Longitudinal Aging Study In India Research Articles

Third Agers in India: Empirical Evidence From Longitudinal Aging Study in India (LASI), 2017-2018.

Given that the ontological origins of the Third Age lie in the cultural logics of social class, consumer society and "habitus," a majority of its gerontological examination is qualitative in nature. We utilize the recently released Longitudinal Aging Study in India (2017-2018) and harness the time-use module to offer an empirical portrait of Third Agers in India. Considering that the aging scholarship in India has been often articulated in the empirical language of dependency, care regimes, and (economic) insecurity, we believe this examination allows us to shift the gerontological gaze from a risk perspective to one that is positive and affirmative. Following an exploratory factor analysis and nested linear regression, we corroborate the emergence of a "silver market" where educated, urban, affluent, and professionally qualified older Indians are the ones who are more likely to engage in active leisure pursuits. Noteworthy is the combined effects of wealth and professional education in determining who is ultimately able to "purchase" leisure in a highly segmented emerging senior market. In all, we conclude by discussing how these findings upend our cultural imagination around growing old in contemporary India.

Spousal Concordance of Hypertension Among Middle-Aged and Older Heterosexual Couples Around the World: Evidence From Studies of Aging in the United States, England, China, and India.

Health concordance within couples presents a promising opportunity to design interventions for disease management, including hypertension. We compared the concordance of prevalent hypertension within middle-aged and older heterosexual couples in the United States, England, China, and India. Cross-sectional dyadic data on heterosexual couples were used from contemporaneous waves of the HRS (US Health and Retirement Study, 2016/17, n=3989 couples), ELSA (English Longitudinal Study on Aging, 2016/17, n=1086), CHARLS (China Health and Retirement Longitudinal Study, 2015/16, n=6514), and LASI (Longitudinal Aging Study in India, 2017/19, n=22 389). Concordant hypertension was defined as both husband and wife in a couple having hypertension. The prevalence of concordant hypertension within couples was 37.9% (95% CI, 35.8-40.0) in the United States, 47.1% (95% CI, 43.2-50.9) in England, 20.8% (95% CI, 19.6-21.9) in China, and 19.8% (95% CI, 19.0-20.5) in India. Compared with wives married to husbands without hypertension, wives married to husbands with hypertension were more likely to have hypertension in the United States (prevalence ratio, 1.09 [95% CI, 1.01- 1.17), England (prevalence ratio, 1.09, 95% CI, 0.98-1.21), China (prevalence ratio, 1.26 [95% CI, 1.17-1.35), and India (prevalence ratio, 1.19 [95% CI, 1.15-1.24]). Within each country, similar associations were observed for husbands. Across countries, associations in the United States and England were similar, whereas they were slightly larger in China and India. Concordance of hypertension within heterosexual couples was consistently observed across these 4 socially and economically diverse countries. Couple-centered interventions may be an efficient strategy to prevent and manage hypertension in these countries.

Examining widowhood duration with depression and cognitive impairment among older women using nationally representative Longitudinal Aging Study in India

AbstractBackgroundLosing loved ones is considered one of the most stressful events in life. With the increase in life expectancy globally over the past century, widowhood has become an older women’s issue. The study aimed to examine the association of widowhood duration with depression and cognitive function among older women in India.MethodWe used the nationally representative Longitudinal Aging Study in India baseline wave, conducted during 2017‐18. Sample comprised of 16,075 older women ages 60 years and above. We conducted descriptive statistics, bivariate analysis and multivariable logistic regression to examine the association of widowhood duration with depression and cognitive impairment.ResultNearly 25% of the older women who suffered from cognitive impairment were widowed for more than 10 years whereas, about 14% of older women who suffered from depression were widowed for at least four years. Older women who were widowed for more than 10 years were 43% significantly more likely to suffer from cognitive impairment in reference to older women who were currently married [adjusted odds ratio (AOR): 1.43, confidence interval (CI): 1.27‐1.61]. Older women who were widowed for at least four years were two times significantly more likely to suffer from depressive symptoms compared to older women who were currently married [AOR: 2.01, CI: 1.66‐2.42].ConclusionThe findings highlight that widowed older Indian women are disadvantaged with respect to the duration of bereavement that leads to worse mental health both in the short and long terms. It suggests that women who are struggling to adjust to such transitions may be particularly at risk for adverse mental health outcomes.

