International Day of Older Persons: India Needs Age-Responsive Tuberculosis Care | PWOnlyIAS 2023

October 2, 2023

Context:

This article is based on an Editorial “An ageing India needs age-responsive TB care” which was published in the Hindu. October 1 is observed as International Day of Older Persons. India is moving towards a future where the elderly will make up a significant proportion of society (expected to be 12.5% by 2030), primarily due to advances in health care and increased life expectancy.

Relevancy for Prelims: International Day of Older Persons, Tuberculosis (TB) and associated elimination strategy.

Relevancy for Mains: Health, Government Policies & Interventions, India’s TB Prevalence and Challenges.

International Day of Older Persons: How Tuberculosis Affects India’s Elderly Population?

Affected Population: TB affects over 25 lakh Indians every year, and kills at least 1,000 every day.
Affected Aging Population: India’s National Tuberculosis Prevalence Survey, 2021, revealed that the prevalence of TB in people over the age of 55 was 588 (per one lakh population), much higher than the overall national prevalence of 316.
Reason for high prevalence of TB among Aging Population: Symptoms of TB including cough, fatigue and weight loss are mistaken as signs of other diseases or dismissed as signs of old age.
- The risk of having a TB diagnosis delayed or missed altogether is higher for the elderly compared to other adults.

International day of Older Persons

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Challenges and Potential Strategies

The challenges faced by older individuals in the context of tuberculosis (TB) are multifaceted and require targeted efforts to address them.
Here are the challenges and potential strategies to overcome them:

Feature	Challenge	Addressing the Challenge
Delayed Diagnosis and Misidentification of Symptoms	Tuberculosis symptoms are often mistaken for signs of other diseases or dismissed as part of aging.	Conduct awareness campaigns targeting older populations. Train healthcare professionals to recognize TB symptoms and conduct regular screenings.
Management Complications due to Comorbidities	Older individuals with tuberculosis often have multiple comorbidities, especially diabetes, complicating TB management.	Develop age-specific clinical guidelines for tuberculosis management that account for comorbidities. Provide training for healthcare professionals to handle complex cases.
Access to Health Services	Older individuals may struggle to travel to health facilities, especially in rural areas. Limited access to reliable health information and infrastructure-related challenges further exacerbate the problem.	Implement mobile diagnostic vans for tuberculosis screenings in remote areas. Establish geriatric OPDs and ensure accessibility for older individuals. Improve infrastructure at health facilities. Provide reliable and accessible health information through community outreach programs.
Nutritional Challenges	Older individuals may not have access to high-quality nutritious food, which is crucial for recovery from tuberculosis.	Integrate nutritional support into tuberculosis care programs. Provide doorstep delivery of nutritious meals or supplements for older TB patients. Collaborate with community organizations to address food insecurity among older populations.
Economic Dependence and Social Isolation	Older individuals may face economic dependence, leading to challenges in accessing healthcare. Age-related stigma and social isolation can impact mental health.	Design and implement elder-focused community care models. Establish special help desks for the elderly at healthcare facilities. Introduce age-responsive peer support and counseling services.
Limited Participation in Social Welfare Schemes	Limited awareness and accessibility to social welfare schemes for the elderly.	Enhance awareness about existing social welfare schemes through community engagement and outreach. Simplify application processes and provide support with documentation to ensure older individuals can access available schemes.
Data Collection and Analysis of Gaps	Lack of comprehensive data on tuberculosis trends among older populations.	Include age-disaggregated data collection in tuberculosis reporting systems. Conduct research specifically focused on TB in the elderly to understand trends, outcomes, and co-morbidities.
Research Gaps	Limited research focused on tuberculosis in the elderly.	Support and prioritize research initiatives that investigate tuberculosis trends, outcomes, and specific challenges among older individuals. Strengthen collaboration between researchers, healthcare providers, and older individuals to inform evidence-based interventions.

Conclusion

The elderly represent a storehouse of wisdom, and respect for their rights and freedoms benefits society. On this International Day of Older Persons, we must resolve to invest in the health of our elderly population, and pay attention to their unique needs.