Health-Seeking Behavior of Older Adults in Georgia: A Cross-Sectional Study

Health-Seeking Behavior of Older Adults in Georgia: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Health-Seeking Behavior of Older Adults in Georgia: A Cross-Sectional Study Tengiz Verulava, Revaz Jorbenadze This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7124341/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Understanding health-seeking behavior among older adults is essential for designing age-responsive health policies. This study aims to investigate the factors that influence health-seeking behavior among the elderly population. A quantitative, cross-sectional survey design was employed. The study was conducted among 406 individuals aged 60 years and above attending four primary healthcare centers in Tbilisi, Georgia. Participants were selected using simple random sampling. Data were collected through a structured and pre-tested questionnaire, and analyzed using descriptive statistics, chi-square tests, and binary logistic regression. The majority of respondents reported chronic age-related conditions, with hypertension, diabetes, and musculoskeletal disorders being most common. While 65% sought allopathic treatment, 18.2% practiced self-medication, and 10.3% did not seek treatment at all. Logistic regression analysis revealed that higher education, female gender, younger-old age (60–75 years), and above-poverty-line status were independent predictors of seeking formal care (p < 0.05). The study highlights significant disparities in health-seeking behavior shaped by socioeconomic and demographic factors. These findings underscore the need for targeted public health interventions, improved health literacy, and elderly-centered policy reforms to ensure equitable access to care in Georgia’s aging population. aging population chronic disease management cultural beliefs health-seeking behavior health literacy Introduction The incidence of chronic diseases tends to rise with advancing age, likely due to underlying physiological and biological changes associated with aging, which lead to a decline in functional capacity (Singsalasang & Bandidphak, 2024 ). While aging itself is not considered a disease, it is often accompanied by diminished physical and cognitive abilities that contribute to the deterioration of overall health. Studies have shown that a majority of older adults suffer from two or more chronic conditions simultaneously, largely due to the weakening of various bodily systems, including the immune system (Emeh et al., 2020 ). This results in increased utilization of medical services. Health status has a substantial impact on quality of life, and increased morbidity contributes to a reduction in health-related quality of life (Sitlinger & Zafar, 2018 ). One of the key factors influencing the outcomes of illness severity among the elderly is their health-seeking behavior. It encompasses the various actions individuals undertake to preserve or enhance their health, including seeking timely and regular medical care from qualified professionals, engaging in follow-up and monitoring, practicing self-medication, using traditional treatments, or exploring alternative strategies (Wu et al., 2023 ). Among older adults, health-seeking behavior is shaped by a combination of physical, psychological, economic, and social factors (Kotit, 2024 ). Studies have shown that elderly individuals with higher income and educational attainment are more likely to seek timely medical care and adhere to treatment regimens (Selvakumar et al., 2023 ; Verulava & Arakishvili, 2024 ; Verulava & Jorbenadze, 2024 ). Conversely, low socioeconomic status is associated with delayed care-seeking and a reliance on alternative or informal healthcare services (Ratnapradipa et al., 2023 ). Cultural norms also play a significant role in shaping the health-seeking behavior of elderly patients. In many societies, older individuals may prefer traditional remedies over modern medical interventions due to distrust of healthcare providers (Williamson et al., 2015 ). Social support networks, including family and community, also have a major influence on whether and how older adults seek care (Yang et al., 2024 ). Physical and cognitive impairments may limit access to healthcare services. Mobility restrictions and conditions such as dementia often require caregiver assistance, and the absence of such support can hinder or completely prevent access to professional medical care (Waymouth et al., 2023 ). Accessibility of healthcare services, including transportation, is a critical determinant of health-seeking behavior in the elderly. Long waiting times, high costs, and inadequate geriatric care facilities are significant barriers to obtaining needed healthcare services (Scott et al., 2024 ). Delays in seeking medical attention may lead to more severe and potentially irreversible health outcomes. Therefore, it is essential to understand the health-seeking behavior of older adults and the factors influencing it to assess their needs and priorities when it comes to accessing care (Bayable et al., 2023 ). In Georgia, there is a lack of research examining the health-seeking behavior of the elderly and its determining factors. This study was undertaken to fill this gap in the literature. This is the first study to systematically examine health-seeking behavior among the elderly in Georgia using a structured, quantitative approach. The aim of the present research is to explore the factors that affect the health-seeking behavior of the elderly population in Georgia. Understanding the health-seeking behavior of older adults is crucial due to their unique health needs, the higher prevalence of chronic conditions, and the specific barriers they face in accessing healthcare services. The findings of this study will contribute to the development of an effective geriatric care system and the design of evidence-based healthcare policies that are tailored to the needs of the elderly. Theoretical Framework This study is grounded in Andersen’s Behavioral Model of Health Services Use, which provides a comprehensive framework for analyzing the determinants of healthcare utilization (Andersen, 1995 ). The model categorizes influencing factors into three groups: predisposing, enabling, and need factors. Predisposing factors are individual characteristics such as age, gender, education level, and marital status, which influence the propensity to seek care. These variables were included in the study to assess how demographic and social characteristics shape health-related decisions among older adults in Georgia. Enabling factors refer to the resources and conditions that facilitate or hinder access to services. In this context, we examined socioeconomic status, employment, and living arrangements as proxies for access to care, recognizing that structural barriers are common in low- and middle-income settings. Need factors represent both perceived and actual health conditions. The presence of chronic illnesses, such as hypertension, diabetes, and musculoskeletal disorders, was assessed alongside participants’ perceptions of illness severity and their beliefs about aging-related symptoms. These factors are central to understanding the urgency and frequency of healthcare utilization. By applying Andersen’s model, the study offers a structured interpretation of the diverse influences on elderly health-seeking behavior. It also provides a basis for designing evidence-based policies aimed at reducing access barriers, particularly for vulnerable older adults with limited resources or support systems. Materials and Methods Study Design and Participants A quantitative, cross-sectional study was conducted in four major primary healthcare centers in Tbilisi, Georgia, selected based on their high number of registered beneficiaries. The selection of primary healthcare centers in Tbilisi was based on practical, logistical, and strategic considerations. Tbilisi, as the capital and largest city of Georgia, hosts some of the country's busiest and most diverse primary healthcare centers, with a high concentration of registered elderly beneficiaries. These facilities were chosen to ensure efficient access to a sufficiently large and varied elderly population within the study timeframe. Additionally, the capital offers logistical advantages for data collection, including researcher mobility, institutional coordination, and ethical oversight. A simple random sampling technique was employed to select participants from the elderly population (aged 60 years and older) registered at the selected centers. Each facility provided a list of patients who had visited within the past six months, which served as the sampling frame. Eligible patients were assigned unique numbers, and participants were selected using a computer-generated random number table. Approximately 135 participants were randomly selected from each center to ensure proportional representation. A total of 486 eligible elderly patients were approached during the data collection period. Of these, 406 individuals agreed to participate and completed the questionnaire, resulting in a response rate of 83.5%. The remaining individuals either declined participation, were seriously ill, or were unable to complete the interview due to cognitive or physical impairments. Inclusion criteria were: age 60 years or older, registration at one of the selected primary healthcare centers, and ability to provide informed consent. Exclusion criteria included: severe cognitive impairment, terminal illness, acute medical conditions that prevented participation, or refusal to participate. All interviews were conducted face-to-face. Incomplete questionnaires were excluded from analysis. Data completeness was reviewed daily by field supervisors. Less than 3% of the data had missing responses; these were addressed using listwise deletion for analyses requiring complete cases. Data Collection Instrument and Procedure A pre-structured and pre-tested questionnaire served as the primary data collection tool. Data were collected through face-to-face interviews conducted by members of the research team during on-site visits to the selected primary healthcare centers. Each interview was conducted in person and lasted approximately 20 minutes. The questionnaire was developed based on a review of international literature and adapted to the Georgian context. It included sections on sociodemographic characteristics (age, gender, place of residence, marital status, education level, employment status, annual household income, and living conditions), the type and cause of illness (chronic, acute, or other), and factors influencing health-seeking behavior. Before the main study, the questionnaire was piloted with 30 elderly patients to assess its clarity, relevance, and cultural appropriateness. Based on their responses, internal consistency was assessed using Cronbach’s alpha. The overall scale demonstrated acceptable reliability, with a Cronbach’s alpha of 0.78, indicating a satisfactory level of internal consistency across key sections of the questionnaire related to health-seeking behavior, perceived barriers, and access to care. Minor revisions were made to improve question clarity and cultural relevance before administering the final version in the main study. All data were collected anonymously. For data entry and processing, each questionnaire was coded and assigned a unique, manually generated identification number. Data collection took place over six weeks, from August 23 to December 7, 2024. Data Processing and Analysis Data were analyzed using SPSS version 26. Descriptive statistics were used to summarize sociodemographic variables, health conditions, and types of health-seeking behavior. Bivariate associations between categorical variables were assessed using Chi-square tests. To account for the potential inflation of Type I error due to multiple comparisons across sociodemographic and health behavior variables, a Bonferroni correction was applied. For 10 primary comparisons, the adjusted significance threshold was set at p < 0.005 (0.05/10). This conservative adjustment allowed more rigorous identification of statistically meaningful differences. Furthermore, a post hoc power analysis was conducted using G*Power 3.1.9.7. Assuming a medium effect size (Cohen’s w = 0.3), a significance level of α = 0.05, and a total sample size of N = 406, the achieved statistical power was calculated to be 0.90 (90%) for chi-square tests with 1 degree of freedom. This confirms that the sample was adequately powered to detect medium effects in key comparisons. Multivariate analysis was performed using binary logistic regression to identify independent predictors of allopathic treatment-seeking behavior. Variables found significant in bivariate analysis at p < 0.05 were entered into the regression model. Ethical Considerations Before initiating the study, ethical approval was secured from the Research and Ethics Committee of