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Introduction: Falls are an important health problem among elderly, with various consequences. The objectives of this study were to estimate 1-year incidence of falls, distribution, and severity of fall-related injuries and to determine risk factors for fall risk among the elderly population aged =60 years. Methods: A total of 140 urban community-dwelling participants aged =60 years were studied using an investigator-administered questionnaire. Short physical performance battery, chair stand test, handgrip strength, and anthropometric measurements were done. The Chi-square test was done to compare fallers and nonfallers. Logistic regression was done for independently associated risk factors. Results: One-year incidence of falls was 14.3%; 17.6% among women and 9.1% among men. Sixty percent of participants had multiple falls. Seventy-five percent of the fallers were overweight or obese. Sprain was the most common reported fall-related injury (20%), whereas 45% had no injuries. Depression (60%), osteoporosis (80%), poor activities of daily living (90%), and polypharmacy (35%) were significantly associated with falls. Osteoporosis (odds ratio: 14.89; 95% confidence interval: 1.91-115.95) was independently associated with fall risk. Conclusions: The burden of falls among urban elderly was low. The majority of the population experienced multiple falls. Since chronic diseases including osteoporosis and poor mobility were directly associated with the risk of falls, further longitudinal studies may explore the health-related and socioenvironmental risks further. [ABSTRACT FROM AUTHOR]

Objectives: The objective was to determine odds of frailty syndrome with coexistence of hypertension and depression among oldest-old adults. Methods: We analysed secondary data from 167 community-dwelling hypertensive participants aged 80 years and older from a cross-sectional study of frailty conducted in India. Data included sociodemographic, medical history, physical performance, functional limitations, mobility-disability, cognition, depression, sleep, frailty syndrome and chronic diseases. Odds of frailty syndrome was compared among individuals having only hypertension, and individuals having hypertension and depression. Chi-square test, t-test and logistic regression were performed to determine odds of frailty. Results: Frailty was significantly higher (OR:4.93;95%CI:1.89-12.84) among individuals having hypertension and coexisting depression, compared to individuals having only hypertension. Men (OR:5.07;95%CI:1.02-25.17) and women (OR: 4.58;95%CI:1.36-15.40) with hypertension and depression showed a higher risk of frailty, compared with hypertension alone. Logistic regression models were adjusted for age, sex, cognitive impairment, chronic obstructive pulmonary disease, cardiovascular diseases, anaemia, diabetes, obesity, physical performance, activities of daily living and 4-meter walking speed. Conclusion: Coexistence of hypertension and depression increased risk of frailty syndrome among men and women above 80 years of age by almost 5 folds. Treating depression in hypertensive older individuals may reduce the risk of frailty among them. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of care provided by private practitioners in rural areas of Wardha district. Methodology: The study was carried out in three primary health centres of Wardha district. 20% of the 44 registered private practitioners were selected randomly for the study. The data was collected using checklist through direct observation for the infrastructure. Assessment of quality of services delivered, 10 consecutive patients were observed and also the medical practitioner was interviewed. Supplies and logistics were assessed through observation. Results: All the facilities were sheltered from weather conditions and 90% had adequate waiting space. But, drinking water and adequate IEC material was available in only 20% facilities. Complete history taking and relevant physical examination was done in only 20% cases. Only 20% practitioners recorded blood pressure and 30% recorded temperature in cases with fever. Provisional diagnosis was not written in any of the case and only 20% explained prescription to the patients. Conclusion: There is considerable scope to improve the quality of services of private practitioners. To achieve this quality assurance programs may be initiated along with the training of private medical practitioners. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were to estimate prevalence of obesity among frail individuals aged =80 years and examine the association of obesity with cognitive impairment and depression among frail individuals aged =80 years. Methods: Twohundred community-dwelling participants aged =80 years, were enrolled; 166 frail participants were further analyzed. Obesity and adiposity were determined by Body Mass Index (BMI), Waist Circumference (WC) and Body Fat Percentage (BF%). Cognitive impairment and Depression were assessed using Mini Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15). Frailty was assessed by Fried criteria. Chi-Square, t-test, trend-analysis and Logistic Regression (LR) were done. Results: Obesity among Frail individuals aged =80 years was 40% using BMI and 73.2% using WC. Obesity was inversely associated with cognitive impairment and depression among frail individuals. Severity of cognitive impairment and depression was lower among obese frail than non-obese frail. Trend-analysis showed decreasing cognitive impairment and depression with increasing BF%. On LR, obesity among frail individuals had inverse association with cognitive impairment and depression. Conclusion: Obesity among frail individuals aged =80 years was associated with lower odds of cognitive impairment and depression in our population. Positive effects of weight gain in oldest old frail individuals and development of cognitive impairment and dementia should be explored in further researches. [ABSTRACT FROM AUTHOR]

