Types of household headship and associated life satisfaction among older adults in India: findings from LASI survey, 2017-18

Subjective social status and socio-demographic correlates of perceived discrimination among older adults in India

BACKGROUND

Considering India's diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India.

METHODS

Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions.

RESULTS

39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination.

CONCLUSIONS

That low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health.

Gender differences in the association between physical frailty and life satisfaction among older adults in India

BACKGROUND

One of the sustainable development goals' (SDGs) primary goals (Goal 3) is to ensure healthy lives and promote well-being for persons of all ages. While extensive literature documents the link between physical frailty and low life satisfaction (LLS) among older adults, research of this nature is limited within low and middle-income countries including India. The purpose of this study was to examine the association between physical frailty and life satisfaction among community-dwelling older men and women in India.

METHODS

Data come from the 2017-18 wave 1 of the Longitudinal Ageing Study in India (LASI), with a sample of 30 390 individuals aged 60 and above (14 559 men and 15 831 women). Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. Ordered logistic regression models are employed to examine the association between physical frailty and life satisfaction.

RESULTS

The prevalence of frailty was higher in older women than men (32.2% vs. 27.5%). Nearly 30.4% of men and 33.8% of women reported having LLS. However, after adjusting for the selected confounders, women were less likely (adjusted odds ratio [aOR]: 0.92; CI: 0.87-0.97) to report LLS compared to men. The physically frail older adults were more likely (aOR: 1.40; CI: 1.27-1.55) to report LLS relative to their physically stronger counterparts. Moreover, we found that frail older men had higher odds of reporting LLS than non-frail older men (aOR: 1.25; CI: 1.09-1.43). Also, non-frail older women had lower odds of reporting LLS than non-frail older men (aOR: 0.80; CI: 0.67-0.95).

CONCLUSIONS

Findings of our study suggest that policies and programs to address later life well-being need to consider gender differences. Doing so would not only help identify older adults most at risk of LLS, but gender differentiated policies would help streamline health expenditures and costs typically relegated to assist all older adults without proper focus on the uniqueness of their social location.

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.

Living arrangement of Indian elderly: a predominant predictor of their level of life satisfaction

OBJECTIVE

This article aims to examine the level of life satisfaction (LS) among Indian older adults and to determine whether their living arrangement is one of the potential determinants of their level of LS.

METHODS

Data was drawn from the first and most recent wave of Longitudinal Ageing Study in India conducted in 2017-18. Using the Satisfaction with Life Scale, the level of LS was assessed for 30,370 elderly aged 60 + . Bivariate analysis was carried out to see the variation in the level of LS across elderlies with different socio-demographic characteristics. To investigate the association between LS and living arrangements and the selected socio-demographic factors multinomial logistic regression model was fitted.

RESULT

The findings reveal that 25.4% and 45.5% of the elderlies have reported having a low and high level of LS, respectively. Living alone was associated with low level of LS. Co-residing with a spouse was associated with a higher likelihood of reporting high level of LS. The study also found that having both spouse and children as coresident increases the likelihood of reporting high level of LS (RRR = 3.15, 95%CI = 2.3-4.28). Elderly with self-reported poor health, limitation in more than two activities of daily living and presence of depressive symptoms were significantly associated with reporting low level of LS. However, being diagnosed with more than three chronic illnesses was associated with high level of LS (RRR = 1.41, 95%CI = 1.25-1.59). Older adults with the following characteristics were more likely to report a lower level of LS: male, 60-64 years old, no or few years of schooling, unmarried, working, rural resident, living in a poor household, Scheduled Caste and Tribe.

CONCLUSION

The level of life satisfaction in Indian older adults is significantly associated with their living arrangements, thus suggesting that the LS of older adults could be facilitated through interventions that consider their living arrangements. Older adults with various personal and household characteristics were identified as vulnerable groups, who should be the prime targets of the existing welfare policies.

Socioeconomic and health-related inequalities in major depressive symptoms among older adults: a Wagstaff's decomposition analysis of data from the LASI baseline survey, 2017-2018

OBJECTIVES

To find out the association between socioeconomic and health status and depression among older adults and explore the contributing factors in the socioeconomic and health-related inequalities in late-life depression.

DESIGN

A cross-sectional study was conducted using large representative survey data.

SETTING AND PARTICIPANTS

Data for this study were derived from the baseline wave of the Longitudinal Ageing Study in India conducted during 2017-2018. The effective sample size was 30 888 older adults aged 60 years and above.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome variable in this study was depression among older adults. Descriptive statistics along with bivariate analysis was conducted to report the preliminary results. Multivariable binary logistic regression analysis and Wagstaff's decomposition were used to fulfil the objectives of the study.

RESULTS

There was a significant difference for the prevalence of depression (4.3%; p<0.05) among older adults from poor (11.2%) and non-poor categories (6.8%). The value of the Concentration Index was -0.179 which also confirms that the major depression was more concentrated among poor older adults. About 38.4% of the socioeconomic and health-related inequality was explained by the wealth quintile for major depression among older adults. Moreover, about 26.6% of the inequality in major depression was explained by psychological distress. Self-rated health (SRH), difficulty in activities of daily living (ADL) and instrumental ADL (IADL) contributed 8.7%, 3.3% and 4.8% to the inequality, respectively. Additionally, region explained about 23.1% of inequality followed by life satisfaction (11.2) and working status (9.8%) for major depression among older adults.

CONCLUSIONS

Findings revealed large socioeconomic and health-related inequalities in depression in older adults which were especially pronounced by poor household economy, widowhood, poor SRH, ADL and IADL difficulty, and psychological distress. In designing prevention programmes, detection and management of older adults with depression should be a high priority, especially for those who are more vulnerable.