Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

Interaction between living conditions and plant-based dietary pattern on cognitive function: A 10-year cohort analysis of Chinese older adults

BACKGROUND

Plant-based dietary patterns have been associated with better cognitive function, whereas there has been limited research on the relationship between living conditions and cognitive function. This study aimed to examine these associations in older adults in China.

METHODS

This study utilized a ten-year cohort of older adults, including 1630 participants aged 65 and older from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), all of whom had normal cognition at baseline. Living conditions were categorized into three levels: good, fair, and poor, based on three factors: housing stability, economic stability, and personal space. A simplified food frequency questionnaire was used to assess the overall plant-based diet index (PDI). Cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination (MMSE). The latent class trajectory modeling (LCTM) was applied to classify participants into two PDI types: high-rapid-decreasing PDI and low-stable-decreasing PDI. Binomial logistic regression analysis was employed to explore the associations, with further stratified analyses conducted by PDI.

RESULTS

Of the 1630 participants, 48.53% were male, with a median age of 73 years [IQR (Interquartile Range): 69-79]. Living in fair or poor conditions was associated with an 86.0% (OR = 1.860, 95% CI: 1.235-2.798) and 206.1% (OR = 3.061, 95% CI: 1.826-5.131) increased risk of developing cognitive impairment, respectively, compared to those in good living conditions (reference group). The associations between living conditions and cognitive impairment were more pronounced in the "Low-stable-decreasing PDI" group (OR for poor vs good = 3.774, 95% CI: 1.745-8.161) than in the "High-rapid-decreasing PDI" group (OR for poor vs good = 2.344, 95% CI: 1.071-5.130).

CONCLUSION

A plant-based dietary pattern may help mitigate the negative effects of poor living conditions on cognitive function in older adults. Adhering to a plant-based dietary pattern may serve as an effective preventive strategy to safeguard cognitive health, especially among vulnerable populations exposed to adverse environmental factors, such as limited healthcare access or poor living conditions.

Dementia health matters: Influence of literacy, fears, and endorsements on dementia risk mitigation and screening among community-dwelling older adults

BACKGROUND

Up to one-third of dementia cases may be preventable, with evidence suggesting that modifying lifestyle and health behaviors can significantly lower the risk of developing dementia. However, motivating older adults to adopt and sustain these changes poses a considerable challenge, particularly when facing the specter of dementia.

AIM

To explore the interaction effect between dementia fear and dementia literacy on the perceived ability of community-dwelling older adults to reduce dementia risk and engage in dementia screening.

METHOD

A cross-sectional study involving 1,067 community-dwelling older adults was conducted from August 2022 to December 2023. Participants completed surveys assessing their dementia literacy, personal dementia fear, motivation to change lifestyle and health behaviors, and willingness to engage in investigational screening for memory in primary care.

FINDINGS

Personal dementia fear exhibited significant positive correlations with motivation to change lifestyle and health behavior (r = 0.621, p < 0.001) and investigational screening for memory in primary care (r = 0.559, p < 0.001), indicating that higher levels of fear are associated with increased motivation. Second, dementia literacy demonstrated positive correlations with motivation to change lifestyle and health behavior (r = 0.349, p < 0.001) and investigational screening (r = 0.269, p < 0.001), suggesting that more excellent knowledge enhances perceived ability. Lastly, both dementia literacy and personal dementia fear were positively correlated with motivation to change health behaviors, with respective effects of β = 0.266 and β = 0.595, highlighting their interactive role in shaping perceptions of risk reduction and screening.

IMPLICATION

The significant contributions of dementia literacy, personal dementia fear, and their interaction highlight the importance of these factors in accepting investigational screening for memory in primary care.

Household Environments and Cognitive Decline Among Middle-Aged and Older Adults in China: Exploring Gender, Age, and Residential Variations

This study examined the relationship between household environments and trajectories of cognitive function among middle-aged and older adults in China and its urban/rural, gender, and age variations. We estimated multi-level linear growth curve models using a representative sample of 16,111 respondents aged 45 years and over from the China Health and Retirement Longitudinal Study (2011-2018). Older people who lived with a spouse, but not with children, and those with higher living expenditures, better housing quality, and indoor clean fuels for cooking had a slower cognitive decline. Living arrangement more strongly predicted men's cognitive decline, while living expenditure, solid fuel use, and housing quality significantly predicted only women's cognitive decline. Only for older adults and rural residents, those living alone had significantly faster cognitive decline than those living with a spouse only. These findings underscore the importance of improving the living conditions of older adults to help alleviate their cognitive decline.

