Abstract

Comorbidity is most generally defined as the co-occurrence of two or more chronic diseases. Comorbidity is often associated with poor treatment outcome, severe illness course and high service utilization. This presents a significant challenge with respect to the identification, prevention and management of people with comorbid disorders. The main objective of this study was to determine the prevalence and variety of comorbid disorders affecting the elderly of the Buea-town community.  A cross-sectional study was conducted among the community dwelling elderly people aged 65 and above in the Buea-town community, where a convenient sampling technique was used on a sample size of 48 elderly. Interviews were performed and medical records verified. The overall prevalence of comorbidity in the Buea-town community was 81.25%. The most common chronic conditions were hypertension, arthritis, diabetes, hearing impairment and visual impairment and the most prevalent comorbid condition is arthritis and malnutrition. The high prevalence of comorbidity requires a re-organization of healthcare systems in sub-Saharan Africa, especially in Cameroon.

CHAPTER ONE

INTRODUCTION

1.0 Background to the Study

Elderly people are now the most rapidly growing proportion of the patient population in the majority of western countries, and ageing seldom comes alone, often being accompanied by chronic diseases, comorbidity, disability, frailty, and social isolation. Multiple diseases and multimorbidity inevitably lead to the use of multiple drugs, a condition known as polypharmacy.

The term comorbidity was coined by Feinstein (1970) to refer to the situation in which an individual has two or more physical and/or mental illness. In medicine, comorbidity is the presence of one or more additional diseases or disorders co-occurring with (that is, concomitant or concurrent with) a primary disease or disorder. The additional disorder may be a behavioral or mental disorder.

Comorbidity is clinically important for three reasons. First, some types of comorbidity complicate diagnosis because presenting complaints are a mix of symptoms of different comorbid conditions. Second, some types of comorbidity complicate treatment because standard therapies for one disorder in a comorbid set are contraindicated for patients with another disorder in the set. Third, some types of comorbid disorders can magnify the functional impairment and adversely influence the course of other conditions. (Kessler, 2001).

The 2009 American Recovery and Reinvestment Act identified patients with multiple chronic conditions as a priority population for patient-centered health research (Department of Health and Human Services Agency for Healthcare Research and Quality, 2009). Approximately 75 million people in the United States have two or more conditions that last a year or more and require ongoing medical attention or limit activities of daily living, or both. Among Medicare beneficiaries 83% have at least one chronic condition. The 23% who have five or more such conditions account for 68% of Medicare expenditures. A survey of members of a health maintenance organization ages 65 and over found the average person had 8.7 chronic diseases. Patients with multiple chronic conditions have on average a higher level of morbidity, poorer physical functioning and quality of life, a greater likelihood of persistent depression, and lower levels of social wellbeing. Such patients incur increased risks of adverse drug events and mortality.

1.1 Problem Statement

The increasing prevalence rate of comorbidity among elderly in developing countries is a major problem. Information on elderly condition is important in allocation of resources to help the elderly affected. Unfortunately, in Cameroon there is limited information on this which increases the public health burden.  Because of this, this is why I study its prevalence in the Buea-town community.

1.2 Purpose of the study

The purpose of this study was to improve the care of the elderly in the Buea-town community and Cameroon, by providing data on the prevalence of comorbidity.

1.3 Research question

1. What is the prevalence of comorbidity in the elderly of Buea-town community?
2. What are the comorbid disorders which affect the elderly in the Buea-town community?

1.4 OBJECTIVES

1.4.1 Main Objective

To determine the prevalence and variety of comorbid disorders affecting the elderly in the Buea-town community.

1.4.2 Specific objective

1. To determine the prevalence of comorbidities in the elderly in the Buea-town community
2. To determine the comorbid disorders that affect the elderly in the Buea-town community

1.5 significance of study

This study will go a long way to bring out the knowledge and increase care given by their family and health care givers to the elderly people regarding comorbidity. It will also help increase awareness on comorbidities.

1.6 Scope of the study

This study focused on the elderly (aged 65 years old and more) in the Buea-town community suffering from comorbid conditions. It was limited bringing out knowledge on comorbidities.

1.7 Operational definition of terms

Comorbidity: In medicine, comorbidity is the presence of one or more additional disease or disorder co-occuring with (that is, concomitant or concurrent with) a primary disease or disorder.

Elderly: Conventionally, elderly has been defined as a chronological age of 65years old and above.

Research: In this study, research will be defined as a diligent inquiry or examination to seek or revise facts, principles, theories and applications.

Polypharmacy: It is the concurrent use of multiple medications by a patient.

Chronic condition: A chronic condition is a human health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time.