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Pai M, Muhammad T. Separate and combined associations of cognitive impairment and body pain with functional and mobility disabilities among older women and men in India. Geriatr Nurs 2024; 59:463-470. [PMID: 39146637 DOI: 10.1016/j.gerinurse.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 07/16/2024] [Accepted: 08/05/2024] [Indexed: 08/17/2024]
Abstract
This study examined the separate and combined associations of cognitive impairment and body pain with functional and mobility disabilities (FMDs) among older women and men in India. Multivariable linear regression models were applied using data from the Longitudinal Aging Study in India (2017-18) comprising 31,464 adults aged 60+. Older adults with cognitive impairment and pain reported higher levels of FMDs than peers without any pain and cognitive impairment. The likelihood of FMDs was significantly greater among older Indians enduring both cognitive impairment and pain (p < 0.05). Moreover, the association between cognitive impairment and functional disability was noticeably stronger in older women, particularly those with frequent pain, while the link between cognitive impairment and mobility disability was more pronounced in men with pain. Integrated cognitive rehabilitation and pain management programs, along with guided physical therapy, gender-specific support groups, and community-based health promotion activities, should be considered to reduce FMDs in older Indians.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH 44242, USA.
| | - T Muhammad
- Center for Healthy Aging, Pennsylvania State University, University Park, PA 16802, USA.
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Singh S, Goodwin S, Zhong S, Avan A, Rogers K, Hachinski V, Frisbee S. Inequalities in health-related quality of life and functional health of an aging population: A Canadian community perspective. PLoS One 2024; 19:e0304457. [PMID: 38968188 PMCID: PMC11226017 DOI: 10.1371/journal.pone.0304457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/13/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Reducing health inequalities among older adults is crucial to ensuring healthy aging is within reach for all. The current study provides a timely update on demographic- and geographic-related inequalities in healthy aging among older adults residing in Canadian communities. METHODS Data was extracted from the Canadian Health Survey on Seniors [2019-2020] for ~6 million adults aged 65 years and older residing in 10 provinces of Canada. Healthy aging was defined by two indices: 1] health-related quality of life and 2] functional health. Poisson regression models and spatial mapping were used to demonstrate inequalities among age, race, and sex categories, and health regions. RESULTS Approximately 90.3% of individuals reported less than perfect quality of life and 18.8% reported less than perfect functional health. The prevalence of less than perfect quality of life was higher for females [PR 1.14, 95% CI;1.02-1.29] and for older adults aged ≥80 years as compared to males and older adults aged ≤79 years [PR 1.66, 95% CI;1.49-1.85]. Similarly, the prevalence of less than perfect functional health was higher for females [PR 1.58, 95% CI;1.32-1.89] and for older adults aged ≥80 years [PR 2.71, 95% CI;2.59-2.84]. Spatial mapping showed that regions of lower quality of life were concentrated in the Prairies and Western Ontario, whereas regions of higher quality of life were concentrated in Quebec. CONCLUSIONS Amongst older individuals residing in Canadian communities, less than perfect quality of life and functional health is unequally distributed among females, older adults aged ≥80 years, and those residing in the Prairie regions specifically. Newer policy should focus on interventions targeted at these subpopulations to ensure that healthy aging in within reach for all Canadians.
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Affiliation(s)
- Sarah Singh
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Shane Goodwin
- Department of Sociology, University of Western Ontario, London, Ontario, Canada
| | - Shiran Zhong
- Department of Geography, University of Western Ontario, London, Ontario, Canada
| | - Abolfazl Avan
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Kem Rogers
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Vladimir Hachinski
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, and Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Stephanie Frisbee
- Department of Pathology & Laboratory Medicine, and Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Vennu V. Association between chronic disease, sensory impairment, walking limitation, and activities of daily living of community-dwelling older Indians. Medicine (Baltimore) 2024; 103:e37318. [PMID: 38428896 PMCID: PMC10906618 DOI: 10.1097/md.0000000000037318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/30/2024] [Indexed: 03/03/2024] Open
Abstract
Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34-1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70-2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82-2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15-1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42-1.65, P < .0001; aOR = 1.27, 95% CI = 1.17-1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.
