Global Epidemic of Ageing: A Systematic Review of the Literature on Ageing in Low and Middle Income Countries Open Access

Busman, Hannah (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/d791sg24d?locale=en%255D
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Abstract

Context: The percentage of the elderly population in Low and Middle Income Countries (LMIC) is rapidly increasing, leading to a growing number of people who are likely to  require the care and assistance from caregivers and health services from an often frail health system. In sub-Saharan Africa, the proportion of dependent persons aged 60 and older will increase from 21% to 30% between the years 2000-2050. In India it will increase from 21% to 30%, and in Latin America from 23% to 47% (Acosta, Rottbeck, Rodriguez, Ferri, & Prince, 2008). This increase in ageing populations in LMIC will coincide with an increase in non-communicable diseases for the elderly and care-givers, and could have serious repercussions for health care systems not equipped not equipped to manage the chronic care of the patients or the caregivers.

Objective: To evaluate published data on elderly care in low and middle income countries.

Data Sources: Systematic search of published literature in PubMed, EMBASE, and Web of Science. The literature that was included in the study were from the years of 1993-2018. 

Study Selection and Data Extraction: Twenty-nine publications met a priori inclusion criteria (randomized controlled trial, cohort, case-control, case study, and meta-analysis). Publications were reviewed for quality. Published studies identified through websites and institutional review articles were also reviewed and included.  Reference lists of published literature and systematic reviews were hand-searched to obtain additional peer-reviewed published studies. 

Results: Dependency, caregiver, and health systems for the elderly were identified as the three main themes  in the literature. 

Conclusion: Both qualitative and quantitative studies need to be conducted to better understand how countries can improve the care of the elderly.  National and sub-national indicators and targets need to be created within the World Health Organization‘s  Global Strategy and Action Plan on Ageing and Health framework to allow countries to understand the process and steps that can be taken to best improve their ability to care for the elderly. 

Key words: ageing, public health, low and middle income countries, elderly care

Table of Contents

Chapter I ............................................................................................................................ 1

 

Introduction .................................................................................................................................... 1

 

Objectives: ................................................................................................................................................... 2

 

Definition of Terms ....................................................................................................................................... 2

 

Chapter II .......................................................................................................................... 4

 

Comprehensive Literature Review ................................................................................................. 4

 

Global burden of disease .............................................................................................................................. 6

 

Breaking down the Continuum of Care........................................................................................................... 8

 

Integrated Geriatric Care .............................................................................................................................. 9

 

Integrated Palliative Care .............................................................................................................................10

 

Low and Middle Income Countries ...............................................................................................................11

 

Chapter III ....................................................................................................................... 14

 

Methods ....................................................................................................................................... 14

 

Literature Search Strategy............................................................................................................................14

 

Inclusion Criteria ..........................................................................................................................................14

 

Exclusion criteria ..........................................................................................................................................16

 

Analysis Strategy ..........................................................................................................................................16

 

Chapter IV ........................................................................................................................ 17

 

Results ........................................................................................................................................... 17

 

Chapter V............................................................................................................................ 33

 

Discussion ....................................................................................................................................... 33

 

Chapter VI ...........................................................................................................................41

 

Limitations ........................................................................................................................................ 41

 

Recommendations ........................................................................................................................... 42

 

Conclusion ........................................................................................................................................44

 

References ..........................................................................................................................46

 

 

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