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Time of India
28-05-2025
- Health
- Time of India
Hearing aids could help reduce falls among older adults, results from clinical trial suggest
New Delhi: Providing hearing aids to older adults, along with counselling their families, were found to reduce falls by nearly 30 per cent over a three-year period, according to a study published in The Lancet Public Health journal. Falls -- a leading cause of injury and major health concern among the elderlies -- have been linked with hearing loss, among other factors, including a decline in physiological responses, mobility and cognitive skills. Researchers, including those from Edinburgh Napier University, UK, provided hearing aids and counselling to family members of half of 977 adults in the US, aged 70-84, with untreated hearing loss and without substantial cognitive impairment. The other half -- 487 participants -- were the 'control group' and given health education. Results from the 'ACHIEVE' trial revealed that the average number of falls over three years among those receiving hearing interventions -- hearing aids and counselling -- was 1.45, compared to 1.98 in the control group. "The intervention group had a 27 per cent reduction in the mean number of falls over three years compared with the control group," the authors wrote. The team said that evidence from previous studies that examined the link between using hearing aids and falls has been contradictory. The ACHIEVE trial is the "first large-scale" randomised control trial that has explored the potential effect of hearing intervention on falls, the researchers said. Findings from the trial suggest that hearing aids and counselling may reduce falls among older adults with hearing loss, even as further research is required to examine the longer-term effects of hearing intervention on falls. A study, published in 'The Evidence' journal in March 2024, found that prevalence of falls among older adults in India (aged 60 and above) was 11.43 per cent. Data of 28,710 participants from the Longitudinal Aging Study of India (LASI), collected during 2017-2019, was analysed. The study attributed the risk of falling to chronic conditions, such as diseases of bones and joints, and vision problems. Self-reported poor health emerged as a strong predictor for falls, emphasising the interplay of physical health and self-perception in risk of falling, it said. Further, women were found to be at a 31 per cent higher risk of falling, compared to men.
The Hindu
26-05-2025
- Health
- The Hindu
Dementia — the urgent need for India to invest in elder care
India's population is rapidly ageing. The share of individuals aged 60 or older is expected to touch 20 crore by 2031. Estimates indicate it is then projected to increase to nearly 20% of the total Indian population by 2050. With age being a major risk factor for dementia - an umbrella term for several diseases affecting memory, other cognitive abilities and behaviour that interfere significantly with a person's ability to maintain their activities of daily living - India faces an alarming potential increase in the number of people with age-related cognitive decline. In 2023, the Longitudinal Aging Study in India (LASI) and LASI-Diagnostic Assessment for Dementia reported that the prevalence of dementia in India among individuals aged 60 and older was 7.4%, with higher rates in women and rural regions. The study estimated that by 2036, the number of cases would quadruple, touching 1.7 crore. The World Health Organization (WHO) declared dementia a public health priority in 2012 and launched a Global Action Plan on the public health response to dementia (2017 – 2025) which emphasises critical areas such as dementia awareness, risk reduction, diagnosis, treatment, caregiver support, and research. As India grapples with the challenges of a rapidly growing elderly demographic, the need for specialised elder care has never been more urgent, experts say. Currently, India has a severe shortage of resources, trained caregivers, and comprehensive healthcare systems to adequately address the needs of those suffering from dementia. The first steps: risk reduction, early diagnosis Despite advances in drug development, risk reduction remains the only proven prevention tool, Alzheimer's Disease International (ADI), the global federation of over 100 Alzheimer's and dementia associations, has warned. Calling on governments around the world to urgently fund dementia risk-reduction research, education, and support services, ADI has said that nearly 40% of projected dementia cases can be delayed or potentially even avoided by addressing risk factors. While 40 governments worldwide have so far developed national dementia plans, the proposal is yet to gain momentum in India. Asserting the importance of early detection, awareness and effective care systems, Thomas Gregor Issac, associate professor at the Centre for Brain Research (CBR) at the Indian Institute of Science (IISc) in Bengaluru, said there is a need for expanded healthcare infrastructure, professional training, and a national dementia policy. This will help address India's growing dementia challenge, which includes early diagnosis and treatment gaps, he said. Pointing out that dementia is often misunderstood in India, he said this was due to a lack of awareness and cultural misconceptions, which led to delayed evaluations and diagnosis. This in turn considerably impairs the quality of care. 