Life course rural/urban place of residence, depression and cognitive impairment among older adults: Findings from the Longitudinal Aging Study in India

AbstractBackgroundGiven the unique socioeconomic structures and rural/urban differentials in mental health outcomes in the country, this study aimed to explore the associations of childhood, adulthood and late‐life place of residence with mental health outcomes of depression and cognitive impairment among older adults in India. The study also examined the relationship between older individuals’ life‐course rural/urban place of residence and late‐life mental and cognitive health.MethodUtilizing data from the Longitudinal Aging Study in India (n = 28,041 older adults age 60 years and above), I employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life‐course residence, depression and cognitive impairment among older adults.ResultChildhood and adulthood place of residence was not associated with depression in older men and women. Current rural place of residence was positively associated with depression in older women [OR: 1.37, CI: 1.05‐ 1.80] but not men. Childhood [OR: 1.88, CI: 1.16‐ 3.04], adulthood [OR: 2.00, CI: 1.26‐ 3.16] and current rural residence [OR: 1.93, CI: 1.27‐ 2.91] was positively associated with cognitive impairment in men. Only current rural residence [OR: 1.71, CI: 1.29‐ 2.27] was associated with cognitive impairment in women. There was no significant association between life‐course place of residence and depression except in case of lifetime rural residence Respondents with urban‐urban‐urban place of residence were less likely to be depressed [Coef.: ‐0.14, CI: ‐0.21‐ ‐0.07] compared to those with rural‐rural‐rural place of residence. There were significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants, showing a urban advantage in cognitive function among older adults.ConclusionThis study showed significant associations between life‐course residence and depression among permanent rural/urban residents. The study also showed significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants. Considering the rural disadvantage, the government should continue to support policies that can promote education among people residing in rural areas. The findings also urge social scientists and gerontologists, in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Defining anthropometric thresholds (mid-arm circumference and calf circumference) in older adults residing in the community: a cross-sectional analysis using data from the population representative Longitudinal Aging Study in India (LASI DAD)

ObjectivesTo identify factors associated with malnutrition (undernutrition and overnutrition) and determine appropriate cut-off values for mid-arm circumference (MAC) and calf circumference (CC) among community-dwelling Indian older adults.DesignData from the first...

Multiple socioeconomic risks and cognitive impairment among older men and women in India.

Socioeconomic status (SES) is negatively associated with innumerable health outcomes, including cognitive functioning. Yet much remains undiscovered about SES patterns in later-life cognition in low-and middle-income countries (LMICs). The purpose of this study was to examine the association between separate and combined socioconomic risks and cognitive impairment among older adults in India. Further, given gender disparities in later life cognitive functioning and SES, the study examines the associations between socioeconomic risks and cognitive impairment separately, for older men and women. Data come from the 2017-18, first wave of the Longitudinal Aging Study in India (LASI), with 31,464 older adults aged 60years and above. Cognitive impairment was assessed using multiple broad measures of memory, orientation, arithmetic function, and visuo-spatial construction skills. We present descriptive statistics along with cross-tabulation of the outcome variable. Additionally, binary logistic regression analysis was used to test the association between outcome and explanatory variables. SES is measured using education, paid work status, and household wealth measured using monthly per-capita consumption expenditure (MPCE). A proportion of 7.14% of the older men and 20.03% of older women reported cognitive impairment. The odds of cognitive impairment were higher among uneducated older men and women, and older men and women in lowest wealth quintile. Surprisingly, older women without current or prior work history report lower odds of cognitive impairment compared to their peers in labor force. While odds of cognitive impairment are higher among non-working older men, this association is not statistically significant. In older men, the odds of cognitive impairment were 5.34, 7.14, and 13.05 times higher with one, two, and three risk factors, respectively, compared with those with no risk exposure. A similar trend was observed for women but with comparatively lower odds. Our findings underscore the need to distinguish between varying elements of SES to construct "upstream" health policies and programs that redistribute resources. In particular, the findings support the use of multiple SES indicators in identifying older adults most susceptible to cognitive deficits, and planning gender-based interventions to improve cognitive health in late life.

