinical
Received: 2018/07/15 | Accepted: 2018/12/25 | Published: 2019/03/10
Received: 2018/07/15 | Accepted: 2018/12/25 | Published: 2019/03/10
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