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Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Rashmi R, Mohanty SK. Socioeconomic and geographic variations of disabilities in India: evidence from the National Family Health Survey, 2019-21. Int J Health Geogr 2024; 23:4. [PMID: 38369479 PMCID: PMC10874552 DOI: 10.1186/s12942-024-00363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/09/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Increasing disability is of global and national concern. Lack of evidence on disability across socioeconomic groups and geographic levels (especially small areas) impeded interventions for these disadvantaged subgroups. We aimed to examine the socioeconomic and geographic variations in disabilities, namely hearing, speech, visual, mental, and locomotor, in Indian participants using cross-sectional data from the National Family Health Survey 2019-2021. METHODS Using data from 27,93,971 individuals, we estimated age-sex-adjusted disability rates at the national and sub-national levels. The extent of socioeconomic variations in disabilities was explored using the Erreygers Concentration Index and presented graphically through a concentration curve. We adopted a four-level random intercept logit model to compute the variance partitioning coefficient (VPC) to assess the significance of each geographical unit in total variability. We also calculated precision-weighted disability estimates of individuals across 707 districts and showed their correlation with within-district or between-cluster standard deviation. RESULTS We estimated the prevalence of any disability of 10 per 1000 population. The locomotor disability was common, followed by mental, speech, hearing, and visual. The concentration index of each type of disability was highest in the poorest wealth quintile households and illiterate 18 + individuals, confirming higher socioeconomic variations in disability rates. Clusters share the largest source of geographic variation for any disability (6.5%), hearing (5.8%), visual (24.3%), and locomotor (17.4%). However, States/Union Territories (UTs) account for the highest variation in speech (3.7%) and mental (6.5%) disabilities, where the variation at the cluster level becomes negligible. Districts with the highest disability rates were clustered in Madhya Pradesh, Maharashtra, Karnataka, Tamil Nadu, Telangana, and Punjab. Further, we found positive correlations between the district rates and cluster standard deviations (SDs) for disabilities. CONCLUSIONS Though the growing disability condition in India is itself a concerning issue, wide variations across socioeconomic groups and geographic locations indicate the implementation of several policy-relevant implications focusing on these vulnerable chunks of the population. Further, the critical importance of small-area variations within districts suggests the design of strategies targeting these high-burden areas of disabilities.
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Affiliation(s)
- Rashmi Rashmi
- Department of Population and Development, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Sanjay K Mohanty
- Department of Population and Development, International Institute for Population Sciences, Mumbai, 400088, India
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Rana MS, Alam MB, Khanam SJ, Kabir MI, Khandaker G, Khan MN. Prevalence and patterns of comorbidities in people with disabilities and their associated socio-demographic factors. Sci Rep 2024; 14:1425. [PMID: 38228776 PMCID: PMC10791601 DOI: 10.1038/s41598-024-51678-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/08/2024] [Indexed: 01/18/2024] Open
Abstract
The presence of comorbidities among individuals with disabilities worsens their already complex health and social circumstances. This study aims to explore prevalence and patterns of morbidities among persons with disabilities in Bangladesh and identify associated socio-demographic factors. Data from 4270 persons with disability was analysed extracted from the 2021 Bangladesh National Household Survey on Persons with Disability. Outcome variable considered was the occurrence of morbidity among persons with disabilities. Explanatory variables encompassed factors at the individual, household, and community levels. Adjusted and unadjusted multilevel mixed-effects logistic regression model was used to explore association of outcome variable with explanatory variables. We found that approximately half of individuals with disabilities experienced one or more morbidities, with chronic conditions being the most prevalent (44%). Around 42% of total persons with disability were unable to work. Specifically, hypertension (18.3%), diabetes (9.1%), and heart problems (17.1%) were prevalent chronic conditions. The likelihood of experiencing comorbidity was found to be higher among females (aOR 1.3, 95% CI 1.1, 1.7), increase year of education (aOR, 1.1, 95% CI 1.0-1.2), and those from wealthier households (aOR 1.6, 95% CI 1.2, 2.2). This underscores the need for targeted policies and interventions addressing their distinct healthcare needs.
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Affiliation(s)
- Md Shohel Rana
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Md Badsha Alam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Shimlin Jahan Khanam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
| | - Md Iqbal Kabir
- Climate Change and Health Promotion Unit (CCHPU), Health Services Division, Ministry of Health and Family Welfare, Topkhana Road, Dhaka, 1000, Bangladesh
- Department of Disaster Science and Climate Resilience, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Gulam Khandaker
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh.
