1. Farid Najafi MD PhD School of Public Health Kermanshah University of Medical Sciences Health status of the elderly population of Iran in 2012

2. Global aging and health assessment The proportion of the world population of people aged over 60 years will double by the year 2050 In Iran, the elderly population has grown 2.9 times over the past 30 years 10% of total population by 2026 Health status assessment among elderly is a complex issue: Physiologic assessment Physical assessment Social assessment Mental dimention Assessment of differnet comorbidities

3. Global aging and health assessment (cont) Lack of enough rehabilitation services, counseling centers and special medical centers in developing countries such as Iran Necessity of comprehensive analysis of health status of elderly to fulfill the future increasing the burden of chronic disease among such group This is the first nation wide study on health status of elderly in Iran

4. Methods 5 representing provinces from total 31 provinces (Alborz, Norht Khorasan, Eastern Azerbaijan, Khouzestan, and Sistan Baluchestan; 18.6% of Iran’s population) A sample comprising 1350 people were selected using multistage sampling Cluster sampling from 109 health centers in 66 towns Main outcomes assessment: Mini-nutritional assessment Functional status: activity of daily living (ADL) and instrumental activities of daily living (IADL)

5. Methods (cont) Psychosocial and cognitive status using the short form of 15- item geriatric depression scale (GDS-15) Evaluation of chronic disease and risk factors including diabetes, hypertension, lipid profile and other risk factors using: Self report Medical files Physical examination

6. p valueFemale N (%)Male N (%)Variable(N*) 0.001 279(39.4)191(29.7)60-75y Age class(1350) 307(43.3)262(41.0)76-85 122(17.3)189(29.3)>85 0.27 Residential place (1347) 385(54.6)329(51.2)Urban 320(45.4)313(48.89)Rural 0.001 Educational level(1346) 554(78.4)334(52.3)Illiterate 105(16.3)199(31.3)Elementary school 17(2.4)51(8.0)High school 3(0.04)30(4.7)Bachelor degree 4(0.05)25(3.9)College 0.001 Marital Status(1344) 328(46.5)34(5.3)Widow 365(51.7)587(92)Married 13(1.8)17(2.7) Divorced 0.001 Living with(1329) 123(17.7)150(23.7)Partner 216(31.1)406(64.0)Partner and children 259(37.2)57(9.0)Other 97(14.0)21(3.3)Alone 0.48 Insurance (1350) 679(95.9)617(96.1)Yes 29(4.1)25(3.9)No 0.001 Smoking(1330) 15(2.2)92(14.4)Yes 678(97.8)545(85.6)No 0.001 Pension (1334) 211(30.2)267(41.9)Yes 486(69.8)370(59.1)No 0.001 Receive support from others(1308) 261(37.9)185(29.8)Yes 427(62.1)435(70.2)No

7. Variable(N*) Yes No N (%) P value Under control N(%) No control N(%) High blood lipid (1291) Male106 (17.2)41(6.6)469 (76.2) 0.002 Female193(28.6)57(8.4)425(63.0) Hypertension (1250) Male217 (36.8)64(10.8)  309(52.4) 0.001 Female298 (45.2)45(6.8)317(48.0) Diabetes (1334) Male93(14.0)41(6.2)  530 (79.8) 0.015 Female138(19.9)25(3.6)532 (76.5) Alzheimer (1247) Male10(1.7)73(12.3)512(86.0) 0.82 Female12(1.8)73(11.2)567(87.0) Obesity (846) Male14(3.4)56(13.7)339(82.9) 0.001 Female25(6.7)124(28.4)  288(65.9)

8. Variable(N*)Total (%) Men (%) Women (%) P Depression(1350)GDS>8495(36.6)194(30.2)301(42.5)0.001 Nutrition(1338) Malnutrition(<17)70(5.5)24(4.0)46(6.8) 0.001 At risk of MN(17-23.5)554(41.3)243(38.2)311(44.2) normal(>24)714(53.2)369(57.8)345(49.0) ADL(1337) Independent1162(86)558(87.4)604(86.8) 0.001 Dependent 1-2ADL125(9.3)54(8.4)71(10.0) dependent≥3ADL50 (3.7)27 (4.2)23(3.2) IADL(1338) Independent461(34.3)242(37.9)219(31.1) 0.001 Dependent for1 IADL250(18.7)106(16.7)144(20.5) Dependent for2 IADL194(14.5)111(17.4)83 (11.8) Dependent for3 IADL143(10.7)64(10.1)79(11.3) Dependent for4 IADL130(9.8)51(8.1)79(11.3) Dependent for 5 IADL160(12.0)62(9.8)98(14.0)

9. 39%36%

10. Conclusion 1. Space for having better health among elderly in Iran 2. Challenges for improvement of health among people how are mostly illiterate 3. Need to take immediate action to promote the health status of elderly people in a country where have no prepared infrastructure for facing such problem

11. Thank you