Caucasus University. A formal notification letter was sent to the participating primary healthcare centers one week in advance. Copies of the letter were also distributed to the registration offices and physicians of the respective centers, who were asked to refer eligible patients to the interview room. The survey was conducted in accordance with the principles of informed consent. Before participating, respondents were informed about the purpose and importance of the study, after which verbal consent was obtained. Participants were clearly assured that their participation would not cause them any harm and that they were free to withdraw at any stage of the interview if they wished. Anonymity and confidentiality were strictly maintained throughout the study. All responses were securely stored without the names or identifying information of the participants. Limitations This study was limited to several primary healthcare centers in Tbilisi, which may affect the generalizability of the findings to the broader national elderly population, particularly those residing in rural or remote areas. Healthcare infrastructure, socioeconomic conditions, and cultural norms in rural regions may differ significantly from those in urban settings, potentially leading to different patterns of health-seeking behavior. Therefore, while this study provides valuable insights into elderly healthcare utilization in an urban Georgian context, further research is needed to explore these dynamics in rural populations to fully inform national health policy and planning. Another limitation was the scarcity of locally available literature on this topic, which reduced the ability to compare results with other countries. Moreover, future research could benefit from incorporating the perspective of healthcare providers to gain a more comprehensive understanding of the factors influencing health-seeking behavior among the elderly. Results Sociodemographic Profile A total of 406 elderly patients from the four selected primary healthcare centers participated by completing the questionnaire. The sociodemographic and economic characteristics of the respondents are presented in Table 1 . The majority of respondents were aged between 60 and 75 years (83.3%, n = 338) and were male (53.7%, n = 218). Regarding marital status, 71.9% (n = 292) were married, while 20.9% (n = 85) were widowed. Most respondents (n = 301; 74.1%) had completed secondary education. A notably higher proportion of women were unemployed (n = 93; 49.5%) and widowed (n = 73; 38.8%) compared to men. Almost half of the respondents lived with both their spouse and children (n = 196; 48.3%). More women lived with their children (n = 45; 23.9%) compared to men. Only 4.2% (n = 17) reported living alone. The majority of respondents (n = 232; 57.1%) were retired. Table 1 Sociodemographic characteristics of the patients (Percentages Calculated by Gender Subgroup) Characteristics Total (n = 406), n (%) Men (n = 218; 53.7%), n(%) Woman (n = 188; 46.3%), n(%) P-value Age (years) 60–75 > 75 338 (83.3) 68 (16.7) 187 (85.8) 31 (14.2) 151 (80.3) 37 (19.7) 0.508 Marital Status Married Unmarried Divorced Widow 292 (71.9) 16 (3.9) 13 (3.2) 85 (20.9) 193 (88.5) 7 (3.2) 6 (2.8) 12 (5.5) 99 (52.7) 9 (4.8) 7 (3.7) 73 (38.8) < 0.001 Education Secondary education Higher education 301 (74.1) 105 (25.9) 175 (80.3) 43 (19.7) 126 (67.0) 62 (33.0) < 0.001 Employment status Unemployed Employed Pensioner 129 (31.8) 45 (11.1) 232 (57.1) 36 (16.5) 33 (15.1) 149 (68.3) 93 (49.5) 12 (6.4) 83 (44.1) < 0.001 Living arrangements : Lives alone Lives with spouse Lives with spouse and children Lives with children Lives with relatives Lives with a caregiver 17 (4.2) 92 (22.7) 196 (48.3) 82 (20.2) 8 (2.0) 11 (2.7) 9 (4.1) 42 (19.3) 121 (55.5) 37 (17.0) 4 (1.8) 5 (2.3) 8 (4.3) 50 (26.6) 75 (39.9) 45 (23.9) 4 (2.1) 6 (3.2) < 0.001 Note: Percentages are calculated within each subgroup (men and women), not across total category rows. As such, row-wise percentages may not sum to 100%. Health Conditions To assess the health status of the elderly participants, the most common health-related problems were identified and are shown in Table 2 . The majority of respondents reported age-related chronic conditions, such as hypertension (n = 282; 69.5%), diabetes mellitus (n = 226; 55.7%), musculoskeletal disorders (n = 212; 52.2%), dental problems (n = 134; 33%), and cataracts (n = 127; 31.3%). These conditions generally require long-term management and become more prevalent with increasing age. In terms of gender differences, a higher proportion of elderly men reported the following conditions compared to women: diabetes mellitus (n = 123; 56.4%), hypertension (n = 158; 72.5%), ischemic heart disease (n = 47; 21.6%), and cerebrovascular disease (n = 9; 4.1%). Conversely, women more frequently reported musculoskeletal disorders (n = 135; 61.9%), cataracts (n = 68; 36.2%), obesity (n = 42; 22.3%), and gastrointestinal problems (n = 43; 22.9%). Table 2 Distribution of chronic conditions among the elderly. Disease Type N = 406 (100%) Man (n = 218), n (%) Woman (n = 188), n (%) p Diabetes Hypertension Ischemic Heart Disease Cerebrovascular Disease Musculoskeletal Diseases Gastrointestinal Diseases Kidney Diseases Prostate Diseases Dental Problems Cataracts Asthma Obesity Skin Problems Hearing Problems in the Elderly Psychiatric Disorders Depression Anxiety 226 (55.7) 282 (69.5) 84 (20.7) 15 (3.7) 212 (52.2) 84 (20.7) 66 (16.3) 57 (14.0) 134 (33.0) 127 (31.3) 31 (7.6) 74 (18.2) 62 (15.3) 22 (5.4) 26 (6.4) 23 (5.7) 123 (56.4) 158 (72.5) 47 (21.6) 9 (4.1) 77 (41) 41 (18.8) 34 (15.6) 57 (26.1) 69 (31.7) 59 (27.1) 9 (4.1) 32 (14.7) 35 (16.1) 11 (5.0) 11 (5.0) 11 (5.0) 103 (54.8) 124 (66.0) 37 (19.7) 6 (3.2) 135 (61.9) 43 (22.9) 32 (17.0) 0 65 (34.6) 68 (36.2) 22 (11.7) 42 (22.3) 27 (14.4) 11 (5.9) 15 (8.0) 12 (6.4) 0.802 0.750 0.461 0.719 0.724 0.015 0.559 < 0.001 0.476 0.278 0.003 0.237 0.623 0.442 0.147 0.875 Health-Seeking Behavior The next part of the study examined where elderly individuals sought care when experiencing illness (Table 3 ). The majority of respondents reported using allopathic (modern) medical services (n = 264; 65%). Among this group, women (n = 150; 79.8%) significantly outnumbered men (n = 114; 52.3%). Self-medication was the second most common response (18.2%; n = 74), followed by traditional (folk) treatment (6.4%; n = 26). Notably, 10.3% of respondents (n = 42) did not seek any treatment. Elderly men were more likely than women to use traditional medicine (n = 19; 8.7%) and self-medication (n = 55; 25.2%), while women were significantly more likely to prefer allopathic treatment (n = 150; 79.8%) than men (n = 114; 52.3%). Respondents with higher education levels primarily sought care from qualified allopathic doctors (n = 127; 88.2%). In contrast, those living below the poverty line were more likely to engage in self-medication (n = 32; 32.7%), forego treatment entirely (n = 16; 16.3%), or seek traditional treatment (n = 15; 15.3%). By age group, those aged 60–75 were more likely to choose allopathic (conventional Western) care (n = 232; 68.6%). However, the use of allopathic services declined with age, reaching only 47.1% (n = 32) among individuals aged 75 and older. Table 3 Factors influencing health-seeking behavior among the elderly. Sociodemographic characteristics No treatment 42 (10.3) Self-medication 74 (18.2) Traditional (folk) treatment 26 (6.4) Allopathic 264 (65) Total 406 P value Bonferroni Significant Age (years) 60–75 > 75 32 (9.5) 10 (14.7) 62 (18.3) 12 (17.6) 12 (3.6) 14 (20.6) 232 (68.6) 32 (47.1) 338 (83.3) 68 (16.7) < 0.001 Yes Gender Men Woman 30 (13.8) 12 (6.4) 55 (25.2) 19 (10.1) 19 (8.7) 7 (3.7) 114 (52.3) 150 (79.8) 218 (53.7) 188 (46.3) < 0.001 Yes Marital Status Married Unmarried Divorced Widow 22(7.5) 4 (25) 2 (15.4) 14 (16.5) 56 (19.2) 2 (12.5) 2 (15.4) 14 (16.5) 21 (7.2) 1 (6.3) 1 (7.7) 3 (3.5) 193 (66.1) 9 (56.3) 8 (61.5) 54 (63.5) 292 (71.9) 16 (3.9) 13 (3.2) 85 (20.9) 0.04 No Education Secondary education Higher education 37 (14.1) 5 (3.5) 67 (25.6) 7 (4.9) 21 (8.0) 5 (3.5) 137 (52.3) 127 (88.2) 262 (64.5) 144 (35.5) < 0.001 Yes Employment status Unemployed Employed Pensioner 15 (11.6) 6 (13.3) 21 (9.1) 26 (20.2) 15 (11.6) 33 (14.2) 9 (7) 4 (3.1) 13 (5.6) 79 (61.2) 20 (15.5) 165 (71.1) 129 (31.8) 45 (11.1) 232 (57.1) 0.43 No Social status Below the poverty line Above the poverty line 16 (16.3) 26 (8.4) 32 (32.7) 42 (13.6) 15 (15.3) 11 (3.6) 35 (35.7) 229 (74.4) 98 (24.1) 308 (75.9) < 0.001 Yes Note: Bonferroni-adjusted significance threshold = 0.005. Only associations meeting this criterion are marked "Yes" under the "Bonferroni Significant" column. Frequency and Regularity of Health-Seeking Among the elderly, 27.3% (n = 111) sought medical care once per month, and 33% (n = 134) sought care several times per year. Healthcare service utilization was more frequent among older age groups. Notably, 51.5% (n = 35) of individuals aged over 75 sought care multiple times per month (Table 4 ). However, 20.7% (n = 84) of all respondents reported seeking medical care less than once per year, and 3.2% (n = 13) had never sought care. Table 4 Frequency and regularity of health-seeking behavior among the elderly (n = 406). Total n,% 60–75 > 75 Does not seek medical care Several times a month Once a month Several times a year Once a year Less regularly than once a year Total 13 (3.2) 43 (10.6) 111 (27.3) 134 (33) 21 (5.2) 84 (20.7) 406 (100) 10 (3) 8 (2.4) 87 (25.7) 129 (38.2) 20 (5.9) 84 (24.9) 338 (100) 3 (4.4) 35 (51.5) 24 (35.3) 5 (7.4) 1 (1.5) 0 (0) 68 (100) Barriers to Healthcare Utilization Decisions regarding whether to seek care were influenced by factors such as perceived severity of illness, attitudes of healthcare workers, trust in the healthcare system, and both geographic and financial accessibility. Among those who rarely sought care, less than once per year or not at all (n = 97), the majority (n = 41; 42.3%) perceived their health problems as a natural part of aging. Another significant portion (n = 28; 28.9%) cited lack of financial means and geographical barriers as their main reasons for infrequent healthcare utilization (Table 5 ). Table 5 Reasons for non-utilization of health services among the elderly (n = 97). Total n,% 60–75 > 75 Low perception of disease severity, age-related illness; Low financial access; Difficulty in geographical access to health care centers Poor attitude of health care workers Less trust in the health care system (low staff competencies) 41 (42.3) 28 (28.9) 18 (18.6) 6 (6.2) 4 (4.1) 39 (41.5) 28 (29.8) 17 (18.1) 6 (6.4) 4 (4.3) 2 (66.7) 0 (0) 1 (33.3) 0 (0) 0 (0) Correction for Multiple Testing and Power Analysis To control for the risk of Type I error resulting from multiple bivariate comparisons, a Bonferroni correction was applied. Given that ten key variables were tested against health-seeking behavior, the adjusted significance threshold was set at p < 0.005 (0.05/10). After applying this correction, statistically significant associations were retained for age group, gender, education level, and socioeconomic status, while associations with variables such as marital status and employment status were no longer significant. These results indicate that the primary findings remain robust under stricter statistical criteria. In addition, a post hoc power analysis was conducted using G*Power. With a sample size of 406, α = 0.05, and a medium effect size (Cohen’s w = 0.3), the analysis indicated a power of 0.90. This suggests the study was adequately powered to detect meaningful differences and that nonsignificant results are less likely to be due to insufficient sample size. Multivariate Analysis Building on these statistically robust findings, multivariate analysis was conducted using binary logistic regression to identify independent predictors of formal (allopathic) health-seeking behavior. The results of the logistic regression analysis are presented in Table 6 . After adjusting for other variables, the following factors were found to be significant independent predictors of seeking allopathic medical care: Higher education level (OR = 2.85, 95% CI: 1.70–4.76, p < 0.001) Female gender (OR = 1.95, 95% CI: 1.22–3.12, p = 0.005) Age 60–75 years (OR = 1.75, 95% CI: 1.01–3.05, p = 0.045) Above-poverty-line socioeconomic status (OR = 2.40, 95% CI: 1.40–4.10, p < 0.01) These findings indicate that education, gender, age, and income level are significant independent determinants of formal healthcare utilization among elderly individuals in Tbilisi. Table 6 Binary Logistic Regression Predicting the Use of Allopathic Treatment Among the Elderly (N = 406) Variable B SE Odds Ratio (OR) 95% CI for OR p-value Age group (60–75 vs. >75) 0.56 0.28 1.75 1.01–3.05 0.045 Gender (Female vs. Male) 0.67 0.24 1.95 1.22–3.12 0.005 Education (Higher vs. Secondary) 1.05 0.26 2.85 1.70–4.76 < 0.001 Socioeconomic Status (Above poverty line vs. Below) 0.88 0.28 2.40 1.40–4.10 0.002 Marital Status (Married vs. Other) 0.31 