Search

Adult height is a summary measure of health and net nutrition in early childhood. This study examines the association between height and quality-of-life outcomes in older adults (50+) in India. Cross-sectional data from Wave 1 of the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) conducted in 2007 were analysed. The association between height and quality of life was assessed using bivariate and multivariate logistic and linear regression models. The mean WHO quality-of-life score (WHO-QoL) increased from 45.2 among the older adults in the lowest height quintile to 53.2 for those in the highest height quintile. However, the prevalence of self-rated poor quality of life declined from 16.4% in the lowest height quintile to 6.1% in the highest height quintile. In the fully adjusted regression model, height was found to be positively associated with quality-of-life outcomes among both men and women, independent of socioeconomic and physical health confounders. The association was particularly strong for women. Women in the highest height quintile had a 2.65 point higher WHO-QoL score than those in the lowest height quintile. Similarly, the likelihood of reporting a poor quality of life was lower among women in the highest height quintile. Furthermore, measures of economic status, handgrip strength, cognitive ability and poor self-rated health were significantly associated with WHO-QoL and self-rated poor quality of life. Overall, this study revealed a significant association between height and quality of life among older adults in India, suggesting a significant role of childhood circumstances in quality of life in later life.

Very little is known about the association of back pain with subjective health and well-being and sleep problems among the older population in middle-income countries. In this study, we examine the association of back pain with four health outcomes — poor self-rated health, impairments in activities of daily living (1+ADL), sleep problems and World Health Organization Quality of Life score (WHOQOL) — and to study what extent the association differs by age group. Nationally representative data from World Health Organization’s Study on global AGEing and adult health (WHO-SAGE) consisting of 33,878 older adults aged 50 or above were analyzed. The linkages of back pain with poor self-rated health, impairments in activities of daily living (1+ADL), and sleep problems were examined using multivariate logistic regression analysis. Multivariate linear regression was used to assess the association between back pain and quality of life. In the pooled analysis, the association of back pain with four health outcomes were significant. Older adults who reported low back pain were more likely to report poor self-rated health (OR=1.91; p < .001), impairments in activities of dailiy living (ADL) (OR=2.06; p < .001), and sleep problems (OR=2.04; p < .001), and had lower quality of life score (β = −3.23, p < .001). Furthermore, the association of back pain and poor self-rated health, impairments in ADL, and sleep problems was stronger for the 50–59 age group than the 80 or above age group, suggesting significant age interaction in the association. This study suggested the significant role of back pain in determining subjective health, wellbeing, and sleep problems. Measures to prevent back pain, particularly among those in the 50–59 age group, are important to enhance overall wellbeing of the growing older population in low- and middle-income countries.

Globally, elder abuse/mistreatment is a common form of violence against the elderly. This study examines the association between multimorbidity and abuse/mistreatment among the elderly population (60+) in India. Cross-sectional data from the United Nations Population Fund (UNFPA)’s “Building Knowledge Base on Population Aging in India” (BKPAI, 2011) was analyzed. We generated a multimorbidity variable by combining 20 self-reported diagnosed chronic diseases. Bivariate analysis was used to understand the sample distribution and prevalence estimation of elder abuse/mistreatment by multimorbidity and state. Furthermore, multilevel mixed-effect logistic regression was used to examine the association between multimorbidity and elder abuse/mistreatment. The overall prevalence of elder abuse/mistreatment in the study population is 11.4%. The prevalence of elder abuse/mistreatment among elderly with no chronic diseases is 6.01% which increases to 22.7% among elderly with four or more chronic diseases. Furthermore, the result from the multilevel mixed-effect logistic regression showed a close association between multimorbidity and elder abuse. Elderly with two, three, and four or more chronic diseases are 3.02 (CI = 2.33, 3.91, p < .000), 4.16 (CI = 3.02, 5.74, p < .000), and 5.06 (CI = 3.50, 7.31, p

