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Objectives To measure the prevalence of depression among the rural elderly population of North Tamilnadu in India and to identify the associated social factors. Methods A community based cross sectional study was carried out among those aged 60 years and above. The data was collected from 162 consenting participants, who were selected through a multi staged cluster sampling, using a structured interviewer administered questionnaire and Geriatric depression scale (short form) and prevalence was calculated. A binary logistic regression was done to identify the independent association of risk factors with depression. Results The study found the prevalence of old age depression as 52.5% (95% CI: 44.7-60.3) with factors low socio economic status, increasing age and single status posing strong independent risk. Conclusion The authors advocate community based support systems in rural areas which will increase the social interaction and inclusiveness of the aged.

Background: Malnutrition plays an important role in the economic burden of society as well as the country. This study aimed to identify the various risk factors and determinants of severe acute malnutrition (SAM) as defined by WHO growth reference standards in children aged 6 months to 59 months living in Vellore. Methods: A community-based case-control study matched for age (±2months), gender and location was done among the children of the age group 6- 59 months residing in both rural and urban Vellore. Children of age group 6-59 months with SAM according to WHO definition, i.e., weight for height of less than -3SD with or without nutritional oedema were classified as cases. Children with weight-for-height z-score more than -1 SD and MUAC ≥13.5cms were classified as controls. With 2 controls per case, the required sample size was 54 cases and 108 controls. A questionnaire used to identify the risk factors including dietary intake. Uni-variate and multivariate analysis was done to generate an odds ratio and 95% confidence interval for the risk factors. Results: Majority of the cases 64.8% and 50% of the controls belonged to low SES. After adjusting all confounders, Severe Acute Malnutrition was significantly associated with birth weight

Introduction: As we are moving from millennium development goals to sustainable development goals, food insecurity is imposing a formidable challenge to the policymakers, especially in developing countries such as India. A survey conducted in the urban slum areas of Vellore district, 6 years back, had reported food insecurity as high as 75%. The current study was a resurvey to assess the food security status in the aforementioned area. Materials and Methods: A community-based survey was conducted in which data were collected using a self-administered questionnaire from 150 households, selected through multistaged cluster sampling, who had given oral consent to be a part of the survey. The prevalence of food security calculated from this study was compared with the results from a previous survey to look for any significant improvement. Results: Nearly 42.7% of the households were food secure, while 26.7% were food insecure without hunger and 30.6% were food insecure with some degree of hunger. Low socioeconomic status (odds ratio [OR]: 3.25, 95% confidence interval [CI]: 1.29–8.16; P < 0.012) and presence of debt (OR: 3.84, 95% CI: 1.90–7.73; P < 0.001) were the major risk factors for food insecurity. A comparison with the findings from the previous study has shown a statistically significant improvement in food security from 25.4% to 42.7% (Chi-square: 27.072, df: 2, P < 0.0001). Conclusion: Although food security levels have shown marked improvement over the years, much needs to be done for India to be free from the shackles of hunger.

Older people suffering from dementia are prone to develop malnutrition. Ensuring adequate nutrition among such patients has always been a challenge for the carers due to the pathological and chronic nature of the disease. In this article, the author tries to analyze the use of five different strategies in providing adequate nutrition for such patients in their own homes by the carers using a narrative literature review method. The strategies include nutrition screening and assessment, training and education program for the caregiver, mealtime environment and routine modification, provision of nutritional supplements, and role of artificial nutrition and hydration (ANH). An attempt was made to critically engage the readers while exploring the feasibility and challenges involved in implementing such strategies in resource-poor settings like low-middle-income countries. The article concludes that the first four strategies should be used in tandem to prevent the risk of malnutrition. It does not recommend ANH and concludes that it does not bring in any added benefit and may worsen the quality of life.