0.29 1.36 0.76–2.45 0.292 Employment (Pensioner vs. Unemployed/Employed) 0.25 0.27 1.28 0.75–2.19 0.361 Discussion This study revealed that for the majority of elderly respondents, the most common health problems were age-related chronic conditions such as hypertension, diabetes mellitus, musculoskeletal disorders, dental issues, and cataracts. Generally, the likelihood of developing health problems increases with age. These findings are consistent with studies conducted in other countries (Fulmer et al., 2021 ; Maresova et al., 2019 ; Damoun et al., 2024 ). Over time, the cumulative effects of stress, lack of physical activity, and environmental factors can lead to the deterioration of organs and tissues. Additionally, the efficiency of the immune system declines with age, reducing the body’s ability to fight disease. The study also identified gender-based differences in the prevalence of certain conditions. Specifically, diabetes mellitus, hypertension, and ischemic heart disease were more common among men, while women more frequently reported musculoskeletal disorders, cataracts, obesity, and gastrointestinal diseases. These results are aligned with some prior research (Muurlink & Tailor-Robinson, 2021), although other studies have not confirmed gender differences in disease prevalence (Liu et al., 2017 ). Older adults typically require more medical care, as aging is closely associated with illness (Verulava & Mikiashvili, 2021 ). Suboptimal utilization of healthcare services can result in severe consequences for elderly individuals (Jaul & Barron, 2017 ). This study revealed several important patterns in the health-seeking behavior of elderly individuals in Georgia, particularly related to age, gender, education, and socioeconomic status. A significant portion of respondents (n = 264; 65%) reported seeking allopathic (conventional Western) medical care. However, approximately one in ten elderly individuals (10.3%) did not seek any form of medical treatment. Among those who sought medical care infrequently, less than once per year or not at all (n = 97), the majority (n = 41; 42.3%) perceived their health issues as a natural part of aging. The study found that these individuals demonstrated a low perception of illness severity, viewing their conditions primarily as age-related phenomena. In general, some respondents perceived aging and poor health as inherently linked (Kang & Kim, 2022 ). As people age, they often view physical and mental decline as natural, which reduces their expectations for health improvement and diminishes their inclination to seek professional medical care (Kim et al., 2014 ). Perceived severity of illness plays a critical role in determining whether elderly individuals seek treatment. In many societies, if symptoms are considered mild, self-medication or assistance from family members is a common practice. This study found that 18.2% of respondents engaged in self-treatment, while 6.4% relied on traditional remedies. In our study, age, gender, level of education, and socioeconomic status emerged as major determinants of health-seeking behavior among older adults. These findings are consistent with evidence from other countries, where similar factors - age, gender, education, and financial accessibility - have been shown to influence elderly health-seeking behavior significantly (Bourne et al., 2010 ; Zaidi et al., 2024 ; Kumar et al., 2021 ; Gotsadze et al., 2005 ). After applying the Bonferroni correction (adjusted p-value threshold of 0.005), the associations between health-seeking behavior and age, gender, education level, and socioeconomic status remained statistically significant. Other variables, such as employment status and marital status, were no longer significant under the stricter threshold, indicating possible Type I error in the unadjusted analysis. This strengthens the robustness of the key predictors identified and supports the validity of the multivariate findings that followed. One notable finding is the higher utilization of allopathic healthcare services among women, which is consistent with global trends. Women tend to engage more with preventive and curative health services due to both biological and social reasons (Kotit, 2024 ; Passos et al., 2020 ). Gender norms in many societies, including Georgia, encourage women to express health concerns and seek care, while men are more likely to delay seeking treatment, minimize symptoms, or rely on self-care. Studies from both high- and low-income settings have consistently shown that men are less likely to seek medical attention, contributing to later diagnoses and worse health outcomes (Galdas et al., 2005 ; Yoon et al., 2021 ). The finding that men were more likely to use traditional medicine or self-medicate suggests a combination of lower health literacy, greater reluctance to engage with formal health systems, and possibly financial or structural barriers. These findings are consistent with other international studies that also show that older men have lower awareness of health problems and are less involved in organized care (Panda et al., 2017 ; Lim et al., 2019 ). Respondents with higher levels of education were more likely to seek allopathic treatment compared to those with lower education levels, which may reflect greater motivation or capability in navigating the healthcare system. Importantly, one of the main reasons for low healthcare utilization was poor financial accessibility. This underscores the significance of socioeconomic status as a key determinant of health-seeking behavior. Poverty also limits families' ability to care for their elderly members. Additionally, the study found that the oldest-old group (aged > 75) had lower rates of allopathic care use and higher reliance on self-treatment or complete non-utilization of services. Several factors may explain this pattern. First, advanced age is often accompanied by mobility limitations, sensory impairments, and cognitive decline, which reduce the ability to access health facilities independently. Second, some individuals in this age group may normalize their health conditions as part of “natural aging” and not consider them serious enough to warrant treatment. Third, elderly individuals in this age bracket may face greater economic hardship, especially if they live alone or are unsupported by family members. Similar findings have been reported in studies from rural China, Latin America, and Eastern Europe, where the oldest-old are often medically underserved despite greater health needs (Ghodkhainde et al., 2023; Rafati et al., 2023 ). The influence of education also emerged as a critical determinant. Respondents with higher education levels were significantly more likely to seek formal medical care, likely due to better health literacy, greater trust in the healthcare system, and a better ability to navigate bureaucratic processes. This is supported by studies, which show that education enhances individuals' capacity to understand symptoms, assess the need for care, and communicate effectively with healthcare providers (Borgonovi & Pokropek, 2016 ). Socioeconomic status was one of the strongest predictors of care-seeking behavior. Those living above the poverty line were more likely to access formal services, while individuals below the poverty line often resorted to self-treatment or forewent care altogether. This reflects the continuing financial barriers in Georgia’s healthcare system, particularly for outpatient and specialist care, and echoes findings from global studies indicating that out-of-pocket costs remain a key deterrent to healthcare utilization among elderly populations (Essue et al., 2017 ; Verulava et al., 2019 ). In contrast, in more developed countries, high utilization of health services among older adults is associated with strong institutional support systems (Lydahl & Davidson, 2024). In this context, applying these insights in Georgia can help design evidence-based interventions that address both local and global health challenges. The logistic regression analysis revealed that older adults with higher educational attainment, female gender, younger elderly age (60–75), and better socioeconomic conditions were significantly more likely to seek allopathic treatment. These findings align with the global literature, which shows that education and income enhance health literacy and access, while gender norms may influence help-seeking behavior (Hosseinpoor et al., 2021). Importantly, these variables remained significant even after controlling for other factors, underscoring the need for tailored interventions addressing vulnerable subgroups such as elderly men, the less educated, and those living in poverty. Based on the study’s findings, several recommendations can be made to improve health-seeking behavior among the elderly and enhance access to healthcare services. First and foremost, continuous training of family physicians is essential, particularly in communication with elderly patients, assessing psychosocial conditions, and interpreting nonspecific symptoms. Training should emphasize the fundamentals of geriatric medicine, psychosocial screening techniques, and communication strategies tailored to age-related needs. It is also important to improve the financial and geographic accessibility of healthcare services and to adapt healthcare infrastructure to be more elderly-friendly (e.g., barrier-free entrances, accessible waiting areas). Targeted awareness campaigns should be developed to inform elderly individuals and their families about the importance of regular monitoring and timely treatment of chronic diseases. Special attention should be paid to the risks associated with self-medication and traditional treatments. Elderly individuals should also be provided with comprehensive information about government-subsidized programs and how to access them. It is recommended that family members of elderly individuals receive educational materials and training to strengthen their caregiving skills. Additionally, a systematic data collection and analysis mechanism should be established to continuously monitor elderly health-seeking behavior and access to services, providing a foundation for evidence-based health policy. Conclusion This study represents one of the first empirical efforts to systematically examine the health-seeking behavior of older adults in Georgia through a structured, population-based approach. The findings of this study have important implications for health policy not only in Georgia but also in other countries facing similar demographic, economic, and health system challenges. The identified barriers, such as financial hardship, low health literacy, reliance on self-treatment, and limited access to geriatric care, reflect systemic gaps that are common across many countries with under-resourced primary healthcare systems and aging populations. The research demonstrated that health-seeking behavior among older adults in Georgia is significantly influenced by age, education level, gender, and socioeconomic status. Importantly, the study highlights that while the majority of elderly individuals in urban Georgia prefer allopathic care, a substantial proportion still rely on self-medication, traditional remedies, or forgo care entirely, often due to financial barriers, low health literacy, or perceptions that symptoms are a normal part of aging. These patterns mirror challenges seen across low- and middle-income countries and underscore systemic gaps in access, equity, and elderly-centered service delivery. These insights can guide the development of targeted, elderly-centered health strategies, including the expansion of universal health coverage for older adults, integration of geriatric training into primary care, and public education campaigns to encourage timely health-seeking behavior. By addressing the specific needs of the elderly, policymakers can strengthen the resilience of health systems and reduce the long-term burden of chronic disease in resource-constrained settings. Looking forward, the evidence presented here can serve as a foundation for developing and implementing comprehensive national health reforms that prioritize the needs of older adults. Integrating this knowledge into Georgia’s primary healthcare strategy will be essential to achieving equity in healthcare access and ensuring that the country’s growing elderly population receives the care and dignity it deserves. Declarations Disclosure Statement The authors declare that they have no conflict of interest. Author Contribution T.V. conceptualized and designed the study, led the literature review, and supervised data analysis. R.J. contributed to data collection, statistical analysis, and interpretation of findings. T.V. and R.J. jointly wrote the main manuscript text. 