A cross‐national comparison of the risk factors associated with the Motoric Cognitive Risk syndrome in high and middle‐income countries

AbstractBackgroundThe Motoric Cognitive Risk (MCR) syndrome is associated with increased risk of Alzheimer’s disease and vascular dementia. MCR does not require cognitive or lab tests to diagnose, increasing its utility in resource‐poor settings. The specific risk factors associated with MCR in different high‐ and middle‐income countries are not established.MethodsWe examined the epidemiology of MCR in harmonized cross‐sectional data from 17,050 adults aged ≥ 65 years enrolled in the U.S. Health and Retirement Study (HRS; n = 3,748), English Longitudinal Study of Ageing (ELSA; n = 4,110), Mexican Health and Aging Study (MHAS; n = 738), the China Health and Retirement Study (CHARLES; n = 3,275), the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI‐DAD; n = 1,276) and the Survey of Health, Ageing and Retirement in Europe (SHARE; n = 3,973). MCR was defined as the presence of cognitive complaints and slow gait in the absence of mobility disability and dementia. Risk factors included demographics [age, sex, education], medical [hypertension, diabetes, Parkinson’s, heart disease, stroke, obesity], sensorimotor [grip strength, hearing], psychological [depression], behavioral factors [smoking, sedentariness, sleep quality] and falls (see Table 1 for definitions). Logistic regression was used to examine factors associated with prevalent MCR.ResultsParticipants’ mean age in different cohorts ranged between 71.3 and 80.2 years. Proportion of females ranged between 45.3% and 60.9%. MCR prevalence was 3.6%, 2.1%, 8.9% 6.1%, 5.8% and 6.8% in HRS, ELSA, MHAS, CHARLES, LASI‐DAD and SHARE, respectively. Tables 2 and 3 show risk factors associated with each cohort in univariate and multivariable models. Despite some overlaps, specific risk factors were associated with each cohort with relative risk ratios ranging as follows: 0.4‐2.8 for education and multiple falls in HRS, 2.3‐7.1 for poor hearing and sedentariness in ELSA, 2.3‐2.6 for weak grip strength and diabetes in MHAS, 1.9‐2.2 for depression and sedentariness in CHARLES, 0.5‐5.3 for education and stroke in LASI‐DAD and 0.3‐2.4 for education and depression in SHARE.ConclusionIn community‐dwelling older adults from twenty countries (high‐ and middle‐income), specific risk factors were associated with MCR in each cohort – laying the foundation for preventing MCR and subsequently dementia in ethnically, culturally, and socioeconomically diverse populations.

