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Pengpid S, Peltzer K. Rural-urban health differences among aging adults in India. Heliyon 2024; 10:e23397. [PMID: 38173538 PMCID: PMC10761573 DOI: 10.1016/j.heliyon.2023.e23397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/08/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Background The aim of this study was to determine the rural-urban health differences among aging adults in India. Methods The national cross-sectional data of 67,489 individuals (≥45 years) in 2017-2018 from 35 states and union territories of India (excluding Sikkim) in 2017-2018 were analysed. Various sociodemographic data, well-being indicators, lifestyle factors and physical conditions were assessed by face-to-face interviews and physical measurement. Univariable and multivariable logistic regression was utilized to assess the predictors between residence status (rural dweller, urban migrant, and urban dweller) and various health indicator outcomes. Results Majority (70.4 %) of the participants lived in rural areas, 10.3 % were urban migrants and 19.3 % urban dwellers. In the multivariable logistic regression analysis, urban migrants and urban dwellers had a higher self-rated health status, cognitive functioning, physical inactivity, overweight or obesity and abdominal obesity than rural dwellers, while urban migrants and/or urban dwellers had lower functional disability, insomnia symptoms, current smokeless tobacco use, current smoking, heavy episodic drinking and underweight than rural dwellers. Furthermore, urban migrants and/or urban dwellers had higher odds of diabetes, hypertension, heart disease, cancer, high cholesterol than rural dwellers, while urban migrants and/or urban dwellers had lower odds of persistent headaches, major injury, recurrent fall, physical pain, periodontal disease, vision impairment, and gastrointestinal problems than rural dwellers. Conclusion Among 30 health indicators assessed, 16 had an urban migrant and/or urban dweller advantage, 8 had urban migrant and/or urban dweller penalty, and 6 did not differ between rural-urban groups. Public health promotion and health care should address differing health care needs of rural and urban middle-aged and older adults.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Muhammad T. Life course rural/urban place of residence, depressive symptoms and cognitive impairment among older adults: findings from the Longitudinal Aging Study in India. BMC Psychiatry 2023; 23:391. [PMID: 37268912 DOI: 10.1186/s12888-023-04911-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/29/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Given the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms 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. METHODS Utilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults. RESULTS Childhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05-1.80] but not men. Childhood [aOR: 1.88, CI: 1.16-3.04], adulthood [aOR: 2.00, CI: 1.26-3.16] and current rural residence [aOR: 1.93, CI: 1.27-2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 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 depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -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 an urban advantage in cognitive function among older adults. CONCLUSIONS This study showed significant associations between life-course residence and depressive symptoms 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 in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. 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.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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Muhammad T, Srivastava S, Debnath P, Kumar P, Kumar M. Does tandem balance test predict cognitive impairment among older adults? Findings from Longitudinal Ageing Study in India, 2017-18. Aging Clin Exp Res 2023; 35:855-865. [PMID: 36757673 DOI: 10.1007/s40520-023-02359-1] [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: 12/17/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Ageing entails a decline in physical and functional abilities including a reduced body balance due to complex integration and coordination of sensory acuity, motor control, neural and cognitive functions. This study aimed to examine the association between tandem balance test and cognitive impairment among older Indian adults. The study also examined the gender differentials in the associations with an interaction analysis. METHODS Data for this study were drawn from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the present study included 26,539 older adults age 60 years and above. Descriptive statistics and bivariate analysis were used to present the preliminary results. Two sample proportion test was used to evaluate the significance for gender differences. Further, multivariable binary logistic regression analysis was used to evaluate the independent association of balance test performance and cognitive impairment among older adults. RESULTS Nearly 16% of male and 26% of female older adults could not finish full tandem test in this study. There were significant gender differences in cognitive impairment among older adults (male-6.5% and female-18.9%). The likelihood of cognitive impairment was significantly higher among older adults who could not finish the full tandem test compared to those who finished the tandem test [AOR: 1.22; CI: 1.09-1.36]. The interaction model revealed that older females who could not finish the full tandem test were 2.11 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.11; CI: 1.81,2.45]. Similarly, older females who finished the full tandem test were 2.42 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.42; CI: 2.02,2.88]. CONCLUSION The findings of the study suggest that healthcare professionals working with older adults should consider the results of a balance test to screen for their risk of cognitive impairment. Results from the relationship between failing to finish the tandem test and cognitive impairment may be helpful for identifying older men and women who are at higher risk of experiencing mobility decline and their progression to dementia.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, Maharashtra, India.
