Association of Social deprivation with cognitive abilities in older adults in India – Evidence from LASI

Abstract

Background Existing evidence indicates that the link between socioeconomic status and mental health is complex and overlapping. Although cognitive functioning declines with age and is directly linked to biological brain changes as people age, socioeconomic factors play an essential role in the level and change of cognitive functioning and onset of depression in older adults. This study attempts to assess the association between social deprivation, cognitive status, and depression among older persons in India. Data and Methods The LASI Wave 1, collected in India between 2017 and 2018, was used for this study. Social deprivation Index (SDI) was constructed. Education, wealth quintile, working status, living arrangements etc. were SDI indicators. Multivariate logistic regressions were used to establish the association between outcome and explanatory variables. Results The findings reveal that 31% of people with higher social deprivation have poor cognitive health compared to only 8% of people with lower social deprivation. Further, 60.5% of people with higher social deprivation have depressive symptoms compared to 25.8% of people with lower social deprivation. The prevalence of poor cognitive health (18.5%) and depressive symptoms (32.1%) are highest among older adults with no schooling, and further the good cognitive health (0.3%) in older adults with ten or more years of education. The exploratory analysis indicated that cognitive health and depressive symptoms were significantly associated with age, place of residence, marital status, caste/tribe, and religion. Conclusion The findings suggest that older adults (75 and above) with depressive and cognitive dysfunctioning were the largest in the case of highly socially deprived. In other age groups, highly socially deprived people are more vulnerable to poor cognitive health and depressive symptoms. The findings from the study inform the policymakers and planners to devise policies considering equitable healthcare needs to improve mental health among older adults, which is generally ignored in India.