Aging Medicine and Healthcare 2020;11(1):10-19. doi:10.33879/AMH.2020.033-1904.010 Aging Medicine and Healthcare https://www.agingmedhealthc.com Original Article Health Status of Elderly Population in the Buea Health District, Cameroon *Agbor Nathan Emeh1,2, Fongang Che Landis1,3, Tambetakaw Njang Gilbert1,2, Atongno Ashu Humphrey1,2 1University of Buea, Cameroon 2Ministry of Public Health, Yaounde, Cameroon 3Cameroon Christian University, Cameroon ABSTRACT Background/Purpose: The purpose of this study was to assess the socio- clinical profile, heath status and determine the impact of age on health related behaviors of geriatric population in the Buea Health District. Since studies on the subject are lacking in Cameroon, we believe this study provides ground work for further studies on geriatrics in Cameroon. Methods: Two-stage systematic sampling was used. Firstly, 30 communities of the Buea Health District were randomly selected. Eligible participants in these communities were then selected in turns. Interviewer-administered questionnaire, physical examination and health record checks were used to capture the study objectives. Results: Of the 142 sampled elderlies, 57.7% (82/142) were females with the young-old (60-75 years) constituted the majority (69.01%; 98/142). Most of the elderlies (88%; 125/142) had at least one chronic disease, 35.9% (51/142) had *Correspondence at least two and 9.86% (14/142) had at least three chronic diseases. The major Dr. Agbor Nathan Emeh chronic diseases suffered by elderlies included arthritis (38.73%; 55/142), gastritis (38.73%; 55/142) and hypertension (29.58%; 42/142). Most affected Department of Public Health body systems were musculoskeletal (86.62%; 123/142), neurologic (85.21%; and Hygiene, University of 121/142), and eye (76.76%; 109/142). Arthritis (p=0.072) and musculoskeletal Buea, Cameroon system disorders (p=0.028) were more prevalent in elderly women than men. Email: Majority of the elderlies perceived their health state as “good” (44.37%; [email protected] 63/142), then “fair” (35.21%; 50/142), and then “poor” (20.42%; 29/142) (p=0.889). Statistically significant higher proportion of women (54.88%; 45/82) Received 5 April 2019 than men (25%; 15/60) consumed addictive substances (p <0.001). Accepted 28 October 2019 Conclusion: The health status of older adults in Cameroon deserves more Keywords attention and more studies are needed to further improve it. Chronic diseases, elderly, health status, signs and ISSN 2663-8851/Copyright © 2020, Asian Association for Frailty and Sarcopenia and Taiwan symptoms. Association for Integrated Care. Published by Full Universe Integrated Marketing Limited. 1. INTRODUCTION gradually increasing due to decline in fertility and adult mortality.2,3 Life expectancy is increasing as Aging is a natural process, which presents an unique a result of overall socio-economic development challenge for all sections of the society.1 Globally, and development in medical science,4 including the proportion of elderly people in countries are improvement in health-care delivery services.1 Year- 10 Aging Medicine and Healthcare 2020;11(1):10-19. doi:10.33879/AMH.2020.033-1904.010 wise distribution of old persons in 1901, 1951, therefore important to put into perspective these 2001, were 12 million, 19 million, and 77 million, different factors when building a health structure to respectively, estimating that it will be 177 million manage an elderly community. by 2025,5 and subsequently to 2 billion in 2050.6 Although this appears to be a success in the history of Self-reported health status has widely been used in public health, this also seems to give rise to social and census, survey and observational studies as a measure economic consequences. In addition to increasing that may encompass the subjective concept of dependency ratio that accompanies increasing elderly health.19,20 The determinants of reported health status population,7 there is expected to be an overburdened have also been widely studied21 and their outcome health-care delivery system as utilisation of healthcare has been shown to predict future morbidity and services for chronic diseases, physical disabilities, mortality.22 Saurabh and collaborators reported the mental illness, and other co-morbidities increase in existence of an array of determinants of self-reported the elderly.8,9 Aging of the population creates two health status and quality of life of elderlies including potential major pressure on health care finances: social concerns such as isolation without physical increase utilization of health services and decreased support in daily activities, maltreatment towards revenue (as a declining share of the population is elderlies, psycho-emotional concerns, financial economically active).3 With such increase in the constraints, health-care system factors, etc.1 In our elderly population, medical practice will have to suffer study, we assessed the relationship between different adaption.10 self-reported health status of the