Multimorbidity and Complex Multimorbidity in India: Findings from the 2017-2018 Longitudinal Ageing Study in India (LASI).
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SUBMITTER: Sinha A
PROVIDER: S-EPMC9332385 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectivesThis study investigates the gender disparities in difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) and explores its contributing factors among older adults in India.DesignA cross-sectional study was conducted using country representative survey data.Setting and participantsThe present study uses the data from the Longitudinal Ageing Study in India, 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India.Primary and secondary outcome measuresDifficulty in ADL and IADL were the outcome variables. Descriptive statistics and bivariate analysis were carried out to present the preliminary results. Multivariate decomposition analysis was used to identify the contributions of covariates that explain the group differences to average predictions.ResultsThere was a significant gender differential in difficulty in ADL (difference: 4.6%; p value<0.001) and IADL (difference: 17.3%; p value<0.001). The multivariate analysis also shows significant gender inequality in difficulty in ADL (coefficient: 0.046; p value<0.001) and IADL (coefficient: 0.051; p value<0.001). The majority of the gender gap in difficulty in ADL was accounted by the male-female difference in levels of work status (18%), formal education (15% contribution), marital status (13%), physical activity (9%), health status (8%) and chronic morbidity prevalence (5%), respectively. Equivalently, the major contributors to the gender gap in difficulty in IADL were the level of formal education (28% contribution), marital status (10%), alcohol consumption (9%), health status (4% contribution) and chronic morbidity prevalence (2% contribution).ConclusionDue to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for older adults and women in particular should be the highest priority for physicians and health decision-makers.
| S-EPMC9058763 | biostudies-literature
Project description:IntroductionCataracts are the leading cause of blindness among older people, but they can be treated with corrective surgery. India boasts the oldest blindness control programme in the world. We aimed to assess the prevalence of cataract surgery, and we compared the determinants of undergoing cataract surgery and identified the unmet needs for cataract surgery among older adults in India.MethodsWe included 52,380 individuals aged ≥50 years from the Longitudinal Ageing Study in India, wave-1. The primary outcome measures of our study were the prevalence of cataract surgery and the unmet need for cataract surgery. Multivariate analysis was executed to investigate the association between socio-demographic variables and outcomes, expressing the results as adjusted odds ratios with 95% confidence intervals (CIs).ResultsThe overall prevalence of cataracts was 14.85%. The coverage of cataract surgery was 76.95%, with 23% having unmet needs for cataract surgery. Notably, cataract surgery coverage was higher at 78.30% (95% CI: 76.88-79.48) among participants aged 66-80 years, while the percentage of those who did not undergo cataract surgery was higher at 24.62% (95% CI: 23.09-26.20) among participants aged 50-60 years. The most deprived group had a higher odds ratio [adjusted odds ratio: 1.20 (95% CI: 1.00-1.44)] (p < 0.05) of having unmet needs for cataract surgery.ConclusionsThere is a considerable burden of age-related cataracts in India. While the coverage of cataract surgery is high, the unmet need for cataract surgery cannot be overlooked. The existing blindness control programme has contributed significantly to increasing the coverage of cataract surgery, but it still needs to be strengthened, especially to reach the most deprived sections of society.
| S-EPMC10985141 | biostudies-literature
Project description:BackgroundHousehold headship with decision-making power may have a positive influence on life satisfaction in older adults. This study examines the associations of several types of household headship with life satisfaction among older adults in India.MethodThe study utilized the data from the Longitudinal Ageing Study in India (2017-18). The effective sample size for the study was 31,464 adults aged 60 years or older. Ordered logistic regression model was employed to find the association of life satisfaction with household headship status after adjusting for selected socioeconomic and demographic factors.ResultsIt was found that about 1.3% of older male and 1.5% of older females had nominal headship status in their household. Higher percentage of older males (42%) and females (48.3%) who had nominal headship status had low life satisfaction. In multivariable analysis, older adults who practiced nominal headship had significantly higher odds of low life satisfaction in reference to older adults who practiced functional headship [Adjusted odds ratio (AOR): 1.87; confidence interval (CI): 1.45,2.42]. Interaction model reveals that older men who practised nominal headship had significantly higher odds of low life satisfaction in reference to older men who practised functional headship [AOR: 2.34; CI: 1.59,3.45]. Similarly, older women who practised nominal headship had 55% significantly higher likelihood to have low life satisfaction in reference to older men who practised functional headship [AOR: 1.55; CI: 1.09, 2.18].ConclusionThe recognition of older individuals as active agents of the households they belong to, and giving them the value they deserve may help boosting their mental well-being. As a direct driver of subjective well-being, headship status and decision making power deserve a more prominent role and future studies are required on the mechanisms of functional and nominal headship statuses that have impact on successful aging.
