Academic journal article Indian Journal of Psychiatry

Sample Attrition Rate of a Community Study: An Analysis of Lucknow Urban and Rural Elderly Follow-Up over a Period of 9 Years

Academic journal article Indian Journal of Psychiatry

Sample Attrition Rate of a Community Study: An Analysis of Lucknow Urban and Rural Elderly Follow-Up over a Period of 9 Years

Article excerpt

Byline: Bhupendra. Singh, Nisha. Pandey, R. Garg, Neera. Kohli, Kausar. Usman, G. Agarwal, Sarvada. Tiwari

Background: Longitudinal/ follow-up studies of older adults are a tough task as sample attrition rates due to mortality and other factors may be high in this particular group. However, such studies are very much needed to assess the outcome of health status as well as explore preventive, protective, interventional aspects, as well as risk factors. Given this, a follow-up study was planned and carried out. Aim: To discuss the rate of sample loss as well as the reasons over 9 years. Methods: An Indian Council of Medical Research (ICMR) supported follow-up study of urban and rural elderly was done during June, 2016-May, 2017; these subjects were studied in 2007-09 through two independent ICMR supported studies. Similar methodology and assessment tools were applied in these studies. During follow-up a semi structured proforma was developed to get the information of study cohort, obtained data was analyzed and presented applying percentage statistics. Results: The sample attrition rate was reported to be comparatively high in urban 52.1% (n= 633) cohort than their rural counterparts 36.3% (n= 457). Conclusion: Over a period of 9 years chances of cohort loss due to mortality is about 32%-35%.

Background

Long-term follow-up studies on aging provide a chance to explore many issues related to healthy/unhealthy conditions, cognitive status, possible variations in the external milieu, etc. To identify risk factors for the assessment of negative health outcomes, one needs to carry out long-term follow-up; however, this leads to increased sample attrition rate due to noncooperation, nonavailability of the participants as well as mortality, and migration. Most of the longitudinal studies focus on one or other kind of problems or disease. Studies from abroad reveal that researchers seldom have information about how people who drop out would have responded if they had stayed in the study.[1] It is also reported that attrition can occur due to death or frailty, discontinued participation (withdrawal), and lack of success in recontacting the participant for a follow-up survey (no contact) or by nonreturn of a survey by a participant (nonreturn).[2] Another review reports the need for future work within six broad study topics, i.e., cognitive function, socioeconomic status (SES), health and physical performance, morbidity and mortality predictors, healthcare costs, and genetics.[3] The Australian Longitudinal Study of Aging reported that poor performance on nearly all cognitive variables is associated with mortality and cause of sample attrition.[4] Further, follow-up studies over 2-20 years have reported that poor self-reported health,[5],[6],[7] impaired cognitive function,[8] and depression[9] are some of the major risk factors for mortality in elderly. However, hardly Indian studies had provided a comprehensive analysis on healthy and unhealthy groups of elderly vis-a-vis cause sample loss. Such analysis provides clues and assists in estimating a usual pattern of mortality in elderly over a particular period.

The authors had an opportunity to carry out a follow-up study with the financial support of the Indian Council of Medical Research (ICMR) in which a total of 4786 (2283 urban and 2503 rural) elderly participants aged 64 years and above had to studied over 9 years. Nine years back, these participants were recruited and studied thoroughly in two independent ICMR-funded projects applying similar methodology and tools. These projects were ' an epidemiological study of the prevalence of neuropsychiatric disorders with special reference to cognitive disorders among (Urban) Elderly ( Lucknow urban elderly study ) ' and ' an epidemiological study of the prevalence of neuropsychiatric disorders with special reference to cognitive disorders among (rural) elderly (Lucknow rural elderly study).' At the time of recruitment, these participants were aged 55 years and above and thus distinguished in two groups, i. …

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