Cardiovascular disease and mobility disability in rural older indians: the mobility and independent living in elders study (MILES)

[摘要] Increase in older population is most rapid in developing countries and will have major impact on public health. Indian older population is not well described and there is an urgent need to estimate the burden of prevalent disease, disability and risk factors. To accomplish this, we established a longitudinal cohort study – MILES, in a rural population of older Indians. We enrolled a random sample of 562 men and women aged 60+ from rural India. Baseline visit consisted of a comprehensive clinical examination and interview.We examined the prevalence of CVD and its relationship with traditional CVD risk factors in MILES. CVD was defined as a composite of self-reported history of CVD, major ECG abnormality or peripheral artery disease (PAD). Prevalence of CVD was 24.6% in men and 25.6% in women. In multivariate analyses among men, BMI, hypertension and physical inactivity were associated with higher prevalence of CVD. Among women, chewing tobacco, hypertension and physical inactivity were associated with higher prevalence of CVD.Additionally, we estimated the prevalence and risk factors for mobility disability in MILES population by using inability to attempt or complete a 400-meter usual paced walk as a measure of mobility disability. Mobility disability prevalence was much higher in women (43.8%) compared to men (27.9%). In men, knee pain, fair vision, chronic lung disease and greater number of depressive symptoms were associated with mobility disability. Among women, waist circumference, depressive symptoms, knee pain, poor vision, CVD history and PAD were associated with mobility disability. Mean walking times were high in those men (435 seconds) and women (503 seconds) who completed the walk. Higher walking times were associated with higher waist circumference, knee pain and use of walking aid in both men and women.This dissertation has major public health significance. In this dissertation, we identified the rural older Indian population to be very frail, and with high prevalence of disease and mobility disability. There is a high prevalence of risk factors, low heath awareness and poor health care access. These data indicate urgent need for primary prevention measures and increasing availability of treatment to prevent further complications.

[发布机构] the University of Pittsburgh