| S-EPMC8790881 | biostudies-literature
Project description:ObjectiveThis study examines the prevalence, patterns and factors of chronic disease-related multimorbidity. Also, this study examines the inequality in the prevalence of multimorbidity among older adults in India.DesignCross-sectional study; large nationally representative survey data.Setting and participantsWe have used the first wave of a Longitudinal Ageing Study in India conducted in 2017-2018 across all the 35 states (excluded Sikkim) and union territories in India. This study used information from 31 373 older people aged 60+years in India.Primary and secondary outcome measuresThe outcome variable for this study is multimorbidity. The study used multinomial logistic regression to examine the risk factors for multimorbidity among older adults. To measure the inequality in multimorbidity, the slope of index inequality and relative index of inequality have been used to understand the ranked-based inequality.ResultsAlmost one-fourth (24.1%) reported multimorbidity. The relative risk ratio (RRR) of multimorbidity (RRR=2.12; 95% CI=1.49 to 3.04) was higher among higher educated older adults than uneducated older adults. Furthermore, the RRR of multimorbidity (RRR=2.35; 95% CI=2.02 to 2.74) was higher among urban older adults than their rural counterparts. Older adults in the richest wealth quintile were more likely to report multimorbidities (RRR=2.86; 95% CI=2.29 to 3.55) than the poorest older adults. Good self-rated health and no activities of daily living disability were associated with a lower risk of multimorbidities.ConclusionsThis study contributes to the comprehensive knowledge of the prevalence, factors and inequality of the chronic disease-related multimorbidity among older adults in India. Considering India's ageing population and high prevalence of multimorbidity, the older adults must be preferred in disease prevention and health programmes, however, without compromising other subpopulations in the country. There is a need to develop geriatric healthcare services in India. Additionally, there is a need to disseminate awareness and management of multimorbidity among urban and highly educated older adults.
| S-EPMC8961109 | biostudies-literature
Project description:BackgroundIndia suffers from a high burden of diarrhoea and other water-borne diseases due to unsafe water, inadequate sanitation and poor hygiene practices among human population. With age the immune system becomes complex and antibody alone does not determine susceptibility to diseases which increases the chances of waterborne disease among elderly population. Therefore the study examines the prevalence and predictors of water-borne diseases among elderly in India.MethodData for this study was collected from the Longitudinal Ageing Study in India (LASI), 2017-18. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Proportion test was applied to check the significance level of prevalence of water borne diseases between urban and rural place of residence. Additionally, binary logistic regression analysis was used to estimate the association between the outcome variable (water borne diseases) and the explanatory variables.ResultsThe study finds the prevalence of water borne disease among the elderly is more in the rural (22.5%) areas compared to the urban counterparts (12.2%) due to the use of unimproved water sources. The percentage of population aged 60 years and above with waterborne disease is more in the central Indian states like Chhattisgarh and Madhya Pradesh followed by the North Indian states. Sex of the participate, educational status, work status, BMI, place of residence, type of toilet facility and water source are important determinants of water borne disease among elderly in India.ConclusionElderly people living in the rural areas are more prone to waterborne diseases. The study also finds state wise variation in prevalence of waterborne diseases. The elderly people might not be aware of the hygiene practices which further adhere to the disease risk. Therefore, there is a need to create awareness on basic hygiene among this population for preventing such bacterial diseases.