Associations between Physical Activity Frequency in Leisure Time and Subjective Cognitive Limitations in Middle-Aged Spanish Adults: A Cross-Sectional Study

There is a global ageing of the world's population. Ageing is associated with multiple pathologies, reductions in physical activity, and losses in cognitive function. This study aimed to analyse the associations between the frequency of leisure-time physical activity (PAF) in middle-aged Spaniards and subjective cognitive limitations (SCLs): self-reported problems for remembering or concentrating (data extracted from the 2017 National Health Survey and the 2020 European Health Survey in Spain). Furthermore, the study aimed to evaluate risk factors that could be related to a higher probability of developing SCLs. This was a cross-sectional study with 15,866 middle-aged Spaniards. The associations between FAP and SCLs were analysed using chi-square. Also, the risk factors for SCLs were evaluated using binary multiple logistic regression. The median age of participants was 55 years, with 49% men and 51% women. Associations were found between PAF and SCLs (p < 0.001). The highest prevalence of SCLs was found in physically inactive people and the lowest in very active people (13.7% vs. 5.8%, p < 0.05), and people with SCLs had a higher prevalence of inactivity than those without SCLs (47.2% vs. 33.8%, p < 0.05). Physical inactivity, low educational level, low social class, and being female were the main risk factors for SCLs. Among the actions to prevent cognitive limitations, as well as interventions in people with cognitive limitations, it would be advisable to include physical activity programmes, both as a preventive measure to delay cognitive limitations and to reduce the risk of other pathologies in people who already have them.

Associations between cognitive function and lifestyle in community-living older people: a correlational study

BACKGROUND

Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries.

AIM

This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021.

METHODS

This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant.

RESULTS

The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001).

CONCLUSION

The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.

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

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.

Relationship between socioeconomic status and cognitive ability among Chinese older adults: the moderating role of social support

BACKGROUND

Understanding the causes and pathways of cognitive decline among older populations is of great importance in China. This study aims to examine whether the discrepancy in socioeconomic status (SES) makes a difference to the cognitive ability among Chinese older adults, and to disentangle the moderating role of different types of social support in the process in which SES influences cognition.

METHODS

We utilized a nationally representative sample from the 2018 Chinese Longitudinal Healthy Longevity Survey. A cumulative SES score was constructed to measure the combined effect of different socioeconomic statuses on the cognitive ability of the elderly. We further examined the moderating role of two types of social support, including emotional support, and financial support. Hierarchical regression analysis was applied to test the direct effect of SES on cognitive ability, and to investigate the moderating role of social support on the association of the SES with the dependent variables.

RESULTS

The results showed that the higher SES of older adults was significantly associated with better cognitive ability (β = 0.52, p < 0.001) after controlling for age, sex, marital status, living region, Hukou, health insurance, lifestyle factors, and physical health status. Emotional support and financial support were moderated the relationship between SES score and cognitive ability.

CONCLUSION

Our results reveal the importance of considering social support in buffering the effects of SES and the associated cognitive ability for aging populations. It highlights the importance of narrowing the socioeconomic gap among the elderly. Policymakers should consider promoting social support to improve the cognitive ability among older adults.

Does tandem balance test predict cognitive impairment among older adults? Findings from Longitudinal Ageing Study in India, 2017-18

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.

Multivariate decomposition of gender differentials in successful aging among older adults in India

BACKGROUND

Rowe and Kahn define successful aging as a high physical, psychological, and social functioning in old age without major diseases. It is considered a viable solution to the burdens placed on healthcare systems and financial and social security in societies with aging population. The present study aimed to determine the prevalence of successful aging and explore the factors contributing to gender differentials in successful aging among older adults in India.

METHODS

This study utilized data from the nationally representative Longitudinal Ageing Study in India, conducted in 2017-18. The study is based on a sample of 15,098 older men and 16,366 older women aged 60 years and above. The outcome variable was a dichotomous measure of successful aging with six components including absence of chronic diseases, free from disability, high cognitive ability, free from depressive symptoms, active social engagement in life and free from obesity. Older adults satisfying all these conditions were considered aging successfully. Descriptive and bivariate analyses were carried out. Proportion test was used to evaluate the gender differentials and reflect the statistical significance in the associated factors. Multivariate decomposition analysis was conducted to identify covariates' contribution in explaining the gender differences in successful aging.