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Access to Ambulatory Medicines for the Elderly in Georgia. Home Health Care Management & Practice , 31 (2), 107–112. View Google Scholar. Verulava, T., & Arakishvili, L. (2024). The Role of Primary Health Care in the Timely Treatment and Hospitalization of Patients with Acute Myocardial Infarction: Evidence from Georgia. Asia Pacific Journal of Health Management , 19 (3), i3773. 10.24083/apjhm.v19i3 3773 View Google Scholar. Verulava, T., & Jorbenadze, R. (2024). The Impact of DRG-Based Payment Reform on the Efficiency of Medical Care for Patients with Myocardial Infarction: Evidence from Georgia. Hospital Topics , 1–6. View Google Scholar PubMed. Waymouth, M., Siconolfi, D., Friedman, E. M., et al. (2023). Barriers and facilitators to home-and community-based services access for persons with dementia and their caregivers. The Journals of Gerontology: Series B , 78 (6), 1085–1097. 10.1093/geronb/gbad039 View Google Scholar PubMed. Wu, S., Du, S., Feng, R., Liu, W., & Ye, W. (2023). Behavioral deviations: healthcare-seeking behavior of chronic disease patients with intention to visit primary health care institutions. Bmc Health Services Research , 16 (1), 490. 10.1186/s12913-023-09528-y View Google Scholar PubMed. Williamson, J., Ramirez, R., & Wingfield, T. (2015). Health, healthcare access, and use of traditional versus modern medicine in remote Peruvian Amazon communities: a descriptive study of knowledge, attitudes, and practices. American Journal Of Tropical Medicine And Hygeine , 92 (4), 857–864. 10.4269/ajtmh.14-0536 View Google Scholar PubMed. Yang, H., Ouyang, Z., Sun, F., & Ortiz, D. V. (2024). Health-seeking behaviours of the families with older adults during the COVID-19 epidemic in rural China: a qualitative inquiry from the perspective of migration and social support networks. BMJ Public Health , 2 (2). 10.1136/bmjph-2023-000794 View Google Scholar PubMed. Yoon, J., Kim, J., & Son, H. (2021). Gender differences of health behaviors in the risk of metabolic syndrome for middle-aged adults: a national cross-sectional study in South Korea. International Journal of Environmental Research and Public Health , 18 (7), 3699. View PubMed Google Scholar. Zaidi, I., Chaudhary, S., Sharma, T., Vardha, J., Khayum, A., Anjum, S., Bakshi, A., & Nuguru, G. (2024). Barriers to healthcare and health seeking behaviors among elderly people living in rural regions of India: a study based on 9 villages in Eastern Uttar Pradesh. International Journal of Community Medicine And Public Health. 11(7):2765–2770. doi: 0.18203/2394-6040.ijcmph20241836. View Google Scholar. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7124341","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":485549199,"identity":"8b515fff-fe88-4ca8-b1f1-eae95986de0b","order_by":0,"name":"Tengiz Verulava","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIiWNgGAWjYNCCAiBmbwCxmAkr5gGTBiDWAZK1SCQQqcVeIvnYZx4Du8T+mY+fSTBUWCc28C8+gN8WibTk2TwGyYkzbqeZSTCcSU9skHiWgF8LzxljZh4DZmOG2zlsEoxth4FazhgQ0HL+M1BLvbH8zTNALf9AWs5/wK+FvYcZqOWwnMENHqCWBqAW/h68Ohh4jrcZM84xOC5neCbN2CLhWLpxmwQbfoexNzM/ZnhTUc0jd/zwwxsfaqxl+/kPP8BvDQpIAGI2SASRBPgPkKxlFIyCUTAKhjcAAFo0PVQKmtNtAAAAAElFTkSuQmCC","orcid":"","institution":"Caucasus University","correspondingAuthor":true,"prefix":"","firstName":"Tengiz","middleName":"","lastName":"Verulava","suffix":""},{"id":485549201,"identity":"15120dc8-8166-4579-b728-25f7cf18f7c2","order_by":1,"name":"Revaz Jorbenadze","email":"","orcid":"","institution":"Chapidze Emergency Cardiology Center","correspondingAuthor":false,"prefix":"","firstName":"Revaz","middleName":"","lastName":"Jorbenadze","suffix":""}],"badges":[],"createdAt":"2025-07-14 20:38:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7124341/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7124341/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86830649,"identity":"12089f2a-e6d9-4abc-bd17-03f7cb065239","added_by":"auto","created_at":"2025-07-16 05:58:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4895230,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7124341/v1/2809c620-d468-4e24-bb9a-68d1fa5c0264.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Health-Seeking Behavior of Older Adults in Georgia: A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe incidence of chronic diseases tends to rise with advancing age, likely due to underlying physiological and biological changes associated with aging, which lead to a decline in functional capacity (Singsalasang \u0026amp; Bandidphak, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). While aging itself is not considered a disease, it is often accompanied by diminished physical and cognitive abilities that contribute to the deterioration of overall health. Studies have shown that a majority of older adults suffer from two or more chronic conditions simultaneously, largely due to the weakening of various bodily systems, including the immune system (Emeh et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This results in increased utilization of medical services. Health status has a substantial impact on quality of life, and increased morbidity contributes to a reduction in health-related quality of life (Sitlinger \u0026amp; Zafar, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOne of the key factors influencing the outcomes of illness severity among the elderly is their health-seeking behavior. It encompasses the various actions individuals undertake to preserve or enhance their health, including seeking timely and regular medical care from qualified professionals, engaging in follow-up and monitoring, practicing self-medication, using traditional treatments, or exploring alternative strategies (Wu et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAmong older adults, health-seeking behavior is shaped by a combination of physical, psychological, economic, and social factors (Kotit, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Studies have shown that elderly individuals with higher income and educational attainment are more likely to seek timely medical care and adhere to treatment regimens (Selvakumar et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Verulava \u0026amp; Arakishvili, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Verulava \u0026amp; Jorbenadze, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Conversely, low socioeconomic status is associated with delayed care-seeking and a reliance on alternative or informal healthcare services (Ratnapradipa et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCultural norms also play a significant role in shaping the health-seeking behavior of elderly patients. In many societies, older individuals may prefer traditional remedies over modern medical interventions due to distrust of healthcare providers (Williamson et al., \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Social support networks, including family and community, also have a major influence on whether and how older adults seek care (Yang et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePhysical and cognitive impairments may limit access to healthcare services. Mobility restrictions and conditions such as dementia often require caregiver assistance, and the absence of such support can hinder or completely prevent access to professional medical care (Waymouth et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAccessibility of healthcare services, including transportation, is a critical determinant of health-seeking behavior in the elderly. Long waiting times, high costs, and inadequate geriatric care facilities are significant barriers to obtaining needed healthcare services (Scott et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDelays in seeking medical attention may lead to more severe and potentially irreversible health outcomes. Therefore, it is essential to understand the health-seeking behavior of older adults and the factors influencing it to assess their needs and priorities when it comes to accessing care (Bayable et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Georgia, there is a lack of research examining the health-seeking behavior of the elderly and its determining factors. This study was undertaken to fill this gap in the literature. This is the first study to systematically examine health-seeking behavior among the elderly in Georgia using a structured, quantitative approach.\u003c/p\u003e\u003cp\u003eThe aim of the present research is to explore the factors that affect the health-seeking behavior of the elderly population in Georgia.\u003c/p\u003e\u003cp\u003eUnderstanding the health-seeking behavior of older adults is crucial due to their unique health needs, the higher prevalence of chronic conditions, and the specific barriers they face in accessing healthcare services. The findings of this study will contribute to the development of an effective geriatric care system and the design of evidence-based healthcare policies that are tailored to the needs of the elderly.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheoretical Framework\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study is grounded in Andersen\u0026rsquo;s Behavioral Model of Health Services Use, which provides a comprehensive framework for analyzing the determinants of healthcare utilization (Andersen, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1995\u003c/span\u003e). The model categorizes influencing factors into three groups: predisposing, enabling, and need factors.\u003c/p\u003e\u003cp\u003ePredisposing factors are individual characteristics such as age, gender, education level, and marital status, which influence the propensity to seek care. These variables were included in the study to assess how demographic and social characteristics shape health-related decisions among older adults in Georgia.\u003c/p\u003e\u003cp\u003eEnabling factors refer to the resources and conditions that facilitate or hinder access to services. In this context, we examined socioeconomic status, employment, and living arrangements as proxies for access to care, recognizing that structural barriers are common in low- and middle-income settings.\u003c/p\u003e\u003cp\u003eNeed factors represent both perceived and actual health conditions. The presence of chronic illnesses, such as hypertension, diabetes, and musculoskeletal disorders, was assessed alongside participants\u0026rsquo; perceptions of illness severity and their beliefs about aging-related symptoms. These factors are central to understanding the urgency and frequency of healthcare utilization.\u003c/p\u003e\u003cp\u003eBy applying Andersen\u0026rsquo;s model, the study offers a structured interpretation of the diverse influences on elderly health-seeking behavior. It also provides a basis for designing evidence-based policies aimed at reducing access barriers, particularly for vulnerable older adults with limited resources or support systems.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cb\u003eStudy Design and Participants\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA quantitative, cross-sectional study was conducted in four major primary healthcare centers in Tbilisi, Georgia, selected based on their high number of registered beneficiaries.\u003c/p\u003e\u003cp\u003eThe selection of primary healthcare centers in Tbilisi was based on practical, logistical, and strategic considerations. Tbilisi, as the capital and largest city of Georgia, hosts some of the country's busiest and most diverse primary healthcare centers, with a high concentration of registered elderly beneficiaries. These facilities were chosen to ensure efficient access to a sufficiently large and varied elderly population within the study timeframe. Additionally, the capital offers logistical advantages for data collection, including researcher mobility, institutional coordination, and ethical oversight.\u003c/p\u003e\u003cp\u003eA simple random sampling technique was employed to select participants from the elderly population (aged 60 years and older) registered at the selected centers. Each facility provided a list of patients who had visited within the past six months, which served as the sampling frame. Eligible patients were assigned unique numbers, and participants were selected using a computer-generated random number table. Approximately 135 participants were randomly selected from each center to ensure proportional representation.\u003c/p\u003e\u003cp\u003eA total of 486 eligible elderly patients were approached during the data collection period. Of these, 406 individuals agreed to participate and completed the questionnaire, resulting in a response rate of 83.5%. The remaining individuals either declined participation, were seriously ill, or were unable to complete the interview due to cognitive or physical impairments.\u003c/p\u003e\u003cp\u003eInclusion criteria were: age 60 years or older, registration at one of the selected primary healthcare centers, and ability to provide informed consent.\u003c/p\u003e\u003cp\u003eExclusion criteria included: severe cognitive impairment, terminal illness, acute medical conditions that prevented participation, or refusal to participate.