UDC 614.2:616-036.1-053.9 (574)
ANALYSIS OF MORBIDITY RATE AMONG THE OLDER AGE GROUP PERSONS ON THE
KAZAKHSTAN EXAMPLE
Doszhanova G.N., Аbduldayeva A.A., Dubitskiy A.A.
Astana Medical University , Kazakhstan
Introduction: One
of the criteria of human potential is his health. Health is the greatest social
value. It depends on the age of a person.
An
age is one of the most powerful predictors of disease progression. Older age is
characterized as irreversible structural changes in the body, accompanied by a
gradual reduction of human functions that violates human adaptation to its
environment [1]. Most often this is due to the unstable course of the disease,
an increase in the number of chronic diseases associated, reduced reactivity
and methods of treatment.
According
to the materials of the UN World Assembly on Ageing, in 80-86% of individuals
of appropriate age have chronic diseases that reduce physical and social
activity.
The
rate of morbidity among the older age persons (60-74 years) on average
in
2 times higher, and in the elderly age persons (75-89 years) in 4 times higher
than in people of working age in Kazakhstan. Morbidity rate in the older age
group has certain characteristics, which include, first of all polymorbidity
and chronicity of a disease [2].
Goal: to study the
structure of morbidity among the persons of older age in Astana.
Materials and methods: The information was obtained from the secondary informative sources
[3-6] for the period from 2011 to 2013 on registered diseases in the reporting
year in accordance with the ICD revision X.
The following methods have been used: informative -analytical, content
analysis, ratios, comparison indices, indices of clarity, statistical methods.
Results and discussion: study
of general morbidity structure in older age groups in dynamics for three years,
ranked by frequent somatic diseases and presented in Table 1.
Table1 – Diseases ranking
among the older age contingent for the period 2011-2013 years.
|
Name of disease grade |
2011 |
2012 |
2013 |
|||
|
Total |
Rank |
Total |
Rank |
Total |
Rank |
|
|
Diseases of circulatory system |
32,8% |
1 |
36% |
1 |
36% |
1 |
|
Diseases of eye and adnexa |
13,8% |
2 |
11,2% |
2 |
10,4% |
2 |
|
Respiratory diseases |
9,7% |
3 |
8,4% |
4 |
8,3% |
4 |
|
Diseases of the digestive system |
7,5% |
4 |
6,3% |
7 |
6,5% |
7 |
|
Diseases of the genitourinary system |
7,2% |
5 |
6,7% |
6 |
6,7% |
6 |
|
Endocrine diseases, nutritional and metabolic disorders |
7,1% |
6 |
8,4% |
3 |
8,6% |
3 |
|
Diseases of bone - muscular system |
7,0% |
7 |
6,9% |
5 |
7,1% |
5 |
|
Neoplasms |
3,4% |
8 |
3,9% |
8 |
3,8% |
8 |
|
Diseases of the nervous system |
3,0% |
9 |
3,0% |
9 |
3,1% |
9 |
|
Diseases of the ear and mastoid process |
2,6% |
10 |
2,1% |
10 |
2,3% |
10 |
|
Injuriesandpoisonings |
1,8% |
11 |
1,7% |
11 |
1,5% |
11 |
|
Diseases of skin and subcutaneous tissue |
1,2% |
12 |
1,3% |
13 |
1,1% |
12 |
|
Mental disorders |
1,1% |
13 |
1,3% |
12 |
0,7% |
13 |
|
Infectious and parasitic diseases |
0,5% |
14 |
0,7% |
14 |
0,6% |
14 |
|
Diseases of blood, blood-forming organs |
0,3% |
15 |
0,4% |
15 |
0,3% |
15 |
|
Systemic connective tissue disorders |
0,04% |
16 |
0,01% |
16 |
0,03% |
16 |
|
TOTAL |
126426 |
|
120206 |
|
133475 |
|
Diseases
ranking showed that during period of time - 2012 -2013 years diseases of the
circulatory system (DCS) take first place in senior group , in second place -
diseases of the eye and adnexa, in third place - endocrine diseases,
nutritional and metabolic disorders, fourth place belongs to respiratory
diseases and fifth place –to disease of
bone - muscular system.
DCS
take a leading place n the structure of morbidity among the older age groups in
2011 as well as, disorders of eye and adnexa, while the third and fourth place
belong to diseases of the respiratory and digestive systems, and on the fifth
place are the diseases of the genitourinary system.
Given
the tendency of ranking in the structure of morbidity in older adults for
2012-2013, there is an interest to examine the structure of morbidity in the
context of each nosology belonging to these groups of diseases (Table. 2).