elderlies. The quality of life changes over time and health Although a substantial number of geriatric studies becomes one of the major concerns at old age for have been conducted in different parts of the globe4 both individuals and society.11 By assessing how the with few in the developing countries,23 very little is activities of daily living deviates from the normal role known about the major morbidities, health status and function, one can assess the impact of age on social the health-seeking behavior of elderly people in Buea aspect of health.12 Participation of elderly people in Health District and Cameroon as a whole. It was, different social work, community activities, staying therefore, important to conduct a study that will stage together with family members and their mental, ground information for further work on the geriatric emotional supports are therefore significant predictors population in the country. Our research objectives of the perceived health of elderly peoples.5 were to identify the major health problems affecting elderly people, determine the morbidity pattern and There is a general tendency of deterioration of the to identify the impact of age on functional habits health status of elderly people as chronic disabilities among the elderly people in the Buea Health District. in this group of people are higher than in any other age group.13 Geriatric persons present 3.5 times The operational definition of elderly: Defining more health problems when comparing to persons an individual as being old, elderly or classifying who are younger than 65 years of age.14 Out of five him/her as belonging to the geriatric population geriatric patients, four (80%) will present at least one is controversial.1 This concept has both physio- chronic disease, the majority of who will have more anatomical and social implications. Generally, an than one associated condition.14 As a result, there is a individual is classified as geriatric when he is 60 tendency that elderly people remain on permanent/ years and above. In a study in 2009, Zizza and semi-permanent drugs to manage these multiple collaborators24 subclassed the geriatric population disabilities. Common chronic conditions affecting into the young-old (aged 60-75), the middle-old (aged the elderly population include hypertension, cancers, 76-85) and the old-old (aged over 85). We used the diabetes mellitus, respiratory diseases, heart disease, above age limits to define the elderly in our study. and arthritis.13,15 Major morbidities in elderly people include visual impairment, locomotor disabilities, 2. METHODS respiratory, and digestive disorders.16 WHO suggested that by 2015 death from chronic diseases such as 2.1. Study Setting and Population cancer, hypertension, and cardiovascular system, and diabetes were to have a 17% increase.17 The Buea Health District (BHD), situated in the Fako Division of Cameroon is bounded to the West Due to these complex array of determinants/ and the North by Mt Cameroon, to the South by predictors of health at old age, it will be expected Mutengene and the East by Ekona town. As of that these groups of persons have a complex health- the time of this study, the BHD had about 86272 seeking behavioral pattern.1 The major reasons inhabitants. It has 7 Health Areas (HAs) and a total of postulated why elderly people delay seeking health 66 communities (Appendix 1). The equatorial climate care from health facilities include lack of money, with a temperature range of 25-29ºC has attracted attributing ill-health to aging, negative attitude of so many elderly persons during their retirement health workers toward the care of the elderly.18 It is period. There are two seasons encountered in 11 Aging Medicine and Healthcare 2020;11(1):10-19. doi:10.33879/AMH.2020.033-1904.010 this area: rainy season (June to October) and the RN+2SI, RN+3SI, etc. until the 30 communities were dry season (November to May). Although this is a gotten (Appendix 1). The positions were rounded cosmopolitan area, subsistence farming is the main to the nearest whole numbers. In the second stage, occupation, with capitalizing agriculture dominated eligible participants were selected in turns from the by the Cameroon Development Corporation (C.D.C.) sampled communities by systematically inquiring and in Banana and Tea Estate. The rapid development in selecting the households in which there was an eligible this area is attracting many people to the area making participant, beginning from the house of the quarter it very strategic a location for all groups of people, head and moving towards the main nearby street. particularly the elderly to live in. 2.7. Data Collection and Tools 2.2. Study Design Each household was visited once and only one The study was a community based cross-sectional participant was selected per household. Eligible study where participants were requested to self- participants were interviewed using an interviewer- report past and current socio-economic indicators of administered questionnaire.