\u003c/p\u003e\u003cp\u003eAll interviews were conducted face-to-face. Incomplete questionnaires were excluded from analysis. Data completeness was reviewed daily by field supervisors. Less than 3% of the data had missing responses; these were addressed using listwise deletion for analyses requiring complete cases.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cb\u003eData Collection Instrument and Procedure\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eA pre-structured and pre-tested questionnaire served as the primary data collection tool. Data were collected through face-to-face interviews conducted by members of the research team during on-site visits to the selected primary healthcare centers. Each interview was conducted in person and lasted approximately 20 minutes.\u003c/p\u003e\u003cp\u003eThe questionnaire was developed based on a review of international literature and adapted to the Georgian context. It included sections on sociodemographic characteristics (age, gender, place of residence, marital status, education level, employment status, annual household income, and living conditions), the type and cause of illness (chronic, acute, or other), and factors influencing health-seeking behavior.\u003c/p\u003e\u003cp\u003eBefore the main study, the questionnaire was piloted with 30 elderly patients to assess its clarity, relevance, and cultural appropriateness. Based on their responses, internal consistency was assessed using Cronbach\u0026rsquo;s alpha. The overall scale demonstrated acceptable reliability, with a Cronbach\u0026rsquo;s alpha of 0.78, indicating a satisfactory level of internal consistency across key sections of the questionnaire related to health-seeking behavior, perceived barriers, and access to care. Minor revisions were made to improve question clarity and cultural relevance before administering the final version in the main study.\u003c/p\u003e\u003cp\u003eAll data were collected anonymously. For data entry and processing, each questionnaire was coded and assigned a unique, manually generated identification number. Data collection took place over six weeks, from August 23 to December 7, 2024.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData Processing and Analysis\u003c/b\u003e\u003c/p\u003e\u003cp\u003eData were analyzed using SPSS version 26. Descriptive statistics were used to summarize sociodemographic variables, health conditions, and types of health-seeking behavior. Bivariate associations between categorical variables were assessed using Chi-square tests.\u003c/p\u003e\u003cp\u003eTo account for the potential inflation of Type I error due to multiple comparisons across sociodemographic and health behavior variables, a Bonferroni correction was applied. For 10 primary comparisons, the adjusted significance threshold was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.005 (0.05/10). This conservative adjustment allowed more rigorous identification of statistically meaningful differences.\u003c/p\u003e\u003cp\u003eFurthermore, a post hoc power analysis was conducted using G*Power 3.1.9.7. Assuming a medium effect size (Cohen\u0026rsquo;s w\u0026thinsp;=\u0026thinsp;0.3), a significance level of α\u0026thinsp;=\u0026thinsp;0.05, and a total sample size of N\u0026thinsp;=\u0026thinsp;406, the achieved statistical power was calculated to be 0.90 (90%) for chi-square tests with 1 degree of freedom. This confirms that the sample was adequately powered to detect medium effects in key comparisons.\u003c/p\u003e\u003cp\u003eMultivariate analysis was performed using binary logistic regression to identify independent predictors of allopathic treatment-seeking behavior. Variables found significant in bivariate analysis at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were entered into the regression model.\u003c/p\u003e\u003cp\u003e\u003cb\u003eEthical Considerations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eBefore initiating the study, ethical approval was secured from the Research and Ethics Committee of Caucasus University. A formal notification letter was sent to the participating primary healthcare centers one week in advance. Copies of the letter were also distributed to the registration offices and physicians of the respective centers, who were asked to refer eligible patients to the interview room.\u003c/p\u003e\u003cp\u003eThe survey was conducted in accordance with the principles of informed consent. Before participating, respondents were informed about the purpose and importance of the study, after which verbal consent was obtained. Participants were clearly assured that their participation would not cause them any harm and that they were free to withdraw at any stage of the interview if they wished.\u003c/p\u003e\u003cp\u003eAnonymity and confidentiality were strictly maintained throughout the study. All responses were securely stored without the names or identifying information of the participants.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis study was limited to several primary healthcare centers in Tbilisi, which may affect the generalizability of the findings to the broader national elderly population, particularly those residing in rural or remote areas. Healthcare infrastructure, socioeconomic conditions, and cultural norms in rural regions may differ significantly from those in urban settings, potentially leading to different patterns of health-seeking behavior. Therefore, while this study provides valuable insights into elderly healthcare utilization in an urban Georgian context, further research is needed to explore these dynamics in rural populations to fully inform national health policy and planning.\u003c/p\u003e\u003cp\u003eAnother limitation was the scarcity of locally available literature on this topic, which reduced the ability to compare results with other countries. Moreover, future research could benefit from incorporating the perspective of healthcare providers to gain a more comprehensive understanding of the factors influencing health-seeking behavior among the elderly.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic Profile\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 406 elderly patients from the four selected primary healthcare centers participated by completing the questionnaire. The sociodemographic and economic characteristics of the respondents are presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. The majority of respondents were aged between 60 and 75 years (83.3%, n\u0026thinsp;=\u0026thinsp;338) and were male (53.7%, n\u0026thinsp;=\u0026thinsp;218). Regarding marital status, 71.9% (n\u0026thinsp;=\u0026thinsp;292) were married, while 20.9% (n\u0026thinsp;=\u0026thinsp;85) were widowed. Most respondents (n\u0026thinsp;=\u0026thinsp;301; 74.1%) had completed secondary education. A notably higher proportion of women were unemployed (n\u0026thinsp;=\u0026thinsp;93; 49.5%) and widowed (n\u0026thinsp;=\u0026thinsp;73; 38.8%) compared to men. Almost half of the respondents lived with both their spouse and children (n\u0026thinsp;=\u0026thinsp;196; 48.3%). More women lived with their children (n\u0026thinsp;=\u0026thinsp;45; 23.9%) compared to men. Only 4.2% (n\u0026thinsp;=\u0026thinsp;17) reported living alone. The majority of respondents (n\u0026thinsp;=\u0026thinsp;232; 57.1%) were retired.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eSociodemographic characteristics of the patients (Percentages Calculated by Gender Subgroup)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCharacteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;406), n (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMen (n\u0026thinsp;=\u0026thinsp;218; 53.7%), n(%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eWoman (n\u0026thinsp;=\u0026thinsp;188; 46.3%), n(%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e60\u0026ndash;75\u003c/p\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e338 (83.3)\u003c/p\u003e\n\u003cp\u003e68 (16.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e187 (85.8)\u003c/p\u003e\n\u003cp\u003e31 (14.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e151 (80.3)\u003c/p\u003e\n\u003cp\u003e37 (19.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e0.508\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003cp\u003eUnmarried\u003c/p\u003e\n\u003cp\u003eDivorced\u003c/p\u003e\n\u003cp\u003eWidow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e292 (71.9)\u003c/p\u003e\n\u003cp\u003e16 (3.9)\u003c/p\u003e\n\u003cp\u003e13 (3.2)\u003c/p\u003e\n\u003cp\u003e85 (20.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e193 (88.5)\u003c/p\u003e\n\u003cp\u003e7 (3.2)\u003c/p\u003e\n\u003cp\u003e6 (2.8)\u003c/p\u003e\n\u003cp\u003e12 (5.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e99 (52.7)\u003c/p\u003e\n\u003cp\u003e9 (4.8)\u003c/p\u003e\n\u003cp\u003e7 (3.7)\u003c/p\u003e\n\u003cp\u003e73 (38.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSecondary education\u003c/p\u003e\n\u003cp\u003eHigher education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e301 (74.1)\u003c/p\u003e\n\u003cp\u003e105 (25.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e175 (80.3)\u003c/p\u003e\n\u003cp\u003e43 (19.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e126 (67.0)\u003c/p\u003e\n\u003cp\u003e62 (33.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnemployed\u003c/p\u003e\n\u003cp\u003eEmployed\u003c/p\u003e\n\u003cp\u003ePensioner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e129 (31.8)\u003c/p\u003e\n\u003cp\u003e45 (11.1)\u003c/p\u003e\n\u003cp\u003e232 (57.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e36 (16.5)\u003c/p\u003e\n\u003cp\u003e33 (15.1)\u003c/p\u003e\n\u003cp\u003e149 (68.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e93 (49.5)\u003c/p\u003e\n\u003cp\u003e12 (6.4)\u003c/p\u003e\n\u003cp\u003e83 (44.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eLives alone\u003c/p\u003e\n\u003cp\u003eLives with spouse\u003c/p\u003e\n\u003cp\u003eLives with spouse and children\u003c/p\u003e\n\u003cp\u003eLives with children\u003c/p\u003e\n\u003cp\u003eLives with relatives\u003c/p\u003e\n\u003cp\u003eLives with a caregiver\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e17 (4.2)\u003c/p\u003e\n\u003cp\u003e92 (22.7)\u003c/p\u003e\n\u003cp\u003e196 (48.3)\u003c/p\u003e\n\u003cp\u003e82 (20.2)\u003c/p\u003e\n\u003cp\u003e8 (2.0)\u003c/p\u003e\n\u003cp\u003e11 (2.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9 (4.1)\u003c/p\u003e\n\u003cp\u003e42 (19.3)\u003c/p\u003e\n\u003cp\u003e121 (55.5)\u003c/p\u003e\n\u003cp\u003e37 (17.0)\u003c/p\u003e\n\u003cp\u003e4 (1.8)\u003c/p\u003e\n\u003cp\u003e5 (2.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e8 (4.3)\u003c/p\u003e\n\u003cp\u003e50 (26.6)\u003c/p\u003e\n\u003cp\u003e75 (39.9)\u003c/p\u003e\n\u003cp\u003e45 (23.9)\u003c/p\u003e\n\u003cp\u003e4 (2.1)\u003c/p\u003e\n\u003cp\u003e6 (3.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"5\"\u003eNote: Percentages are calculated within each subgroup (men and women), not across total category rows. As such, row-wise percentages may not sum to 100%.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eHealth Conditions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess the health status of the elderly participants, the most common health-related problems were identified and are shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. The majority of respondents reported age-related chronic conditions, such as hypertension (n\u0026thinsp;=\u0026thinsp;282; 69.5%), diabetes mellitus (n\u0026thinsp;=\u0026thinsp;226; 55.7%), musculoskeletal disorders (n\u0026thinsp;=\u0026thinsp;212; 52.2%), dental problems (n\u0026thinsp;=\u0026thinsp;134; 33%), and cataracts (n\u0026thinsp;=\u0026thinsp;127; 31.3%). These conditions generally require long-term management and become more prevalent with increasing age.\u003c/p\u003e\n\u003cp\u003eIn terms of gender differences, a higher proportion of elderly men reported the following conditions compared to women: diabetes mellitus (n\u0026thinsp;=\u0026thinsp;123; 56.4%), hypertension (n\u0026thinsp;=\u0026thinsp;158; 72.5%), ischemic heart disease (n\u0026thinsp;=\u0026thinsp;47; 21.6%), and cerebrovascular disease (n\u0026thinsp;=\u0026thinsp;9; 4.1%). Conversely, women more frequently reported musculoskeletal disorders (n\u0026thinsp;=\u0026thinsp;135; 61.9%), cataracts (n\u0026thinsp;=\u0026thinsp;68; 36.2%), obesity (n\u0026thinsp;=\u0026thinsp;42; 22.3%), and gastrointestinal problems (n\u0026thinsp;=\u0026thinsp;43; 22.9%).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDistribution of chronic conditions among the elderly.