ObjectivesSince the onset of the COVID-19 pandemic, behavioural interventions to reduce disease transmission have been central to public health policy worldwide. Sustaining individual protective behaviour is especially important in low-income and middle-income settings, where health systems have fewer resources and access to vaccination is limited. This study seeks to assess time trends in COVID-19 protective behaviour in India.DesignNationally representative, panel-based, longitudinal study.SettingWe conducted a panel survey of Indian households to understand how the adoption of COVID-19 protective behaviours has changed over time. Our data span peaks and valleys of disease transmission over May–December 2020.ParticipantsRespondents included 3719 adults from 1766 Indian households enrolled in the Harmonised Diagnostic Assessment of Dementia for the Longitudinal Ageing Study in India.AnalysisWe used ordinary least squares regression analysis to quantify time trends in protective behaviours.ResultsWe find a 30.6 percentage point (95% CI (26.7 to 34.5); p<0.01) decline in protective behaviours related to social distancing over the observation period. Mask wearing and handwashing, in contrast, decreased by only 4.3 percentage points (95% CI (0.97 to 7.6); p<0.05) from a high base. Our conclusions are unchanged after adjusting for recorded COVID-19 caseload and nationwide COVID-19 containment policy; we also observe significant declines across socioeconomic strata spanning age, gender, education and urbanicity.ConclusionWe argue that these changes reflect, at least in part, ‘COVID-19 fatigue,’ where adherence to social distancing becomes more difficult over time irrespective of the surrounding disease environment.

Background The coronavirus disease (COVID) pandemic caused disruption globally and was particularly distressing in low- and middle-income countries such as India. This study aimed to provide population representative estimates of COVID-related outcomes in India over time and characterize how COVID-related changes and impacts differ by key socioeconomic groups across the life course. Methods The sample was leveraged from an existing nationally representative study on cognition and dementia in India: Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD). The wave-1 of LASI-DAD enrolled 4096 older adults aged 60 years and older in 3316 households from 18 states and union territories of India. Out of the 3316 LASI-DAD households, 2704 with valid phone numbers were contacted and invited to participate in the Real-Time Insights COVID-19 in India (RTI COVID-India) study. RTI COVID-India was a bi-monthly phone survey that provided insight into the individual’s knowledge, attitudes, and behaviour towards COVID-19 and changes in the household’s economic and health conditions throughout the pandemic. The survey was started in May 2020 and 9 rounds of data have been collected. Findings till date Out of the 2704 LASI-DAD households with valid phone numbers, 1766 households participated in the RTI COVID-India survey at least once. Participants were in the age range of 18–102 years, 49% were female, 66% resided in rural area. Across all rounds, there was a higher report of infection among respondents aged 60–69 years. There was a greater prevalence of COVID-19 diagnosis reported in urban (23.0%) compared to rural areas (9.8%). Respondents with higher education had a greater prevalence of COVID-19 diagnosis compared to those with lower or no formal education. Highest prevalence of COVID-19 diagnosis was reported from high economic status compared to middle and low economic status households. Comparing education gradients in experiencing COVID-19 symptoms and being diagnosed, we observe an opposite pattern: respondents with no formal schooling reported the highest level of experiencing COVID-19 symptoms, whereas the greatest proportion of the respondents with secondary school or higher education reported being diagnosed with COVID-19. Future plans The study group will analyse the data collected showing the real-time changes throughout the pandemic and will make the data widely available for researchers to conduct further studies.

The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is a nationally representative in-depth study of cognitive aging and dementia. We present a publicly available dataset of harmonized cognitive measures of 4,096 adults 60 years of age and older in India, collected across 18 states and union territories. Blood samples were obtained to carry out whole blood and serum-based assays. Results are included in a venous blood specimen datafile that can be linked to the Harmonized LASI-DAD dataset. A global screening array of 960 LASI-DAD respondents is also publicly available for download, in addition to neuroimaging data on 137 LASI-DAD participants. Altogether, these datasets provide comprehensive information on older adults in India that allow researchers to further understand risk factors associated with cognitive impairment and dementia.

BackgroundMultilingualism is hypothesized to protect late life cognition such that older multilinguals demonstrate better cognitive functioning compared to monolinguals. However, several studies have failed to find evidence of a multilingual advantage among aging populations. Methodological differences such as inconsistent accounting of critical environmental and sociocultural factors (e.g., educational experiences, lifecourse socioeconomic status, residential urbanicity) associated with multilingualism may explain these inconsistent findings. Furthermore, the lack of research conducted in low‐ and middle‐income countries limit the generalizability of these findings. India offers a unique opportunity to study the role of multilingualism in cognitive aging, given its rich linguistic and sociocultural diversity.MethodThe current study utilizes a national representative sample of older Indian adults from the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Study in India (LASI‐DAD). Respondents included 4,088 adults aged 60 and over, speaking over 40 different languages and dialects (73.6% monolingual, 26.4% report speaking ≥2 languages). We evaluated the association of multilingualism with global cognitive functioning after accounting for critical demographic and health factors such as age, sex, urbanicity, total consumption, diabetes, and hearing loss, among others. We also assessed whether this association differed by region and education.ResultOverall, multilingualism was associated with better global cognition after controlling for demographic and health confounds. There was an interaction between region and multilingualism such that there was a greater benefit of multilingualism on cognition in South India compared to North India. The effect of multilingualism on cognition also differed by level of education, with the greatest benefit among multilinguals with higher levels of education. However, stratified models demonstrated that multilingualism was positively associated with cognition, regardless of education, in South India, whereas this association was only observed among those with higher educational attainment in North India.ConclusionIn India, multilingualism was associated with better cognition, but this association differed by region and educational attainment. Future research should investigate regional variations in lifecourse factors that may explain the differences in the multilingual advantage observed across North and South India. Furthermore, future studies should deconstruct multilingualism (e.g., age of acquisition, proficiency) in order to evaluate their association with cognition cross‐sectionally and longitudinally.

BackgroundThe coronavirus disease (COVID) pandemic caused disruption globally and was particularly distressing in low- and middle-income countries such as India. This study aimed to provide population representative estimates of COVID-related outcomes in India over time and characterize how COVID-related changes and impacts differ by key socioeconomic groups across the life course.MethodsThe sample was leveraged from an existing nationally representative study on cognition and dementia in India: the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD). The wave-1 of LASI-DAD enrolled 4,096 older adults aged 60 years and older in 3,316 households from 18 states and union territories of India. Out of the 3,316 LASI-DAD households, 2,704 households with valid phone numbers were contacted and invited to participate in the Real-Time Insights COVID-19 in India (RTI COVID-India) study. RTI COVID-India is a bi-monthly phone survey that provides insight into the individual’s knowledge, attitudes, and behaviour towards COVID-19 and changes in the household’s economic and health conditions throughout the pandemic. The survey was started in May,2020 and 8 rounds have been completed till date.Findings till dateOut of the 2,704 LASI-DAD households with valid phone numbers, 1,766 households participated in the RTI COVID-India survey at least once. Participants were in the age range of 16-102 years Using the first four waves of survey data, Schaner et al. (2022) reported a gradual decline in protective behaviours like mask wearing and hand washing alongside a more rapid decline in distancing behaviour with a 30% decline in social distancing observed over the first 4 survey waves. Furthermore, women and older adults showed less adherence to protective behaviour, likely due to lower levels of mobility.Future plansA nineth and final round of the study is underway to measure the economic and socio-behavioural changes in the aftermath of India’s Omicron wave. The study group will analyse the data collected showing the real-time changes throughout the pandemic and make them publicly available for researchers to conduct further studies.