| | | | | | | | - Manish Kumar
- Population Research Centre (PRC), Dharwad, India
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Pengpid S, Peltzer K. Food insecurity and health outcomes among community-dwelling middle-aged and older adults in India. Sci Rep 2023; 13:1136. [PMID: 36670204 PMCID: PMC9859825 DOI: 10.1038/s41598-023-28397-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
The study assessed associations between food insecurity and mental, physical, and behavioural health outcomes in India. The study analysed national cross-sectional population-based data (N = 72,262; ≥ 45 years) from in India in 2017-2018. The overall prevalence of food insecurity was 9.7%. Food insecurity was significantly positively associated with poor mental health [low life satisfaction (AOR: 2.75, 95% CI 2.35-3.23), low self-reported health (AOR: 1.61, 95% CI 1.11-1.42), insomnia symptoms (AOR: 1.64, 95% CI 1.45-1.85), depressive symptoms (AOR: 2.21, 95% CI 1.97-2.48), major depressive disorder (AOR: 2.37, 95% CI 2.03-2.77), Alzheimer's/dementia (AOR: 1.75, 95% CI 1.13-2.69), and poorer cognitive functioning (AOR: 0.68, 95% CI 0.49-0.93)], poor physical health [bone or joint disease (AOR: 1.18, 95% CI 1.04-1.34), angina (AOR: 1.80, 95% CI 1.58-2.06), underweight (AOR: 1.28, 95% CI 1.16-1.40), chronic lung disease (AOR: 1.22, 95% CI 1.03-1.45), and functional disability (AOR: 1.68, 95% CI 1.47-1.92)], and health risk behaviour [tobacco use (AOR: 1.13, 95% CI 1.01-1.25), heavy episodic drinking (AOR: 1.45, 95% CI 1.10-1.91) and physical inactivity (AOR: 1.42, 95% CI 1.21-1.67)]. Furthermore, food insecurity was negatively associated with overweight/obesity (AOR: 0.80, 95% CI 0.73-0.88). Food insecurity was associated with seven poor mental health indicators, five poor physical health conditions, and three health risk behaviours. Programmes and policies that improve food availability may help improve mental and physical health among middle-aged and older adults in India.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.,Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand. .,Department of Psychology, University of the Free State, Bloemfontein, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Wufeng, Taichung, 41354, Taiwan.
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Sharma M, Pradhan MR. Socioeconomic inequality in cognitive impairment among India's older adults and its determinants: a decomposition analysis. BMC Geriatr 2023; 23:7. [PMID: 36604625 PMCID: PMC9817366 DOI: 10.1186/s12877-022-03604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/09/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cognitive impairment (CoI) is a significant risk factor for ill-health status among the older adults and a major burden on public health. This study unearths the degree of socioeconomic inequalities and assesses the determinants of CoI among the older adults in India. METHODS Data on cognitive impairment of older adults aged 60 + years (n = 31,646) gathered in a nationally representative Longitudinal Ageing Study in India (2017-18) was analyzed through STATA with a significance level of 5%. Binary logistic regression, the concentration index, concentration curve, and Shapley decomposition analysis were performed to assess the socioeconomic inequalities and the determinants of CoI. RESULTS Sixteen percent of the older adults had CoI. Females (OR = 1.88, 95% CI = 1.70-2.09), those aged 80 plus years (OR = 3.98, 95%CI = 3.56-4.44), from ST (OR = 2.65, 95%CI = 2.32-3.02), with perceived poor health (OR = 1.61,95%CI = 1.45-1.79), with depression (OR = 1.32, 95%CI = 1.21-1.43), with no schooling (OR = 16.46, 95%CI = 11.31-23.97) with 1 + ADL (OR = 1.43, 95%CI = 1.31-1.57) and 1 + IADL (OR = 1.30, 95%CI = 1.19-1.41) had higher odds of CoI than their respective counterparts. Older adults from urban areas (OR = 0.63, 95%CI = 0.57-0.70), higher income groups (OR = 0.61, 95%CI = 0.53- 0.70) and higher education level with sources of financial support (OR = 0.68, 95%CI = 0.61- 0.76) less likely to experience CoI. Economic inequalities exist in the distribution of CoI-the poorest being the most disadvantaged (concentration index value = -0.118). CONCLUSIONS There are socioeconomic-related inequalities in CoI among the older adults. The socioeconomically vulnerable older adults, including those illiterates, with poor economic status, women, not-in-union, the older, and those without social support, are more likely to develop CoI. The results suggest awareness generation and more customized policies and programs to reduce the socioeconomic inequalities in CoI among the older adults in India. The improved mental health of the older adults will contribute to achieving Sustainable Development Goals, including Goal 3 on guaranteeing good health and well-being for all.
