Waad Ali

This study examined the associations between migrant status, social isolation, and loneliness among older adults in India, as well as whether these associa

This study examines the long-term relationship between loneliness and depressive symptoms in older U.S. adults over 16 years. Data were drawn from the Health and Retirement Study, specifically Waves 8 (2006) and 16 (2022). Two samples were created: (1) participants aged 60+ without depressive symptoms in 2006 (n = 790) to examine whether baseline loneliness predicts later depressive symptoms, and (2) participants not lonely in 2006 (n = 788) to examine whether baseline depressive symptoms predict later loneliness. Loneliness was measured using the Revised UCLA Loneliness Scale, and depressive symptoms were assessed with a modified 7-item CES-D scale. Descriptive statistics and logistic regression models were used. Older adults who reported loneliness in 2006 had nearly twice the odds of developing depressive symptoms by 2022 compared to their non-lonely counterparts (AOR = 1.98, 95% CI: 1.06-3.69). Baseline depressive symptoms also increased the likelihood of later loneliness (AOR = 1.70, 95% CI: 1.04-2.79). Additionally, cognitive impairment was associated with later loneliness, with women and individuals with poorer self-rated health at higher risk of developing depressive symptoms. The findings reveal a strong link between loneliness and depressive symptoms in later life, emphasizing the need for interventions that tackle both issues together.

We examined the associations between perceived neighborhood safety, crime exposure, and the prevalence of chronic conditions and multimorbidity among older adults in India. Moreover, we examined whether these associations varied by functional disabilities measured by difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Data came from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE), India Wave 2, conducted in 2015. Neighborhood safety was measured by perceptions of safety at home and while walking after dark, whereas crime exposure was assessed through reports of household victimization by violent crime in the past year. Chronic conditions were self-reported physician diagnoses of hypertension, diabetes, stroke, arthritis, angina, asthma, and lung disease, with multimorbidity defined as the presence of more than two chronic diseases. Multivariable regression analyses were used to examine the main associations and interaction terms to test the moderating role of ADL/IADL disabilities. The mean score of neighborhood safety (on a scale of 0–10) was 7.72 (SD: 2.05). Approximately 6% of the participants reported that they or someone in their household had been victims of violent crime in the previous year. Older adults with perceived neighborhood safety reported a lower number of chronic conditions (adjusted beta: -0.03, confidence interval [CI]: -0.04 to 0.01) and lower odds of multimorbidity (adjusted OR: 0.95, CI: 0.91 – 0.99). Those with crime exposure reported a higher number of chronic conditions (adjusted beta: 0.10, CI: 0.02 – 0.19). These associations were significantly more pronounced among those with ADL/IADL disabilities. Perceived neighborhood safety and crime exposure were significantly linked to chronic diseases and multimorbidity among older adults in India, particularly among those with functional disabilities. These findings underscore the need for targeted strategies to improve neighborhood safety and support among older Indians with functional disabilities.

With a rapidly aging population, physical frailty has become a significant public health concern globally. While the association between frailty, depression, and cognitive decline has been widely studied in developed countries, there is limited evidence from low- and middle-income countries, including India. Additionally, little is known about the sex-specific associations between frailty, and mental and cognitive health outcomes. We examined the associations of physical frailty with depressive symptoms and cognitive functioning among older Indian men and women, while also exploring how the frailty-cognition link differs between those with and without depression. We used data from the Longitudinal Aging Study in India, conducted between 2017 and 2019. The analytic sample consisted of 14,652 males and 15,899 females aged ≥ 60 years. Frailty was assessed using a modified version of Fried’s frailty phenotype, depressive symptoms were evaluated using the Composite International Diagnostic Interview- Short Form, and cognitive ability was measured through memory, orientation, arithmetic, executive function, and object naming tasks. Univariate and multivariable linear regression models were used to examine the associations between frailty, depressive symptoms, and cognitive ability in older men and women, as well as frailty-cognition association by depressive status. The prevalence of frailty was higher in older women than that in older men (32.2% vs. 27.4%). The mean depressive symptom score was higher (0.8 vs 1.0), and the mean cognitive score was lower (26.4 vs 22.1) among older women than men. Physical frailty was associated with higher levels of depressive symptoms (β = 0.51; 95% CI: 0.39, 0.64), and poor cognitive performance (β = -1.06; 95% CI: -1.37, -0.75). Non-frail older men had lower depressive symptoms than frail older men (β = -0.48; 95% CI: -0.66, -0.31), however, the association was not significant among older women. Furthermore, frail older women performed worse on cognitive tests than did frail older men (β = -2.14; 95% CI: -2.40, -1.87). In addition, non-frail older women had poorer cognitive performance than frail older men (β = -0.77; 95% CI: -1.22, -0.32). Conversely, stratification by depressive status showed that frailty was associated with worse cognitive ability, with no difference between individuals with and without depression. We found that frail older individuals, particularly women, have significant mental and cognitive deficits compared with their non-frail counterparts. Our findings have major implications in both community and clinical settings. Appropriate policies and programs should be implemented to reinforce the strength of pre-frail and frail older adults and maintain improved mental health and cognition in older adults.