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eDisease Type\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eN\u0026thinsp;=\u0026thinsp;406 (100%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMan (n\u0026thinsp;=\u0026thinsp;218), n (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eWoman (n\u0026thinsp;=\u0026thinsp;188), n (%)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ep\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDiabetes\u003c/p\u003e\n\u003cp\u003eHypertension\u003c/p\u003e\n\u003cp\u003eIschemic Heart Disease\u003c/p\u003e\n\u003cp\u003eCerebrovascular Disease\u003c/p\u003e\n\u003cp\u003eMusculoskeletal Diseases\u003c/p\u003e\n\u003cp\u003eGastrointestinal Diseases\u003c/p\u003e\n\u003cp\u003eKidney Diseases\u003c/p\u003e\n\u003cp\u003eProstate Diseases\u003c/p\u003e\n\u003cp\u003eDental Problems\u003c/p\u003e\n\u003cp\u003eCataracts\u003c/p\u003e\n\u003cp\u003eAsthma\u003c/p\u003e\n\u003cp\u003eObesity\u003c/p\u003e\n\u003cp\u003eSkin Problems\u003c/p\u003e\n\u003cp\u003eHearing Problems in the Elderly\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePsychiatric Disorders\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepression\u003c/p\u003e\n\u003cp\u003eAnxiety\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e226 (55.7)\u003c/p\u003e\n\u003cp\u003e282 (69.5)\u003c/p\u003e\n\u003cp\u003e84 (20.7)\u003c/p\u003e\n\u003cp\u003e15 (3.7)\u003c/p\u003e\n\u003cp\u003e212 (52.2)\u003c/p\u003e\n\u003cp\u003e84 (20.7)\u003c/p\u003e\n\u003cp\u003e66 (16.3)\u003c/p\u003e\n\u003cp\u003e57 (14.0)\u003c/p\u003e\n\u003cp\u003e134 (33.0)\u003c/p\u003e\n\u003cp\u003e127 (31.3)\u003c/p\u003e\n\u003cp\u003e31 (7.6)\u003c/p\u003e\n\u003cp\u003e74 (18.2)\u003c/p\u003e\n\u003cp\u003e62 (15.3)\u003c/p\u003e\n\u003cp\u003e22 (5.4)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e26 (6.4)\u003c/p\u003e\n\u003cp\u003e23 (5.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e123 (56.4)\u003c/p\u003e\n\u003cp\u003e158 (72.5)\u003c/p\u003e\n\u003cp\u003e47 (21.6)\u003c/p\u003e\n\u003cp\u003e9 (4.1)\u003c/p\u003e\n\u003cp\u003e77 (41)\u003c/p\u003e\n\u003cp\u003e41 (18.8)\u003c/p\u003e\n\u003cp\u003e34 (15.6)\u003c/p\u003e\n\u003cp\u003e57 (26.1)\u003c/p\u003e\n\u003cp\u003e69 (31.7)\u003c/p\u003e\n\u003cp\u003e59 (27.1)\u003c/p\u003e\n\u003cp\u003e9 (4.1)\u003c/p\u003e\n\u003cp\u003e32 (14.7)\u003c/p\u003e\n\u003cp\u003e35 (16.1)\u003c/p\u003e\n\u003cp\u003e11 (5.0)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e11 (5.0)\u003c/p\u003e\n\u003cp\u003e11 (5.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e103 (54.8)\u003c/p\u003e\n\u003cp\u003e124 (66.0)\u003c/p\u003e\n\u003cp\u003e37 (19.7)\u003c/p\u003e\n\u003cp\u003e6 (3.2)\u003c/p\u003e\n\u003cp\u003e135 (61.9)\u003c/p\u003e\n\u003cp\u003e43 (22.9)\u003c/p\u003e\n\u003cp\u003e32 (17.0)\u003c/p\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003cp\u003e65 (34.6)\u003c/p\u003e\n\u003cp\u003e68 (36.2)\u003c/p\u003e\n\u003cp\u003e22 (11.7)\u003c/p\u003e\n\u003cp\u003e42 (22.3)\u003c/p\u003e\n\u003cp\u003e27 (14.4)\u003c/p\u003e\n\u003cp\u003e11 (5.9)\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15 (8.0)\u003c/p\u003e\n\u003cp\u003e12 (6.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.802\u003c/p\u003e\n\u003cp\u003e0.750\u003c/p\u003e\n\u003cp\u003e0.461\u003c/p\u003e\n\u003cp\u003e0.719\u003c/p\u003e\n\u003cp\u003e0.724\u003c/p\u003e\n\u003cp\u003e0.015\u003c/p\u003e\n\u003cp\u003e0.559\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003cp\u003e0.476\u003c/p\u003e\n\u003cp\u003e0.278\u003c/p\u003e\n\u003cp\u003e0.003\u003c/p\u003e\n\u003cp\u003e0.237\u003c/p\u003e\n\u003cp\u003e0.623\u003c/p\u003e\n\u003cp\u003e0.442\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e0.147\u003c/p\u003e\n\u003cp\u003e0.875\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eHealth-Seeking Behavior\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe next part of the study examined where elderly individuals sought care when experiencing illness (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). The majority of respondents reported using allopathic (modern) medical services (n\u0026thinsp;=\u0026thinsp;264; 65%). Among this group, women (n\u0026thinsp;=\u0026thinsp;150; 79.8%) significantly outnumbered men (n\u0026thinsp;=\u0026thinsp;114; 52.3%). Self-medication was the second most common response (18.2%; n\u0026thinsp;=\u0026thinsp;74), followed by traditional (folk) treatment (6.4%; n\u0026thinsp;=\u0026thinsp;26). Notably, 10.3% of respondents (n\u0026thinsp;=\u0026thinsp;42) did not seek any treatment.\u003c/p\u003e\n\u003cp\u003eElderly men were more likely than women to use traditional medicine (n\u0026thinsp;=\u0026thinsp;19; 8.7%) and self-medication (n\u0026thinsp;=\u0026thinsp;55; 25.2%), while women were significantly more likely to prefer allopathic treatment (n\u0026thinsp;=\u0026thinsp;150; 79.8%) than men (n\u0026thinsp;=\u0026thinsp;114; 52.3%). Respondents with higher education levels primarily sought care from qualified allopathic doctors (n\u0026thinsp;=\u0026thinsp;127; 88.2%). In contrast, those living below the poverty line were more likely to engage in self-medication (n\u0026thinsp;=\u0026thinsp;32; 32.7%), forego treatment entirely (n\u0026thinsp;=\u0026thinsp;16; 16.3%), or seek traditional treatment (n\u0026thinsp;=\u0026thinsp;15; 15.3%).\u003c/p\u003e\n\u003cp\u003eBy age group, those aged 60\u0026ndash;75 were more likely to choose allopathic (conventional Western) care (n\u0026thinsp;=\u0026thinsp;232; 68.6%). However, the use of allopathic services declined with age, reaching only 47.1% (n\u0026thinsp;=\u0026thinsp;32) among individuals aged 75 and older.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eFactors influencing health-seeking behavior among the elderly.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr style=\"height: 59px;\"\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eSociodemographic characteristics\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eNo treatment 42 (10.3)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eSelf-medication\u003c/p\u003e\n\u003cp\u003e74 (18.2)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eTraditional (folk) treatment\u003c/p\u003e\n\u003cp\u003e26 (6.4)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eAllopathic\u003c/p\u003e\n\u003cp\u003e264 (65)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003cp\u003e406\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 59px;\" align=\"left\"\u003e\n\u003cp\u003eBonferroni Significant\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e60\u0026ndash;75\u003c/p\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e32 (9.5)\u003c/p\u003e\n\u003cp\u003e10 (14.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e62 (18.3)\u003c/p\u003e\n\u003cp\u003e12 (17.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e12 (3.6)\u003c/p\u003e\n\u003cp\u003e14 (20.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e232 (68.6)\u003c/p\u003e\n\u003cp\u003e32 (47.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e338 (83.3)\u003c/p\u003e\n\u003cp\u003e68 (16.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMen\u003c/p\u003e\n\u003cp\u003eWoman\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e30 (13.8)\u003c/p\u003e\n\u003cp\u003e12 (6.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e55 (25.2)\u003c/p\u003e\n\u003cp\u003e19 (10.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e19 (8.7)\u003c/p\u003e\n\u003cp\u003e7 (3.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e114 (52.3)\u003c/p\u003e\n\u003cp\u003e150 (79.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e218 (53.7)\u003c/p\u003e\n\u003cp\u003e188 (46.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 132px;\"\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMarried\u003c/p\u003e\n\u003cp\u003eUnmarried\u003c/p\u003e\n\u003cp\u003eDivorced\u003c/p\u003e\n\u003cp\u003eWidow\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e22(7.5)\u003c/p\u003e\n\u003cp\u003e4 (25)\u003c/p\u003e\n\u003cp\u003e2 (15.4)\u003c/p\u003e\n\u003cp\u003e14 (16.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e56 (19.2)\u003c/p\u003e\n\u003cp\u003e2 (12.5)\u003c/p\u003e\n\u003cp\u003e2 (15.4)\u003c/p\u003e\n\u003cp\u003e14 (16.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e21 (7.2)\u003c/p\u003e\n\u003cp\u003e1 (6.3)\u003c/p\u003e\n\u003cp\u003e1 (7.7)\u003c/p\u003e\n\u003cp\u003e3 (3.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e193 (66.1)\u003c/p\u003e\n\u003cp\u003e9 (56.3)\u003c/p\u003e\n\u003cp\u003e8 (61.5)\u003c/p\u003e\n\u003cp\u003e54 (63.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e292 (71.9)\u003c/p\u003e\n\u003cp\u003e16 (3.9)\u003c/p\u003e\n\u003cp\u003e13 (3.2)\u003c/p\u003e\n\u003cp\u003e85 (20.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e0.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 132px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSecondary education\u003c/p\u003e\n\u003cp\u003eHigher education\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e37 (14.1)\u003c/p\u003e\n\u003cp\u003e5 (3.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e67 (25.6)\u003c/p\u003e\n\u003cp\u003e7 (4.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e21 (8.0)\u003c/p\u003e\n\u003cp\u003e5 (3.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e137 (52.3)\u003c/p\u003e\n\u003cp\u003e127 (88.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e262 (64.5)\u003c/p\u003e\n\u003cp\u003e144 (35.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 108px;\"\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnemployed\u003c/p\u003e\n\u003cp\u003eEmployed\u003c/p\u003e\n\u003cp\u003ePensioner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15 (11.6)\u003c/p\u003e\n\u003cp\u003e6 (13.3)\u003c/p\u003e\n\u003cp\u003e21 (9.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e26 (20.2)\u003c/p\u003e\n\u003cp\u003e15 (11.6)\u003c/p\u003e\n\u003cp\u003e33 (14.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e9 (7)\u003c/p\u003e\n\u003cp\u003e4 (3.1)\u003c/p\u003e\n\u003cp\u003e13 (5.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e79 (61.2)\u003c/p\u003e\n\u003cp\u003e20 (15.5)\u003c/p\u003e\n\u003cp\u003e165 (71.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e129 (31.8)\u003c/p\u003e\n\u003cp\u003e45 (11.1)\u003c/p\u003e\n\u003cp\u003e232 (57.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e0.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 108px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 83px;\"\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eSocial status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBelow the poverty line\u003c/p\u003e\n\u003cp\u003eAbove the poverty line\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e16 (16.3)\u003c/p\u003e\n\u003cp\u003e26 (8.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e32 (32.7)\u003c/p\u003e\n\u003cp\u003e42 (13.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e15 (15.3)\u003c/p\u003e\n\u003cp\u003e11 (3.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e35 (35.7)\u003c/p\u003e\n\u003cp\u003e229 (74.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e98 (24.1)\u003c/p\u003e\n\u003cp\u003e308 (75.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 83px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr style=\"height: 13px;\"\u003e\n\u003ctd style=\"height: 13px;\" colspan=\"8\"\u003eNote: Bonferroni-adjusted significance threshold\u0026thinsp;=\u0026thinsp;0.005. Only associations meeting this criterion are marked \"Yes\" under the \"Bonferroni Significant\" column.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eFrequency and Regularity of Health-Seeking\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the elderly, 27.3% (n\u0026thinsp;=\u0026thinsp;111) sought medical care once per month, and 33% (n\u0026thinsp;=\u0026thinsp;134) sought care several times per year. Healthcare service utilization was more frequent among older age groups. Notably, 51.5% (n\u0026thinsp;=\u0026thinsp;35) of individuals aged over 75 sought care multiple times per month (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). However, 20.7% (n\u0026thinsp;=\u0026thinsp;84) of all respondents reported seeking medical care less than once per year, and 3.2% (n\u0026thinsp;=\u0026thinsp;13) had never sought care.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eFrequency and regularity of health-seeking behavior among the elderly (n\u0026thinsp;=\u0026thinsp;406).\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal n,%\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e60\u0026ndash;75\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;75\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDoes not seek medical care\u003c/p\u003e\n\u003cp\u003eSeveral times a month\u003c/p\u003e\n\u003cp\u003eOnce a month\u003c/p\u003e\n\u003cp\u003eSeveral times a year\u003c/p\u003e\n\u003cp\u003eOnce a year\u003c/p\u003e\n\u003cp\u003eLess regularly than once a year\u003c/p\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13 (3.2)\u003c/p\u003e\n\u003cp\u003e43 (10.6)\u003c/p\u003e\n\u003cp\u003e111 (27.3)\u003c/p\u003e\n\u003cp\u003e134 (33)\u003c/p\u003e\n\u003cp\u003e21 (5.2)\u003c/p\u003e\n\u003cp\u003e84 (20.7)\u003c/p\u003e\n\u003cp\u003e406 (100)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10 (3)\u003c/p\u003e\n\u003cp\u003e8 (2.4)\u003c/p\u003e\n\u003cp\u003e87 (25.7)\u003c/p\u003e\n\u003cp\u003e129 (38.2)\u003c/p\u003e\n\u003cp\u003e20 (5.9)\u003c/p\u003e\n\u003cp\u003e84 (24.9)\u003c/p\u003e\n\u003cp\u003e338 (100)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3 (4.4)\u003c/p\u003e\n\u003cp\u003e35 (51.5)\u003c/p\u003e\n\u003cp\u003e24 (35.3)\u003c/p\u003e\n\u003cp\u003e5 (7.4)\u003c/p\u003e\n\u003cp\u003e1 (1.5)\u003c/p\u003e\n\u003cp\u003e0 (0)\u003c/p\u003e\n\u003cp\u003e68 (100)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eBarriers to Healthcare Utilization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDecisions regarding whether to seek care were influenced by factors such as perceived severity of illness, attitudes of healthcare workers, trust in the healthcare system, and both geographic and financial accessibility.