| S-EPMC9112585 | biostudies-literature
Project description:ObjectivesFew studies have examined frailty in Indian adults, despite an increasing population of older adults and an escalating burden of chronic diseases. We aimed to study the prevalence and correlates of frailty in middle-aged and older Indian adults.SettingCross-sectional data from Wave 1 of Longitudinal Ageing Study in India, conducted in 2017-2018 across all states and union territories, were used.ParticipantsThe final analytical sample included 57 649 participants aged 45 years and above who had information on frailty status.Primary outcome measureThe deficits accumulation approach to measuring frailty was employed, creating a frailty index between 0 and 1, based on 40 deficits. Individuals with a frailty index of 0.25 or more were defined as 'frail'.ResultsPrevalence of frailty among 45+ adults was 30%. 60+ women were two times as likely to be frail compared with 60+ men, after adjusting for a wide range of sociodemographic, economic and lifestyle factors. The sex difference was more pronounced in adults aged 45-59 years. Odds of hospitalisation in the last 12 months, and having falls in the past 2 years, were two times as high in frail adults compared with non-frail adults. Frail middle-aged and older adults had 33% and 39% higher odds, respectively, of having poor cognition than non-frail adults. The relative increase was higher in women for all three outcomes, although not statistically significant.ConclusionsThere needs to be careful consideration of sex differences when addressing frailty, particularly for optimising frailty interventions. Frailty, although typically assessed in older adults, was shown in this study to be also prevalent and associated with adverse outcomes in middle-aged Indian adults. More research into assessment of frailty in younger populations, its trajectory and correlates may help develop public health measures for prevention of frailty.
| S-EPMC10391831 | biostudies-literature
Project description:Background Older adults experience a natural decline in health, physical and cognitive functionality, and vision impairment (VI) is one among them and has become an increasing health concern worldwide. The present study assessed the association of chronic morbidities such as diabetes, hypertension, stroke, heart diseases and various socioeconomic factors with VI among older Indian adults. Methods Data for this study were derived from the nationally-representative Longitudinal Ageing Study in India (LASI), wave-1 (2017–18). VI was assessed using the cut-off of visual acuity worse than 20/80, and additional analysis was carried out using the definition of VI with a cut-off of visual acuity worse than 20/63. Descriptive statistics along with cross-tabulation were presented in the study. Proportion test was used to evaluate the significance level for sex differentials in VI among older adults. Additionally, multivariable logistic regression analysis was conducted to explore the factors associated with VI among older adults. Results About 33.8% of males and 40% of females suffered from VI in India (visual acuity worse than 20/80). Meghalaya (59.5%) had the highest prevalence for VI among older males followed by Arunachal Pradesh (58.4%) and Tripura (45.2%). Additionally, Arunachal Pradesh (77.4%) had the highest prevalence for VI among females followed by Meghalaya (68.8%) and Delhi (56.1%). Among the health factors, stroke [AOR: 1.20; CI: 1.03–1.53] and hypertension [AOR: 1.12; CI: 1.01–1.22] were the significant risk factors for VI among older adults. Additionally, being oldest old [AOR: 1.58; CI: 1.32–1.89] and divorced/separated/deserted/others [AOR: 1.42; CI: 1.08–1.87] were significantly associated with VI. Moreover, older adults with higher educational status [AOR: 0.42; CI: 0.34, 0.52], currently working [AOR: 0.77; CI: 0.67, 0.88], from urban areas [AOR: 0.86; CI: 0.76–0.98] and from western region [AOR: 0.55; CI: 0.48–0.64] had lower odds of VI in this study. Conclusion This study identified higher rates of VI among those who are diagnosed with hypertension or stroke, currently unmarried, socioeconomically poorer, less educated and urban resident older people that can inform strategies to engage high risk groups. The findings also suggest that specific interventions that promote active aging are required for those who are socioeconomically disadvantaged as well as visually impaired. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-023-03009-w.
| S-EPMC10240694 | biostudies-literature
Project description:ObjectiveThe study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.DesignA cross-sectional study was conducted using a large survey data.Setting and participantsThe study used data from the Longitudinal Ageing Study in India wave 1 (2017-2018). The effective sample size was 31 464 older adults (aged 60 years or older).Primary and secondary outcome measuresThe outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.Results5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.ConclusionsHealthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.
| S-EPMC8671981 | biostudies-literature
Project description:IntroductionThe Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India.Materials and methodsThe data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017-18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study.ResultsA proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively.ConclusionsAdverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.
| S-EPMC8919576 | biostudies-literature
Project description:BackgroundUnderstanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as "the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO)," where "functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value." People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India.MethodsBased on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI.ResultThe mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (β = 2.36; 95% CI: 2.16-2.56).ConclusionThis study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.
| S-EPMC10585826 | biostudies-literature