Better healthcare and living standards have ensured that India’s life expectancy has gone up significantly over the last few decades. That is why India’s elderly (geriatric) population is on the rise.The growing population of the elderly in India poses challenges for the healthcare system.
According to the 2011 Census, the proportion of older people in India was 8.3% of the total population, increasing to 10% by 2020. With a total population of 138 crore, an estimated 13.8 crore people above the age of 60 are currently living in India. From this data, one can estimate the number of geriatricians required in India
According to the ‘Elderly in India 2021’ recent report by the Social Statistics Division of the National Statistical Office, Ministry of Statistics and Programme Implementation, there were nearly 138 million elderly persons in India in 2021, comprising 67 million males and 71 million females. The report said that the growth of the elderly population accelerated mainly due to decrease in the death rate because of various health interventions after Census 1981.
The reports states that the addition of the elderly population during 2001-2011 was more than 27 million. In 1961, 5.6% of the population was in the age bracket of 60 years or more, the proportion has increased to 10.1% in 2021 and further likely to increase to 13.1% in 2031
GERIATRIC POPULATION; CHALLENGES
The challenges of dealing with a population that is aging, however, is a global issue. The years 2021-2030 have been declared by the United Nations as the ‘Decade of Healthy Ageing’.
The government of India too is aware of the challenge. In the course of the last two years, the ministry of social justice and empowerment has set up at least seven committees to look into the problems of India’s aging population.
An estimated 8.5 per cent of the 60-plus population is said to be suffering from dementia. There could be anything between 85 lakh to 1 crore people living with dementia right now. Changing social realities and fractured families have led to anxiety and depression in the elderly. There is an understanding that high blood pressure and pollution lead to reduction in brain capacity, hearing deficits which often go unnoticed in geriatric population. Even though cataract surgeries have gone up, there is still a significant unmet need. Not enough has been done to rehabilitate old people.
Rehabilitation has been limited only to pain management. But there is more to old age than that. In fact, we are now defining new entities to better understand the problems of old age.
NEED FOR GERIATRICIANS :
Geriatric medicine (GM) is a relatively new discipline in the country. Despite the Medical Council of India deciding way back in 1999 — when the National Policy for Older Persons was adopted — that all medical colleges should have a geriatric medicine MD programme, in reality, there are currently about 60-70 seats in the speciality.
According to the Indian Academy of Geriatrics, recent report of 2021, country needs huge geriatric specialists .
As per the RPC (UK) recommendations, if we consider one geriatrician per 50,000 unit population, we need 27,600 geriatricians for 138 crore population. And according to the American Geriatric Society (AGS), 30% of the older population requires geriatric care. Thus 4.14 crore older people in India will require geriatric care. Further, one geriatrician can cater to a maximum of 700 older patients. Therefore, India will need 59,000 geriatricians
It may be recalled that the first Geriatric Medicine ,MD programme was started in Madras Medical College in 1998, but since then, several private institutes such as the Amrita Institute in Kochi and CMC Vellore have started teaching the speciality. AIIMS Delhi’s Geriatric Medicine post -graduate programme started just a decade ago in 2012.
In the government sector, apart from Chennai, the Geriatric Medicine, MD programme is available at AIIMS Delhi, Jodhpur’s SN Medical College, Banaras Hindu University, Calcutta Medical College, Pune’s Armed Forces Medical College, and AIIMS Rishikesh.
(Dr Naresh Purohit is Executive Member, Federation of Hospital Administrator. He is also advisor to the National Communicable Disease Control Programme. Dr. Purohit is also Advisor to six other National Health Programmes. He is visiting Professor in five Medical Universities of Southern India including Thrissur based Kerala University of Health Sciences)
(The views and opinion expressed in this article are those of the author)