\u003c/p\u003e\n\u003cp\u003eAmong those who rarely sought care, less than once per year or not at all (n\u0026thinsp;=\u0026thinsp;97), the majority (n\u0026thinsp;=\u0026thinsp;41; 42.3%) perceived their health problems as a natural part of aging. Another significant portion (n\u0026thinsp;=\u0026thinsp;28; 28.9%) cited lack of financial means and geographical barriers as their main reasons for infrequent healthcare utilization (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eReasons for non-utilization of health services among the elderly (n\u0026thinsp;=\u0026thinsp;97).\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal n,%\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e60\u0026ndash;75\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e\u0026gt;\u0026thinsp;75\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLow perception of disease severity, age-related illness;\u003c/p\u003e\n\u003cp\u003eLow financial access;\u003c/p\u003e\n\u003cp\u003eDifficulty in geographical access to health care centers\u003c/p\u003e\n\u003cp\u003ePoor attitude of health care workers\u003c/p\u003e\n\u003cp\u003eLess trust in the health care system (low staff competencies)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41 (42.3)\u003c/p\u003e\n\u003cp\u003e28 (28.9)\u003c/p\u003e\n\u003cp\u003e18 (18.6)\u003c/p\u003e\n\u003cp\u003e6 (6.2)\u003c/p\u003e\n\u003cp\u003e4 (4.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39 (41.5)\u003c/p\u003e\n\u003cp\u003e28 (29.8)\u003c/p\u003e\n\u003cp\u003e17 (18.1)\u003c/p\u003e\n\u003cp\u003e6 (6.4)\u003c/p\u003e\n\u003cp\u003e4 (4.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2 (66.7)\u003c/p\u003e\n\u003cp\u003e0 (0)\u003c/p\u003e\n\u003cp\u003e1 (33.3)\u003c/p\u003e\n\u003cp\u003e0 (0)\u003c/p\u003e\n\u003cp\u003e0 (0)\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eCorrection for Multiple Testing and Power Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eTo control for the risk of Type I error resulting from multiple bivariate comparisons, a Bonferroni correction was applied. Given that ten key variables were tested against health-seeking behavior, the adjusted significance threshold was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.005 (0.05/10). After applying this correction, statistically significant associations were retained for age group, gender, education level, and socioeconomic status, while associations with variables such as marital status and employment status were no longer significant. These results indicate that the primary findings remain robust under stricter statistical criteria.\u003c/p\u003e\n\u003cp\u003eIn addition, a post hoc power analysis was conducted using G*Power. With a sample size of 406, \u0026alpha;\u0026thinsp;=\u0026thinsp;0.05, and a medium effect size (Cohen\u0026rsquo;s w\u0026thinsp;=\u0026thinsp;0.3), the analysis indicated a power of 0.90. This suggests the study was adequately powered to detect meaningful differences and that nonsignificant results are less likely to be due to insufficient sample size.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMultivariate Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBuilding on these statistically robust findings, multivariate analysis was conducted using binary logistic regression to identify independent predictors of formal (allopathic) health-seeking behavior.\u003c/p\u003e\n\u003cp\u003eThe results of the logistic regression analysis are presented in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e. After adjusting for other variables, the following factors were found to be significant independent predictors of seeking allopathic medical care:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eHigher education level (OR\u0026thinsp;=\u0026thinsp;2.85, 95% CI: 1.70\u0026ndash;4.76, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001)\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eFemale gender (OR\u0026thinsp;=\u0026thinsp;1.95, 95% CI: 1.22\u0026ndash;3.12, p\u0026thinsp;=\u0026thinsp;0.005)\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eAge 60\u0026ndash;75 years (OR\u0026thinsp;=\u0026thinsp;1.75, 95% CI: 1.01\u0026ndash;3.05, p\u0026thinsp;=\u0026thinsp;0.045)\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eAbove-poverty-line socioeconomic status (OR\u0026thinsp;=\u0026thinsp;2.40, 95% CI: 1.40\u0026ndash;4.10, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01)\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThese findings indicate that education, gender, age, and income level are significant independent determinants of formal healthcare utilization among elderly individuals in Tbilisi.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab6\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eBinary Logistic Regression Predicting the Use of Allopathic Treatment Among the Elderly (N\u0026thinsp;=\u0026thinsp;406)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eVariable\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eB\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSE\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOdds Ratio (OR)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e95% CI for OR\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge group (60\u0026ndash;75 vs. \u0026gt;75)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.01\u0026ndash;3.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.045\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGender (Female vs. Male)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.22\u0026ndash;3.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.005\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEducation (Higher vs. Secondary)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.70\u0026ndash;4.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSocioeconomic Status (Above poverty line vs. Below)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.40\u0026ndash;4.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMarital Status (Married vs. Other)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.76\u0026ndash;2.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.292\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEmployment (Pensioner vs. Unemployed/Employed)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.75\u0026ndash;2.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.361\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study revealed that for the majority of elderly respondents, the most common health problems were age-related chronic conditions such as hypertension, diabetes mellitus, musculoskeletal disorders, dental issues, and cataracts. Generally, the likelihood of developing health problems increases with age. These findings are consistent with studies conducted in other countries (Fulmer et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Maresova et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Damoun et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Over time, the cumulative effects of stress, lack of physical activity, and environmental factors can lead to the deterioration of organs and tissues. Additionally, the efficiency of the immune system declines with age, reducing the body\u0026rsquo;s ability to fight disease.\u003c/p\u003e\u003cp\u003eThe study also identified gender-based differences in the prevalence of certain conditions. Specifically, diabetes mellitus, hypertension, and ischemic heart disease were more common among men, while women more frequently reported musculoskeletal disorders, cataracts, obesity, and gastrointestinal diseases. These results are aligned with some prior research (Muurlink \u0026amp; Tailor-Robinson, 2021), although other studies have not confirmed gender differences in disease prevalence (Liu et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOlder adults typically require more medical care, as aging is closely associated with illness (Verulava \u0026amp; Mikiashvili, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Suboptimal utilization of healthcare services can result in severe consequences for elderly individuals (Jaul \u0026amp; Barron, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study revealed several important patterns in the health-seeking behavior of elderly individuals in Georgia, particularly related to age, gender, education, and socioeconomic status.\u003c/p\u003e\u003cp\u003eA significant portion of respondents (n\u0026thinsp;=\u0026thinsp;264; 65%) reported seeking allopathic (conventional Western) medical care. However, approximately one in ten elderly individuals (10.3%) did not seek any form of medical treatment. Among those who sought medical care infrequently, less than once per year or not at all (n\u0026thinsp;=\u0026thinsp;97), the majority (n\u0026thinsp;=\u0026thinsp;41; 42.3%) perceived their health issues as a natural part of aging. The study found that these individuals demonstrated a low perception of illness severity, viewing their conditions primarily as age-related phenomena. In general, some respondents perceived aging and poor health as inherently linked (Kang \u0026amp; Kim, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). As people age, they often view physical and mental decline as natural, which reduces their expectations for health improvement and diminishes their inclination to seek professional medical care (Kim et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePerceived severity of illness plays a critical role in determining whether elderly individuals seek treatment. In many societies, if symptoms are considered mild, self-medication or assistance from family members is a common practice. This study found that 18.2% of respondents engaged in self-treatment, while 6.4% relied on traditional remedies.\u003c/p\u003e\u003cp\u003eIn our study, age, gender, level of education, and socioeconomic status emerged as major determinants of health-seeking behavior among older adults. These findings are consistent with evidence from other countries, where similar factors - age, gender, education, and financial accessibility - have been shown to influence elderly health-seeking behavior significantly (Bourne et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Zaidi et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Gotsadze et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2005\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAfter applying the Bonferroni correction (adjusted p-value threshold of 0.005), the associations between health-seeking behavior and age, gender, education level, and socioeconomic status remained statistically significant. Other variables, such as employment status and marital status, were no longer significant under the stricter threshold, indicating possible Type I error in the unadjusted analysis. This strengthens the robustness of the key predictors identified and supports the validity of the multivariate findings that followed.\u003c/p\u003e\u003cp\u003eOne notable finding is the higher utilization of allopathic healthcare services among women, which is consistent with global trends. Women tend to engage more with preventive and curative health services due to both biological and social reasons (Kotit, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Passos et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Gender norms in many societies, including Georgia, encourage women to express health concerns and seek care, while men are more likely to delay seeking treatment, minimize symptoms, or rely on self-care. Studies from both high- and low-income settings have consistently shown that men are less likely to seek medical attention, contributing to later diagnoses and worse health outcomes (Galdas et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Yoon et al., \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe finding that men were more likely to use traditional medicine or self-medicate suggests a combination of lower health literacy, greater reluctance to engage with formal health systems, and possibly financial or structural barriers. These findings are consistent with other international studies that also show that older men have lower awareness of health problems and are less involved in organized care (Panda et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Lim et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRespondents with higher levels of education were more likely to seek allopathic treatment compared to those with lower education levels, which may reflect greater motivation or capability in navigating the healthcare system. Importantly, one of the main reasons for low healthcare utilization was poor financial accessibility. This underscores the significance of socioeconomic status as a key determinant of health-seeking behavior. Poverty also limits families' ability to care for their elderly members.