title: Prevalence and Predictors of Unmet Needs among the Elderly Residents of the Rural Field Practice Area of a Tertiary Care Centre from Northern India.
abstract: BACKGROUND
  Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified.
  
  
  METHODS
  A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs.
  
  
  RESULTS
  185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender (P= 0.046), elderly aged 70 years and above (P= 0.032), those living alone (P= 0.035), low monthly family income (P= 0.044), financially fully dependent elderly (P= 0.0002), and those having 3 or more physical disabilities (P= 0.033).
  
  
  CONCLUSIONS
  The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities.
authors.affiliation: Department of Community Medicine, Shaheed Hasan Khan Mewati Government Medical College, Nalhar (Mewat) Haryana, PIN- 122107, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Singh
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, Ansari Nagar New Delhi - 110029 India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Bairwa
authors.affiliation: Department of Microbiology, Teerthanker Mahaveer Medical College and Research Centre, N. H. 24, Delhi Road, Moradabad, Uttar Pradesh 244001 India.
authors.forename: Shewtank
authors.initials: S
authors.lastname: Goel
authors.affiliation: Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar New Delhi - 110029 India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Bypareddy
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Madhav Nagar, Manipal-576104, Karnataka India.
authors.forename: Prassana
authors.initials: P
authors.lastname: Mithra
keywords: Prevalence; elderly; predictors; rural India; rural. Geriatric; unmet needs