Table2 – Structure of morbidity
rate among the persons of older age in the context of each nosology.
|
№ |
Structure of morbidity rate |
% M±m |
|
1 |
Diseases of circular system: |
5103,44±0,53 |
|
Arterial hypertension (AH) |
57,6% |
|
|
Ischemic heart disease (IHD) |
19,7% |
|
|
Cerebrovascular disease |
8,4% |
|
|
Angina pectoris |
6,5% |
|
|
Heart failure |
0,9% |
|
|
Varicose veins expansion of lower limbs |
0,6% |
|
|
Rheumatic heart disease |
0,6% |
|
|
Cardiac arrhythmias |
0,5% |
|
|
Occlusive disease, thromboangiitis obliterans |
0,3% |
|
|
2 |
Eye disease and adnexa: |
1409±0,26 |
|
Cataract |
35,4% |
|
|
Glaucoma |
18% |
|
|
Myopia |
5,9% |
|
|
Acuteallergicconjunctivitis |
0,2% |
|
|
3 |
Endocrine diseases, nutritional and
metabolic disorders: |
1103,43±0,41 |
|
Insulin-dependentdiabetesmellitus |
46,6% |
|
|
Hypothyroidism |
12,5% |
|
|
Obesity |
6,2% |
|
|
Thyrotoxicosis |
1,1% |
|
|
Insulin-dependentdiabetesmellitus |
1,0% |
|
|
Hypoparathyroidism |
0,1% |
|
|
Diabetesinsipidus |
0,07% |
|
|
4 |
Respiratory diseases: |
810,13±0,19 |
|
Chronic obstructive pulmonary disease (COPD) |
20% |
|
|
Bronchial asthma |
15,1% |
|
|
Chronicbronchitis, emphysema |
8,9% |
|
|
Chronicrhinitis, pharyngitis, nasopharyngitis |
6,1% |
|
|
Pneumonia |
5,0% |
|
|
Vazamotornyandallergicrhinitis |
1,5% |
|
|
Chronic disease of tonsils, adenoids |
0,9% |
|
|
Chronicsinusitis |
0,9% |
|
|
5 |
Diseases of bone - muscular system: |
1090,6±0,29 |
|
Arthrosis |
3405 |
|
|
Gonartroz |
1146 |
|
|
Rheumatoidarthritis |
587 |
|
|
Coxarthrosis |
236 |
|
|
Gout |
79 |
A
detailed analysis of the morbidity structure in older adults showed that the
most common types of DCS pathology are hypertension, ischemic heart disease,
cerebrovascular disease and angina pectoris.
Theprevalencerateofcardiovasculardiseasesisincreasingrapidlywithageincreasing.According to WHO, the premature mortality rate in
Kazakhstan of circulatory system diseases takes the second place among the CIS countries and 3-4 times higher
than in Western European countries [7].
Cataracts,
glaucoma, myopia and acute allergic conjunctivitis have a large portion among
the diseases of the eye and adnexa.
Endocrine
diseases, nutritional and metabolic disorders take a third place in the
structure of morbidity in older adults where the large part belongs to
non-insulin-dependent diabetes mellitus, hypothyroidism and obesity.
Thus,
the presented data on mortality rate show high needs of older persons in public
health care. Particular attention should be paid to the circulatory system
diseases, the eye and adnexa and endocrine diseases, nutritional and metabolic
disorders required great effectiveness of treatment - preventive measures at
the stage of primary health care.
Conclusions:
1.
Diseases of circular system take a
first place in structure of morbidity in older adults (36%), second place - diseases
of eye and adnexa (10.4%), third
place - endocrine diseases, nutritional and metabolic disorders (8 6%), the fourth and fifth places- respiratory diseases (8.3%) and bone - muscular system (7.1%).
2.
This trend ranking disease in older adults kept for two years
(2012 and 2013).
3.
Ranking of diseases in 2011 in the
patients of the older age group revealed differences among the third, fourth
and fifth ranks, corresponding to respiratory diseases, diseases of the
digestive and urinary systems.
4.
The most common diseases of circular
system in older adults include hypertension, coronary heart disease,
cerebrovascular disease and angina pectoris.
5.
The large portion among the diseases
of the eye and adnexa take cataracts, then glaucoma, myopia and acute allergic
conjunctivitis.
6.
A significant proportion of
endocrine diseases, nutritional and metabolic disorders belongs to
insulin-dependent diabetes mellitus, hypothyroidism and obesity.
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контингентах больных, состоящих под диспансерным наблюдением за 2013 год».
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2002, посвященная проблеме старения.