The geriatric population refers to elderly individuals aged 60 years and above. The United Nations defines elderly people as those who are 60 years of age or older.(1) In India, the National Policy for Older Persons, established in January 1999, also defines senior citizens or elderly people as individuals aged 60 years and above.(2) Globally, population ageing is emerging as a major public health challenge. India is predicted to have the greatest proportion of aged people worldwide by 2025, which will substantially increase the burden of chronic illnesses, disability, and mortality.(3,4) In India, the geriatric population is increasing steadily, with 8.6% of the population being above 65 years of age. Elderly individuals have health needs that differ significantly from those of the general adult population. Ageing is a complex biological and physiological process that leads to progressive decline in bodily functions. As age advances, elderly people face multiple social, mental, emotional, and physical challenges, predisposing them to various morbidities affecting different organ systems, which may result in disability or even death.(4) In the Union Territory of Jammu & Kashmir, the share of elderly individuals (aged 60+) is notably high, accounting for about 9.4% of the region’s total population. This demographic also shows relatively high life expectancy after age 60 compared to other regions, with males and females exhibiting life expectancies of approximately 20.3% and 23.0%, respectively, beyond age 60. Projections suggest that by 2031, nearly 17% of Jammu & Kashmir’s estimated 1.48 crore residents—around 25 lakh people will be aged 60 years and above, indicating an accelerating ageing trend within the population.(5) The growing burden of chronic and incapacitating morbidities among the elderly necessitates timely medical care, palliative care, rehabilitative services, and physiotherapy. However, geriatric healthcare services in India remain inadequate due to a shortage of trained personnel and insufficient infrastructure, particularly beyond tertiary care hospitals(3,4) In this context, the present study aims to examine the morbidity profile of elderly individuals in order to generate baseline data and assist in the planning and strengthening of geriatric healthcare services.

 

Aim & Objectives:

1) To determine the various Socio-demographic factors in geriatric population.

2) To find out the prevalence of morbidity profile in relation with sex, age and educational status among the study population.

 

                                                   

A Community based cross-sectional descriptive study field practice area of the RHTC SAGAM Dept of community medicine GMC Anantnag. The study subjects were in the age group of 60 years and above and residing in this area were included in the study. Ethical approval by ethical committee of Institute was sought. The protocol and importance of the study was explained to the participants before recruitment into the study, followed by a signed informed consent by them. Duration of study period was from June – September 2024. The study was performed by house-to-house survey after taking verbal consent from the study population. Total population of the study area was 4074 and total study subjects were 125 after complete enumeration. Predesigned, pretested, and semi‑structured questionnaire was used to collect data on sociodemographic characters of study participants and history on morbidity status. This was be followed by complete general, physical, and systematic examination.

 

Statistical analysis: The collected data was entered in Microsoft Excel spread sheet and data analysis was done using appropriate statistical tool.

 

Inclusion criteria:

1) Elderly who are 60 years and above.

2) Elderly who give consent to participate in the study.

Exclusion criteria:

1) Elderly who show hostile behaviour and did not give consentto participate in the study.

2) Elderly who were not present at home at the time of the visit.