Effect modification of the association between BMI and cognition in India

AbstractBackgroundHigh body‐mass index in midlife is an established risk factor for poor cognition and dementia. While most evidence supporting the association between high BMI and dementia comes from high‐income countries, 60% of global dementia cases are expected to be in low‐ and middle‐income countries by 2050. Existing evidence from India suggests higher BMI is associated with better cognition and lower odds of dementia. We sought to replicate these findings and investigate effect modification by age, rurality, and education to better contextualize results.MethodWe used cross‐sectional data from the Longitudinal Aging Study in India (N = 57,164). We used weighted linear regression models to assess associations between latent cognitive functioning, estimated from confirmatory factor analysis models, and BMI category. We compared unadjusted models to models controlling for age, sex, rurality, state, literacy, education, per capita consumption quintile, parental education, smoking, and depressive symptoms. We investigated effect modification by age, rurality, and education.ResultCompared to unadjusted models, estimated associations from multivariable models were substantially attenuated but remained statistically significant. Underweight BMI was associated with lower cognitive scores and overweight and obesity were associated with higher cognitive scores (underweight = ‐0.16 SD units [‐0.18‐ ‐0.14]; overweight = 0.10 [0.09‐0.12]; obese = 0.13 [0.11‐0.16]). For participants in urban settings or with higher educational attainment, associations between cognition and overweight and obesity were smaller and not statistically significant for those with tertiary education. A global ANOVA test for effect modification was statistically significant for rurality (p<0.01), trending towards significance for education (p = 0.09), but not significant for age category (p = 0.31).ConclusionCounter to findings in high‐income settings, but consistent with prior findings in India, high BMI was associated with higher cognitive performance. Lack of evidence for effect modification by age and the association between low BMI (underweight) and lower cognition, indicate reverse causation due to weight loss in early disease stages is unlikely to explain results. Instead, strong attenuation of effects with confounder control and effect modification by rurality and education indicate that associations could be due to the clustering of access to fat‐enriched foods with other factors that are beneficial for health, such as higher education and access to healthcare.

Household polluting cooking fuels and intrinsic capacity among older population: A harmonized nationwide analysis in India and China

BackgroundsHousehold polluting cooking fuels, as an important changeable behavior, are related to various detrimental health effects among the elderly. There is limited research on the association between polluting cooking fuel use and intrinsic capacity (IC) as an indicator of healthy aging. This study aimed to evaluate the above-mentioned association in India and China, where polluting cooking fuel use is common. MethodsWe enrolled 33,803 participants aged ≥60 years from two nationally representative studies: the Longitudinal Aging Study in India and the China Health and Retirement Longitudinal Study. Polluting cooking fuel use was defined as a self-report of using wood, coal, kerosene, crop residue, or dung. IC was measured by five aspects, including locomotion, cognition, vitality, sensory, and psychological capacity. The random-effects mixed linear regression and logistic regression with population weighting were performed. Multivariable-adjusted model and propensity score were used to adjust for potential confounders. ResultsA total of 47.54 % and 59.32 % of elderly adults reported primary cooking using polluting fuels in India and China, respectively. Using polluting cooking fuels was consistently associated with IC decline; particularly, cognitive capacity was the most susceptible domain. In India, participants using polluting fuels had a 1.062 (95 % confidence interval [CI]: 1.047–1.078) times risk for IC deficits, whereas more prominent results were observed in China (odds ratio [OR]: 2.040, 95 % CI: 1.642–2.533). Such harmful effects might be alleviated by transferring from polluting to clean fuels. Additionally, the duration of polluting fuel use was also positively associated with IC deficits. ConclusionThis study provided substantial public implications on healthy aging for the elderly population at a global scale, strengthening the importance of health education and policy efforts to accelerate the transition from polluting to clean fuels.

Lifestyle and socio-economic disparities in the prevalence of diabetes among the elderly population (aged 60+) in India: a decomposition analysis using longitudinal aging study in India data

Background: This study aimed to determine the prevalence of self-reported diabetes by sex and investigate the socio-economic, demographic, and lifestyle risk factors associated with diabetes. Additionally, it aimed to understand the coexistence of diabetes with other morbid conditions. Methods: The study design used in this research is a cross-sectional study design. This study utilized data from the longitudinal aging study in India (LASI), a nationally representative survey of older adults. The sample included 15,098 males and 16,366 females aged 60 years and above. Results: The prevalence of diabetes in India varies by state, zone, and rural/urban areas. Kerala has the highest prevalence among both men (33%) and women (28.5%). Urban areas have a higher prevalence (20%) compared to rural areas (8.5%). Hypertension and cancer are strongly associated with diabetes. Other morbid conditions like heart disease, high cholesterol, and vision problems also show significant links with diabetes. Conclusions: Diabetes in India is a significant health concern, with variations across regions and associations with comorbidities like hypertension, cancer, heart disease, high cholesterol, and vision problems. To address this, comprehensive preventive measures and health promotion campaigns are needed, targeting high-risk groups and improving healthcare access. Early detection, effective management, and promoting healthy lifestyles are crucial for diabetes prevention and control in India.