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Wang J, Zhou Y, Zhang Q, Li J, Zhai D, Li J, Han B, Liu Z. Loneliness among older Chinese individuals: the status quo and relationships with activity-related factors. BMC Geriatr 2024; 24:42. [PMID: 38200432 PMCID: PMC10782757 DOI: 10.1186/s12877-023-04611-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND With the rapid population aging, healthy aging has become a concern for society as a whole. In this study, loneliness and its relationships with activity-related individual factors were examined among older Chinese individuals from the perspective of mental health and daily leisure activities. METHODS The data were from the fourth investigation of the Sample Survey of the Aged Population in Urban and Rural China, which had a total of 220,506 participants. Activity ability was assessed by the Barthel Activity of Daily Living Index, a self-designed activity type questionnaire was used to evaluate activity participation, and loneliness was measured with a single-item question. RESULTS The prevalence of varying degrees of loneliness among Chinese older individuals was 36.6%. The prevalence of loneliness among the older individuals differed significantly by age gender, age, physical health status, annual household income, education level, marital status, living status, ethnic minority status, religious faith and territory of residence. There were differences in activity participation among older Chinese adults in terms of all the demographic factors mentioned above, while there were no significant differences in living status or religious faith, and significant differences in several other demographic factors in terms of activity ability. Self-care ability, as a form of activity ability, and activity participation significantly predicted loneliness among the older participants. CONCLUSION The topic of loneliness among Chinese older individuals is complex and requires greater attention. The buffering effect of activity-related factors on loneliness suggests that old people should improve their activity ability and participate more in daily activities.
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Affiliation(s)
- Jiazhou Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, 100101, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, 100049, Beijing, China
| | - Yueyue Zhou
- Department of Psychology, Henan University, 475004, Kaifeng, China
| | - Qiuxia Zhang
- China Research Center on Aging, 100011, Beijing, China
| | - Jing Li
- China Research Center on Aging, 100011, Beijing, China
| | - Dehua Zhai
- China Research Center on Aging, 100011, Beijing, China
| | - Jia Li
- China Research Center on Aging, 100011, Beijing, China
| | - Buxin Han
- CAS Key Laboratory of Mental Health, Institute of Psychology, 100101, Beijing, China.
- Department of Psychology, University of Chinese Academy of Sciences, 100049, Beijing, China.
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, 100101, Beijing, China.
- Department of Psychology, University of Chinese Academy of Sciences, 100049, Beijing, China.
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Vijayan B, Govil D, Sahoo H. Effect of Autonomy and Physical Activity on Self-Rated Health of Older Adults in India: Gendered Analysis Using Structural Equation Models. Exp Aging Res 2023:1-18. [PMID: 37953538 DOI: 10.1080/0361073x.2023.2278982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023]
Abstract
The gendered expectations and responsibilities placed upon women can impede their ability to participate in social activities and engage in physical leisure pursuits, ultimately having a negative impact on their health. Our study investigates the mechanisms through which gender influences individuals' engagement with physical activity during free time and how this relates to self-rated health outcomes among adults aged 45 years or older living in India. Using cross-sectional analysis and Structural Equation Modelling, we analyzed data stratified by gender and age from the Longitudinal Ageing Study of India to examine these conceptual pathways. We found that compared to men, women face greater limitations related to decision-making autonomy, experience more functional impairments, have weaker social networks that provide less support for engaging in leisure-time physical activity, leading them to report lower levels of overall wellbeing than men. Further analyses demonstrated distinct pathways through which each gender's level of social network connectivity shapes behavior - strong connections increase opportunities for women specifically to engage positively with both peers and physically active pursuits supporting overall wellness goals.
