Multimorbidity of Elderly Individuals in Urban and Rural Areas of the Nizhny Novgorod Region

Abstract

This paper compares the prevalence of pathological changes in different organs and systems among urban and rural residents of the following ages: elderly (60–74 years for men and 55–74 years for women), senile (75–84 years), and advanced (85 years and older). The results of a continuous survey of all individuals of retirement age of one urban (7809 individuals) and two rural areas (14749 individuals) of the Nizhny Novgorod region were analyzed. The region is comparatively homogeneous in terms of the national composition of the population. In the city, the number of chronic pathologies of different organs and systems per individual of elderly age is 2.83 per man and 2.76 per woman for elderly ages, 3.06 and 3.07 for senile ages, and 2.71 and 2.75 for advanced ages, respectively. In rural areas, the analyzed indicators for men and women are respectively 1.64 and 1.58 for elderly, 1.84 and 1.78 for senile, and 1.86 and 1.84 for advanced-age individuals. Demonstrating the difference in the phenotypic manifestations of the genes of predisposition to chronic diseases in old age between the city and rural areas, the results make it possible to assume the following. First, better access to medical care does not guarantee better health status of the elderly, while it contributes to an increase in the life expectancy of men. Second, despite better access to health care, the urban lifestyle contributes to an accumulation of chronic diseases in the population of a region. Third, in case of chronic pathology of three different classes of diseases, the probability of a long life is fundamentally determined by access to health care. Fourth, the probability of longevity is significantly reduced as a result of having neoplasms, cardiovascular, respiratory, endocrine, or genitourinary diseases at working age or the early retirement period.