Background: The integration of mindfulness activities into the daily lives of older adults has demonstrated profound benefits for their overall well‐being and vitality. However, evidence on how mindfulness correlates with muscle strength in older adults remains limited. To fill this gap, we explored the association between mindfulness activities and handgrip strength (HGS) in older adults in India. We also examined whether this association varies by sex. Methods: We employed a propensity score matching technique, leveraging data from the nationally representative Longitudinal Aging Study in India (2017–2018), comprising 27 071 adults aged 60 and above. HGS was measured using a handheld Smedley Hand Dynamometer while participants self‐reported their engagement in mindfulness activities. Results: Seventeen % of the men and 11.5% of the women engaged in mindfulness activities. Analysis of the matched sample revealed that the average treatment effect (ATE) that represents the average effect across the entire population was 1.28 kg for men and 0.60 kg for women, indicating that, on average, participation in mindfulness activities was associated with modest improvements in HGS for both sexes. Further, in the PSM matched regression models, for men, engagement in mindfulness activities was consistently associated with higher HGS across all models including the average treatment effect on the treated (ATT), on the untreated (ATU), and ATE, with the largest effect seen in the ATE model ( β = 1.08, 95% CI: 0.77–1.40). For women, the association was weaker and significant only in the unmatched and ATE models. Conclusions: Engagement in mindfulness activities was associated with modest but meaningful improvements in HGS among older adults in India, with the associations being much more pronounced in older Indian men. These findings underscore the significance of integrating mindfulness practices into public health initiatives aimed at promoting healthier aging.

There is a limited understanding of the age at onset of chronic diseases linked to an increased risk of physical frailty among older persons, despite the well-established link between chronic diseases and frailty. This study aimed to examine the prevalence of early- and late-onset chronic diseases and their association with physical frailty and its components in older adults in India. Data from the Longitudinal Aging Study in India (LASI), wave 1 (2017–2018), were used with a sample of 31,386 older adults aged 60 years and above, including 15,043 males and 16,343 females. Physical frailty was assessed by using an adapted version of the frailty phenotype developed by Fried et al.. The main explanatory variable was self-reported age at the onset of chronic diseases, and a cutoff of 50 years was considered to define the early and late onset of chronic disease. Multivariable logistic regression models were used to examine the association between early and late onset of chronic diseases and physical frailty and its components. Overall, 30.65% of the sample population was physically frail, and frailty was much higher in the 80 years and aboveage group (54.23%). Compared to individuals without any morbidity, those with late onset of single morbidity (AOR: 1.22, CI: 1.09–1.36) and multimorbidity (AOR: 1.49, CI: 1.29–1.71) had higher odds of physical frailty. Similarly, multimorbidity was significantly associated with most components of physical frailty, with the exception of weight loss. Older adults with late-onset hypertension (AOR: 1.22, CI: 1.09–1.36), stroke (AOR: 1.75, CI: 1.35–2.27), and heart disease (AOR: 1.58, CI: 1.21–2.06) had higher odds of physical frailty than those without any morbidity. The odds of being physically frail were higher in those with early onset arthritis (AOR: 1.55, CI: 1.15–2.08) and late-onset of arthritis (AOR: 1.35, CI: 1.13–1.61) than in those without any morbidity. Additionally, the odds of physical frailty were higher among those with late-onset chronic diseases, particularly heart disease (AOR: 3.39, CI: 1.31–8.77) and psychiatric disease (AOR: 3.00, CI: 1.19–7.61), compared to individuals with early onset of these conditions. This study found significant positive associations between early and late onset chronic diseases and physical frailty and its components among older Indians. These findings underscore the importance of managing late-onset chronic diseases, especially heart diseases and psychiatric conditions, to mitigate frailty in older adults. These findings also emphasize the critical role of age at onset of specific chronic conditions and multimorbidity in the development of frailty, suggesting that targeted disease-specific interventions could help delay or prevent frailty.

To investigate the association between body pain and physical frailty among older adults in India and to examine whether this association is mediated by symptoms of depression and insomnia. Data were obtained from the Longitudinal Aging Study in India, comprising 31,464 adults aged 60 and older. Physical frailty was assessed using a modified version of the frailty phenotype developed by Fried and colleagues. Multivariable logistic regression was used to analyze associations, and the Karlson-Holm-Breen method was employed to evaluate mediation effects. The prevalence of frailty was 30.65%, with women showing a higher prevalence than men (33.16% vs. 27.85%). Older adults experiencing body pain had increased odds of frailty (adjusted odds ratio [aOR]: 1.17, 95% CI: 1.06-1.35). Depression (aOR: 1.70, 95% CI: 1.44-2.01) and insomnia symptoms (aOR: 1.58, 95% CI: 1.38-1.81) were independently associated with higher odds of frailty. Mediation analysis showed that depression mediated 8.4% of the association between pain and frailty in men and 6.11% in women. Insomnia symptoms mediated 11.47% of the association in men and 14.54% in women. Body pain was significantly associated with a higher likelihood of frailty among older adults in India. Symptoms of depression and insomnia partially mediated this association, with a stronger mediating effect observed for insomnia in women. Inclusive health care strategies addressing pain, depression, and insomnia could help mitigate the risk of frailty in this population.

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.