Background: Oldest-old population is rapidly increasing in all countries, with many prescribed statin therapy. Statins are associated with multiple cardiovascular benefits at various ages. The benefits of statins above the age of 75 are being questioned. The objective of this study was to measure statins use among the oldest-old population, aged 80 years and above, and to study the effect of statins on cognitive function, depression, and quality of sleep. Materials and Methods: This cross-sectional study randomly enrolled 200 community-dwelling individuals aged >80 years. Data were collected upon home visits on sociodemographic, cognitive functions, depression, sleep, chronic diseases, functional limitations, and disabilities. Cognitive function (Mini Mental State Examination), depression (Geriatric Depression Scale), and quality of sleep (Pittsburgh Sleep Quality Index) among individuals using statins versus not using statins were compared. Chi-square test and t-test were done; odds ratios (ORs) with 95% confidence interval (95% CI) were reported. Logistic regression was done to calculate adjusted OR with age, antidepressants, sedatives, antihistaminics, and sleep medicines. P < 0.05 was considered statistically significant. Results: Overall prevalence of statin use in our study population was 12%; 11.3% in women and 13.2% in men. Cognitive functions, depression, and quality of sleep improved among those using statins (P < 0.05): cognitive impairment - OR: 0.38; 95% CI: 0.16-0.91; depression -- OR: 0.41; 95% CI: 0.17-1.02, and poor sleep quality - OR: 0.39; 95% CI: 0.16-0.96. On stratification by gender, men showed a significant association of improved cognitive function and quality of sleep with the use of statins, whereas women did not show any significant associations with cognitive function and quality of sleep but showed almost significant association with improvement in depression. Conclusions: The prevalence of the use of statins was low in our population. Statins had positive effects on cognitive functions, quality of sleep, and depression over 80 years of age in our population, although gender difference exists. [ABSTRACT FROM AUTHOR]

Objectives of this cross-sectional study were to determine the prevalence of functional limitations, and sex difference among 140 randomly selected older men (N=55) and women (N= 85) elderly, age varying 60 years and above, living in Hyderabad city, (Telangana State) A Short Physical Performance Battery (SPPB) as a measurement of physical performance was used as a measure of data collection. Each participant was administered SPPB individually. Functional limitation was classified as a participant with SPPB score < 9. Other measures included, self-reported health status, history of smoking and alcohol, anthropometric measurements, physical functions, and disabilities. The data was analysed keeping in mind age, sex, marital status, education of participants. Chi-square test and t-test were used. Trend analysis was done using logistic regression to determine the pattern of difference in functional limitations in both the sexes. The prevalence of functional limitation was 62.9 per cent. Older women had poorer physical performance measures than older men (OR:2.63; 95%CI: 1.29-5.35). Older women had poorer physical functions than men counterparts. Components of SPPB showing sex differences were poor balance and poor lower limb muscle strength. The pattern of functional limitation with progressing age was different among men and women in the participants of this study. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Low bone mineral density (BMD) is widely prevalent in Indian populations. Very few studies that reported risk factors for low BMD and osteoporosis did not explore its relationship with age and sex. Objectives were to determine the prevalence of low BMD and osteoporosis in urban adults, and study the age- and sex-wise trends of changing BMD. METHODOLOGY: BMD of 521 healthy adults aged 20 years or more was tested using quantitative ultrasound of right tibia, and T-scores thus obtained indicated normal or low BMD. Multivariate analysis was done to calculate odds ratios for risk factors for low BMD and osteoporosis. RESULTS: Eighty-four percent participants had low BMD. Low BMD increased significantly with increasing age in both genders. An increase in age per standard deviation (SD) was associated with four-fold increase in risk of low BMD for both women (odds ratio [OR]: 4.83, 95% confidence interval [CI]: 2.61–8.92) and men (OR: 4.14, 95% CI: 2.44–7.05). Age per SD (OR: 2.28, 95% CI: 1.37–3.81) and age–gender interaction (OR: 1.09, 95% CI: 1.02-1.17) was positively associated with osteoporosis. Increasing age by one SD was associated with seven-fold increase (OR: 7.35, 95% CI: 3.51–15.40) in risk of osteoporosis among women. CONCLUSIONS: Low BMD is highly prevalent in South Indian urban population. Low BMD and osteoporosis were positively associated with increasing age. Loss of BMD appeared to begin at young ages thereby indicating the need for early institution of prevention measures. [ABSTRACT FROM AUTHOR]