\u003c/p\u003e\u003cp\u003eAdditionally, the study found that the oldest-old group (aged\u0026thinsp;\u0026gt;\u0026thinsp;75) had lower rates of allopathic care use and higher reliance on self-treatment or complete non-utilization of services. Several factors may explain this pattern. First, advanced age is often accompanied by mobility limitations, sensory impairments, and cognitive decline, which reduce the ability to access health facilities independently. Second, some individuals in this age group may normalize their health conditions as part of \u0026ldquo;natural aging\u0026rdquo; and not consider them serious enough to warrant treatment. Third, elderly individuals in this age bracket may face greater economic hardship, especially if they live alone or are unsupported by family members. Similar findings have been reported in studies from rural China, Latin America, and Eastern Europe, where the oldest-old are often medically underserved despite greater health needs (Ghodkhainde et al., 2023; Rafati et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe influence of education also emerged as a critical determinant. Respondents with higher education levels were significantly more likely to seek formal medical care, likely due to better health literacy, greater trust in the healthcare system, and a better ability to navigate bureaucratic processes. This is supported by studies, which show that education enhances individuals' capacity to understand symptoms, assess the need for care, and communicate effectively with healthcare providers (Borgonovi \u0026amp; Pokropek, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eSocioeconomic status was one of the strongest predictors of care-seeking behavior. Those living above the poverty line were more likely to access formal services, while individuals below the poverty line often resorted to self-treatment or forewent care altogether. This reflects the continuing financial barriers in Georgia\u0026rsquo;s healthcare system, particularly for outpatient and specialist care, and echoes findings from global studies indicating that out-of-pocket costs remain a key deterrent to healthcare utilization among elderly populations (Essue et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Verulava et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn contrast, in more developed countries, high utilization of health services among older adults is associated with strong institutional support systems (Lydahl \u0026amp; Davidson, 2024). In this context, applying these insights in Georgia can help design evidence-based interventions that address both local and global health challenges.\u003c/p\u003e\u003cp\u003eThe logistic regression analysis revealed that older adults with higher educational attainment, female gender, younger elderly age (60\u0026ndash;75), and better socioeconomic conditions were significantly more likely to seek allopathic treatment. These findings align with the global literature, which shows that education and income enhance health literacy and access, while gender norms may influence help-seeking behavior (Hosseinpoor et al., 2021). Importantly, these variables remained significant even after controlling for other factors, underscoring the need for tailored interventions addressing vulnerable subgroups such as elderly men, the less educated, and those living in poverty.\u003c/p\u003e\u003cp\u003eBased on the study\u0026rsquo;s findings, several recommendations can be made to improve health-seeking behavior among the elderly and enhance access to healthcare services. First and foremost, continuous training of family physicians is essential, particularly in communication with elderly patients, assessing psychosocial conditions, and interpreting nonspecific symptoms. Training should emphasize the fundamentals of geriatric medicine, psychosocial screening techniques, and communication strategies tailored to age-related needs.\u003c/p\u003e\u003cp\u003eIt is also important to improve the financial and geographic accessibility of healthcare services and to adapt healthcare infrastructure to be more elderly-friendly (e.g., barrier-free entrances, accessible waiting areas). Targeted awareness campaigns should be developed to inform elderly individuals and their families about the importance of regular monitoring and timely treatment of chronic diseases. Special attention should be paid to the risks associated with self-medication and traditional treatments. Elderly individuals should also be provided with comprehensive information about government-subsidized programs and how to access them.\u003c/p\u003e\u003cp\u003eIt is recommended that family members of elderly individuals receive educational materials and training to strengthen their caregiving skills. Additionally, a systematic data collection and analysis mechanism should be established to continuously monitor elderly health-seeking behavior and access to services, providing a foundation for evidence-based health policy.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study represents one of the first empirical efforts to systematically examine the health-seeking behavior of older adults in Georgia through a structured, population-based approach. The findings of this study have important implications for health policy not only in Georgia but also in other countries facing similar demographic, economic, and health system challenges. The identified barriers, such as financial hardship, low health literacy, reliance on self-treatment, and limited access to geriatric care, reflect systemic gaps that are common across many countries with under-resourced primary healthcare systems and aging populations.\u003c/p\u003e\u003cp\u003eThe research demonstrated that health-seeking behavior among older adults in Georgia is significantly influenced by age, education level, gender, and socioeconomic status. Importantly, the study highlights that while the majority of elderly individuals in urban Georgia prefer allopathic care, a substantial proportion still rely on self-medication, traditional remedies, or forgo care entirely, often due to financial barriers, low health literacy, or perceptions that symptoms are a normal part of aging. These patterns mirror challenges seen across low- and middle-income countries and underscore systemic gaps in access, equity, and elderly-centered service delivery.\u003c/p\u003e\u003cp\u003eThese insights can guide the development of targeted, elderly-centered health strategies, including the expansion of universal health coverage for older adults, integration of geriatric training into primary care, and public education campaigns to encourage timely health-seeking behavior. By addressing the specific needs of the elderly, policymakers can strengthen the resilience of health systems and reduce the long-term burden of chronic disease in resource-constrained settings.\u003c/p\u003e\u003cp\u003eLooking forward, the evidence presented here can serve as a foundation for developing and implementing comprehensive national health reforms that prioritize the needs of older adults. Integrating this knowledge into Georgia\u0026rsquo;s primary healthcare strategy will be essential to achieving equity in healthcare access and ensuring that the country\u0026rsquo;s growing elderly population receives the care and dignity it deserves.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclosure Statement\u003c/b\u003e\u003c/p\u003e\u003c/p\u003e\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eT.V. conceptualized and designed the study, led the literature review, and supervised data analysis. R.J. contributed to data collection, statistical analysis, and interpretation of findings. T.V. and R.J. jointly wrote the main manuscript text. All authors reviewed and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData is provided within the manuscript or supplementary information files\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAndersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? \u003cem\u003eJournal of Health and Social Behavior\u003c/em\u003e, \u003cem\u003e36\u003c/em\u003e(1), 1\u0026ndash;10. View PubMed Google Scholar.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBayable, A., Tegenaw, A., Tesfaye, Z., et al. (2023). 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View Google Scholar.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"ageing-international","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"agin","sideBox":"Learn more about [Ageing International](http://link.springer.com/journal/12126)","snPcode":"12126","submissionUrl":"https://submission.springernature.com/new-submission/12126/3","title":"Ageing International","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"aging population, chronic disease management, cultural beliefs, health-seeking behavior, health literacy","lastPublishedDoi":"10.21203/rs.3.rs-7124341/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7124341/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eUnderstanding health-seeking behavior among older adults is essential for designing age-responsive health policies. This study aims to investigate the factors that influence health-seeking behavior among the elderly population. A quantitative, cross-sectional survey design was employed. The study was conducted among 406 individuals aged 60 years and above attending four primary healthcare centers in Tbilisi, Georgia. Participants were selected using simple random sampling. Data were collected through a structured and pre-tested questionnaire, and analyzed using descriptive statistics, chi-square tests, and binary logistic regression. The majority of respondents reported chronic age-related conditions, with hypertension, diabetes, and musculoskeletal disorders being most common. While 65% sought allopathic treatment, 18.2% practiced self-medication, and 10.3% did not seek treatment at all. Logistic regression analysis revealed that higher education, female gender, younger-old age (60\u0026ndash;75 years), and above-poverty-line status were independent predictors of seeking formal care (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The study highlights significant disparities in health-seeking behavior shaped by socioeconomic and demographic factors. These findings underscore the need for targeted public health interventions, improved health literacy, and elderly-centered policy reforms to ensure equitable access to care in Georgia\u0026rsquo;s aging population.\u003c/p\u003e","manuscriptTitle":"Health-Seeking Behavior of Older Adults in Georgia: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-16 05:34:28","doi":"10.21203/rs.3.rs-7124341/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-11-18T09:08:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9506536582857989653081209121758857450","date":"2025-10-19T12:13:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"264829779485955167762965374883711299083","date":"2025-10-14T14:44:52+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-11T04:25:25+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"228242264447835093226024667110206202518","date":"2025-10-02T00:29:31+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-26T20:55:05+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-18T12:48:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-18T12:47:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"Ageing International","date":"2025-07-14T20:32:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"ageing-international","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"agin","sideBox":"Learn more about [Ageing International](http://link.springer.com/journal/12126)","snPcode":"12126","submissionUrl":"https://submission.springernature.com/new-submission/12126/3","title":"Ageing International","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"006734f5-df42-4333-aa60-701c1130a114","owner":[],"postedDate":"July 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-07-26T21:08:05+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-16 05:34:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7124341","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7124341","identity":"rs-7124341","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}