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Affiliation(s)
- Madhurima Sharma
- grid.419349.20000 0001 0613 2600International Institute for Population Sciences, Govandi Station Road, Deonar Mumbai, India
| | - Manas Ranjan Pradhan
- grid.419349.20000 0001 0613 2600Department of Fertility and Social Demography, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, India
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Pengpid S, Peltzer K. Prevalence and associated factors of physical inactivity among middle-aged and older adults in India: results of a national cross-sectional community survey. BMJ Open 2022; 12:e058156. [PMID: 36028277 PMCID: PMC9422873 DOI: 10.1136/bmjopen-2021-058156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to determine the prevalence and associated factors of physical inactivity in middle-aged and older adults in India. DESIGN Population-based cross-sectional study. SETTING Nationally representative sample of general community-dwelling middle-aged and older adult population in India. PARTICIPANTS The sample included 72 262 adults (45 years and older, mean age 58.8 years, SD=11.8), from the longitudinal ageing study in India wave 1 in 2017-2018. PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported physical activity, along with physical measurements, health status and health behaviour, and sociodemographic covariates. Multivariable logistic regression calculated OR with 95% CI for physical inactivity. RESULTS Overall, 36.7% were physically inactive, 42.6% among men, and 32.4% among women (p<0.001). In the adjusted logistic regression analysis, among both men and women, older age (70 years and older), being Sikh, impaired vision and depressive symptoms were positively and cognitive functioning, current tobacco use and social participation were negatively associated with physical inactivity. In addition, among men, higher socioeconomic status, urban residence, functional disability and heart disease or stroke were positively associated with physical inactivity, and among women being married and higher education were negatively, and insomnia symptoms and poor or fair self-rated health status were positively associated with physical inactivity. CONCLUSIONS Almost 4 in 10 middle-aged and older adults in India had inadequate physical activity. Overall and gender specific risk factors for physical inactivity were identified. Interventions may operate at multiple levels and consider gender-related physical inactivity patterns.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, Free State, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Muhammad T, Sekher TV, Srivastava S. Association of objective and subjective socioeconomic markers with cognitive impairment among older adults: cross-sectional evidence from a developing country. BMJ Open 2022; 12:e052501. [PMID: 35981779 PMCID: PMC9394209 DOI: 10.1136/bmjopen-2021-052501] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/07/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study explored how various markers of objective and subjective socioeconomic status (SES) are associated with cognitive impairment among older Indian adults. DESIGN A cross-sectional study was conducted using large nationally representative survey data. SETTING AND PARTICIPANT This study used data from the Longitudinal Ageing Study in India (2017-2018). The sample included 31 464 older adults aged 60 years and above. PRIMARY AND SECONDARY OUTCOME MEASURES Outcome variable was cognitive impairment, measured through broad domains of memory, orientation, arithmetic function, and visuo-spatial and constructive skills. We estimated descriptive statistics and presented cross-tabulations of the outcome. Χ2 test was used to evaluate the significance level of differences in cognitive impairment by subjective (ladder) and objective SES measures (monthly per-capita consumption expenditure (MPCE) quintile, education and caste status). Multivariable linear and logistic regression analyses were conducted to fulfil the objectives. RESULTS A proportion of 41.7% and 43.4% of older adults belonged to low subjective (ladder) and objective (MPCE) SES, respectively. Older adults with low subjective (adjusted OR (aOR): 2.04; p<0.05) and objective SES (aOR: 1.32; p<0.05) had higher odds of having cognitive impairment in comparison with their counterparts, with a stronger subjective SES-cognitive impairment association. Older adults with lower education or belonged to lower caste had higher odds of cognitive impairment than their counterparts. Interaction analyses revealed that older adults who belonged to lower subjective and objective (poorest MPCE quintile, Scheduled Castes and lowest education) SES had 2.45 (CI: 1.77 to 3.39), 4.56 (CI: 2.97 to 6.98) and 54.41 (CI: 7.61 to 388.93) higher odds of cognitive impairment than those from higher subjective and objective SES, respectively. CONCLUSION Subjective measures of SES were linked to cognitive outcomes, even more strongly than objective measures of SES; considering the relative ease of obtaining such measures, subjective SES measures are a promising target for future study on socioeconomic indicators of cognitive impairment.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - T V Sekher
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Sathya T, Nagarajan R, Selvamani Y. Multimorbidity as a Risk Factor of Elder Abuse/Mistreatment in India: A Cross-Sectional Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9191-NP9213. [PMID: 33323003 DOI: 10.1177/0886260520980391] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Globally, elder abuse/mistreatment is a common form of violence against the elderly. This study examines the association between multimorbidity and abuse/mistreatment among the elderly population (60+) in India. Cross-sectional data from the United Nations Population Fund (UNFPA)'s "Building Knowledge Base on Population Aging in India" (BKPAI, 2011) was analyzed. We generated a multimorbidity variable by combining 20 self-reported diagnosed chronic diseases. Bivariate analysis was used to understand the sample distribution and prevalence estimation of elder abuse/mistreatment by multimorbidity and state. Furthermore, multilevel mixed-effect logistic regression was used to examine the association between multimorbidity and elder abuse/mistreatment. The overall prevalence of elder abuse/mistreatment in the study population is 11.4%. The prevalence of elder abuse/mistreatment among elderly with no chronic diseases is 6.01% which increases to 22.7% among elderly with four or more chronic diseases. Furthermore, the result from the multilevel mixed-effect logistic regression showed a close association between multimorbidity and elder abuse. Elderly with two, three, and four or more chronic diseases are 3.02 (CI = 2.33, 3.91, p < .000), 4.16 (CI = 3.02, 5.74, p < .000), and 5.06 (CI = 3.50, 7.31, p <.000) times more likely to experience abuse/mistreatment than elderly with no chronic diseases, respectively. In specific, this association is stronger for the elderly population residing in the urban areas. Furthermore, economic status and educational attainment have a protective role in determining elder abuse/mistreatment in India. In conclusion, multimorbidity has emerged as a significant risk factor of elder abuse/mistreatment in India. Measures to prevent elder abuse should consider the role of multimorbidity.
