HAP Journal of Public Health and Clinical Medicine
issue front

Liss Maria Scaria1

First Published 22 Dec 2022. https://doi.org/10.1177/jpm.221118137
Article Information Volume 1, Issue 1 January 2023
Corresponding Author:

Liss Maria Scaria, Achutha Menon Centre for Health Science Studies, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala 695011, India.
Email: liss@sctimst.ac.in

1Achutha Menon Centre for Health Science Studies, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed


Background: More than half of the people in the geriatric age group have a history of at least one chronic illness, the majority of which are associated with the cardiovascular system. Hypertension, dyslipidemia, and diabetes mellitus are recognized risk factors for cardiovascular disease morbidity and mortality. The early detection of noncommunicable diseases (NCDs) has been found to reduce the disease burden and the associated complications. The study aims to assess the unmet need for screening of NCDs among older adults in the Kottayam district.

Methods: A cross-sectional study was conducted among 420 older adults (60 years and above) in all 11 blocks of the Kottayam district using a structured interview schedule. Statistical analysis using proportions with appropriate stratification was undertaken using SPSS Version 26.

Results: The unmet need for dyslipidemia screening (45.5%) was the highest among the screening. Employment status, socioeconomic status, and education were associated with the unmet need for dyslipidemia screening. Education, employment status, current means of sustenance, and socioeconomic status were associated with the unmet need for screening of diabetes mellitus. The unmet need for screening of only dyslipidemia was 22.4%. Among the participants with hypertension and diabetes mellitus, more than three-fourths (77.0%) had an unmet need for dyslipidemia screening.

Conclusions: Unmet need for screening of dyslipidemia was the highest among all the 3 diseases. About one-eight of those aged 60 and above have not been screened appropriately for all the 3 diseases. Any programmatic effort needs to address this to reduce the burden of NCD morbidity among the elderly.


Diabetes mellitus, hypertension, dyslipidemia, screening, noncommunicable diseases, unmet need