A total of 125 geriatric participants aged 60 years and above were included in the study. The findings are presented under sociodemographic characteristics, psychosocial and living conditions, morbidity profile, multimorbidity, health-care utilization, and analytical associations. The current study reveals that the majority of the participants were of the young-old age group, indicating that the study population was primarily composed of the early elderly. Only a small percentage of participants were older than 85 years. Males outnumbered females, implying male dominance among the elderly participants. In terms of marital status, the majority of participants were currently married, with only a small proportion widowed or divorced. The majority of the elderly were illiterate, and only a small minority had completed their education to graduation or higher. Housewives made up the largest occupational group, followed by labourers, retired government employees, and those who worked for themselves, reflecting the elderly population's diverse occupational background.(Table 1). Table 1: Sociodemographic Profile of the Study Participants Variable Category Frequency (n) Percentage (%) Age Group (years) 60–74 117 93.6 75–84 7 5.6 ≥85 1 0.8 Sex Male 75 60.0 Female 50 40.0 Marital Status Single 5 4.0 Married 107 85.6 Widowed / Divorced 13 10.4 Educational Status Illiterate 85 68.0 Primary standard 10 8.0 Secondary standard 14 11.2 Graduate & above 16 12.8 Occupation Housewife 39 31.2 Labourer 35 28.0 Retired (government) 26 20.8 Self-employed 25 20.0 Table 2. Economic and Living Arrangement Profile of the Study Population Variable Category Frequency (n) Percentage (%) Monthly Income (₹) <10,000 60 48.0 10,000–30,000 50 40.0 >30,000 15 12.0 Family Size Up to 5 40 32.0 5–10 80 64.0 >10 5 4.0 Status in Family Rejected / discarded 8 6.4 With family but unwanted 12 9.6 Tolerated by family 22 17.6 Respected, but no control 37 29.6 Well integrated and controls 46 36.8 Living Arrangement Living alone 10 8.0 With spouse & children 115 92.0 Duration of Living Alone 1–3 years 5 4.0 >5 years 5 4.0 In terms of economic status, nearly half of the participants reported a low monthly income, with only a small fraction falling into the higher-income category. The majority of participants came from moderate-sized families, indicating that joint or extended family structures are still prevalent. An assessment of perceived status within the family revealed that approximately one-third of the elderly felt well integrated and actively involved in family matters, while another one-third perceived themselves as simply tolerated or even unwanted, highlighting the psychosocial vulnerabilities faced by a significant segment of the elderly. The majority of participants lived with their spouse and/or children, with only a small percentage living alone, indicating that institutionalisation or solitary living was uncommon. (Table 2). Table 3. Psychosocial and Social Integration Profile among the Geriatric Population Variable Category Frequency (n) Percentage (%) Unwanted Shifting of Residence Yes 10 8.0 Place of Stay Fixed 113 90.4 Bereavement / Emotional Stress Present 42 33.6 Relationship in Bereavement (n=42) Spouse 18 42.9 Child 9 21.4 Sibling 3 7.1 Others 12 28.6 Duration of Bereavement (n=42) <6 months 7 16.67 6–12 months 19 45.23 >1 year 16 38.10 Restrictions None 51 40.8 Financial 26 20.8 Social 23 18.4 Ill health 62 49.6 Number of Friends None 16 12.8 1–2 (few) 77 61.6 ≥3 (many) 31 24.8 Communication with Relatives/Friends Regular 84 67.2 Occasional 24 19.2 Rare 17 13.6 Degree of Activity Inactive 16 12.8 Partially active 78 62.4 Active 31 24.8 Assessment of Social Integration Not integrated 9 7.2 Somewhat integrated 17 13.6 Moderately integrated 61 48.8 Well integrated 34 27.2 Totally Socially integrated 4 3.2 The majority of participants reported residential stability, with only a small minority reporting unwanted residence changes. Almost one-third experienced bereavement or emotional stress, most commonly from the loss of a spouse, followed by the loss of children, emphasising the emotional burden associated with ageing. Functional and social restrictions were common, with nearly half reporting limitations caused by illness. Financial and social restrictions were reported in smaller proportions. FIG 1. Prevalence of Common Symptoms among Study Population Table 4.Distribution of Morbidities (Overall Prevalence of Major Symptom Groups) Morbidity Group(n=110) n %age Cardiovascular/Metabolic 48 43.6 Musculoskeletal 61 55.5 Respiratory 23 20.9 Urological & Renal 26 23.6 Gastrointestinal Disorders 39 35.5 Endocrine Disorders 25 22.7 Neurological Disorders 14 12.7 Sensory Disorders 47 42.7 Hematological & Immunological Disorders 10 9.1 Psychiatric and Behavioral Disorders 25 22.7 Oncological Disorders 3 2.7 Figure 2. %age Distribution of Multi morbid conditions in Participants Table 5. Utilization Patterns and Satisfaction with Health Services among the Study Population Variable Characteristics (n) %age Type of healthcare facility visited when ill Government 119 95.2 Private 6 4.8 System of medicine commonly used