Aim: To empower and bring the underprivileged senior citizens in the rural areas to the mainstream of life through setting up of model “senior citizens' recreation centers” that can be replicated in the other parts of the country. Materials and Methods: Six senior citizens' recreation centers are run in six villages under a community health program of a leading Medical College in South India, which were started by looking into their perceived needs and in a location where organized self-help women groups (SHGs) showed willingness to take the role of caretakers. Together there are 140 members in 6 centers and the most deserving members were identified using a participatory rural appraisal (PRA) method. These centers are open for 5 days a week and the main attraction of the center has been provision of one good, wholesome, noon-meal a day, apart from several recreational activities. The members were also assessed for chronic energy deficiency (CED) and quality of life at the beginning of enrolment using body mass index (BMI) and WHO-BREF scale. Results: The attendance to these centers was nearly 90% of the enrolled beneficiaries. A statistically significant improvement was noticed in quality of life in the physical, psychological, social, and environmental domain (P < 0.05). There was also a significant increase in the average BMI after 1 year of the intervention (P < 0.05). Conclusion: Care of underprivileged senior citizens is a growing need in the rural areas and the “Recreation centers” proved to be a beneficial model that can be easily replicated.

Background: The objectives of the study were to conduct a field survey to measure the prevalence of chronic diseases by taking history, to assess the feasibility of using remote data collection tools in field surveys and to create the map of the survey area using global positioning system (GPS). Methods: A community survey was carried out in two urban municipal wards by trainees with medical sociology back ground among those aged 35 years and above. There were a total of 563 participants from whom history of chronic diseases were collected and from those aged 60 years and above the presence of frailty was assessed using Canadian Study of Health and Ageing (CSHA) Clinical Frailty Scale. The data was collected using a remote data collection application named KoBo Toolbox, downloaded in their smart phones, which was sent directly to the main computer in the Clinical Epidemiological Unit, using mobile data or Wi-Fi hotspots. The co-ordinates of the households were marked using GPS which was also sent through the KoBo Toolbox to the main computer. At the centre the data was converted into excel sheets and various percentages were calculated. Results: In the survey the proportion affected with diabetes, hypertension, coronary artery disease and cerebrovascular accidents were 24%, 20.6%, 10.5% and 3.5% respectively. Among the older population 2.2% were found to be severely frail or worse requiring special care. The field map of the area surveyed was also generated using the co-ordinates marked using the GPS enabled phones. Conclusions: The remote data collection tool enabled us to conduct a survey on chronic diseases, effectively, within a limited period of time, creating a map of the area surveyed.

Background: Population is ageing in India. Health care and other needs associated with ageing have risen. The study objectives were to explore the concept of ‘healthy ageing’; health problems of elderly; and felt needs in the care of elderly perceived by the community.Methods: Total of five focus group discussions was conducted. Three Focus group discussions were conducted with family members of homebound elderly and one discussion each were conducted with primary health workers and residents of old age home to supplement the qualitative information gathered from the family members.Results: The participant could make a long list of geriatric health problems. But, their knowledge and attitude towards them was grossly incorrect. All the problems were regarded as part and parcel of ageing for which help was not sought proactively. Mental health problems were regarded as ‘behavioural’ and ‘psychological’ problems. The health problems had its bad effect on family relationships. The perceived healthcare needs were mostly of palliative nature. Day care centres were proposed to improve social interaction of elderly. The community could not afford the level of services which they need. Home care visits by a health team were regarded highly useful.Conclusions: Wide spectrum of barriers to healthcare access of elderly exists in the community. In this regard, a comprehensive community based geriatric health care program including health promotive, preventive, curative and palliative services needs to be formulated with a strong component of health education.

In an anticipation of the rising geriatric population in India, the Central government constituted the National Policy for Older Persons in 1999 to promote the health and welfare of senior citizens in India. A major strategy of this policy is to encourage families to take care of their older family members. The policy also encourages voluntary organizations to supplement the care provided by the family and provide care and protection to vulnerable elderly people. The implementation of this policy, particularly in the rural areas, has been negligible and calls for a scaling-up of programs to address the physical, psychological, and social needs of the poor. Due to breakdown of the joint family system and the migration of the younger generation to the towns and cities, the elderly parents in the villages are left to fend for themselves. Too old to work and with little or no source of income, the elders are struggling even to satisfy their basic needs. This article primarily focuses on the various facets of elderly care in India. As a fledgling nation in elderly care, we should take cues from other nations who have pioneered in this field and should constantly evolve to identify and face the various challenges that come up, especially from rural India. The Rural Unit for Health and Social Affairs Department of a well-known Medical College in South India has developed a “senior recreation day care” model which proves to be a useful replicable model to improve the quality of life and nutritional status of the elderly in the lower rungs of society. More than a decade since its inception, it is now the right time to assess the implementation of our geriatric health policy and scale-up programs so that the elderly in our country, irrespective of urban and rural, will have a dignified and good quality life.