Biological ageing and the risk of decreased handgrip strength among community-dwelling older adult Indians: a cross-sectional study

BackgroundEvidence from the literature demonstrates that the risk of decreased handgrip strength is associated with various health issues, particularly in older persons. To make judgments regarding their general health condition that are well-informed for longevity, it is crucial to assess the risk level of decreased handgrip strength among community-dwelling older adult Indians. However, no study has examined the relationship between biological aging and the risk of decreased handgrip strength in Indian men and women aged 60 and older. The goal of the current study was to fill this gap in the literature.MethodsIn this cross-sectional study, we included 31,464 (15,098 men and 16,366 women) community-dwelling older adult Indians aged 60 years and older using data from the Longitudinal Aging Study in India (LASI). The LASI is the world’s most extensive and India’s first multidisciplinary, internationally harmonized, longitudinal aging study. It has enrolled 72,250 individuals aged 45 and above across all 28 states and 8 union territories of India. Secondary analysis of biological ageing was performed by stratifying for age groups (60–64, 65–69, 70–74, 75–79, 80–84, and 85 + years) for both genders. The dominant right and nondominant left handgrip strength was assessed using the portable Smedley’s Hand Dynamometer. All individuals had a dominant right hand. The adjusted logistic regression analysis assessed the association between biological ageing and the risk of decreased handgrip strength for both genders.ResultsCompared to those between the ages of 60–64, those at age 65 and those aged 85 and above had 1-fold and 12-fold odds of decreasing handgrip strength, respectively. Men 85 years or older had a 12-fold higher chance than women in the same age group of having decreased handgrip strength.ConclusionsThe results indicate that community-dwelling older adult Indians aged 65 years and older are significantly associated with a higher risk of decreased handgrip strength, especially among older men. The results of this study can help assess and implement handgrip strength measurement in medicine for older Indians as part of regular admission assessment, particularly for older men.

Sarcopenic Obesity Burden, Determinants, and Association With Risk of Frailty, Falls, and Functional Impairment in Older Adults With Diabetes: A Propensity Score Matching Analysis.

Sarcopenic obesity (SO) is a medical and functional state characterized by the coexistence of excessive adipose tissue and sarcopenia inside an individual. Recent epidemiological studies suggest a rising prevalence of SO in patients with diabetes mellitus (DM) probably due to the conducive environment resulting from adipose tissue dysfunction and muscle wasting accelerated by insulin resistance, chronic inflammation, and altered protein metabolism. Individuals with SO may have higher risk of experiencing falls, frailty, and disabilities due to compromised musculoskeletal integrity, gait abnormalities, and reduced functional capacity.The primary study objective was to determine the prevalence and predictors of SOamong older adults with a history of DM. The secondary objective was to assess the association of falls, frailty, and functional disabilitywith SO in patients with DM. This cross-sectional study analyzed data from the nationally representative Longitudinal Aging Study in India (LASI) Wave 1, focusing on individuals aged 60 and above, with an emphasis on diabetes. SOwas assessed using the Asian Working Group for Sarcopenia criteria. Propensity score matching (PSM), logistic regression, and mediation analysis were used to explore relationships between diabetes, SO, and health outcomes (falls, frailty, and disabilities). Among 31,902 participants aged 60 and above, 14.26% had diabetes, and 17.67% of those with diabetes exhibited SO. Female gender (aOR = 2.63) and urban residence (aOR = 1.40) were significantly associated with higher odds of SO in individuals with diabetes. PSM analysis revealed a 9.0% higher likelihood of SO in older adults with DM than those without DM. SO was further linked to increased risk of falls, frailty, and various levels of activities of daily living (ADL) and instrumental activities of daily living (IADL) disabilities, with significant mediation effects ranging from 3.67% to 45.81%. Diabetes substantially increases the risk ofSO and associated functional disability with the risk of falls in older adults.Standard diabetes care should integrate health promotion especially nutritionto mitigate the risk of SO-linked functional disability and falls.