  1. WHO. Non Communicable Diseases. Published 2021. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Accessed February 1, 2022.
  2. Alam M, James KS, Giridhar G, Sathyanarayana KM. Report on the Status of Elderly in Select States of India, 2011. https://india.unfpa.org/en/publications/report-status-elderly-select-states-india-2011#:~:text=The%20report%20covers%20a%20primary,compared%20to%20the%20national%20average. Accessed July 25, 2022.
  3. WHO. Global Status Report of Non Communicable Diseases 2010. 2010. http://www.who.int/nmh/publications/ncd_report_full_en.pd. Accessed July 25, 2022.
  4. Making a Difference. The World Health Report 1999. Health Millions. 1999;25(4):3–5
  5. Office of the Registrar General & Census Commissioner. Census of India Website: Office of the Registrar General & Census Commissioner, India. Published 2011. https://censusindia.gov.in/2011-common/censusdata2011.html. Accessed February 1, 2022
  6. Thomas MB, James KS. Changes in mortality and human longevity in Kerala: are they leading to the advanced stage Glob Health Action. 2014;7. doi:10.3402/gha.v7.22938.
  7. Soman CR, Kutty VR, Safraj S, et al. All-cause mortality and cardiovascular mortality in Kerala state of India: results from a 5-year follow-up of 161,942 rural community dwelling adults. Asia Pac J Public Health. 2011;23(6):896–903. doi:10.1177/1010539510365100.
  8. Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res. 2007;125(3):217–230.
  9. Kirkman MS, Briscoe VJ, Clark N, et al. Diabetes in older adults. Diabetes Care. 2012;35(12):2650-2664. doi:10.2337/dc 12-1801.
  10. Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217–223. doi:10.1016/S0140- 6736(05)17741-1.
  11. Joshi SR, Parikh RM. India—diabetes capital of the world: now heading towards hypertension. J Assoc Physicians India. 2007;55:323–324.
  12. World Health Organization. Indicator Metadata Registry Details. https://www.who.int/data/gho/indicator-metadata-registry/ imr-details/3236. Accessed February 6, 2022.
  13. Bowen ME, Xuan L, Lingvay I, Halm EA. Performance of a random glucose case-finding strategy to detect undiagnosed diabetes. Am J Prev Med. 2017;52(6):710–716. doi:10.1016/j.amepre.2017.01.023.
  14. Ilgaz A, Gözüm S. Determination of colorectal cancer risk levels, colorectal cancer screening rates, and factors affecting screening participation of individuals working in agriculture in Turkey. Cancer Nurs. 2018;41(4):E46. doi:10.1097/NCC.0000000000000531.
  15. Das J, Mohpal A. Socioeconomic status and quality of care in rural India: new evidence from provider and household surveys. Health Aff. 2016;35(10):1764–1773. doi:10.1377/hlthaff.2016.0558.
  16. National Health Mission, Government of Kerala. NCD- Non Communicable Diseases Control Programme – National Health Mission.http://arogyakeralam.gov.in/2020/03/23/ncd-non-communicable-diseases-control-programme/.Accessed  February 7, 2022.
  17. Government of India. National Programme for Health Care of the Elderly (NPHCE) | National Health Portal Of India. Published 2011. https://www.nhp.gov.in/national-program-of-health-care-for-the-elderly-n_pg. Accessed February 7, 2022.
  18. Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India. 2009;57:563–567.
  19. CDC. How and When to Have Your Cholesterol Checked | cdc.gov. Centers for Disease Control and Prevention. Published April 15, 2021. https://www.cdc.gov/cholesterol/checked.htm. Accessed February 7, 2022.
  20. USPSTF. Screening for high blood pressure in adults: recommendation statement. AFP. 2016;93(4):300–302.
  21. US Preventive Services Task Force. Screening for prediabetes and type 2 diabetes: US preventive services task force recommendation statement. JAMA. 2021;326(8):736–743. doi:10.1001/jama.2021.12531.
  22. Casagrande SS, Cowie CC, Genuth SM. Self-reported prevalence of diabetes screening in the U.S., 2005-2010. Am J Prev Med. 2014;47(6):780–787. doi:10.1016/j.amepre.2014.07.039.
  23. Ahmad K, Jafar TH. Prevalence and determinants of blood pressure screening in Pakistan. J Hypertens. 2005;23(11):1979–1984
  24. Ma J, Stafford RS. Screening, treatment, and control of hypertension in US private physician offices, 2003-2004. Hypertension. 2008;51(5):1275–1281. doi:10.1161/HYPERTENSIONAHA.107.107086.
  25. Nelson RH. Hyperlipidemia as a risk factor for cardiovascular disease. Prim Care. 2013;40(1):195–211. doi:10.1016/j.pop.2012.11.003.
  26. Hedayatnia M, Asadi Z, Zare-Feyzabadi R, et al. Dyslipidemia and cardiovascular disease risk among the MASHAD study population. Lipids Health Dis. 2020;19(1):42. doi:10.1186/s12944-020-01204-y.
  27. Welty FK. Cardiovascular disease and dyslipidemia in women. Arch Intern Med. 2001;161(4):514-522. doi:10.1001/archinte.161.4.514.
  28. Gebreegziabiher G, Belachew T, Mehari K, Tamiru D. Prevalence of dyslipidemia and associated risk factors among adult residents of Mekelle City, Northern Ethiopia. PLOS One. 2021;16(2):e0243103. doi:10.1371/journal.pone.0243103.
  29. Centers for Disease Control and Prevention (CDC). Prevalence of cholesterol screening and high blood cholesterol among adults—United States, 2005, 2007, and 2009. MMWR Morb Mortal Wkly Rep. 2012;61:697–702.
  30. Program H, Wagner JL. Costs and Effectiveness of Cholesterol Screening in the Elderly. 1989:57. https://digital.library.unt.edu/ark:/67531/metadc39941/. Accessed July 25, 2022.
  31. Ambigga K, Jasvindar K, Gurpreet K, et al. Hypercholesterolemia prevalence, awareness, treatment and control among the elderly: The 2011 National Health and Morbidity Survey, Malaysia. J Adv Med Med Res. Published online January 27, 2016:1-9. doi:10.9734/BJMMR/2016/23304.
  32. Lugomirski P, Guo H, Boom NK, Donovan LR, Ko DT, Tu JV. Quality of diabetes and hyperlipidemia screening before a first myocardial infarction. Can J Cardiol. 2013;29(11):1382–1387. doi:10.1016/j.cjca.2013.03.015.
issue front

Order a Print Copy