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Affiliation(s)
- Bevin Vijayan
- School of Development, Azim Premji University, Bhopal, India
| | - Dipti Govil
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
| | - Harihar Sahoo
- Department of Family and Generations, International Institute for Population Sciences, Deonar, Mumbai, India
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Dakua M, Karmakar R, Lhungdim H. Social capital and well-being of the elderly 'left-behind' by their migrant children in India. BMC Public Health 2023; 23:2212. [PMID: 37946157 PMCID: PMC10636804 DOI: 10.1186/s12889-023-17012-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The study aims to examine the association between individual forms of social capital and the well-being of the elderly 'left-behind' parents and to determine if there is a gender difference within the possible relationship. METHODS This study applied the first wave of the Longitudinal Ageing Study in India (LASI, 2017-18) data. In this study, the respondents were 4,736 older parents 'left-behind' by their migrant adult sons. We employed descriptive statistics and bivariate analysis to assess the study sample's characteristics. The proportion test was performed to examine if there was a significant gender difference among older adults regarding depression, ADL, and IADL impairments. In addition, binary logistic regression was utilized to investigate the associations between social capital and elderly parents' health outcomes. RESULTS This study found a significant gender difference in depression (male: 8.26%; female:11.32%; P < 0.001), ADL (male:20.23%; female:25.75%; P = 0.032), and IADL (male: 33.97% female: 54.13%; P < 0.001) limitations. Elderly parents who did not participate in any social activity had a higher odd of ADL (aOR: 2.44; 95%CI: 1.882-3.171; P = < 0.001) and IADL (aOR: 1.22; 95%CI: 1.034-1.766 ; P = < 0.001) limitations. Networking with friends through phone/email conversations has a substantial impact on lowering depression in older parents. Older adults with good personal social capital were less likely to have depression, ADL, and IADL limitations. CONCLUSION Personal social capital is closely associated with the well-being of left-behind older parents. More efforts should be in place to increase the stock of social capital in this group with focused gender disparity.
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Affiliation(s)
- Manoj Dakua
- International Institute for Population Sciences, Mumbai, 400088, India.
| | - Ranjan Karmakar
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Hemkhothang Lhungdim
- Department of Public Health and Mortality studies, International Institute for Population Sciences, Mumbai, 400088, India
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Pai M, Muhammad T. Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators. BMC Geriatr 2023; 23:685. [PMID: 37872470 PMCID: PMC10591391 DOI: 10.1186/s12877-023-04380-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND While 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. METHODS Data 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. RESULTS 39.11% 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. CONCLUSIONS That 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.
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Affiliation(s)
- Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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Mandi R, Bansod DW, Goyal AK. Exploring the association of lifestyle behaviors and healthy ageing among the older adults in India: evidence from LASI survey. BMC Geriatr 2023; 23:675. [PMID: 37853323 PMCID: PMC10585826 DOI: 10.1186/s12877-023-04367-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Understanding 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. METHODS Based 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. RESULT The 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). CONCLUSION This 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.
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Affiliation(s)
- Raghunath Mandi
- International Institute for Population Sciences (IIPS), Mumbai, 400088, India.
| | - Dhananjay W Bansod
- Dept. of Public Health and Mortality Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088, India
| | - Amit Kumar Goyal
- International Institute for Population Sciences (IIPS), Mumbai, 400088, India
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Haghighatfard P, Rezapour A, Khoramrooz M, Eisavi M, Khosravi A. Factors Explaining the Change in Socioeconomic Inequality of Disability in Iran: A Repeated Cross-sectional Study. Med J Islam Repub Iran 2023; 37:90. [PMID: 37750096 PMCID: PMC10518069 DOI: 10.47176/mjiri.37.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Indexed: 09/27/2023] Open
Abstract
Background More than 15% of the world's population live with some form of disability. Assessing socioeconomic inequalities in disability and monitoring its change over time can help policymakers to design and implement targeted interventions to reduce these inequalities. This study aimed to assess the change in socioeconomic inequality in disability in Iran from 2000 to 2010. Methods Data for this cross-sectional study were obtained from 2 waves of Iran's demographic and health surveys (2000 and 2010). The Wagstaff normalized concentration index was used to measure the socioeconomic inequality of disability. Contributing factors to the inequality in 2000 and 2010 were investigated by concentration index decomposition. The Blinder-Oaxaca decomposition method was used to determine contributing factors of change in disability inequality. All analyses were conducted in Stata14. Results The negative and statistically significant concentration indices (-0.132 in 2000 and -0.165 in 2010, P < 0.001) suggested more concentration of disability among poor people. The absolute value of inequality was increased by 0.034 between the 2 points of time (P = 0.025). Level of education (123.5%), household size (12.9%), age (-35.1%), and residency (in terms of Iran's provinces) (-19.3%) were the contributing factors to the measured disability inequality in 2000. In 2010, level of education (105.8%), household size (30.5%), and urban residency (-46.3%) explained the measured inequality. Change in disability inequality was explained by household size (99.4%), province of residence (54.8%), education (36.9%), socioeconomic status (20%), urban residency (-90.3%), and age (-47.7%). Conclusion Iran suffers from significant socioeconomic inequality in disability, and it significantly increased over time. Interventions such as increasing health literacy and providing suitable job opportunities for people with low education level, improving the socioeconomic status of extended households, and paying more attention to the balanced development in the provinces and urban and rural areas, and attending to prevention, treatment, and mitigation of disability adversities among poor young and elderly people could be recommended to tackle increased socioeconomic inequality in disability and its unfavorable consequences in Iran.