The relationship between depression and benign prostatic hyperplasia in middle-aged and elderly men in India: a large-scale population study

BackgroundThere have been few investigations on the association between depression and benign prostatic hyperplasia (BPH). This study aims to explore the correlation between depression and BPH among middle-aged and older men in India.MethodsWe utilized data from male individuals aged 45 years and older who participated in the initial wave (2017–2018) of the Longitudinal Aging Study in India (LASI). The presence of BPH symptoms was based on self-reported information, while depressive symptoms were evaluated using CESD-10. The analysis was a cross-sectional study conducted on a final sample size of 30,108 male participants. To examine associations, we employed multivariate logistic regression analysis along with subgroup analysis and interaction tests.ResultsA total of 439 (1.46%) men reported BPH and had a higher depression score (10.18 ± 4.22 vs. 9.28 ± 4.00). The findings indicated a significant association between the depression score and the likelihood of developing BPH, even after accounting for all potential confounding variables (OR = 1.054, 95% CI: 1.030–1.078, p < 0.00001). The participants were then categorized into a depression group and a normal group based on their CESD-10 score, using a threshold of 10 to ascertain the existence or nonexistence of depression. After adjusting for all variables in model IV, the findings continued to exhibit statistical significance (OR = 1.611, CI: 1.327–1.955, p < 0.00001). Significant interaction effects of age, education level, caste or tribe, and alcohol consumption were observed (p for interaction < 0.05).ConclusionOur research found that BPH was significantly linked to the presence of depressive symptoms among middle-aged and elderly Indian men. Additional prospective research is necessary to clarify this association and investigate potential mechanisms.

Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators

BackgroundWhile functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one’s social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression.MethodsData come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent’s overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects.Results39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments.ConclusionsThat SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS.

Depression by gender and associated factors among older adults in India: implications for age-friendly policies

Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017–2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to examine our study objectives. Depression was reported in − 7.4% (95% CI 7.0, 7.8) of older men and 9.5% (CI 9.1, 10.0) of older women. Poor self-rated health, multimorbidity status, physical activity, difficulty in activities of daily living (ADL) and instrumental ADL (IADL) were the significant health-related factors associated with depression among older men and women. Not being satisfied with one’s life, not being satisfied with their present living arrangement, receiving any type of ill-treatment, and being widowed were the significant factors associated with depression among older men and women. We found gender disparity in self-reported depression. Marital status contributed-to 36.7% of the gender gap in depression among older adults. Additionally, ADL and IADL difficulties among men and women contributed to 17.6% and 34.0%, gender gap, self-rated health contributed to 18.8% gap, whereas not having equal social participation (4.4%) and not satisfied in present living arrangements (8.1%) were other factors that contributed to gender gap for depression in India. Depression is a critical and persistent public health problem among—older females in India. Our findings provide a broader framework for policymakers and health practitioners to focus on gender-specific strategies to mitigate this highly emergent problem.