Aim. Falls are an important contributor to loss of function, morbidity, and mortality in elders. Little is known about falls in Indian populations. The objective of this cross-sectional report was to identify the prevalence and correlates of falls in a cohort of 562 rural southern Indian men and women. Methods. Risk factors included demographics, anthropometrics, self-reported health, medical history, physical function, vision, depression, and lifestyle. Odds ratios were calculated using logistic regression. Results. 71 (13%) subjects reported at least 1 fall in the past year. Prevalence was higher among women (17%) than men (8%), P=0.003. Sex and age showed significant interaction (P=0.04) whereby falls prevalence increased with age among women but decreased among men. Correlates of falls among men included a history of osteoarthritis (OA) (odds ratio (OR): 6.91; 95% CI: 1.4–33.1), depression (OR:9.6; 3.1–30.1), and greater height (OR per 1 standard deviation increase: 2.33; 1.1–5.1). Among women, poor physical performance (OR: 3.33; 1.13–9.86) and history of cardiovascular disease (CVD) (OR: 2.42; 1.01–5.80) were independently associated with falls. Implications. Prevalence of falls in elderly South Indians was lower than published reports from western countries and likely reflects low exposure to fall risks. Patterns with age differed in men and women and may reflect sex differences in the accuracy of age recall. Presence of comorbidities specifically OA, CVD, and depression was independent correlate of falling. [ABSTRACT FROM AUTHOR]

Summary Background Dengue surveillance data in India are limited and probably substantially underestimate the burden of disease. A community-based study was undertaken to assess the prevalence of dengue-specific immunoglobulin G (IgG) antibodies in children across India and to examine historical dengue exposure rates. Potential associations between socio-economic factors and dengue seroprevalence were also assessed (registered at ctri.nic.in: CTRI/2011/12/002243). Methods A convenience sample of 2609 healthy children aged 5–10 years was enrolled; these children were registered at or were living in the vicinity of eight centres located at six geographically distinct sites across India. Blood samples were drawn to test for the presence of dengue IgG antibodies using ELISA. Serotype-specific neutralizing antibody titres were measured in dengue IgG-positive children using dengue plaque reduction neutralization tests. Socio-demographic and household information was collected using a questionnaire. Results Overall, 2558/2609 children had viable samples with laboratory results for dengue IgG. Dengue IgG seroprevalence across all sites was 59.6% (95% confidence interval 57.7–61.5%): the lowest (23.2%) was in Kalyani, West Bengal, and the highest (80.1%) was in Mumbai. Seroprevalence increased with age. Multivariate analysis suggested associations with household water storage/supply and type of housing. Half of the subjects with positive IgG results presented a multitypic profile, indicating previous exposure to more than one serotype. Conclusions The overall dengue seroprevalence suggests that dengue endemicity in India is comparable to that in highly endemic countries of Southeast Asia. Additional prospective studies are required to fully quantify the disease burden, in order to support evidence-based policies for dengue prevention and control in India. [ABSTRACT FROM AUTHOR]