In India, more than one third of older adults are underweight. The prevalence of edentulism is higher among older adults. Yet, the role of underweight in determining edentulism is remains unclear. This study examined the association between underweight and self-reported edentulism among older men and women in India. Nationally representative cross-sectional data from the first wave WHO’s Study on global AGEing and adult health (SAGE ) survey was used (n = 6366). The association between underweight and edentulism was examined using multivariable logistic regression analysis adjusting for age, residence, marital status, years of schooling, wealth quintile, tobacco use, self-rated health, chronic diseases, and state/province. The overall prevalence of underweight in the study population was 38%. The prevalence of edentulism was higher among women (16%) respondents compared to men (14%). Further, underweight women had a 51% higher risk of edentulism (OR = 1.51; CI: 1.12, 2.43; p

This study examines gender differences in sleep problems among older adults in India, China, Ghana, Mexico, Russia, and South Africa. We used data on 33,929 individuals (50+ years) from the WHO-SAGE. Results showed significant gender differences in the prevalence of sleep problems with the largest difference in Russia followed by India. Regression results showed higher odds of sleep problems among women in India, China, Russia, and South Africa. Age, low back pain, depression, and poor self-rated health were significantly associated with sleep problems. This research confirms significant gender differences in sleep problems among the older population in middle-income countries.

Background Cognitive functioning is an important measure of intrinsic capacity. In this study, we examine the association of life course socioeconomic status (SES) and height with cognitive functioning among older adults (50+) in India and China. The age pattern of cognitive functioning with measures of life course socioeconomic status has also been examined. Methods Cross-sectional comparative analysis was conducted using the WHO’s Study on global AGEing and adult health (SAGE) data for India and China. Multilevel mixed-effect linear regression analysis was used to examine the association of life course socioeconomic status and adult height with cognitive functioning. Results In both India and China, parental education as a measure of childhood socioeconomic status was positively associated with cognitive functioning. The association between adult socioeconomic status and cognitive functioning was positive and significant. Height was significantly and positively associated with improved cognitive functioning of older adults in India and China. Furthermore, the age-related decline in cognitive functioning score was higher among older adults whose parents had no schooling, particularly in China. The cognitive functioning score with age was much lower among less-educated older adults than those with higher levels of education in China. Wealthier older adults in India had higher cognitive functioning in middle ages, however, wealth differences narrowed with age. Conclusions The results of this study suggest a significant association of lifetime socioeconomic status and cumulative net nutrition on later-life cognitive functioning in middle-income settings.

Little is known about the prevalence and association between visual impairment, low vision acuity, and sleep indicators (sleep duration and sleep problem) in the Indian context. We investigate this association for Indian older adults (50+ ages). Using cross-sectional data from WHO-Study on global AGEing and adult health (WHO-SAGE) 2007–2008, a sample of 6560 ( Mage = 61.81, SD = 9.00) was selected for analysis. Self-reported visual impairment and performance-based low vision acuity were used as outcome variables, whereas sleep duration, problem in sleep, and medical condition with socio-demographic were used as covariates. Multivariate logistic regression analyses were conducted. In a fully adjusted model (including all covariates), vision impairment was associated with short sleep duration (

Cognitive functioning is an important factor in determining overall well-being in adults. The research conducted in this area has mainly focused on dementia and gender differentials in cognitive ability. Using data from WHO’s Study on global AGEing and adult health (SAGE), this study examines the association of individual, household, contextual socioeconomic status, and chronic morbidities with cognitive abilities of younger (18-49) and older adults (50+) in India. Multilevel linear hierarchical model was used to examine this association. Results show that the years of schooling and household income were positively and significantly associated with cognitive abilities in younger and older adults. Community level socioeconomic status was positively associated with cognition in adults. Females had significantly lower cognitive abilities than male counterparts. Further, chronic morbidites and edentulism were negatively associated with cognition, especially the association of chronic morbidities was stronger in younger adults (β = −0.11; p

Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity—a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO’s Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.