Associations among body mass index, handgrip strength, and cognitive impairment in older men and women in India

BackgroundThis study examined the associations among body mass index (BMI), handgrip strength (HGS) and cognitive impairment among older adults in India. We also assessed whether these associations vary by gender. MethodsWe used data from baseline wave of the Longitudinal Aging Study in India (2017–18) with a sample of 31,464 adults age 60 and above. Cognitive impairment was assessed using different domains of cognition, including memory, orientation, arithmetic functioning, and visuospatial and constructional ability. We used multivariable logistic regression and interaction analyses to test the research hypotheses. ResultsOlder women had 2.25 times the odds of cognitive impairment than older men [AOR: 2.25; CI: 2.01–2.53]. The odds of cognitive impairment were 1.36 times among underweight older adults [AOR: 1.36; CI: 1.23–1.50], 0.72 times among overweight [AOR: 0.72; CI: 0.62–0.83], and 0.66 times among obese older adults [AOR: 0.66; CI: 0.51–0.84] compared to peers with normal BMI. Underweight women had 3.14 times the odds of being cognitively impaired [AOR: 3.14; CI: 2.67–3.68] compared to older men with normal BMI. Further, older men who were underweight and had a weak HGS had higher odds of cognitive impairment than older men with a normal BMI and strong HGS. Conversely, older women who were overweight or obese and had strong HGS reported lower odds of cognitive impairment than older women with normal BMI and strong HGS. ConclusionsThat the association between BMI and cognitive impairment differs between men and women and by HGS gives health care providers and practitioners additional information needed to identify groups of older adults most susceptible to cognitive impairment. In particular, gender specific policies and an assessment of HGS may be useful when crafting interventions to minimize the negative consequences of varying body types on later life cognitive function.

Ten-Year Risk for Developing Cardiovascular Disease Among Older Adults and Elderly in India: A Secondary Analysis of Wave-1 of Longitudinal Aging Study in India.

Background Cardiovascular disease (CVD) risk stratification is recommended by the World Health Organization (WHO) for effective CVD management in primary healthcare settings. Using the 2019 updated WHO CVD risk charts, we estimated the 10-year risk for developing fatal and non-fatal CVD among participants of the Longitudinal Aging Study in India (LASI). Methods We conducted secondary data analysis using the Wave-1 dataset of LASI. Analysis was performed in Stata software (version 14.1; StataCorp LLC, College Station, Texas) after applying sample weights. Ten-year CVD risk was estimated using a non-laboratory-based CVD risk chart. Logistic regression analysis was performed to determine the association between socio-demographic characteristics and 10% or more 10-year CVD risk. Results The weighted prevalence of 10% or more 10-year CVD risk was 24.70% (95% CI: 23.94%-25.47%). Participants who were currently working, living alone, and widowed had 3.63, 1.42, and 1.59 times increased odds of having a high 10-year CVD risk, respectively, after adjusting for other variables. Conclusion About a quarter of older adults and the elderly population in India have a 10-year risk for a fatal or non-fatal cardiovascular event of 10% or more, as estimated using a non-laboratory based chart.

The association between polluted fuel use and self-reported insomnia symptoms among middle-aged and elderly Indian adults: a cross-sectional study based on LASI, wave 1

BackgroundInsomnia predisposes the aging population to reduced quality of life and poor mental and physical health. Evidence of the association between polluted fuel use and insomnia symptoms is limited and is non-existent for the Indian population. Our study aimed to explore the link between polluted fuel use and insomnia symptoms in middle-aged and older (≥ 45 years) Indian populations.MethodsWe utilized data from nationally representative Longitudinal Aging Study in India (LASI) Wave 1. Participants with complete information on fuel use, insomnia symptoms, and covariates were included. Insomnia symptoms were indicated by the presence of at least one of three symptoms: difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), or early morning awakening (EMA), ≥ 5 times/week. Survey-weighted multivariable logistic regression analyses were conducted to evaluate the association between polluted fuel use and insomnia symptoms. We also assessed the interaction of association in subgroups of age, gender, BMI, drinking, and smoking status.ResultsSixty thousand five hundred fifteen participants met the eligibility criteria. Twenty-eight thousand two hundred thirty-six (weighted percentage 48.04%) used polluted fuel and 5461 (weighted percentage 9.90%) reported insomnia symptoms. After full adjustment, polluted fuel use was associated with insomnia symptoms (OR 1.16; 95%CI 1.08–1.24) and was linked with DIS, DMS, and EMA (OR 1.14; 95%CI 1.05–1.24, OR 1.12; 95%CI 1.03–1.22, and OR 1.15; 95%CI 1.06–1.25, respectively). No significant interactions for polluted fuel use and insomnia symptoms were observed for analyses stratified by age, sex, BMI, drinking, or smoking.ConclusionsPolluted fuel use was positively related to insomnia symptoms among middle-aged and older Indians. Suggestions are offered within this article for further studies to confirm our results, to explore underlying mechanisms, and to inform intervention strategies.