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Affiliation(s)
- Payam Haghighatfard
- Department of Health Economics, School of Health Management and
Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of
Medical Sciences, Tehran, Iran
| | - Maryam Khoramrooz
- Department of Health Management and Economics, School of Public Health,
Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan
University of Medical Sciences, Hamadan, Iran
| | - Mahmoud Eisavi
- Faculty of Economics, Allameh Tabataba'i University, Tehran, Iran
| | - Ardeshir Khosravi
- Deputy for Public Health, Iranian Ministry of Health and Medical
Education, Tehran, Iran
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Coste J, Pérès K, Robine JM, Carcaillon-Bentata L. Dimensionality and invariance of ADL, IADL, BI-M2/WG-SS, and GALI in large surveys in France (2008-2014) and implications for measuring disability in epidemiology. Arch Public Health 2023; 81:141. [PMID: 37544985 PMCID: PMC10405560 DOI: 10.1186/s13690-023-01164-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 07/27/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND The epidemiological investigation and surveillance of disability requires well-constructed, invariant, and, if possible, exchangeable measures. However, the current or recommended measures have not been thoroughly investigated with respect to these issues. Here we examined the dimensional structure and invariance of four measures across sociodemographic groups: Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Budapest Initiative Mark 2 (BI-M2) and Washington Group on Disability Statistics Short Set (WG-SS), and Global Activity Limitation Indicator (GALI). METHODS We used data from three large nationwide representative surveys conducted in France between 2008 and 2014. The surveys included these four measures and classical and modern approaches (correlations, principal component analysis, Rasch modeling) were used to assess their dimensional structure as well as their invariance through differential item functioning (DIF) for sociodemographic characteristics. Polytomous logistic regression models were used to assess gradients in health inequalities associated with these measures. RESULTS For many items of ADL, IADL, and BI-M2/WG-SS, we consistently observed disordered response thresholds, rejection of unidimensionality, and DIF evidence for sociodemographic characteristics across the survey samples. Health inequality gradients were erratic. In addition, it was impossible to identify a common continuum for GALI, ADL, IADL, and BI-M2/WG-SS or their constituent items. CONCLUSION This study warns against the current practice of investigating disability in epidemiology using measures that are unsuitable for epidemiological use, incommensurable, and inadequate regarding the basic requisites of dimensionality and invariance. Developing invariant measures and equating them along a common continuum to enlarge the common bases of measurement should therefore be a priority.
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Affiliation(s)
- Joël Coste
- Santé publique France (French national public health agency), Saint-Maurice, France.
| | - Karine Pérès
- University of Bordeaux, INSERM, Bordeaux Population Health, U1219, Bordeaux, France
| | - Jean-Marie Robine
- 3MMDN, University of Montpellier, EPHE, INSERM, Montpellier, France
- PSL Research University, Paris, France
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Krenz A, Strulik H. Physiological aging in India: The role of the epidemiological transition. PLoS One 2023; 18:e0287259. [PMID: 37467173 PMCID: PMC10355452 DOI: 10.1371/journal.pone.0287259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/02/2023] [Indexed: 07/21/2023] Open
Abstract
We construct a cohort-based frailty index from age-related health deficits to investigate physiological aging in India over the period 1990-2019. During this period, the Indian states underwent at different speeds the epidemiological transition and experienced unprecedented economic growth. We show that the rate of physiological aging remained remarkably stable to the changing environment. Age-related health deficits increased by about 3 percent per year of age with little variation across states, ages, cohorts, and over time. We find that, with advancing epidemiological transition, health deficits for given age declined at the individual level (within states and within cohorts). Across cohorts born between 1900 and 1995, we show that, for given age, health deficits are higher for later-born cohorts until birth years around 1940 and remained trendless afterwards. We propose a selection-based theory of aging during the epidemiological transition that explains these facts.