BackgroundCognitive ability is an important measure of intrinsic capacity. In this study, we examine the association of life course socioeconomic status (SES) and height on cognitive functioning among older adults aged 50 and above for the two middle-income countries of India and China. We further assess the age pattern of cognitive decline with measures of life course socioeconomic status. MethodsCross-sectional comparative analysis was conducted using the WHO’s Study on global AGEing and adult health (SAGE) data for India and China. Multilevel mixed-effect regression analysis was used to predict the association of life course socioeconomic status, height with cognitive functioning. ResultsIn India and China, better childhood socioeconomic status measured as parental education is positively associated with cognitive functioning. The association between adult socioeconomic status and cognitive functioning was positive and highly significant. Height was significantly associated with improved cognitive functioning for India and China. Furthermore, the age-related cognitive decline was faster among older adults whose parents had no schooling, particularly the association between mother’s education and cognitive functioning is stronger in China. The cognitive decline is much faster among less-educated older adults than those with 10+ years of schooling in China. Wealthier older adults in India had higher cognitive functioning in middle age, however, wealth differences narrowed in older ages, suggesting the convergence of cognitive functioning by economic status at older ages. ConclusionsThe results of this study suggest a significant long-term impact of childhood conditions on later-life cognitive functioning in middle-income settings.

Background Muscle strength, measured as grip strength is a potential marker of bodily function and sarcopaenia. Yet, not much is known about its patterns and correlates among older population in India. This study assesses the age and socioeconomic patterns and state variations in grip strength among older adults (50+) in India. Methods A cross-sectional and nationally representative data from the first wave of WHO’s Study on global Ageing and Adult Health (SAGE) −2007 (n = 6262) was used. Multivariable linear regression analyses were used to understand the regional variations and association of socioeconomic status and general health with grip strength, adjusting for anthropometric and demographic confounders. Results Socioeconomic status has a significant association with grip strength. Moreover, the association between wealth quintile and grip strength was highly significant. Further, the socioeconomic differences in grip strength narrowed in older ages, especially among men, supporting the convergence of health inequality hypothesis. Notable differences were observed in grip strength across selected states of India. Poor self-rated health was negatively associated with grip strength. Edentulism in men was associated with reduced grip strength. Conclusion This study has contributed to a better understanding of significant social and regional inequalities in grip strength among older population in India. State-specific and subgroup level interventions are important to improve the physical functioning of the growing older population in India.

Sleep is an important predictor of health and quality of life. This study examined the association between sleep problems and sleep duration with self-rated poor health and grip strength among respondents aged 50 years and above in India and China. Methods: The data for this study were derived from the first wave of WHO’s Study on Global Aging and Adult Health (SAGE), a nationally representative panel survey conducted in six LMICs. Grip strength and poor self-rated health were the main outcome variables, while sleep problems and sleep duration were the main predictors. Multivariate logistic regression models and ordinary least squares regression models were used to understand the association between sleep problems and sleep duration with poor self-rated health and grip strength. Sleep problems and sleep duration were strongly and significantly associated with poor self-rated health and grip strength in India and China. Compared to older adults with no sleep problems, the odds ratio for poor self-rated health among older adults with sleep problems was 4.86 (95% CI = 4.12, 5.73, p

Background Underweight defined as body mass index (BMI) < 18.5 is associated with negative health and quality of life outcomes including mortality. Yet, little is known about the socioeconomic differentials in underweight and its association with health and well-being among older adults in India. This study examined the socioeconomic differentials in underweight among respondents aged ≥50 in India. Consequently, three outcomes of the association of underweight were studied. These are poor self-rated health, cognition and quality of life. Methods Cross-sectional data on 6,372 older adults derived from the first wave of the WHO’s Study on global AGEing and adult health (SAGE), a nationally representative survey conducted in six states of India during 2007–8, were used. Bivariate and multivariate regression analyses were applied to fulfil the objectives. Results The overall prevalence of underweight was 38 percent in the study population. Further, socioeconomic status showed a significant and negative association with underweight. The association of underweight with poor self-rated health (OR = 1.60; p < .001), cognition (β = –0.95; p < .001) and quality of life (β = –1.90; p < .001) were remained statistically significant after adjusting for age, sex, place of residence, marital status, years of schooling, wealth quintile, sleep problems, chronic diseases, low back pain and state/province. Conclusion The results indicated significant socioeconomic differentials in underweight and its association with poor self-rated health, cognition and quality of life outcomes. Interventions focussing on underweight older adults are important to enhance the overall wellbeing of the growing older population in India.