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Affiliation(s)
- T Sathya
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - R Nagarajan
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
| | - Y Selvamani
- International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
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Jain U, Angrisani M, Langa KM, Sekher TV, Lee J. How much of the female disadvantage in late-life cognition in India can be explained by education and gender inequality. Sci Rep 2022; 12:5684. [PMID: 35383249 PMCID: PMC8983756 DOI: 10.1038/s41598-022-09641-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/25/2022] [Indexed: 11/09/2022] Open
Abstract
In social environments characterized by high levels of gender inequality, women fare worse than men in human capital accumulation and health. We examine the association of gender inequality with female disadvantage in late-life cognitive function, using newly available data from Wave 1 (2017-2019) of the Longitudinal Aging Study in India (LASI), representative of the Indian population over the age of 45. We find a substantial female gap in cognition among mid-aged and older adults in India; early life socioeconomic conditions and education explain up to 74 percent of the female disadvantage in cognition, and model predictions suggest that it takes nine years of education on average to overcome this deficit. However, further contextualizing the environment, we find that the level of education at which differences in late-life cognition between women and men become negligible increases with the degree of gender inequality.
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Affiliation(s)
- Urvashi Jain
- Department of Economics, Finance and Real Estate, University of South Alabama, Mobile, USA
| | - Marco Angrisani
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-333, USA
- Department of Economics, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-333, USA
| | - Kenneth M Langa
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, USA
- Institute for Social Research, University of Michigan, Ann Arbor, USA
- Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA
| | - T V Sekher
- International Institute for Population Sciences, Mumbai, India
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-333, USA.
- Department of Economics, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-333, USA.
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Vonk JMJ, Gross AL, Zammit AR, Bertola L, Avila JF, Jutten RJ, Gaynor LS, Suemoto CK, Kobayashi LC, O’Connell ME, Elugbadebo O, Amofa PA, Staffaroni AM, Arce Rentería M, Turney IC, Jones RN, Manly JJ, Lee J, Zahodne LB. Cross-national harmonization of cognitive measures across HRS HCAP (USA) and LASI-DAD (India). PLoS One 2022; 17:e0264166. [PMID: 35213581 PMCID: PMC8880818 DOI: 10.1371/journal.pone.0264166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/04/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD). METHODS Data for 3,496 HRS HCAP (≥65 years) and 3,152 LASI-DAD (≥60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision. RESULTS CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample. CONCLUSIONS Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.
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Affiliation(s)
- Jet M. J. Vonk
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Alden L. Gross
- Department of Epidemiology, Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Andrea R. Zammit
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Laiss Bertola
- Medical School, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | - Justina F. Avila
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Roos J. Jutten
- Alzheimer Center & Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Leslie S. Gaynor
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Claudia K. Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, São Paulo, Brazil
| | - Lindsay C. Kobayashi
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Megan E. O’Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Priscilla A. Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, United States of America
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California at San Francisco (UCSF), San Francisco, California, United States of America
| | - Miguel Arce Rentería
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Indira C. Turney
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | - Jennifer J. Manly
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Jinkook Lee
- Center for Economic and Social Research & Department of Economics, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, USA and RAND Corporation, Santa Monica, California, United States of America
| | - Laura B. Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
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11
