Predictors of mortality among elderly people living in a south Indian urban community; a 10/66 Dementia Research Group prospective population-based cohort study
Open Access
- 23 June 2010
- journal article
- Published by Springer Science and Business Media LLC in BMC Public Health
- Vol. 10 (1), 366
- https://doi.org/10.1186/1471-2458-10-366
Abstract
Background Eighty percent of deaths occur in low and middle income countries (LMIC), where chronic diseases are the leading cause. Most of these deaths are of older people, but there is little information on the extent, pattern and predictors of their mortality. We studied these among people aged 65 years and over living in urban catchment areas in Chennai, south India. Methods In a prospective population cohort study, 1005 participants were followed-up after three years. Baseline assessment included sociodemographic and socioeconomic characteristics, health behaviours, physical, mental and cognitive disorders, disability and subjective global health. Results At follow-up, 257 (25.6%) were not traced. Baseline characteristics were similar to the 748 whose vital status was ascertained; 154 (20.6%) had died. The mortality rate was 92.5/1000 per annum for men and 51.0/1000 per annum for women. Adjusting for age and sex, mortality was associated with older age, male sex, having no friends, physical inactivity, smaller arm circumference, dementia, depression, poor self-rated health and disability. A parsimonious model included, in order of aetiologic force, male sex, smaller arm circumference, age, disability, and dementia. The total population attributable risk fraction was 0.90. Conclusion A balanced approach to prevention of chronic disease deaths requires some attention to proximal risk factors in older people. Smoking and obesity seem much less relevant than in younger people. Undernutrition is preventable. While dementia makes the largest contribution to disability and dependency, comorbidity is the rule, and more attention should be given to the chronic care needs of those affected, and their carers.Keywords
This publication has 52 references indexed in Scilit:
- Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: a 10/66 Dementia Research Group population-based surveyThe Lancet, 2009
- The Epidemiology of Dependence in Older People in Nigeria: Prevalence, Determinants, Informal Care, and Health Service Utilization. A 10/66 Dementia Research Group Cross‐Sectional SurveyJournal of the American Geriatrics Society, 2009
- The epidemiology of dependency among urban-dwelling older people in the Dominican Republic; a cross-sectional surveyBMC Public Health, 2008
- The Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, IndiaPLOS ONE, 2008
- The protocols for the 10/66 dementia research group population-based research programmeBMC Public Health, 2007
- Subjective well‐being as a predictor of all‐cause mortality among middle‐aged and elderly people living in an urban Japanese community: A seven‐year prospective cohort studyGeriatrics & Gerontology International, 2006
- The Mortality Divide in India: The Differential Contributions of Gender, Caste, and Standard of Living Across the Life CourseAmerican Journal of Public Health, 2006
- Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay Cohort StudyInternational Journal of Epidemiology, 2005
- Development of the EURO–D scale – a European Union initiative to compare symptoms of depression in 14 European centresThe British Journal of Psychiatry, 1999
- A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECATPsychological Medicine, 1986