Multimorbidity and Complex Multimorbidity in India: Findings from the 2017–2018 Longitudinal Ageing Study in India (LASI)

Sinha, Abhinav; Kerketta, Sushmita; Ghosal, Shishirendu; Kanungo, Srikanta; Lee, John Tayu

doi:10.3390/ijerph19159091

Cited by 14 publications

(19 citation statements)

References 26 publications

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“…Previous studies indicated that the prevalence of multimorbidity was higher among rural older adults [ 20 , 34 ]. A study conducted in India found that participants residing in urban areas were more likely to report complex multimorbidity [ 35 ]. These inconsistencies may be partly due to the differences in sampling size and chronic conditions.…”

Section: Discussionmentioning

confidence: 99%

Gender and Socioeconomic Differences in the Prevalence and Patterns of Multimorbidity among Middle-Aged and Older Adults in China

Zhong

Guo

et al. 2022

IJERPH

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Background: Multimorbidity has become a global public health concern. Knowledge about the prevalence and patterns of multimorbidity will provide essential information for public intervention and clinical management. This study aimed to examine gender and socioeconomic differences in the prevalence and patterns of multimorbidity among a nationally representative sample of middle-aged and older Chinese individuals. Methods: Data were obtained from the 2018 wave of the China Health and Retirement Longitudinal Study. Latent class analysis was conducted to discriminate among the multimorbidity patterns. Multinomial logit analysis was performed to explore gender and socioeconomic factors associated with various multimorbidity patterns. Results: A total of 19,559 respondents over 45 years old were included in the study. The findings showed that 56.73% of the respondents reported multimorbidity, with significantly higher proportions among women. Four patterns, namely “relatively healthy class”, “respiratory class”, “stomach-arthritis class” and “vascular class”, were identified. The women were more likely to be in the stomach-arthritis class. Respondents with a higher SES, including higher education, urban residence, higher consumption, and medical insurance, had a higher probability of being in the vascular class. Conclusions: Significant gender and socioeconomic differences were observed in the prevalence and patterns of multimorbidity. The examination of gender and socioeconomic differences for multimorbidity patterns has great implications for clinical practice and health policy. The results may provide insights to aid in the management of multimorbidity patients and improve health resource allocation.

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Section: Discussionmentioning

confidence: 99%

Gender and Socioeconomic Differences in the Prevalence and Patterns of Multimorbidity among Middle-Aged and Older Adults in China

Zhong

Guo

et al. 2022

IJERPH

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“…Third, the governance scheme for the health poverty vulnerability of rural elderly families should focus on improving the family coping ability. Primary care facilities should be strengthened to increase availability and accessibility while making the facilities affordable ( 64 ).…”

Section: Discussionmentioning

confidence: 99%

The mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China: A cross-sectional survey

Guo

Du²,

Chen³

et al. 2022

Front. Public Health

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BackgroundVulnerability to health-related poverty can predict the probability of families falling into poverty due to health risk impact. In this study, we measured the vulnerability to health-related poverty and examined the mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China.MethodsThis cross-sectional study was conducted in Ningxia, China, in February 2019. A multi-stage stratified cluster-randomized design was used to obtain a representative sample in each county. We included participants aged 60 years and older, who had lived there for more than 1 year. A total of 3,653 rural residents older than 60 years old were selected as the research subjects. The three-stage generalized least square method was used to calculate the expected vulnerability to poverty. We used mediating effect model to test the mediation path of poverty vulnerability related to the physical multimorbidity.ResultsUnder different poverty line standards, i.e., $1.9/day as low vs. $3.1/day as the high poverty line, the proportion of families that could fall into poverty in the future was 5.3 and 53.7%, respectively. The prevalence of chronic diseases and physical multimorbidity among rural residents >60 years old was 64.62 and 21.24%, respectively. The results of mediating effect test showed that self-rated health status (indirect effect a × b = −0.0052), non-agricultural employment (a × b= −0.0046), household cattle production (a × b = 0.0004), housing type (a × b = −0.0008), gift expenses (a × b = 0.0006) and loan for illness (a × b = 0.0034) were the mediation paths of poverty vulnerability related to the physical multimorbidity.ConclusionsConcerted efforts are needed to reduce poverty vulnerability related to the physical multimorbidity. The strategy of alleviating poverty should emphasis on promoting non-agricultural employment of vulnerable groups sustainability and developing rural economy, which are important paths to reduce family's vulnerability to health-related poverty.

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“…For example, “race/ethnicity”, a social construct that is relevant in the U.S., does not have a direct equivalent in India. Therefore, in place of race/ethnicity, we utilized “caste”, a group based on social class hierarchy in India, and “religion”, with sub-categories of Hindu, Muslim, Christian, and others, the latter three being minority religions in a secular India [ 9 , 18 , 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…Prior studies have reported the multimorbidity in India to be as much as 50% or higher among older adults ≥45 years [ 3 , 4 , 5 ]. Previous studies focused on aging in India have reported that the prevalence of multimorbidity- to increases with age and socioeconomic status (SES) [ 3 , 9 , 10 ]. For example, the prevalence of multimorbidity as reported in the urban poor sub-population who were ≥75 years old was higher than in the 60–74 age group or the 45–59 age group in India (64.14 vs. 53.41 vs. 33.83) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Characterizing Multimorbidity Prevalence and Adverse Outcomes in Ethnically and Culturally Diverse Sub-Populations in India: Gaps, Opportunities, and Future Directions

Zanwar,

Taylor,

Hill-Jarrett

et al. 2024

IJERPH

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India is a large middle-income country and has surpassed China in overall population, comprising 20% of the global population (over 1.43 billion people). India is experiencing a major demographic shift in its aging population. Chronic diseases are common among older adults and can be persistent over the life course, lead to the onset of disability, and be costly. Among older adults in India, the existence of multiple comorbid chronic conditions (i.e., multimorbidity) is rapidly growing and represents a burgeoning public health burden. Prior research identified greater rates of multimorbidity (e.g., overweight/obesity diabetes, hypertension, cardiovascular disease, stroke, and malignancies) in minority populations in the United States (U.S.); however, limited studies have attempted to characterize multimorbidity among older adult sub-populations residing in India. To address this gap, we conducted a narrative review of studies on multimorbidity using the data from the Longitudinal Aging Study of India (LASI), the largest nationally representative longitudinal survey study of adults in India. Our definition of multimorbidity was the presence of more than two conditions in the same person. Our findings, based on 15 reviewed studies, aim to (1) characterize the definition and measurement of multimorbidity and to ascertain its prevalence in ethnically and culturally diverse sub-populations in India; (2) identify adverse outcomes associated with multimorbidity in the Indian adult population; and (3) identify gaps, opportunities, and future directions.

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Multimorbidity and Complex Multimorbidity in India: Findings from the 2017–2018 Longitudinal Ageing Study in India (LASI)

Cited by 14 publications

References 26 publications

Gender and Socioeconomic Differences in the Prevalence and Patterns of Multimorbidity among Middle-Aged and Older Adults in China

Gender and Socioeconomic Differences in the Prevalence and Patterns of Multimorbidity among Middle-Aged and Older Adults in China

The mediation path of physical multimorbidity on the vulnerability to health-related poverty of rural aging families in Ningxia, China: A cross-sectional survey

Characterizing Multimorbidity Prevalence and Adverse Outcomes in Ethnically and Culturally Diverse Sub-Populations in India: Gaps, Opportunities, and Future Directions

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