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Pengpid S, Peltzer K. Physical activity, health and well-being among a nationally representative population-based sample of middle-aged and older adults in India, 2017-2018. Heliyon 2021; 7:e08635. [PMID: 34988323 PMCID: PMC8695286 DOI: 10.1016/j.heliyon.2021.e08635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/03/2021] [Accepted: 12/15/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aimed to determine the association between physical activity (PA) and health and well-being in middle-aged and older community-dwelling adults in India. METHODS The cross-sectional sample consisted of 72,262 individuals (≥45 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017-2018. Logistic regression, adjusted for relevant confounders, was used to predict associations between PA levels and 23 health indicators. RESULTS In all 23.8% of participants were inactive, 12.9% had low, 7.6% moderate, and 55.7% high PA. In the final adjusted logistic regression analyses, higher PA levels were associated with better mental health (less insomnia symptoms, less depressive symptoms, less loneliness, and better cognitive functioning), and better well-being (self-rated health status, life satisfaction, happiness, functional ability, and hand grip strength). Moreover, moderate and/or high PA were negatively associated with diabetes, heart disease, stroke, hypertension, chronic lung disease, vision impairment, cataract, chronic renal failure, and Alzheimer's disease/dementia. While in unadjusted analysis, moderate and/or high PA were protective against major depressive disorder and bone or joint diseases, this became non-significant in the adjusted model. PA was not significantly associated with abdominal obesity and cancer. CONCLUSION Overall, higher PA levels were positively associated with 10 of 11 mental health and well-being indicators as well as being protective against 9 of 12 chronic conditions.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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12
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Pengpid S, Peltzer K. Associations of loneliness with poor physical health, poor mental health and health risk behaviours among a nationally representative community-dwelling sample of middle-aged and older adults in India. Int J Geriatr Psychiatry 2021; 36:1722-1731. [PMID: 34216053 PMCID: PMC8511338 DOI: 10.1002/gps.5592] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/29/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Loneliness may negatively impact on health outcomes. The study aimed to estimate the associations between loneliness and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India. METHODS The sample included 72,262 middle-aged and older adults from a cross-sectional national community-dwelling survey in India in 2017-2018. RESULTS Results indicate that the prevalence of moderate loneliness was 20.5%, and severe loneliness was 13.3%. In the adjusted logistic regression analysis, moderate and/or severe loneliness was significantly positively associated with fair or poor self-rated health status, and significantly negatively associated with life satisfaction and cognitive functioning. Furthermore, loneliness was associated with stroke, angina, physical injury, difficulty of Activities of Daily Living, difficulties of Instrumental Activities of Daily Living and multi-morbidity. Loneliness increased the odds of major depressive disorder and insomnia symptoms. The associations between loneliness and current tobacco use and body mass index were negative and between loneliness and physical inactivity and underweight were positive. CONCLUSIONS Loneliness is associated with poor physical health, poor mental health and health risk behaviour (physical inactivity), emphasising the need to consider loneliness in various physical and mental health contexts.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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13
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Pengpid S, Peltzer K. Perceived discrimination and health outcomes among middle-aged and older adults in India: results of a national survey in 2017-2018. BMC Geriatr 2021; 21:559. [PMID: 34663217 PMCID: PMC8522245 DOI: 10.1186/s12877-021-02508-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/29/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The study aimed to estimate the associations between perceived discrimination and poor physical health, poor mental health, and health risk behaviours in middle-aged and older adults in a national population survey in India. METHODS The sample included 72,262 middle-aged and older adults from a cross-sectional national community dwelling survey in India in 2017-2018. RESULTS The prevalence of moderate (1-2 types) perceived discrimination was 10.7%, and high (3-6 types) perceived discrimination was 6.6%. In the final adjusted logistic, linear or Poisson regression analyses, moderate and/or high perceived discrimination was significantly positively associated with poor mental health (low life satisfaction, poor cognitive functioning, insomnia symptoms, and depressive symptoms), poor physical health (pain conditions count, and functional limitations), and health risk behaviours (heavy episodic drinking and physical inactivity). CONCLUSION Perceived discrimination is associated with poor mental health, poor physical health, and health risk behaviour, emphasising the need to consider perceived discrimination in various physical and mental health contexts.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
- Department of Research Administration and Development, University of Limpopo, Turfloop, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Turfloop, Polokwane, South Africa.
