Development of a memory center for older adults in Almaty, Kazakhstan: Innovative Practice.

Recognizing the economic and health-outcome value of early cognitive assessment and intervention among its older citizens has guided the Innovative Research School in Gerontology of the SD Asfendiyarov Kazakh National Medical University to begin the process of establishing its nation's first memory center in Almaty, Kazakhstan. Life expectancy in Kazakhstan, which continues to undergo health-care reform since its independence in 1991 from the former Soviet Union, has steadily risen from 64.4 years in 1996 to 68.67 in 2009. With increased life expectancy has been a corresponding rise in cognitive impairments among older adults. The components of the Memory Center, which comprises assessment, education and support, non-pharmaceutical and pharmaceutical interventions, are described.

Trends in ageing of the population and the life expectancy after retirement: A comparative country-based analysis.

BACKGROUND: During the 20(th) century, the share of elderly in the total population of the Earth has increased steadily. It is expected that this trend will continue in the 21(st) century. In 1950, the elderly (persons aged 60 years and older) were 8% of the world population; in 2000, is already 10%; and in 2050, according to United Nations projections, the proportion will reach 21%. This research on Kazakhstan provides demographic analysis from 1989 to 2012 and presents the main features of population' ageing through comparative analysis. MATERIALS AND METHODS: We used information-analytical, content-analysis, mathematical treatment and comparative analysis of statistical data on demographic status in Kazakhstan and some other countries of the world (UK, USA, Turkey, Russia) over the 1989-2012. RESULTS: Age dependency ratio of the Russian federation - >1.7 times, in the USA-up to 1.9 times and the UK has dependency ratio higher than 2.5 times of similar indicators in Kazakhstan in 2010. CONCLUSION: Life expectancy of the elderly population KZ after 65 years in 2010 was only 13.8 years, which is 6-9 years inferior to European and U.S. indices. Thus, increasing the retirement age is inappropriate for the current period.

Inequalities in self-rated health among 45+ year-olds in Almaty, Kazakhstan: a cross-sectional study.

BACKGROUND: Self-rated health (SRH) has been widely studied to assess health inequalities in both developed and developing countries. However, no studies have been performed in Central Asia. The aim of the study was to assess gender-, ethnic-, and social inequalities in SRH in Almaty, Kazakhstan. METHODS: Altogether, 1500 randomly selected adults aged 45 years or older were invited to participate in a cross-sectional study and 1199 agreed (response rate 80%). SRH was classified as poor, satisfactory, good and excellent. Multinomial logistic regression was applied to study associations between SRH and socio-demographic characteristics. Crude and adjusted odds ratios (OR) for poor vs. good and for satisfactory vs. good health were calculated with 95% confidence intervals (CI). RESULTS: Altogether, poor, satisfactory, good and excellent health was reported by 11.8%, 53.7%, 31.0% and 3.2% of the responders, respectively. Clear gradients in SRH were observed by age, education and self-reported material deprivation in both crude and adjusted analyses. Women were more likely to report poor (OR=1.9, 95% CI: 1.2-3.1) or satisfactory (OR=1.6, 95% CI: 1.2-2.1) than good health. Ethnic Russians and unmarried participants had greater odds for poor vs. good health (OR=2.3, 95% CI: 1.5-3.7 and OR=4.0, 95% CI: 2.7-6.1, respectively) and for satisfactory vs. good health (OR=1.4, 95% CI: 1.1-1.9 and OR=1.9, 95% CI: 1.4-2.5, respectively) in crude analysis, but the estimates were reduced to non-significant levels after adjustment. Unemployed and pensioners were less likely to report good health than white-collar workers while no difference in SRH was observed between white- and blue-collar workers. CONCLUSION: Considerable levels of inequalities in SRH by age, gender, education and particularly self-reported material deprivation, but not by ethnicity or marital status were found in Almaty, Kazakhstan. Further research is warranted to identify the factors behind the observed associations in Kazakhstan.

Inpatient care in Kazakhstan: A comparative analysis.

BACKGROUND: Reforms in inpatient care are critical for the enhancement of the efficiency of health systems. It still remains the main costly sector of the health system, accounting for more than 60% of all expenditures. Inappropriate and ineffective use of the hospital infrastructure is also a big issue. We aimed to analyze statistical data on health indices and dynamics of the hospital stock in Kazakhstan in comparison with those of developed countries. MATERIALS AND METHODS: Study design is comparative quantitative analysis of inpatient care indicators. We used information and analytical methods, content analysis, mathematical treatment, and comparative analysis of statistical data on health system and dynamics of hospital stock in Kazakhstan and some other countries of the world [Organization for Economic Cooperation and Development (OECD), USA, Canada, Russia, China, Japan, and Korea] over the period 2001-2011. RESULTS: Despite substantial and continuous reductions over the past 10 years, hospitalization rates in Kazakhstan still remain high compared to some developed countries, including those of the OECD. In fact, the hospital stay length for all patients in Kazakhstan in 2011 is around 9.9 days, hospitalization ratio per 100 people is 16.3, and hospital beds capacity is 100 per 10,000 inhabitants. CONCLUSION: The decreased level of beds may adversely affect both medical organization and health system operations. Alternatives to the existing inpatient care are now being explored. The introduction of the unified national healthcare system allows shifting the primary focus on primary care organizations, which can decrease the demand on inpatient care as a result of improving the health status of people at the primary care level.