'A large chunk of pre-dementia syndromes like mild cognitive impairment and subjective cognitive decline is often misdiagnosed, underdiagnosed and undiagnosed. While the thrust should be on better screening strategies at the community level, a national portal or dementia registry that is fully functional, ensuring patient and caregiver anonymity, but with proper medical data, blood test reports and neuroimaging data can be a wonderful resource for all researchers in the country working on different angles of this problem,' he said. A previous global survey by ADI revealed that a shocking 80% of the public still incorrectly believes that dementia is a normal part of ageing rather than a medical condition. 'In a value-driven society such as India, where intergenerational support and family ties are strongly embedded in cultural norms, help-seeking behaviour for dementia remains low. The idea of using care facilities or depending on care homes is often perceived as a failure to fulfil familial responsibilities and is associated with stigma. The absence of proper support networks for caregivers greatly increases the financial, emotional, and physical strain, which frequently results in stress, burnout, and weakened health, all of which influence the standard of care given to people with disabilities or chronic illnesses,' Dr. Issac explained. Community-level care P. T. Sivakumar, professor of psychiatry, and head of the Geriatric Psychiatry Unit at the Department of Psychiatry, NIMHANS, Bengaluru, said dementia care requires a holistic, public health approach with a focus on prevention, early diagnosis, comprehensive post-diagnostic support, daycare, long-term care and caregiver support. Promoting public awareness to facilitate timely diagnosis, and a dementia-friendly community with adequate resources to support care were essential, he said. Dementia care should be community-based through the development of a cadre of community-based health workers, with a primary focus on integrated health and social care for the elderly population, he said. 'Increasing the investment to promote community-based healthcare of the elderly and long-term care systems is essential to prepare for the rapid growth of the elderly population in the next two decades. The development of the cadre of ASHA workers at the community level two decades ago was one of the biggest healthcare reforms for maternal and child healthcare. It is time to develop a similar cadre of health workers with a dedicated focus on the elderly population, including for dementia care,' he said. Asserting that training and capacity-building of health workers at all levels of the health system to promote dementia care was also essential, Dr. Sivakumar said there was an urgent need to develop programmes and services for dementia care under the existing policies and schemes relevant to the elderly. 'The National Mental Health Programme and the National Programme for Health Care of Elderly should be strengthened adequately to support dementia care. States with high proportions of elderly population like Kerala, Tamil Nadu, Karnataka, Himachal Pradesh, etc. need to focus on this area,' he said. NIMHANS has launched a pilot study for Amyloid PET imaging to diagnose Alzheimer's disease, the most common form of dementia which can impair memory and significantly lower quality of life. 'A public health emergency' Ramani Sundaram, executive director of Dementia India Alliance (DIA), said despite its impact, a majority of dementia cases are identified only in the advanced stages when intervention options are limited, care costs are high, and the quality of life for individuals and their families is severely compromised. Pointing out that dementia is a public health and economic emergency, she said without early detection and intervention, India's already stretched healthcare infrastructure will bear the brunt of rising hospitalisations, emergency admissions, and long-term institutional care. Late-stage dementia care is significantly more expensive than early interventions. DIA president Radha S. Murthy said public health systems would soon be overburdened due to a lack of community-based support. 'Families suffer financially and emotionally with unplanned expenses and the demands of full-time care,' she added. According to a study published in the Indian Journal of Public Health in 2013, the cost of dementia care in India in 2010 for 37 lakh people was ₹23,300 crore annually. It was estimated that at present, families of 88 lakh people with dementia would be spending about ₹1,18,902 crore annually to take care of their kin. Based on current projections, the economic burden on households to take care of 1.7 crore people with dementia by 2036, would be a staggering ₹3, 08,395 crore annually, experts pointed out. Despite this growing crisis, India continues to lack adequate infrastructure, resources, and policies to support dementia patients and their families. Also Read: Indian Institute of Science researchers highlight India's need for national dementia policy with focus on cultural factors Need for a comprehensive policy A recent paper by researchers from CBR highlighted the need for a comprehensive dementia policy in India to address the needs of the older population and their caregivers on a national scale. This policy should prioritise effective dementia prevention strategies and equitable allocation of resources, incorporating evidence-based approaches. The policy should also integrate dementia care into both geriatric and mental health plans, stated the paper published in The Lancet Psychiatry in January this year. Establishing such a policy, the paper noted, required extensive consultations among various stakeholders and organisations, including government bodies, healthcare professionals, researchers, and individuals living with dementia and their caregivers.
