Hypertension and Diabetes Mellitus Among The Residents Of An Old Folks Home In North Malaysia.

摘要

: Hypertension and diabetes are the major threats to the growing elderly population. The existence of either one or both of these conditions markedly increases multi-systemic complications. However, not much epidemiological research has been done concerning these diseases among the elderly in developing countries like Malaysia. Aim: To determine the prevalence of hypertension and diabetes mellitus and their associated risk factors among older adults living in an old folks home in Penang, Malaysia. Material and methods: A cross sectional study was conducted among 155 residents who were 60 years old and above. Standard procedure of blood pressure measurement was used based on the American Heart Association guidelines. Fasting blood glucose was measured using a capillary glucometer. Besides the socio demographic information, Elderly Cognitive Assessment Questionnaire (ECAQ), Geriatric Depression Scale (GDS), and Barthel’s Index were used to assess other co-morbidities among the elderly and their possible association with hypertension and diabetes.Results: Among the 155 participants, the prevalence of hypertension was 62.6% and 47.6% of them had uncontrolled blood pressure. The prevalence of diabetes mellitus was 25.8% of which 33% of them had uncontrolled blood glucose level. The diabetics were significantly at a higher risk to have hypertension and vice versa (OR=2.56). Conclusion: This study revealed a high prevalence and low awareness rates of both hypertension and diabetes mellitus among the elderly in this institution. At least one third of them had poor control of their blood pressure and blood glucose levels. Therefore a more vigilant screening program in this population is essential. Introduction The elderly population is expected to grow considerably in the near future.1 This rise will especially be prominent in the developing countries where an increment of 140% is projected, compared to 51% in the developed countries.2 As a result of this, a significant impact on the overall healthcare cost is inevitable. According to a study done in nine countries from the Organization for Economic Co-Operation and Development Countries (OECD) in the 1990s, health expenditure of people aged 65 and above ranged from 32% to 42%, which was far beyond their population share of 12% to 18%.3 Cardiovascular diseases especially hypertension and diabetes are a major public health concern especially in older adults. The reported prevalence of hypertension varies between countries and within communities in the same country depending upon the economic development and affluence. Prevalence of hypertension in the Asia-Pacific region ranges from five to 47% in men and from seven to 38% in women.4 Based on the National Health and Morbidity Survey (NHMS) III the national prevalence of hypertension in Malaysia in 2006 was 32.2% for residents aged 18 years and above.5 Most were unaware that they had hypertension, while those who were aware and on treatment, most did not have controlled blood pressure. The prevalence of hypertension among the elderly in north Malaysia has been reported as high as 58.3% in the community and ranging from 36 to 50.3% in old folks homes.6 The prevalence of diabetes mellitus is also increasing in Malaysia over the decades as shown in the First and Second National Health and Morbidity Survey 7&8. A rise of prevalence from 6.3% to 8.3% was observed in Malaysia between 1986 and 1996. This figure continued to increase tremendously to 14.9% in 2006 as revealed by the Third National Health and Morbidity Survey.5 Although hypertension and diabetes mellitus among the elderly are common and could lead to severe cardiovascular complications, local studies in this field are still limited. The objective of this study was to determine the prevalence of hypertension and diabetes and their associated factors amongst the residents of a privately run home for the aged in Penang, Malaysia. Method Setting: This study was conducted in a 190-bed