Allopathic 64 51.2 Ayush 61 3.2 Frequency of PHC/Sub-centre/other health services utilization Often (weekly) 21 16.8 Occasionally (monthly) 28 22.4 Whenever ill 71 56.8 Not utilizing 5 4 Awareness of a special clinic functioning for beneficiaries (Knowledge) 51 40.8 Adequate treatment facilities at Health Unit (Subjective) 92 26.4 Enrolled in Ayushman Bharat Scheme PM-JAY 108 86.4 Availing of Ayushman Bharat Scheme PM-JAY 81 64.8 Condition for availing Ayushman Bharat Scheme PM-JAY (among users) Medical 73 90.1 Surgical 5 6.2 Both 19 23.5 Satisfied with the services provided Yes 101 80.8 In terms of social interaction, the majority of participants reported having one or two friends, with a small proportion having no friends at all. The majority of respondents reported regular communication with relatives or friends, indicating some level of social connectedness. In terms of physical activity, the majority of participants were only partially active, with less than one-fourth identifying as fully active. The overall assessment of social integration revealed that nearly half were moderately integrated, one-fourth were well integrated, and a small minority lacked social integration, indicating varying levels of social engagement in the elderly. (table 3) Musculoskeletal complaints dominated the morbidity profile, followed by cardiovascular, metabolic, sensory, and gastrointestinal disorders. Psychiatric, endocrine, and urological conditions affected a smaller but significant proportion, whereas neurological, haematological, and oncological disorders were relatively uncommon. The presence of more than one morbidity in a large proportion of participants demonstrates the high prevalence of multimorbidity in this age group.(Table 4). Healthcare-seeking behaviour revealed that the majority of participants used government health facilities, with very few preferring private services. Allopathic medicine was the most widely used system, and healthcare services were generally sought whenever illness struck, with a smaller proportion requiring frequent or regular visits. More than half of the participants were unaware of special clinics for the elderly. However, the majority were enrolled in the Ayushman Bharat PM-JAY scheme, and a sizable proportion had reaped the benefits. The majority of participants reported overall satisfaction with healthcare services, indicating that they have a positive perception of the available healthcare services.(Table 5) Age, gender, marital status, education, and income were found to have no statistically significant association with morbidity. Although females and low-income participants had higher odds of morbidity, these associations were not statistically significant, implying that morbidity among the elderly is influenced by multiple interacting factors beyond basic sociodemographic characteristics.(Table 6-8). Table 6. Association of Socio-Demographic Characteristics with Morbidity among the Elderly Variable Category Morbidity Odds Ratio p-value (+) (-) Age 60–74 100 17 1.00 – ≥75 6 2 0.51 0.53 Gender Male 61 14 1.00 – Female 45 05 2.07 0.18 Marital Status Currently Married 91 16 1.00 – Widowed/Divorced 15 03 0.88 0.89 Education Illiterate 73 12 1.29 0.69 Literate 33 7 1.00 – Income ≤ ₹10,000 54 6 2.54 0.24 ₹10,000 to 30,000 39 11 1.00 – > 30,000 13 2 1.83 0.61 Table 7. Association of Social Support Indicators with Morbidity Variable Category Morbidity Odds Ratio p-value (+) (–) Family Size ≤5 members 40 35 5 1.00 – 5–10 members80 68 12 0.71 0.46 >10 members5 3 2 0.19 0.16 Living Arrangement With Family 98 17 1.00 – Living Alone 8 2 0.69 0.66 Friend Circle None 9 7 0.17 0.001 1–2 friends 68 9 1.00 – ≥3 friends 29 3 1.28 0.63 Table 8. Association of Psychosocial Stressors and Social Engagement on Morbidity Variable Category Morbidity (+) Morbidity (–) Odds Ratio p-value Restriction Financial (+) 24 2 2.49 0.182 Financial (–) 82 17 1.00 — Social (+) 22 1 4.71 0.103 Social (–) 84 18 1.00 — Ill-health (+) 56 6 2.42 0.028 Ill-health (–) 50 13 1.00 — Communication Frequency Regular 81 3 1.00 — Occasional/Rare 25 16 0.06 <0.01 Social Integration Well/Moderate 82 17 1.00 — Poor 24 2 2.49 0.182 Bereavement Status Present 39 3 3.10 0.091 Not 67 16 1.00 — On analytical assessment, age, gender, marital status, educational status, and income did not show a statistically significant association with morbidity. Females had higher odds of morbidity compared to males (OR = 2.07), and participants with lower income showed increased odds of morbidity; however, these associations were not statistically significant (Table 6). Absence of a friend circle was significantly associated with morbidity (p = 0.001). Restrictions due to ill health were also significantly associated with morbidity (OR = 2.42, p = 0.028). Infrequent communication with relatives or friends showed a statistically significant association with morbidity (p < 0.01). Other psychosocial factors such as bereavement, financial restriction, social restriction, and poor social integration demonstrated increased odds of morbidity, although these associations did not reach statistical significance (Tables 7 and 8)