Hindustan Times
25-04-2025
- Health
- Hindustan Times
With ‘MenCan', TMH steps up on gender-inclusive oncology
Mumbai: Tata Memorial Hospital (TMH), which has for long led efforts to provide cancer care to women and children in India, has launched MenCan, a comprehensive initiative focused exclusively on male cancer patients. The initiative marks a crucial step toward gender-inclusive oncology as it addresses prostate, testicular, and penile cancers, which are common among men. Male pelvic cancers are deeply stigmatised, and silence often leads to late-stage diagnosis. TMH alone sees around 1,100 prostate, 300 testicular, and 150 penile cancer cases annually. But nearly 80% prostate cancer patients are diagnosed in the advanced stages, which contrasts sharply with trends in developed countries, where 80% cases are detected early. 'In India, only 20–30% cases are diagnosed in the second stage. Most reach us when the cancer is far advanced,' said Dr Gagan Prakash, professor of surgical oncology at TMH. 'This is due to a mix of stigma, lack of awareness, and limited access to screening.' MenCan is TMC's answer to this crisis. The programme combines medical care with holistic support—focusing on early detection, counseling, fertility services, financial aid, and long-term rehabilitation through a survivorship clinic. It also works to normalise discussions around male health through public education and outreach. A key concern MenCan addresses is treatment dropout. 'Nearly 20–30% male patients discontinue treatment, primarily due to financial constraints,' said Dr Vedang Murthy, a core member of the initiative. 'Our goal is to ensure no one drops out because they can't afford care, or because they're too ashamed to ask for help.' The initiative includes a confidential helpline (8451009760) for guidance and emotional support, which links up patients with support groups, survivorship meetings, and counselling sessions. 'Our helpline ensures men don't have to face this battle alone,' said Dr Prakash. According to the Global Cancer Observatory 2022, India is expected to record 41,736 prostate, 4,640 testicular, and 11,264 penile cancer cases by 2025. Prostate cancer ranks 12th in India but is expected to climb as the elderly male population grows. The Longitudinal Ageing Study in India (LASI) estimates the 60+ demographic will nearly double, from 8.6% to 19.5% by 2050. Though rare, testicular cancer affects men between 14 and 44 years and has a 90% survival rate even in advanced stages. Penile cancer, despite being rare globally, sees the highest incidence in India. TMH's audit of 750 penile cancer cases revealed patients aged between 22 and 91 years. MenCan has roped in well-known singer Shaan as brand ambassador. It has also developed a campus navigation app for TMH's 60-acre ACTREC campus to help first-time visitors. 'MenCan is not just about treating cancer—it's about restoring dignity, breaking silence, and making sure every man gets the care he deserves,' said Dr Prakash. The initiative is likely to be expanded across all Tata Memorial Centres in India, he added.
The Hindu
23-04-2025
- Health
- The Hindu
Senior citizens in India grapple with long distances to health facilities, study finds
Even within a universal healthcare system, there continue to remain marked disparities in access to care among older adults, with distance to healthcare facility posing a critical barrier, said a study published in The Lancet Regional Health Southeast Asia titled 'Miles to go before I seek: distance to the health facility and health care use among older adults in India'. It further noted that ensuring availability of health services within reach and reducing geographical barriers are paramount towards ensuring an equitable and inclusive healthcare system where no one is left behind. The study points out that while a lot of research has explored financial constraints and health literacy as barriers to healthcare access, there is limited evidence on how physical distance impacts healthcare utilisation and health-seeking behaviours in older adults in India. For this paper, researchers used the nationally representative Longitudinal Ageing Study of India (LASI) (Wave-1, 2017–18) consisting of 31,902 older adults' data to analyse the average distance travelled by older adults for their routine and acute healthcare needs and concomitant healthcare utilisation through an equity lens. Distances travelled In India, access to healthcare is often restricted by factors including availability of local health services, financial constraints, low health literacy, and inadequate family or social support systems. India, home to 138 million older adults, is witnessing a rapid demographic transition, with the proportion of the population aged 60 and above increasing from 7.4% in 2001 to a projected 13.2% in 2031. Nearly half of these populations have multiple long-term or debilitating conditions that demand continuous and coordinated health care. The study notes that older adults, on an average, travelled a distance of 14.54 km to seek outpatient services and 43.62 km for inpatient care respectively. For two-thirds (67%) of urban older adults, the availed outpatient facility was within 10 km of reach, while for their rural counterparts, it was 28.3 km, revealing a significant urban-rural disparity. This grew disproportionately for in-patient care, where the distance and time taken was two times higher for rural sexagenarians compared to their urban counterparts. For in-patient admission, 95 per cent arranged their own mode of transport, while 5 per cent used ambulance services, with no significant urban-rural difference. Further both out-patient and in-patient care utilisation was high (73% and 40% respectively) when the facility distance was within 10 km. As the distance increased, a commensurate decline in the out-patient utilisation was observed, being 17% and 10% for facilities at 11–30 km and 30 km or more respectively. Additionally, for women, those living alone, and those with low education and income, this decline was more pronounced. Around 19% of rural older adults had to travel at least 60 km to avail of in-patient care. The situation was similar for urban dwellers with 10% travelling at least 60 km for in-patient care. Risk of adverse outcomes Long travel times and distant facilities act as a potential barrier to receiving timely and essential healthcare for this population which could posit high risk of adverse outcomes, warned the study adding that addressing transportation barriers could be a key strategy to improve access to care among the geriatric population, especially those residing in rural areas. 'Various studies have shown that interventions aimed at minimising transportation barriers among low-income, remote and older populations not only improves access to medical care but patient outcome as well, while being cost-efficient. Future research must develop and demonstrate how community-based transport service can be embedded within as a model for implementation for geriatric care. Given the rising number of ageing populations who are home-bound, a shift from clinic-based out-patient care to home-based primary care merits consideration through a mix of mobile medical van, digital healthcare and inclusive social support,'' recommends the study. It adds that there is a need to design and formulate strategies on how existing Ayushman Arogya Mandir (community-based primary care centres) can be strengthened to meet the comprehensive healthcare needs of growing geriatric population.