RESULTS

There was a significant gender difference in successful aging among older adults in India (Difference: 8.7%; p-value < 0.001] with 34.3% older men and 25.6% older women experiencing successful aging. A proportion of 88% of gender difference in successful aging was explained by the differences in the distribution of characteristics (Coef: 0.082; p-value < 0.05). Considerable gender gap in successful aging would be reduced if women had similar levels of work status (28% reduction) to their male counterparts. Bringing the level of frequent physical activity in women to the same levels observed in men would reduce the gender gap by 9%.

CONCLUSIONS

The findings suggest that women had a lower score in successful aging, which is attributed to several socioeconomic and behavioural factors including not working status and physical inactivity. More studies must be done to explore the reasons for such differences and what particular factors in low-income countries create differences among older men and women in achieving successful aging.

Assessing the role of depressive symptoms in the association between social engagement and cognitive functioning among older adults: analysis of cross-sectional data from the Longitudinal Aging Study in India (LASI)

OBJECTIVE

The present study aimed to examine the confounding effects of depressive symptoms and the role of gender in the association between social engagement and cognitive functioning among older Indian adults.

DESIGN

Large-scale cross-sectional survey data were analysed.

SETTING AND PARTICIPANTS

Data from the Longitudinal Aging Study in India (2017-2019) were used in the analysis. The sample included 23 584 individuals aged 60 years and above (11 403 men and 12 181 women).

OUTCOME MEASURES

The outcome variable was cognitive functioning, which was based on various measures including immediate and delayed word recall, orientation, executive functioning, arithmetic ability and object naming. Social engagement measure consists of marital status, living arrangement, availability of confidant, and participation in indoor games, and social and cultural functions. The Center for Epidemiological Studies-Depression Scale was used to assess depressive symptoms.

RESULTS

Significant gender differences in mean cognition scores (men: 25.8, women: 21.1; on a scale of 0-43) were observed. Two-way stratification between social engagement and depressive symptoms was significantly associated with cognitive functioning after controlling for selected explanatory factors. Older men with a low level of social engagements had significantly poor cognitive functioning (β=-1.12; 95% CI: -1.53 to -0.72) compared with men with a high level of social engagements. On the other hand, women with a higher level of social engagement performed poorly on cognitive tests (β=-1.54; 95% CI: -2.11 to -0.98) compared with men with higher social engagements. Three-way stratification between social engagement, gender and depressive symptoms suggests that social engagement's buffering effects are lower in women than in men. The Karlson-Holm-Breen method identified a significant confounding effect of depressive symptoms on the relationship between social engagement and cognitive functioning.

CONCLUSION

The positive association of social engagement with cognitive functioning was significantly confounded by depressive symptoms, suggesting the need for maintaining social relations that help improve mental health and cognitive functioning among older adults.

How socioeconomic status, social capital and functional independence are associated with subjective wellbeing among older Indian adults? A structural equation modeling analysis

Background

Subjective well-being (SWB) is of particular interest among gerontologists and health researchers with important implications for interventions especially in poor-resource settings. This study aimed to explore the possible pathways from socioeconomic status (SES), functional independence and social capital towards SWB among older adults in India.

Methods

Cross-sectional data from the “Building a Knowledge Base on Population Aging in India” (BKPAI) survey with a total sample of 9231 older adults aged 60 years and above were used. The outcome variable was low SWB (LSWB). The study used univariate and bivariate analysis for reporting the initial results. Further, the study employed the structural equation modeling (SEM) technique using maximum likelihood estimation (MLE) procedure to estimate the covariance matrix.

Results

Overall, about 27% of older adults reported LSWB. Reporting LSWB was more prevalent among older adults who had no income (30.8%) and those who had income but not sufficient to fulfil their basic needs (39.4%, p < 0.001). The prevalence of reporting LSWB was significantly higher among older adults who had no asset ownership (36.5%, p < 0.001) than those who had asset ownership. The path from the SEM shows that LSWB and SES are negatively related to each other. Moreover, LSWB had significant negative relationship with independence (β = -0.032, p < 0.001) and social capital (β = -0.020; p < 0.001). In addition, results found a positive relationship between SES and independence (β = 0.019; p < 0.001), SES and social capital (β = 0.016; p < 0.001), and independence and social capital (β = 0.033; p < 0.001).

Conclusions

The findings highlight that higher SES, good physical functioning as well as favorable social capital are interdependent factors of late-life wellbeing and a multidimensional approach in policymaking can ensure a successful and active ageing among older Indian adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14215-4.