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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14
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Pengpid S, Peltzer K. Elder abuse and health outcomes among community-dwelling older adults in India: results of a national survey in 2017-2018. J Elder Abuse Negl 2021; 33:327-341. [PMID: 34433374 DOI: 10.1080/08946566.2021.1970683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The study aimed to estimate the associations between elder abuse and poor physical health, poor mental health, and health risk behaviors in older adults in a national community-based survey in India. The study sample included 31,477 older adults (≥60 years) from a cross-sectional national community dwelling survey in India in 2017-2018. Results indicate that the prevalence of elder abuse in the past 12 months was 5.2%. In the adjusted logistic regression analysis, elder abuse was significantly positively associated with poor mental health and poor well-being (low life satisfaction, not happy, insomnia symptoms, depressive symptoms, loneliness, neurological or psychiatric problems, and lower self-rated health status), poor physical health (bone or joint disease, physical pain, gastrointestinal problems, incontinence, functional disability, underweight, and persistent headaches), fall and health care utilization. In addition, in unadjusted analysis, elder abuse was associated with poorer cognitive functioning, current tobacco use, and dizziness. Elder abuse among older adults in India is associated with poor physical health, poor mental health, and health care utilization, emphasizing the need to consider elder abuse in various physical and mental health contexts.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa.,College of Medical and Health Science, Asia University, Taichung, Taiwan
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15
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Pengpid S, Peltzer K. Geriatric Conditions and Functional Disability among a National Community-Dwelling Sample of Older Adults in India in 2017-2018. Geriatrics (Basel) 2021; 6:geriatrics6030071. [PMID: 34449626 PMCID: PMC8396018 DOI: 10.3390/geriatrics6030071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to determine the prevalence of geriatric conditions and their association with disability in older community-dwelling adults in India. The cross-sectional sample consisted of 31,477 individuals (≥60 years) from the Longitudinal Ageing Study in India (LASI) Wave 1 in 2017–2018. Geriatric conditions assessed included injurious falls, impaired cognition, underweight, dizziness, incontinence, impaired vision and impaired hearing. More than two in five participants (44.3%) had no geriatric condition, 32.7% had one, 15.9% two and 7.1% had three or more geriatric conditions; 26.9% were underweight, 14.5% dizziness, 13.7% had impaired vision, 9.6% impaired hearing, 9.3% impaired cognition, 8.2% major depressive disorder, 5.7% injurious falls, 4.0% incontinence, and 7.4% had Activity of Daily Living (ADL) dependencies. In logistic regression analysis, adjusted by sociodemographic factors and the number of chronic conditions, we found a higher number of geriatric conditions, and a higher number of chronic conditions were associated with ADL dependencies. In a model adjusted for sociodemographic factors and the type of chronic conditions, we found that a higher number of geriatric conditions and heart disease, stroke, and bone or joint disorder were positively associated with ADL dependencies. The odds of ADL dependencies increased with impaired cognition, impaired vision, impaired hearing, and major depressive disorder. Impaired cognition, incontinence, impaired vision and major depressive disorder were positively associated with dressing, bathing, eating, transferring, and toileting dependency. In addition, impaired hearing was associated with transferring and toileting dependency. More than half of older adults in India had at least one geriatric condition. The prevalence of geriatric conditions was as high as the prevalence of chronic conditions, which in some cases were associated with disability. Geriatric conditions should be included in health care management.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand; or
- Department of Research Administration and Development, University of Limpopo, Sovenga 0757, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence:
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16
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Tungu M, Amani PJ, Hurtig AK, Dennis Kiwara A, Mwangu M, Lindholm L, San Sebastiån M. Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study. Glob Health Action 2021; 13:1841962. [PMID: 33236698 PMCID: PMC7717594 DOI: 10.1080/16549716.2020.1841962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: Health care systems in developing countries such as Tanzania depend heavily on out-of-pocket payments. This mechanism contributes to inefficiency, inequity and cost, and is a barrier to patients seeking access to care. There are efforts to expand health insurance coverage to vulnerable groups, including older adults, in Sub-Saharan African countries. Objective: To analyse the association between health insurance and health service use in rural residents aged 60 and above in Tanzania. Methods: Data were obtained from a household survey conducted in the Nzega and Igunga districts. A standardised survey instrument from the World Health Organization Study on global AGEing and adult health was used. This comprised of questions regarding demographic and socio-economic characteristics, health and insurance status, health seeking behaviours, sickness history (three months and one year prior to the survey), and the receipt of health care. A multistage sampling method was used to select wards, villages and respondents in each district. Local ward and hamlet officers guided the researchers in identifying households with older people. Crude and adjusted logistic regression methods were used to explore associations between health insurance and outpatient and inpatient health care use. Results: The study sample comprised 1,899 people aged 60 and above of whom 44% reported having health insurance. A positive statistically significant association between health insurance and the utilisation of outpatient and inpatient care was observed in all models. The odds of using outpatient (adjusted OR = 2.20; 95% CI: 1.54, 3.14) and inpatient services (adjusted OR = 3.20; 95% CI: 2.46, 4.15) were higher among the insured. Conclusion: Health insurance is a predictor of outpatient and inpatient health services in people aged 60 and above in rural Tanzania. Further research is needed to understand the perceptions of both the insured and uninsured regarding the quality of care received.
