Gender differences in the association between cardiovascular diseases and major depressive disorder among older adults in India

Muhammad, T.; Pai, Manacy; Ansari, Salmaan

doi:10.1016/j.dialog.2023.100107

Cited by 3 publications

(3 citation statements)

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“…Second, the CESD-10 was used to identify depression, which is not considered a clinical diagnosis and could contribute to misclassification bias given different cut points used in different studies for the probable depression. However, epidemiology research among older adults in India has shown that the CESD-10 is reliable and valid, as many studies have used this scale to measure depression [ 18 , 70 ]. Third, the cross-sectional nature of the study does not allow any causal associations in this study; and there can be bidirectional or reciprocal associations, for example, between self-rated health and depression among multimorbid older patients.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have also shown that individuals residing in urban areas may be more likely to experience depression than those living in rural areas because of the diminution in social connections and social isolation [ 13 , 14 ]. The most recent studies on multimorbidity and associated depression among older adults in India were conducted in community settings [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study

Saha,

Mandal,

Muhammad

et al. 2024

BMC Psychiatry

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Background In India, the prevalence of depression among older adults dealing with multiple health conditions varies between rural and urban areas due to disparities in healthcare access and cultural factors. The distinct patterns observed underscore the necessity for tailored research and interventions to address mental health inequalities among multimorbid older patients in diverse geographic contexts. Methods This study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017–18). A total of 7,608 adults aged ≥ 60 years who were diagnosed with two or more chronic conditions (such as hypertension, diabetes, cancer, chronic lung disease, chronic heart diseases, stroke, bone/joint disease, any neurological or psychiatric diseases, and high cholesterol) were included in this study. Descriptive statistics, bivariate analysis, logistic regression estimates, and Fairlie decomposition method were used to accomplish the study’s objectives. Results The prevalence of depression among older adults with multimorbidity was 9.48% higher in rural areas (38.33%) than in urban areas (28.85%).. Older adults with multimorbidity belonging to the scheduled caste group were 40% more likely to experience depression. Moreover, those with multimorbidity and any form of disability in activities of daily living (ADL) were 93% more likely to experience depression than those without disability, whereas those with multimorbidity and perceived good general health were 65% less likely to suffer from depression than those with poor self-perceived health. Additionally, decomposition analysis revealed that education (35.99%), caste status (10.30%), IADL disability (19.30%), and perceived discrimination (24.25%) were the primary factors contributing to the differences in depression prevalence among older adults with multimorbidity between rural and urban areas. Conclusions We found significant rural–urban differences in depression among older Indians with multimorbidity. The findings underscore the need for targeted interventions that address the unique challenges faced by older patients in rural areas, including lack of social capital, discrimination, and limited resources that enable access to healthcare services. Policymakers and healthcare professionals must collaboratively design and implement effective strategies to improve the mental health and overall well-being of rural older adults, particularly those with multiple comorbidities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study

Saha,

Mandal,

Muhammad

et al. 2024

BMC Psychiatry

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“…Nevertheless, gender brings a curse to men too. For instance, research in India showed that the association of multiple chronic conditions with depressive symptoms is more pronounced in older men than women 21 , 22 . Similarly, a study among older adults in Korea showed that household wealth, unlike income and education, was significantly associated with higher depressive symptoms in men but not in women 23 .…”

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confidence: 99%

Depression by gender and associated factors among older adults in India: implications for age-friendly policies

Paul,

Muhammad,

Rashmi

et al. 2023

Sci Rep

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Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017–2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to examine our study objectives. Depression was reported in − 7.4% (95% CI 7.0, 7.8) of older men and 9.5% (CI 9.1, 10.0) of older women. Poor self-rated health, multimorbidity status, physical activity, difficulty in activities of daily living (ADL) and instrumental ADL (IADL) were the significant health-related factors associated with depression among older men and women. Not being satisfied with one’s life, not being satisfied with their present living arrangement, receiving any type of ill-treatment, and being widowed were the significant factors associated with depression among older men and women. We found gender disparity in self-reported depression. Marital status contributed-to 36.7% of the gender gap in depression among older adults. Additionally, ADL and IADL difficulties among men and women contributed to 17.6% and 34.0%, gender gap, self-rated health contributed to 18.8% gap, whereas not having equal social participation (4.4%) and not satisfied in present living arrangements (8.1%) were other factors that contributed to gender gap for depression in India. Depression is a critical and persistent public health problem among—older females in India. Our findings provide a broader framework for policymakers and health practitioners to focus on gender-specific strategies to mitigate this highly emergent problem.

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Exploring multimorbidity clusters in relation to healthcare use and its impact on self-rated health among older people in India

Ansari,

Anand,

Hossain

2023

PLOS Glob Public Health

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The conventional definition of multimorbidity may not address the complex treatment needs resulting from interactions between multiple conditions, impacting self-rated health (SRH). In India, there is limited research on healthcare use and SRH considering diverse disease combinations in individuals with multimorbidity. This study aims to identify multimorbidity clusters related to healthcare use and determine if it improves the self-rated health of individuals in different clusters. This study extracted information from cross-sectional data of the first wave of the Longitudinal Ageing Study in India (LASI), conducted in 2017–18. The study participants were 31,373 people aged ≥ 60 years. A total of nineteen chronic diseases were incorporated to identify the multimorbidity clusters using latent class analysis (LCA) in the study. Multivariable logistic regression was used to examine the association between identified clusters and healthcare use. A propensity score matching (PSM) analysis was utilised to further examine the health benefit (i.e., SRH) of using healthcare in each identified cluster. LCA analysis identified five different multimorbidity clusters: relatively healthy’ (68.72%), ‘metabolic disorder (16.26%), ‘hypertension-gastrointestinal-musculoskeletal’ (9.02%), ‘hypertension-gastrointestinal’ (4.07%), ‘complex multimorbidity’ (1.92%). Older people belonging to the complex multimorbidity [aOR:7.03, 95% CI: 3.54–13.96] and hypertension-gastrointestinal-musculoskeletal [aOR:3.27, 95% CI: 2.74–3.91] clusters were more likely to use healthcare. Using the nearest neighbor matching method, results from PSM analysis demonstrated that healthcare use was significantly associated with a decline in SRH across all multimorbidity clusters. Findings from this study highlight the importance of understanding multimorbidity clusters and their implications for healthcare utilization and patient well-being. Our findings support the creation of clinical practice guidelines (CPGs) focusing on a patient-centric approach to optimize multimorbidity management in older people. Additionally, finding suggest the urgency of inclusion of counseling and therapies for addressing well-being when treating patients with multimorbidity.

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Gender differences in the association between cardiovascular diseases and major depressive disorder among older adults in India

Cited by 3 publications

References 88 publications

Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study

Decomposing the rural–urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study

Depression by gender and associated factors among older adults in India: implications for age-friendly policies

Exploring multimorbidity clusters in relation to healthcare use and its impact on self-rated health among older people in India

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