Context: On the occasion of International Day for Older Persons (1st of October), this article talks about the challenges associated with the elderly population of India.

Background

• The World Population Prospects 2022 report of the UN Department of Economic and Social Affairs (UNDESA) projects that India will house the largest population in the world which would include a large elderly sub-population.

• Even other United Nations reports have also estimated that the proportion of India’s elderly population will increase by nearly two times to reach about 20% of the total population by 2050. 

• The changes projected in the demographic structure of the country will increase the burden on public health systems that are not equipped to deliver universal health services efficiently.

• Further, the social security measures of the country such as old-age and disability pensions are also not adequately equipped to address the issues.

Issues related to elderly

• The Hyderabad Ocular Morbidity in the Elderly Study (HOMES) by the L.V. Prasad Eye Institute has been undertaking a series of studies and reports on aspects such as health, quality of life, mental health, morbidity, and disability among the elderly living in old age homes in Hyderabad.

• Various studies have been using eye care as an entry point to measure various aspects of health and social metrics over a large range of socio-economic circumstances. 

• In India, there is an increase in the prevalence of non-communicable diseases like diabetes, hypertension, heart diseases, vision disabilities, hearing defects and problems with mobility among the elderly. 

• Close to 50% of the participants had a minimum of one disability and about 33% of them had multiple morbidities. 

• Further, nearly 70% of the participants used at least one assistive device with spectacles being the most common assistive device used. 

The challenges of eye care

• According to a study, more than 30% of the elderly who participated in the study had distance vision loss and more than 50% of the participants had near vision impairment.

• The reports have also shown the interconnection between vision impairment and mental health and the confidence of the elderly.

• Individuals with vision impairment or defects are seen to have greater fear and are at risk of falling which is said to be one of the key causes of disability and hospitalisation among the elderly population.

• Also, vision impairment reduced the movement and independence of elderly individuals which often led to depression.

• Other chronic health conditions like diabetes and hypertension cause irreversible vision loss which has also become a major challenge.

Road Ahead

• There is a need to introduce a series of interventions that covers various aspects such as assistive devices for defects in vision hearing and mobility to psychiatric support for depression and other mental health issues.

• Setting up a comprehensive national eye care model as a holistic eye care model will help in recalibrating the overall elderly care services as per the requirements.

• Introduction of cross-subsidy models in eye health in India to help address the financial issues of the elderly.

• Incentivising centres which can carry out eye examinations because such examinations and tests help in identifying and recognising various systemic issues among the elderly. 

• Adoption of modern and advanced imaging technologies, tele-health facilities, portable devices and apps that help to increase access to eye care facilities.

• Creating referral platforms that help connect eye care with other health specialities.

Conclusion

• The reports on the changes in the demographic structure of the country indicate that the country’s elderly population would increase significantly in the coming years. This requires the policymakers to come up with a long-term strategy that is comprehensive, universal, integrated and accessible to elderly individuals.