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Affiliation(s)
- Malale Tungu
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences , Dar es Salaam, Tanzania.,Epidemiology and Global Health, Umeå University , Umeå, Sweden
| | - Paul Joseph Amani
- Epidemiology and Global Health, Umeå University , Umeå, Sweden.,Department of Health Systems Management, School of Public Administration and Management, Mzumbe University , Morogoro, Tanzania
| | | | - Angwara Dennis Kiwara
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences , Dar es Salaam, Tanzania
| | - Mughwira Mwangu
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences , Dar es Salaam, Tanzania
| | - Lars Lindholm
- Epidemiology and Global Health, Umeå University , Umeå, Sweden
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Smith JP. THE HRS AROUND THE WORLD SURVEYS-A REVIEW. JOURNAL OF THE ECONOMICS OF AGEING 2021; 18:100295. [PMID: 33282674 PMCID: PMC7709960 DOI: 10.1016/j.jeoa.2020.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- James P Smith
- SENIOR ASSOCIATE/ECONOMIST, ROSE LI & ASSOCIATES, INC
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18
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Bitar D, Walton LM, Schbley B, Mohamed ME, Adel M. Differences in dual task paradigms and executive function ability for recreational athletes in United Arab Emirates. J Phys Ther Sci 2020; 32:698-705. [PMID: 33281283 PMCID: PMC7708006 DOI: 10.1589/jpts.32.698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/04/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study to measure four components of executive function:
(1) cognitive flexibility, (2) inhibition, (3) working memory and (4) processing speed,
along with the ability to dual task in recreational athletes. [Participants and Methods]
This was a cross-sectional study of (n=102) male and female participants, between the ages
of 18–40 years of age across different levels and types of sport related physical
activity. The International Physical Activity Questionnaire (IPAQ), short version, Dual
Task Abilities (DTA) were measured utilizing a quantitative, dual task, gait test and
Executive Function (EF) was measured through Stroop Color Word Test and Trail Making Test.
[Results] Differences in EF and Dual Task-Interference (DTI) in recreational athletes did
not show a significant difference between varying types of sport and level of sport
related activity, with reported values high across all groups. Males reported better dual
task interference abilities than females, though there were no significant differences in
executive function between males and females. Executive function performance was the
highest among the age group (18–24 years) population, but there were no significant
differences between those in the higher age groups (25–34 years) and (35–40 years).
[Conclusion] Overall, those participating in the study exhibited high prevalence of strong
EF ability, regardless of sport activity type or level. This may suggest that type and
level of sport activity may not be important when considering executive function
performance maintenance for recreational athletes.
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Affiliation(s)
- Deema Bitar
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | - Lori Maria Walton
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | | | | | | | - Maha Ehab Mohamed
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
| | - Mennatallah Adel
- Department of Physiotherapy, University of Sharjah: Sharjah, Non-US 00000, United Arab Emirates
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Differential item functioning in the cognitive screener used in the Longitudinal Aging Study in India. Int Psychogeriatr 2019; 31:1331-1341. [PMID: 30782222 DOI: 10.1017/s1041610218001746] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The Longitudinal Aging Study in India (LASI) was initiated to capture data to be comparable to the Health and Retirement Survey (HRS) and hence used study instruments from the HRS. However, a rigorous psychometric evaluation before adaptation of cognitive tests may have indicated bias due to diversities across Indian states such as education, ethnicity, and urbanicity. In the present analysis, we evaluated if items show differential item functioning (DIF) by literacy, urbanicity, and education status. METHODS We calculated proportions for each item and weighted descriptive statistics of demographic characteristics in LASI. Next, we evaluated item-level measurement differences by testing for DIF using the alignment approach implemented using Mplus software. OBSERVATION We found that cognitive items in the LASI interview demonstrate bias by education and literacy, but not urbanicity. Items relating to animal (word) fluency show DIF. The model rates correct identification of the prime minister as the most difficult binary response item whereas the day of the week and numeracy items are rated comparatively easier. CONCLUSIONS Our study would facilitate comparison across education, literacy and urbancity to support analyses of differences in cognitive status. This would help future instrument development efforts by recognizing potentially problematic items in certain subgroups.
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20
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Let's call the whole thing off: evaluating gender and sex differences in executive function. Neuropsychopharmacology 2019; 44:86-96. [PMID: 30143781 PMCID: PMC6235899 DOI: 10.1038/s41386-018-0179-5] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023]
Abstract
The executive functions allow for purposeful, deliberate, and intentional interactions with the world-attention and focus, impulse control, decision making, and working memory. These measures have been correlated with academic outcomes and quality of life, and are impacted by deleterious environmental events throughout the life span, including gestational and early life insults. This review will address the topic of sex differences in executive function including a discussion of differences arising in response to developmental programming. Work on gender differences in human studies and sex differences in animal research will be reviewed. Overall, we find little support for significant gender or sex differences in executive function. An important variable that factors into the interpretation of potential sex differences include differing developmental trajectories. We conclude by discussing future directions for the field and a brief discussion of biological mechanisms.