Prevalence and correlates of vision impairment and its association with cognitive impairment among older adults in India: a cross-sectional study

OBJECTIVE

This study aimed to investigate the predictors of vision impairment in old age and how impaired vision is associated with cognitive impairment among the ageing population.

DESIGN

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

SETTING AND PARTICIPANTS

This study used data from the 'Building a Knowledge Base on Population Ageing in India' survey, conducted in 2011. Participants included 9541 older adults aged 60 years and above.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome variables were vision impairment and cognitive impairment. Descriptive statistics along with bivariate analysis were presented. Additionally, multivariable binary logistic regression analysis was performed to fulfil the objectives.

RESULTS

A proportion of 59.1% of the respondents had vision impairment. Nearly 60% of the participants had cognitive impairment. Those who had vision impairment were 11% more likely to have cognitive impairment compared to their counterparts (OR: 1.11, 95% CI: 1.01 to 1.23). low psychological health (OR: 1.55; 95% CI: 1.36 to 1.77), low activities of daily living (OR: 1.80; 95% CI: 1.43 to 2.27), low instrumental activities of daily living (OR: 1.26; 95% CI: 1.14 to 1.40), poor self-rated health (OR: 1.28; 95% CI: 1.15 to 1.41) and chronic morbidity (OR: 1.27; 95% CI: 1.14 to 1.41) were found to be risk factors for cognitive impairment among older adults.

CONCLUSIONS

Additional efforts in terms of advocacy, availability, affordability and accessibility especially in a country with big illiteracy issue are mandatory to increase the reach of eye-care services and reduce the prevalence of avoidable visual impairment and vision losses that lead to cognitive deficits among the older population.

Rural-urban differences in food insecurity and associated cognitive impairment among older adults: findings from a nationally representative survey

INTRODUCTION

Due to rapid urbanization, Covid-19 pandemic and increasing food prices, a higher rate of food insecurity has been observed in recent years in India. Thus, we aim to study the prevalence of food insecurity among older Indian adults and the association of food insecurity as a modifiable risk factor with late-life cognitive impairment.

METHOD

Data for this study were obtained from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the study was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming) adapted from the cognitive module of the US Health and Retirement Study (HRS). Descriptive statistics along with cross-tabulation were presented in the study. Additionally, multivariable logistic regression analysis was used to fulfil the objectives of the study.

RESULTS

It was found that 7.7% of older adults in rural areas reduced their size of meals due to unavailability (urban, 3.2%), 41.2% of them did not eat enough food of their choice (urban, 38.3%), 6.9% were hungry but did not eat food (urban, 2.6%), 5.0% did not eat for whole day (urban, 2.2%), and 6.9% lost weight due to lack of food in their household (urban, 2.9%). It was found that older adults who did not have enough food of their choice had significantly higher odds [AOR: 1.24; CI: 1.14, 1.35] of suffering from cognitive impairment in reference to their counterparts. Similarly, the older adults who were hungry but did not eat were 30% [AOR: 1.30; CI: 1.02, 1.73] more likely to suffer from cognitive impairment in reference to their counterparts. Interaction model revealed that older adults who had food insecurity in rural areas had higher odds of cognitive impairment than older adults who had food insecurity in urban areas.

CONCLUSION

The findings of the study highlight that the food security status in older adults may bring about greater challenges due to their limited economic resources. Interventions focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.

Relationship between physical activity and cognitive functioning among older Indian adults

In a culturally different and low-resource setting, where lifestyle habits, including dietary pattern and physical activities differ from those in high-income countries, the association between physical activity and cognition is expected to differ. We aimed to investigate the association between physical activity and cognitive functioning after controlling for potential confounders among older adults in India. Furthermore, gender differences in this relationship were analyzed. Using a national-level data from the Longitudinal Ageing Study in India (2017-2018), this paper employed propensity score matching (PSM) approach to examine the association between physical activities and cognitive functioning among Indian older adults. Cognitive impairment was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming). We limit our sample to older adults aged 60 + years, and our final dataset contains 31,464 participants (men = 16,366, and women = 15,098). The results indicated that older adults who engaged in frequent physical activity have greater cognitive functioning than older adults without physical activity after adjusting for various individual, health, lifestyle, and household factors. This association holds true for both older men and older women. The results from the PSM revealed that the cognitive function score was increased by 0.98 and 1.32 points for the frequently physically active older men and women population, respectively. The results demonstrate the possible beneficial effects of frequent physical activity on cognitive functioning among older adults. Thus, regular physical activity can be considered as an effective lifestyle factor to promote healthy cognitive aging.