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Affiliation(s)
- Astrid Krenz
- Department of Management and Economics, Center for Entrepreneurship, Innovation and Transformation (CEIT), Ruhr University Bochum, Bochum, Germany
| | - Holger Strulik
- Department of Economics, University of Göttingen, Göttingen, Germany
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Halder M, Saha J, Roy A, Roy D, Chouhan P. Functional disability and its associated factors among the elderly in rural India using LASI Wave 1 data. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
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15
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Back to Basics: The Role of Living Arrangement on Self-Reported Morbidity Among Older Adults in India. AGEING INTERNATIONAL 2023. [DOI: 10.1007/s12126-023-09517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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16
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Nguyen VC, Moon S, Oh E, Hong GRS. Factors Associated With Functional Limitations in Daily Living Among Older Adults in Korea: A Cross-Sectional Study. Int J Public Health 2022; 67:1605155. [PMID: 36570875 PMCID: PMC9780261 DOI: 10.3389/ijph.2022.1605155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Objective: This paper assesses the relationship between demographics, health parameters, and functional limitations among older adults in Korea, including limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Methods: We analyzed data from the Korean Longitudinal Study of Aging survey in 2020 and included only participants aged 65 and older. Multinomial logistic regression models were conducted to evaluate the factors that predicted functional limitations. Results: The prevalence of at least one ADL and IADL limitations were 6.14% (severe 1.94% and moderate 4.20%) and 15.49% (severe 3.11% and moderate 12.38%), respectively. People aged 85 and older had high rates of severe disability with 7.37% for ADLs and 12.06% for IADLs. High rates also occurred among people with low education, underweight, physical inactivity, depression, and three or more chronic diseases. Conclusion: Factors associated with functional limitations were age, educational status, body mass index, physical activity, depression, and chronic diseases. To prevent and improve functional limitations in the older populations, active and applicable interventions should be considered for modifiable factors such as physical activity, depression, and abnormal weight.
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Affiliation(s)
| | - SeolHawa Moon
- Research Institute of Nursing Science, Hanyang University, Seoul, South Korea
| | - Eunmi Oh
- Research Institute of Nursing Science, Hanyang University, Seoul, South Korea
| | - Gwi-Ryung Son Hong
- College of Nursing, Hanyang University, Seoul, South Korea,*Correspondence: Gwi-Ryung Son Hong,
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17
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Malik MA. Functional disability among older adults in India; a gender perspective. PLoS One 2022; 17:e0273659. [PMID: 36103480 PMCID: PMC9473438 DOI: 10.1371/journal.pone.0273659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 08/14/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Older adults are always at a greater risk of physical and functional health challenges. These complications result into morbidity, disability and death making them more vulnerable at later ages. Therefore, this paper will examine the functional health status among older adults and its gender perspective, along with associated risk factors. Materials and methods Using the first round of Longitudinal ageing survey of India (2017–18). Functional disability was computed based on general and instrumental activities of daily living (ADL and IADL) (n = 20910). Functional disability was coined with individual having at least one of the limitations of these activities. Applying bivariate and multivariate analysis the present paper studied the association, gender perspective and risk factors of functional disability among older adults aged 50 and above in India. Results Our results clearly showed the gender bias in functional disability, with greater proportion of women (52%) at risk for functional disability then men (35%). Factors like multimorbidity, depression and life satisfaction are key risk factors identified by this study that increase the likelihood of disability. Conclusion Functional disability is key to healthy ageing and needs immediate attention given its greater concentration among the elderly, particularly women. The results reflect the substantial burden of functional disability than self-care among older adults in India and therefore indicates some significant policy interventions to reduce the likely impact of functional disability.
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Affiliation(s)
- Manzoor Ahmad Malik
- Research Fellow Department of Humanities and Social Sciences, Indian Institute of Technology (IIT), Roorkee, Haridwar, India
- * E-mail:
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Yu C, Liang H, Wang B, Liang F, Liu E, Xiang N. The association between reproductive history and the multidimensional health of older adults in rural China and its gender differences: Evidence from the Chinese longitudinal healthy longevity survey. Front Public Health 2022; 10:952671. [PMID: 35968445 PMCID: PMC9364953 DOI: 10.3389/fpubh.2022.952671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFew studies have examined the association between reproductive history and the multidimensional health of older adults with more diverse reproductive histories and poorer health status in rural China. The purpose of this study is to explore the effect of parity, sex ratio of children and late childbearing on multidimensional health and its gender differences.MethodsThe analytical sample consisted of 3,377 older adults in rural China who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. Linear regression models were applied to estimate the relationship between reproductive history and multidimensional health, with separate models for each indicator of health outcomes.ResultsOlder adults in rural areas with greater parity were more likely to have better cognitive function (β = 0.409, 95% CI: 0.255–0.563), fewer Activities of Daily Living (ADL) limitations (β = −0.085, 95% CI: −0.137 to −0.034) and symptoms of depression (β = −0.396, 95% CI: −0.577 to −0.216). The social mechanism of intergenerational support from children later in life partly explained the positive effect of parity. Late childbearing had negative effects on cognitive function (β = −1.220, 95% CI: −1.895 to −0.545), ADL (β = 0.253, 95% CI: 0.028–0.478) and symptoms of depression (β = 1.025, 95% CI: 0.237–1.812). Women were more likely to be influenced by the positive effect of parity; the association between late childbearing and health was only significant in the male group.ConclusionsParity and late childbearing are associated with cognitive function, activities of daily living, and symptoms of depression in the older adults in rural China. Older adults with more children might be in better health, and this finding is especially significant in women. However, late childbearing had a negative effect on multidimensional health, especially for men. The social mechanism and gender differences between reproductive history and health need to be further explored.