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21
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Age, socioeconomic patterns and regional variations in grip strength among older adults (50+) in India: Evidence from WHO’s Study on Global Ageing and Adult Health (SAGE). Arch Gerontol Geriatr 2018; 76:100-105. [DOI: 10.1016/j.archger.2018.02.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 12/31/2022]
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22
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Selvamani Y, Singh P. Socioeconomic patterns of underweight and its association with self-rated health, cognition and quality of life among older adults in India. PLoS One 2018. [PMID: 29513768 PMCID: PMC5841798 DOI: 10.1371/journal.pone.0193979] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Underweight defined as body mass index (BMI) < 18.5 is associated with negative health and quality of life outcomes including mortality. Yet, little is known about the socioeconomic differentials in underweight and its association with health and well-being among older adults in India. This study examined the socioeconomic differentials in underweight among respondents aged ≥50 in India. Consequently, three outcomes of the association of underweight were studied. These are poor self-rated health, cognition and quality of life. METHODS Cross-sectional data on 6,372 older adults derived from the first wave of the WHO's Study on global AGEing and adult health (SAGE), a nationally representative survey conducted in six states of India during 2007-8, were used. Bivariate and multivariate regression analyses were applied to fulfil the objectives. RESULTS The overall prevalence of underweight was 38 percent in the study population. Further, socioeconomic status showed a significant and negative association with underweight. The association of underweight with poor self-rated health (OR = 1.60; p < .001), cognition (β = -0.95; p < .001) and quality of life (β = -1.90; p < .001) were remained statistically significant after adjusting for age, sex, place of residence, marital status, years of schooling, wealth quintile, sleep problems, chronic diseases, low back pain and state/province. CONCLUSION The results indicated significant socioeconomic differentials in underweight and its association with poor self-rated health, cognition and quality of life outcomes. Interventions focussing on underweight older adults are important to enhance the overall wellbeing of the growing older population in India.
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Affiliation(s)
- Y. Selvamani
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, India
- * E-mail:
| | - Pushpendra Singh
- Department of Humanities & Social Sciences, Indian Institute of Technology Roorkee, Roorkee, Uttarakhand, India
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Xu H, Ostbye T, Vorderstrasse A, Dupre M, Wu B. Place of Residence and Cognitive Function among the Adult Population in India. Neuroepidemiology 2018. [DOI: 10.1159/000486596] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Lee J, McGovern ME, Bloom DE, Arokiasamy P, Risbud A, O'Brien J, Kale V, Hu P. Education, gender, and state-level disparities in the health of older Indians: Evidence from biomarker data. ECONOMICS AND HUMAN BIOLOGY 2015; 19:145-156. [PMID: 26398850 PMCID: PMC4658270 DOI: 10.1016/j.ehb.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Revised: 08/07/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
Using new biomarker data from the 2010 pilot round of the Longitudinal Aging Study in India (LASI), we investigate education, gender, and state-level disparities in health. We find that hemoglobin level, a marker for anemia, is lower for respondents with no schooling (0.7g/dL less in the adjusted model) compared to those with some formal education and is also lower for females than for males (2.0g/dL less in the adjusted model). In addition, we find that about one third of respondents in our sample aged 45 or older have high C-reaction protein (CRP) levels (>3mg/L), an indicator of inflammation and a risk factor for cardiovascular disease. We find no evidence of educational or gender differences in CRP, but there are significant state-level disparities, with Kerala residents exhibiting the lowest CRP levels (a mean of 1.96mg/L compared to 3.28mg/L in Rajasthan, the state with the highest CRP). We use the Blinder-Oaxaca decomposition approach to explain group-level differences, and find that state-level disparities in CRP are mainly due to heterogeneity in the association of the observed characteristics of respondents with CRP, rather than differences in the distribution of endowments across the sampled state populations.
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Affiliation(s)
- Jinkook Lee
- Dornsife Center for Economic and Social Research, University of Southern California, 638 Downey Way, Los Angeles, CA 90089, USA; RAND Corporation, Santa Monica, CA, USA.
| | - Mark E McGovern
- Queen's University Belfast, Belfast, United Kingdom; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Cambridge, MA, USA
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - P Arokiasamy
- International Institute for Population Sciences, Mumbai, India
| | - Arun Risbud
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Jennifer O'Brien
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Varsha Kale
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Peifeng Hu
- University of California, Los Angeles, CA, USA
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25
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McGovern ME. Comparing the Relationship Between Stature and Later Life Health in Six Low and Middle Income Countries. JOURNAL OF THE ECONOMICS OF AGEING 2014; 4:128-148. [PMID: 25590021 PMCID: PMC4289608 DOI: 10.1016/j.jeoa.2014.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This paper examines the relationship between stature and later life health in 6 emerging economies, each of which are expected to experience significant increases in the mean age of their populations over the coming decades. Using data from the WHO Study on Global Ageing and Adult Health (SAGE) and pilot data from the Longitudinal Ageing Study in India (LASI), I show that various measures of health are associated with height, a commonly used proxy for childhood environment. In the pooled sample, an additional 10cm increase in height is associated with between a 2 and 3 percentage point increase in the probability of being in very good or good self-reported health, a 3 percentage point increase in the probability of reporting no difficulties with activities of daily living or instrumental activities of daily living, and between a fifth and a quarter of a standard deviation increase in grip strength and lung function. Adopting a methodology previously used in the research on inequality, I also summarise the height-grip strength gradient for each country using the concentration index, and provide a decomposition analysis.
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Affiliation(s)
- Mark E McGovern
- Harvard Center for Population and Development Studies; Department of Global Health and Population, Harvard School of Public Health
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