During the past six decades, global life expectancy at birth has increased by 20 years. In other words, from 52 years in 1960, it becomes 72 years in 2017 [1]. Sub-Saharan Africa and Benin in particular, despite a delay, also encounter a change with its life expectancy to 61 years [1]. Therefore, we can guess that there is a significant increase in the proportion of the elderly and demographic estimates predict its rapid growth [2]. Consequently, this demographic situation correlates with a change in the listing of health problems. Actually, the older you are, the more pathology your health faces [3]. In western countries, the main health characteristic of elderly populations is a high prevalence of chronic pathologies [4]. Thus, arthritis/arthritis, depression, cancer, osteoporosis, coronary, pulmonary, and cardiac pathologies are the most common pathologies found in Switzerland [4]. As far as the United States is concerned, the health problems of the elderly are about falls, cognitive decline, heart disease, osteoporosis, respiratory, eye, and cancer pathologies [4] [5]. In sub-Saharan Africa, particularly in Benin, there are no data related to the elderly’s health problems in medical consultation. This situation makes complicate the setting of any policy or strategy to address this new challenge. It is in this perspective that this work focuses on the establishment of an overview about the care requests of the elderly in internal medicine consultation at the CNHU-HKM in Cotonou.

Despite a birth rate that remains high and sustained, population ageing is still a reality in sub-Saharan Africa [4]. This ageing is accompanied by an increase in

the use of medical services that are increasingly confronted with the care of the elderly. In our study, the elderly accounted for 17.35% of patients while the proportion of elderly Beninese was 2.7% according to the 4th general population and housing census in 2013 [5]. This figure is close to that obtained in 2012 by Sough et al. in their study on the attendance of the elderly in the emergency room in Macon (France) [6]. This could imply that in Black Africa, the magnitude of health problems of the elderly is a major part of hospital activity and is closer to that of the West.

Almost 90% of our patients had a known history of chronic disease and a third had at least 3. In Switzerland, Santos-Eggiman finds a little less than 70% of elderly with at least one comorbidity [6], and Woo in South Korea, a proportion of 78% [7]. The difference between our results and those of previous authors might be explained by the fact that our study took place in a specialized setting, and most of the patients received were referred from other lower-level hospitals. Therefore, our patients could have more comorbidities than the general population aged 65 and over.

In our work, high blood pressure was the most common antecedent as well as in Hien et al. in Burkina Faso [8]. Sough et al., in France found similar results [9]. Advancing age is believed to be associated with increased comorbidities and arterial hypertension remains the most frequent “silent killer” with high morbidity and mortality [10].

Besides, in our study, cough (11%) was the most common reason for admission. We do not note a preponderance of any particular type of admission reason. These results contrast with those of Agbodandé et al., who found in Comè (Benin), alteration of general condition as a frequent and dominant reason [7]. Mengue-Me-Mguema had also found at the Gabriel Touré University Hospital in Bamako, a predominant reason for consultation: nontraumatic coma [8]. These differences in the results can be explained by the difference in the methods. The study by Agbodandé et al. took place in the hospitalization department of Medicine. The study of Mengue-Me-Mguema was in the emergency room and ours took place in consultation. We could deduce that, although the reasons pushing the elderly to consult are very diverse, only a portion of patients with particular clinical situations require hospitalization.

The main nosological groups of pathologies, classified according to ICD 10, were dominated by diseases of the osteo-articular system (17.5%), followed by diseases of the respiratory system (16.5%), circulatory system (12.4%), digestive system (8.2%), and genitourinary system, tumors (5.2%). In Tunisia, in a study carried out in the Sousse region, Zedini et al. found, compared to our study, a difference distribution of nosological groups [11]. Cardiovascular pathologies were numerous (26%), followed by diseases of the respiratory system (20.8%) and diseases of the osteo-articular system (19.3%). Cadmus et al. in Nigeria, also found cardiovascular pathologies are also in the first place (48.8%), followed by bone and joint pathologies [12]. As the large proportion of known hypertensive patients in our study (69%) would suggest, this is probably not because of a lower prevalence of cardiovascular pathologies in the elderly population in Benin than our figures concerning cardio-related pathologies vascular are lower. The executives used for the various studies could explain these differences. As our study setting is the Internal Medicine department, it is possible that a large number of elderly patients with cardiovascular pathologies would be in the Cardiology department. Cardiovascular disease is on the rise in Benin too. An absence of therapeutic education as well as the insufficiency of strategies for the management of cardiovascular risk factors would explain the increase in these pathologies in our region [13].

The main pathologies found were pneumonia (11.3%), lumbosacral spondylarthrosis (10.3%), prostatitis (4.1%) and asthma (3.1%). In Sousse in Tunisia, Zedini et al. found arterial hypertension (22.4%), bronchitis (9.2%), type 2 diabetes (7.9%), knee osteoarthritis (4.7%) and tonsillitis (4.1%) as the most frequent pathologies. Salvi et al., in India, also found hypertension as the first condition diagnosed in the elderly [14]. The studies by Zedini et al. and Salvi et al. were both done in basic health centers, that is why screening for high blood pressure came first. Pneumonia was the first pathology in our study, while bronchitis came second in Zedini. These figures should be correlated with WHO data, since in 2016 they found respiratory infections as the 4^th leading cause of death in the world [15]. Agbodandé et al., had also found that pneumonia represented the second pathology in medical hospitalization in Comè (Municipality of Benin). These points highlight the seriousness of pneumonia and the risk of high morbidity and mortality that the elderly face when they have it. Advanced age over 65 is a criterion for hospitalization for pneumonia. Lumbosacral spondylarthrosis, which has a second place in our study, accounts for 6.7% of the pathologies found in the elderly in Cadmus in Nigeria. Wong et al., in their review of studies on low back pain and the elderly, had shown that mechanical pathologies of the lumbar spine were frequent, with a prevalence varying between 12 and 50% depending on the study population [16].

The first limitation is that this study concerns a small population that was received in a non-geriatric specialized service and does not offer a panoramic view of the frequent pathologies of the elderly population in Benin. Geriatric syndromes (mental deterioration, poor physical activity, dizziness/lightheadedness, urinary incontinence, fear of falling/falling) have not been explored. The second major limitation is the retrospective nature of the study.

Older people are taking an increasing share of society in Black African countries. This category of the population, often with numerous pathologies, explaining the taking of several drugs at the same time, notwithstanding the side effects of these drugs and the weight of the pathologies, has diversified health care needs. It is necessary to work towards the prevention of these pathologies and their consequences on the body and their adequate management.

The authors declare no conflicts of interest regarding the publication of this paper.

Azon-Kouanou, A., Aïdasso, M.J.-C.A., Missiho, M.S.G., Dansou, E., Karuhije, F.H., Kondoli, J.K., Oba, R., Agbodande, K.A., Sokadjo, Y.M., Zannou, D.M. and Houngbé, F. (2020) Reasons for the Use of Health Care in Elderly Persons Undergoing Consultation in the University Clinic of Internal Medicine and Medical Oncology of the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) of Cotonou. Open Journal of Internal Medicine, 10, 280-287. https://doi.org/10.4236/ojim.2020.103029