Abstract
BackgroundChronic conditions reduce the likelihood of physical functioning among older adults. However, the contribution of most prevalent diseases and multimorbidity to different measures of functional limitations is relatively underexplored among Indian older adults. The present study explores the prospective association between number of chronic conditions and limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older adults in India.MethodsThis study utilized data from the nationally representative Longitudinal Ageing Study in India (LASI-2017-18). The effective sample size was 31,464 older adults aged 60 years and above. Descriptive statistics along with cross-tabulation were presented in the study. Additionally, binary logistic regression analysis was used to fulfil the objectives. The outcome variables were dichotomized; high representing no difficulty in ADL/IADL and low representing a difficulty in at least one ADL/IADL. The chronic conditions included hypertension, diabetes, neurological/psychiatric disease, lung disease, heart diseases, stroke, and bone-related disease. The number of chronic diseases was categorized into no disease, single, two and three plus based on number of reported disease.Results26.36% of older women and 20.87% of older men had low ADL and the figures for low IADL were 56.86 and 38.84% for older men and women respectively. The likelihood of low ADL (AOR: 1.698, CI:1.544, 1.868) and low IADL (AOR: 1.197; CI: 1.064, 1.346) was higher among womenthan men. With increasing age, the prevalence of low ADL increased among older adults. Respondents with pre-existing chronic conditions had higher likelihood of low ADL and IADL. Older adults with hypertension, psychiatric disease, heart disease, stroke and bone-related disease had significantly higher odds of reporting low IADL. The chances of low ADL and IADL were 2.156 (CI: 1.709, 2.719) and 2.892 (CI: 2.067, 4.047) times respectively higher among older adults with more than three chronic conditions. After controlling for socio-economic and health-related covariates, it was found that men with more than three pre-existing chronic conditions had higher odds of low ADL than women. On the other hand, low IADL were found higher among women with more than three pre-existing chronic conditions.ConclusionsThe present study demonstrates a significant burden of functional limitations among older individuals and that there is a strong association between pre-existing chronic conditions and functional disability. Those with hypertension, diabetes, psychiatric disorders, heart disease, stroke, lung disease or bone-related diseases should be effectively monitored to predict future functional limitations, which may lead to worsening health.
Highlights
Chronic conditions reduce the likelihood of physical functioning among older adults
The present study demonstrates a significant burden of functional limitations among older individuals and that there is a strong association between pre-existing chronic conditions and functional disability
This study examines whether the impact of number of chronic conditions on functional limitations varies by socio-demographic characteristics
Summary
Study design and sample A cross-sectional study design was adopted. The study utilizes data from India’s first nationally representative Longitudinal Ageing Study (LASI- wave 1) conducted during 2017–18, which investigates the health, economic and social determinants and consequences of population ageing in India [20]. This study provides scientific evidence on demographics, household economic status, chronic health conditions, symptoms-based health condition, functional and mental health, biomarkers, health care utilization, work and employment etc It enables the cross-state analyses and the cross-national analyses of ageing, health, economic status and social behaviours and has been designed to evaluate the effect of changing policies and behavioural outcomes in India. For a better understanding of the association of number of chronic conditions with functional impairments, we categorized number of chronic conditions into single, two and three plus, and regressed on low ADL and IADL stratified by sex of the older adults
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