Chronic morbidity and reported disability among older persons from the India Human Development Survey

Abstract

BackgroundThe burden of disability and chronic morbidity among the elderly has been increasing substantially in India in recent years. Yet, the use of nationally representative data to investigate the relationship between chronic morbidity and reported disability in the country has been minimal. The objective of this study is twofold: i) to quantify the association between chronic morbidities and overall disabilities in the activities of daily living (ADLs) among elderly people in India, and ii) to understand how various chronic morbidities influence individual ADLs, specifically, walking, toileting and dressing.MethodsWe used data from the India Human Development Survey-II (IHDS-II) as a basis for this study. We computed the Katz Index of independence in ADL to examine the burden of disability among the elderly. Ordered logistic regression was carried out to examine the effect of chronic morbidities on: i) the disability index (where 0 = no disability; 1 = disability in 1 or 2 ADLs; and 2 = disability in 3 ADLs), and ii) disabilities in three ADLs in the population over-60 years of age in India.ResultsThe percentage of people scoring lower Katz index (indicating severe and mild disability) in at least one of the three ADLs is very high in India (17.91% for males and 26.21% for females). Irrespective of the type of ADL, the Katz score is lower in elderly females than in elderly males. Elderly people who are illiterate and belong to the poorest wealth quintile report lower Katz scores in ADL. Both bivariate and multivariate analyses confirm that all three types of chronic morbidities are positively and significantly associated with a disability condition in the ADLs. Yet, the effects of morbidities vary greatly according to the type of disability. For instance, while diabetes affect walking (OR: 2.56; 95% CI: 2.29–2.86), and toileting (OR: 2.63; 95% CI: 2.26–3.07), high blood pressure mainly affects walking (OR: 2.29, 95% CI: 2.09–2.5) and dressing disabilities (OR: 2.13, 95% CI: 1.84–2.46).ConclusionsChronic morbidity is a decisive factor in old age disability. It is crucial to reduce chronic morbidity in a timely way to minimise the enormous associated burden of disability.

The Role of Socio-Economic Inequality in Physical Immobility Among Older Adults: Did the Scenario Changed from 2004-05 to 2017-18?

“…Interestingly and not consistent with previous studies (50,51), it was found that physical immobility was highly concentrated among well-off older adults. Age of the older adult was the highest contributor to the observed inequality in physical immobility among older adults in India during 2004-05, whereas, monthly Per capita expenditure (MPCE) was the highest contributor to the observed inequality in physical immobility among older adults during 2017-18.…”

Seasonal influenza vaccination in older people: A systematic review and meta-analysis of the determining factors

“…[61] Frequent visits to the physician have been shown to be associated with an increased receipt of SIV. [38] Studies have also suggested a slightly higher morbidity in older females compared with males in some populations, [62,63] with a study from China suggesting that older females have more comorbidities than males. [64] Since morbidity is a determinant of increased SIV uptake, as reported in this review (as well as other studies), the observed variation in the association of sex with SIV uptake in Asia compared with Europe could be a result of more morbidity among older females compared with males in the studies from Asia.…”

Dynamics of chronic diseases in metro and non-metro regions of India: evidence from India Human Development Survey I and II

“…Diabetes, high blood pressure, and heart diseases, which were self-reported in IHDS data in both rounds of survey i.e., 2004 and 2012, are clubbed into variable named chronic diseases coded as 0 and 1. 17 Six cities, which include Mumbai, Delhi, Kolkata, Chennai, Bangalore, and Hyderabad, are clubbed as metro cities in both rounds of IHDS.…”