Introduction Transition to the oldage marks a change in work and social participation. Socio-economic and physical conditions arising from this change pose a risk for cognitive outcomes among the elderly. Gender shows different pathways to deal with the pattern of participation and to maintain cognitive health. In India, work participation in the oldage is an outcome of financial deprivations and lack of support. At the same time, alterations in social interactions can induce stress and precipitate cognitive decline in oldage. A dearth of studies in this domain motivates us to estimate the effect of change in work and social participation on cognitive performance of the elderly in the Indian context. Methods The study has used the cross-sectional data on 5212 elderly from the World Health Organization’s Study on global AGeing and adult health (Wave 1) (2007–08) in India. A composite score for cognition was generated. Interaction between gender, work status and social participation with respect to cognition was performed using multivariate linear regression. A linear prediction of the cognitive scores across all levels of social participation was post-estimated thereafter. Results The study found that the elderly who were ‘presently working’ and showed ‘more’ social participation had a higher mean score for cognitive performance than their counterparts. Results of regression did not indicate any gender interaction with work or social participation. Participation in social activities ‘sometimes’ by those who were ‘retired’ or ‘presently working’ showed a positive and significant co-efficient with cognition among respondents. The post-estimated values for cognition specified that ‘retired’ and ‘presently working’ elderly had higher cognition scores. In the age group of 60–69 years, cognition scores were higher for those who were ‘retired’ and did ‘more’ social participation as compared to the other elderly. Conclusion Cognitive aging is attenuated by higher participation in work and social activities. Adequate financial schemes or the pension system can protect the elderly from developing further stress. Retirement at an appropriate age, along with a reasonable amount of social participation, is a boon for cognitive wellbeing. Hence, building more support can contain the detrimental effect of participation restriction on cognitive outcome among elderly.
Background: To draw optimal benefits of the demographic dividend, healthy life years of the young adults is a growing concern in India. Rising prevalence of chronic non-communicable diseases among the younger population is responsible for increasing the life years lived with disability among them and for affecting their productivity in turn. This study measures the disability burden in various Indian sub-populations and assesses the contribution of disability to the change in person years lived with a disability during 2001-11. Methods: Data from the Census of India, 2001 and 2011 was used for estimating the age distribution and disability prevalence among males and females. The Sample Registration System was used for age-specific mortality rate to calculate the life table for 15 states in India. Life years Lived with Disability (LLD) were estimated using the Sullivan method. The extension of Arriaga method was used to decompose change in life years lived with disability into Mortality and Disability Effect (ME and DE, respectively). Positive ME explains improvement in life years due to decline in mortality rate and a negative DE explains a decline in disability incidence in 2001-11. Results: At national level, the disability prevalence has increased from 2001 to 2011. The prevalence of disability and the share of LLD to Life Expectancy (LE) is higher for males. High and medium fertility states scored highest on living with disability to LE ratio and measured DE in the decomposition analysis. At the national level, the DE increased in the age groups of 20-35 years. It was higher among the females. The states that are in the advanced stages of demographic transition show a negative DE. Conclusion: The study highlights expansion of DE in prime productive years of life, especially among females, in medium and high fertility states. Decline in skilled employment and productivity can be two major economic adversities due to increasing DE in working ages. Disability among young and working age population needs to be prioritised as most of the Indian states stand at crucial stages of demographic transitions.
ObjectiveThis study aims to identify the unique multimorbidity combinations (MMCs) and their associations with the functional disability of Indian older adults. Moreover, the population attributable fractions (PAFs) were calculated to assess the potential impact of additional diseases in the nested groups on disability.DesignA cross-sectional data were analysed in this study.Setting and participantsThe present study uses data from the first wave of the Longitudinal Ageing Study in India (2017–2018). The sample for the study consists of 27 753 aged 60 years and over.Primary and secondary outcome measuresThe primary outcome variable was functional disability, measured by the combined activities of daily living (ADL)-instrumental activities of daily living (IADL) index.ResultsOut of 197 uniquely identified MMCs, the combination of hypertension and high depressive symptoms (HDS) was the most prevalent (10.3%). Overall, all MMCs were associated with increased functional limitation. Specifically, the combination of hypertension, arthritis and HDS was associated with greater ADL-IADL disability than any other MMC. The addition of HDS in group 3 (hypertension and arthritis) (incidence rate ratios (IRR)=1.44; 95% CI 1.26 to 1.64) and the addition of arthritis in group 1 (hypertension, HDS) (IRR=1.48; 95% CI 1.28 to 1.71) and group 2 (hypertension, diabetes) (IRR=1.49; 95% CI 1.22 to 1.82) significantly increases the rates of ADL-IADL disability. The estimated PAFs of the group 1 (hypertension and HDS), group 3 (hypertension and arthritis) and group 4 (arthritis and HDS) for ADL-IADL disability were 22.5% (19.2–25.5), 21.6% (18.7–24.4) and 23.5% (20.6–26.3), respectively.ConclusionThe findings from this study underscore the importance of addressing the morbidity combinations which are more disabling than the others in older adults. Understanding the somatic and psychological relevance of the morbidities in functional health is necessary and can help reduce disabilities among older adults.
Vaccines for COVID-19 in India have been allowed to be administered among large pool of adult population. In-depth knowledge regarding the adverse effect of vaccine is scarce till date, mainly due to the lack of reporting, analysing and making the data publicly available. Informed choice by the recipients is totally barred and further, compensation associated with the vaccination is also compromised. These important issues need to be highlighted in the public forum for greater awareness and action.
Background Disability has been an essential component of the health and development framework of India. Despite policy norms, a surge in disability across the population interrogates the role of the increasing elderly population in terms of chronic diseases led disabilities. The regional variation in demographic transitions possesses an unequal risk for the occurrence of disability in the population. The demographic and socio-economic factors can explain the inequality contributed by the elderly and non-elderly population. Methods We have used the National Sample Survey-76th round (2018) to measure the risk difference of disability between elderly and non-elderly age-groups across selected background characteristics. Fairlie’s decomposition technique has been adopted to measure the contribution made by the socio-economic factors in explaining the differences in the prevalence of disability. Distribution of states with respect to prevalence and risk difference of disability between elderly and non-elderly are plotted, to understand the regional inequality in the occurrence of disability in India. Results The study calculates a risk difference of 68 per 1000 population in India, explaining a higher risk of disability among the elderly that varies across socio-economic factors. Belonging from the Central region of India represents a higher risk of disability at old age (risk difference 76.8 per 1000 population) than the rest of the regions in India. Gender, marital status, and education explain 72 percent of the gap in the occurrence of disability between two broad age-groups. Despite having a similar disability prevalence, Kerala and Odisha have risk differences of 32 and 85 per 1000 population, respectively. Conclusions The gap in the disability prevalence is significantly explained by the marital status and educational status of the individuals. Disparity in the risk difference of disability among elderly and non-elderly across states suggests that large size of the elderly population is not the only reason for the increasing disability burden in India. Inadequate healthcare infrastructure and access also results into an unmet health care need pertaining to disability. Study suggests a policy relevance for disability-inclusive and geriatric centric healthcare and social supports in synchronisation with the demand realised by the states in India.
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