Explaining the Urban-Rural Difference in Late-Life Depression in India: Evidence from a Multivariate Decomposition Analysis Based on Longitudinal Aging Study in India, Wave 2017-18

ABSTRACT Objectives The study explored the associated factors of depression among older Indian adults and the influences of individual and socio-environmental factors in explaining the rural-urban difference in the prevalence of late-life depression. Methods Data come from the Longitudinal Aging Study in India, with a sample of 30,637 older adults aged 60 and above. Multivariable logistic regression and nonlinear multivariate decomposition analyses were conducted to fulfill the objectives. Results About 6.2% older adults in urban areas and 9.5% in rural areas were depressed. Older adults in rural areas had significantly higher likelihood to be depressed than those in urban areas. Poor self-rated health, multiple chronic conditions, functional difficulty, low life satisfaction, social inactivity, low satisfaction with living arrangement, ill-treatment and being widowed increased the risk of depression. Additionally, work status similar to urban older adults, physical activity, living arrangement satisfaction, self-rated health and ill-treatment would decrease the urban-rural difference in depression. Conclusions The study showed significant rural-urban difference in late-life depression, with a rural disadvantage. Clinical implications The findings suggest the need for identifying at-risk populations and developing a framework of targeted policy interventions for mitigating the increased risk of late-life depression among older Indians and in rural areas in particular.

Prevalence and determinants of hysterectomy in India

Increase in the prevalence of hysterectomy among low-and middle-income countries (LMICs) such as India has become a significant concern. Reports based on either a particular group or region show an increasing trend in hysterectomy, but there is a dearth of national-level data in this domain. Hence, there seems to be an urgent need to garner evidence on the prevalence and determinants of hysterectomy, which could pave the way for future programs and policies. We aimed to estimate the prevalence of hysterectomy and assess its determinants using a nationally representative sample. An observational analysis was conducted using data from Longitudinal Aging Study in India (LASI), 2017–2018. 38,154 women aged > 18 years were included. A multivariable logistic regression, presented as an adjusted odds ratio (AOR) with a 95% confidence interval (CI), was used to predict the association between various socio-demographic characteristics and hysterectomy. A separate multivariable logistic regression model was executed to determine the association between selected non-communicable diseases (NCDs) and hysterectomy. Survey weights compensated the complex study design. The overall prevalence of hysterectomy was around 11.35%. Excessive menstrual bleeding followed by fibroids emerged as the leading causes of hysterectomy. The various determinants of hysterectomy were urban residents [AOR: 1.54 (1.21–1.96)], other backward class [AOR: 2.19 (1.72–2.78], working women [AOR: 1.19(1–1.42)] and the most affluent (rich) group [AOR: 2.06 (1.62–2.63)]. Hysterectomy was associated with cancer [AOR: 4.83 (2.51–9.29)], diabetes [AOR: 1.79 (1.25–2.57)], hypertension [AOR: 1.48 (1.27–1.71)] and joint diseases [AOR: 1.43 (1.09–1.88)]. Hysterectomy is considerably prevalent in India, which cannot be overlooked. Health promotion regarding hysterectomy and its implications is needed especially among urban residents, affluent groups and those with a higher body mass index. Health programmes aimed at women should follow a life course approach by prioritizing health and overall well-being even after reproductive years.