An Epidemiological Study Of Correlates Of Cataract Among Elderly Population Aged Over 65 Years In Ut, Chandigarh

摘要

This study was undertaken to find out the prevalence and correlates of cataract among elderly aged 65 years and above in UT Chandigarh. Nine hundred and fifty three houses from 6 randomly selected sectors and 2 villages were visited to cover 245 subjects. (104 were males and 141 females). A total of 178 (72.6%) elderly, [0 (67.3%) males and 108(76.6%) females] were found to have cataract. This prevalence was more among older elderly than the young elderly (78.0% in the age group 75+ years versus 69.9% in the age group of 65-74 years, in urban areas than in rural areas (77.9% versus 52%), for educated ones than for illiterates (75% versus 70.1%), in diabetics than in non-diabetics (81.5% versus 70.1%), in smokers than in non smokers (73.9% versus 73.5%), alcohol drinkers than in non drinkers (73.7% versus 72.6%) and amongst hypertensives than in non-hypertensives (74% versus 69.8%). The findings highlight that aging, diabetes mellitus, smoking, alcohol and hypertension might be operating in the causation of cataract. Since differences between most comparative groups were not statistically significant, a multi factorial causation of cataract is inferred. The above mentioned factors are important not only for cataract causation but also for many other public health problems. Therefore a multi pronged strategy to reduce these factors is required to control cataract development and improve the overall health of the nation. Introduction Unoperated cataract is the main cause (estimated 16 million cases) of visual loss globally 1 . Even after operation outcome may not be favourable in all cases 2 . In developing world, its prevalence is believed to be greater and the onset at earlier ages, making the social and medical cost of blindness from cataract highly disproportional in the areas of the world that can ill afford them 3 . Generally, the normal aging and cataractous changes in the lens are related to its metabolic activity. Despite extensive and on going results on the pathogenesis of cataract we are still unable to prevent the natural ageing changes of the human lens. Senile cataract (nuclear sclerosis) is the most common cause of lens opacity seen by the ophthalmologists. The most common type of cataract in older patients involves the lens nucleus 4 . Increasing age is associated with an increasing prevalence of cataract. Over the next 20 years, it is estimated that the World’s population will increase by about one third. This growth will occur predominantly in developing areas. During the same period, the number of people over 65 years of age will more than double. If nothing else alters, these demographic changes will lead to a doubling in the amount of cataract, visual morbidity and need for cataract surgery. The current 20 million people with severally reduced vision of 3/60 or verse as a result of cataract will have swelled to 40 million by the year 2020 5 . Studies evaluating risk factors for the development of cataracts have implicated dietary factors, medications, exposure to sunlight, race, level of education, metabolic abnormalities, smoking, body mass, handgrip strength and family history in the causation of cataract. With such a large list it is obvious that cataractogenesis is multifactorial. 6 Hence one finds that outside the primary risk factor of age, some environmental physical and nutritional risks have also been associated with earlier onset or progression of cataract 7 . Although surgery is effective, preventing or delaying the development of cataract remains the preferred approach to confront the global cataract problem. Should a factor be found to delay cataract onset by ten years the number of cataract operation is estimated to decrease by 45% 8 . Some of the factors associated with cataract have been studied by the present work. Materials & Method The city Chandigarh has 3 governments. It is the capital of the states of Haryana and Punjab. The Govt. Medical College & Hospital, Sector 32 is under Union Ter