Socioeconomic patterns of underweight and its association with self-rated health, cognition and quality of life among older adults in India

Abstract

BackgroundUnderweight 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.MethodsCross-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.ResultsThe 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.ConclusionThe 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.

The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)

“…It is well-documented that overweight/ obesity are significant predictors of overall mortality [8], chronic diseases such as diabetes [9], cardiovascular disease [10], multimorbidity [11,12], and disabilities [13]. Similarly, underweight is strongly associated with premature mortality, disabilities, and poor self-rated health and well-being, and this association is particularly strong in developing countries [14,15].…”

“…The determinants of the dual burden of malnutrition differ considerably based on gender, socioeconomic, and behavioural factors. Economic status has emerged as an important determinant of overweight/obesity, particularly in developing countries [15][16][17][18]. In contrast, less educated and socially disadvantaged adults tend to be underweight [19,20].…”

“…The selected covariates included age group (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 35-49), place of residence (rural or urban), caste (Scheduled Caste, Scheduled Tribe, Other Backward Class, or other), religion (Hindu, Muslim, or other), currently employed (no or yes), and marital status (unmarried, currently married, widowed, or divorced/ separated).…”

A snapshot of factual bitterness of elderly Indians: It’s time to act

“…(83,84) Underweight, which is other edge of the sword, is associated with poor self-rated health, cognition and quality of life among elderly in India. (85) In the present study, 44% of the elderly were overweight or obese and around 15% were…”

Sleep health disparity: the putative role of race, ethnicity and socioeconomic status

“…70 Eating unhealthy food also causes sleep problems. 71 On the other hand, in underdeveloped countries, low SES can also cause problems tied to being underweight. Because of low SES, an individual can suffer mental and physical health problems, which can then compromise the sleep quality of an individual.…”