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First Post
22-04-2025
- Health
- First Post
How far is my hospital? In India, it's 15 kms for OPD, 44 kms for admission
Estimates published in The Lancet Regional Health-Southeast Asia journal showed a significant urban-rural disparity – urban older adults availed out-patient facilities within 10 kilometres of reach, while the distance was nearly 30 kilometres for their rural counterparts. read more Older adults in India are travelling considerable distances to access healthcare, with some commuting up to 15 kilometres for outpatient visits and nearly 44 kilometres for hospitalisation, according to new research. The study, published in The Lancet Regional Health – Southeast Asia, highlights sharp urban-rural disparities in healthcare access. While seniors in urban areas typically accessed outpatient services within 10 kilometres, their rural counterparts had to travel nearly three times as far, the researchers found. STORY CONTINUES BELOW THIS AD The findings are based on data from nearly 32,000 individuals aged 60 and above, surveyed during the first wave of the Longitudinal Ageing Study of India (LASI) in 2017-2018. India's elderly population, currently estimated at 138 million, is projected to rise from 7.4% of the total population in 2001 to 13.2% by 2031. The study also noted that proximity plays a critical role in healthcare usage: 73% of older adults accessed outpatient services and 40% used inpatient care when facilities were located within 10 kilometres. However, with an increase in commute distance, a commensurate decline in the use of out-patient services was found – 17 per cent utilisation of facilities for 11-30 kilometres distance, and 10 per cent for 30 kilometres and above, respectively. A longer commute and far placed facility is a barrier for receiving timely, essential healthcare for people in this age group, often seen grappling with multiple long-term, debilitating conditions requiring continuous care, the team said. They wrote, 'Older adults, on an average travelled a distance of nine miles (14.54 kilometres) to seek outpatient services and 27 miles (43.62 kilometres) for inpatient care respectively.' State-wise, Tripura, Manipur and Kerala, had the highest in-patient and outpatient visits within 10 kilometres – over 80 per cent, 75 per cent and 59 per cent of older adults availed in-patient services, respectively, while 88 per cent, 78 per cent and 84 per cent availed out-patient ones, respectively STORY CONTINUES BELOW THIS AD .The authors attributed Kerala's high rates to 'easy access and better availability of infrastructure'. In Manipur and Tripura, it may be because people rely on nearby facilities during emergency in-patient situations, they said. Hilly states such as Nagaland, Sikkim and Himachal Pradesh could pose geographical challenges as zero per cent, 17 per cent and about five per cent of older adults in these areas made in-patient visits within 10 kilometres, the study found. Further, in northeastern states, such as Mizoram and Nagaland, a higher percentage of older adults were found to travel more than 60 kilometres to access in-patient and out-patient services, indicating a poor and limited access to nearby facilities. Uttar Pradesh, Bihar, and Madhya Pradesh showed a moderate proximity of 11-60 kilometres for older adults accessing out-patient care, but a higher share of in-patient visits at distances beyond 30 kilometres. The authors added that less variability in commute distance among southern states indicated a well-distributed healthcare infrastructure. For an equitable and inclusive healthcare system in India, improving access to services and reducing geographical barriers are paramount, the team said. STORY CONTINUES BELOW THIS AD With inputs from agencies