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Affiliation(s)
- Changyong Yu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hang Liang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Boyu Wang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Fei Liang
- Policy Research Center, Ministry of Civil Affairs of China, Beijing, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, School of Public Finance and Taxation, Zhongnan University of Economics and Law, Wuhan, China
- *Correspondence: Erpeng Liu
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
- Nan Xiang
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Khenduja P, Sabharwal M. Repercussion of Covid-19 on Health and Nutritional Status of Elderly: Current Scenario. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Ageing is an inevitable process with numerous changes in a physiological, biological, cognitive, and social environment. The COVID-19 pandemic has posed an unprecedented public health crisis globally. Both the problems adversely affect the nutritional and health status of the elderly. Malnutrition, increase risk of chronic morbidities, low socioeconomic status along with social deprivations influence the health and well-being of old age. Lack of physical activity is common due to loss of skeletal muscle mass and an increase of fat mass eventually causes functional inability. The review aimed to report the impact of Covid-19 on the health and nutritional status of the elderly. A thorough recent literature search was conducted using PubMed, Science Direct, and Google Scholar databases using specific keywords related to the aims. All related articles published on COVID-19 during 2020 and their effect on health and nutrition in the elderly were retrieved. The study found that nutritional status influences mortality and co-morbidities among the elderly during the COVID-19 situation. Furthermore, the study found that though nutritional indicators, that is, overweight or obese, significantly increase the risk of co-morbid conditions among older adults, good nutrition reduces the risk of all-cause mortality. Although ageing is an irreversible process, it is never too late to start practicing a healthy behavioral lifestyle for achieving healthy ageing.
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Chauhan S, Kumar S, Bharti R, Patel R. Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India. BMC Geriatr 2022; 22:64. [PMID: 35045809 PMCID: PMC8772104 DOI: 10.1186/s12877-021-02659-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/23/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The increase in life expectancy has proliferated the number of elderly and subsequently increased the prevalence of disability among the elderly. This study assesses the prevalence of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) and analyzes determinants of ADL and IADL among elderly aged 60 and over living in India. METHODS The study utilized the Longitudinal Ageing Study in India (LASI, 2017-18) data, and information was sought from 31,464 elderly aged 60 years and above. An index of ADL and IADL was created on a scale of three levels, exhibiting no, moderate, or severe levels of ADL/IADL disability. Multinomial logistic regression was used to determine the effect of socio-demographic parameters on ADL and IADL disability among the elderly. RESULTS Around 3% of the elderly reported severe ADL disability, and 6% elderly reported severe IADL disability. Elderly who were not involved in any physical activity than their counterparts were more likely to report severe ADL (RRR = 2.68, C.I. = 1.66-4.32) and severe IADL (RRR = 2.70, C.I. = 1.98-3.67) than no ADL and no IADL, respectively. CONCLUSION Amidst the study finding, the study emphasizes the importance of setting-up of geriatric care centers in rural and urban areas. It would be feasible to provide geriatric care under the umbrella of already functioning government health facilities in different parts of the country. Community interventions earmarking the elderly with a focus on physical activity, specifically based in group physical exercise and implemented through existing networks, are rewarding for the elderly.
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Affiliation(s)
- Shekhar Chauhan
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shubham Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, India
| | - Rupam Bharti
- District Information and data Manager (DIDM)- Monitoring, Evaluation, & Learning, Social & Economic Empowerment, Jaipur, Rajasthan, 302015, India
| | - Ratna Patel
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
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