Levels of adulthood physical disability in a rural community in upper Egypt

ABSTRACT

Worldwide, the rapid increase in the elderly population have led to an ongoing debate about wheather longer lives can be matched by longer active lives that are free from disability [Ostir, et al., 1999]. In many developing countries, life expectancy is increasing very rapidly, but little information is available on survival free of disability [Jitapunkul et al, 2003]. Egypt is an example of a country in the middle of its demographic transition. The median age of population has risen with a life expectancy at birth from 51 years in 1970 to 70 years in 2005. Egypt's population is projected to reach 92 million in 2020 with 6.7% aged 65 years or above; approximately 7 million elderly people [CAPMAS, 1995]. To estimate the prevalence rate, identify types and factors associated with disability among adults residing in a rural area. A cross-sectional survey with total coverage of all adult population >/= 18 years residing in Gahdam village. Upper Egypt, was undertaken in 2001. A total of 2.505 adults were screened for disability using the ADL [Activities of Daily Living] and IADL [Instrumental activities of daily living instruments. This was followed by a more detailed questionnaire to describe disability by onset, duration, severity, underlying diseases, health seeking behavior and other factors. Disability was defined as deficiency in one or more of ADL or IADL items. 15.9% of adults were disabled in one or more of the ADL items. Using both ADL and IADL instruments the prevalence of disability among adult population aged >/= 18 years was 22.1%. Disability was associated with age, gender, marital status and educational attainment. Musculo skeletal disorders ranked as the first underlying cause of disability [41.9%] followed by chest disorders [16.5%]. Health services utilization declined from 90.9% at the onset of disability to 62.3% among currently disabled adults. Although private sector had the upper hand among providers sought, a large proportion of disabled adults relied on self medication 37.7%. Hospitalization during the last year was 16.4%; with an average length of stay 16.9 days. Disability among elderly population is a significant burden to individuals, families, and health care