Factors associated with psychiatric disorders and treatment seeking behaviour among older adults in India

Since untreated or undertreated late-life mental disorders is associated with grave consequences including poor quality of life and increased mortality rates, this study investigates the associated factors of psychiatric disorders and its treatment seeking among older adults in India. Data for this study were derived from the Longitudinal Ageing Study in India (LASI) conducted during 2017–2018. The effective sample size was 31,464 older adults aged 60 years and above. Descriptive statistics and bivariate analysis were used to present the preliminary results. Chi-square test was used to find the significance level for bivariate association. Additionally, the Heckprobit selection model was employed to fulfil the objectives. It was revealed that about 2.8% of older adults had psychiatric disorder and of those who were suffering from psychiatric disorder, 41.3% (out of 2.8%) sought medical treatment. It was found that older adults who ever worked but currently not working, who had low level of life satisfaction, had poor self-rated health, had difficulty in activities of daily living (ADL) and instrumental ADL and had symptoms of psychological distress had higher probability of suffering from psychiatric disorder in reference to their counterparts. Older adults from oldest-old age group, who were females, from poorest wealth quintile, from Scheduled Tribe and from eastern region had lower probability of seeking treatment for psychiatric disorder in reference to their counterparts. The findings of the present study urge that greater attention be devoted at detecting and preventing late-life psychiatric disorder particularly among those who are at greater risk vis., male gender, working status as “ever worked but currently not working”, having low life satisfaction, poor SRH, ADL and IADL difficulties, higher psychological distress, belonging to higher wealth quintile and rural place of residence.

Association of elder abuse, crime victimhood and perceived neighbourhood safety with major depression among older adults in India: a cross-sectional study using data from the LASI baseline survey (2017-2018)

OBJECTIVE

The study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.

DESIGN

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

SETTING AND PARTICIPANTS

The study used data from the Longitudinal Ageing Study in India wave 1 (2017-2018). The effective sample size was 31 464 older adults (aged 60 years or older).

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.

RESULTS

5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.

CONCLUSIONS

Healthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.

Feeling about living arrangements and associated health outcomes among older adults in India: a cross-sectional study

INTRODUCTION

Advancement in the field of gerontology has been concerned with the well-being of older adults in a family setup that is associated with caregiving and support. While family life and well-being are defined by emotion, caregiving, and support activities, dissatisfaction/discontent with living arrangements is a public health concern, which is increasing with a rise in the proportion of the older population in the country. The study examines the association of dissatisfaction with living arrangements with health outcomes among older men and women in India.

METHODS

The present research used data from the 'Building a Knowledge Base on Population Aging in India'. The effective sample size for the analysis was 9181 older adults. Descriptive statistics and bivariate analysis were performed to present the preliminary estimates. For finding the association between various health outcomes over explanatory variables, binary logistic regression model was used separately for men and women.

RESULTS

About 22.8% of men and 30.8% of women who were living alone were dissatisfied with their present living arrangement. It was revealed that both men and women who were dissatisfied with their present living arrangements had significantly higher odds of experiencing poor self-rated health [OR:4.45, 3.25 ~ 6.09 and OR:3.32, 2.54 ~ 4.34], low psychological health [OR: 2.15, 1.61 ~ 2.86 and OR: 1.99, 1.57 ~ 2.53], low subjective well-being [OR: 3.37, 2.54 ~ 4.45 and OR: 3.03, 2.36 ~ 3.38], low ADL [OR: 1.77, 1.2 ~ 2.62 and OR: 1.59, 1.17 ~ 2.18, low IADL] [OR: 1.32, 1.03 ~ 1.69 and OR: 1.57, 1.24 ~ 1.98] and low cognitive ability [OR: 1.26, 0.98 ~ 1.61 and OR:1.44, 1.13 ~ 1.82] in comparison to their counterpart from men and women respectively.

CONCLUSION

It is found that dissatisfaction with the living arrangement of older men and women is negatively associated with major health outcomes. Hence, appropriate policies and programs must be developed to promote increased family care and support and an improved residential environment that would create a feeling of comfort and happiness among older individuals.

Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India

BACKGROUND

Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India.

METHODS

Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study.

RESULTS

The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24-2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01-1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95-3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas.

CONCLUSIONS

Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.