Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa.

BACKGROUND: The severe burden imposed by frailty and disability in old age is a major challenge for healthcare systems in low- and middle-income countries alike. The current study aimed to provide estimates of the prevalence of frailty and disability in older adult populations and to examine their relationship with socioeconomic factors in six countries. METHODS: Focusing on adults aged 50+ years, a frailty index was constructed as the proportion of deficits in 40 variables, and disability was assessed using the World Health Organization Disability Assessment Schedule (WHODAS 2.0), as part of the Study on global AGEing and adult health (SAGE) Wave 1 in China, Ghana, India, Mexico, Russia and South Africa. RESULTS: This study included a total of 34,123 respondents. China had the lowest percentages of older adults with frailty (13.1%) and with disability (69.6%), whereas India had the highest percentages (55.5% and 93.3%, respectively). Both frailty and disability increased with age for all countries, and were more frequent in women, although the sex gap varied across countries. Lower levels of both frailty and disability were observed at higher levels of education and wealth. Both education and income were protective factors for frailty and disability in China, India and Russia, whereas only income was protective in Mexico, and only education in South Africa. CONCLUSIONS: Age-related frailty and disability are increasing concerns for older adult populations in low- and middle-income countries. The results indicate that lower levels of frailty and disability can be achieved for older people, and the study highlights the need for targeted preventive approaches and support programs.

Unsuspected sources of leprous infectious

Everybody thinks himself to be at a safe distance from leprosy without knowing where he stands. The general opinion is that it is only to be found among the beggars and the lower class people, that it is an hereditary disease, it visits only those who have sinned in their life, and that the workers in connection with a leprosy clinic are most likely persons to get this disease

Seasonal variations in leprosy in Calcutta

1- Analysis of the records of new cases appearing at the Calcutta leprosy clinic over a period of two years )1936-1938, 2,779 cases) shows that larger numbers per month come between March and October than in the rest of the year. 2- This seasonal increase is found to occur in the neuromacular cases and not in those of the lepromatous type or of the neural type without macules. The seasonal variation in the clinical and bacteriological findings in the 1902 neuromacular cases is studied. 3- It is found that clinical signs of activity in the form of thickening, erythema and radial extension are more common during the months from March to September than at other seasons. 4- It is found that during the months of March, April and May the percentage of neuromacular lesions in which bacilli are found in smears rises markedly, reaching a maximun of about 23 per cent in April or May, and that it falls to below 5 percent in June; during most of the year the percentage is below 10. 5- These findings are interpreted as demonstrating: (a) that in the early months of the year, bacilli in neuromacular lesions tend to multiply increased cellular activity; (b) that the bacillary increase tends to end abruptly in the month of june;and (c) that the increase in cellular activity subsides a few weeks after the bacillary increase has subsided. 6- The causation of these seasonal variations is discussed in the light of the publications of Stein, who attributes a seasonal incidence of lepra reaction to sudden changes in meteorological conditions, and of Oberdoerffer, who attributes seasonal variations seen in Africa to varying consumption and varying toxity of cocoyam (Collocasia antiquorum) at different times of the year. Neither of these factors seems to explain the seasonal variations seen in Calcutta. 7- The seasonal variations in Calcutta appear to be related to meteorological conditions, the period of increased bacterial activity being confined to the hot, relatively dry season and ending abruptly with the onset of the rainy season, the cellular activity gradually subsiding later.