Dataset Information

Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study.

ABSTRACT:

Objectives

India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years.

Design and setting

We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017-2018.

Participants

This study was conducted among n=59 073 respondents.

Outcome measures

Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction.

Results

The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups.

Conclusion

Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.

SUBMITTER: Sinha A

PROVIDER: S-EPMC9693658 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study.

Sinha Abhinav A Puri Parul P Pati Sanghamitra S

BMJ open 20221124 11

<h4>Objectives</h4>India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and ...[more]

PMID: 36424108

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Project description:BackgroundSocial exclusion has far-reaching consequences that extend beyond regular activities and access to resources and knowledge; social exclusion is a major social determinant of health. However, there is a lack of evidence on social exclusion and health outcomes among India's older adults. Thus, the current study investigates the association of social exclusion with depressive symptoms among Indian older adults.MethodsThis study used information on 30,366 older adults from Longitudinal Ageing Study in India (LASI) wave-1, 2017-2018. Social exclusion scores were calculated, and two broad domains of social exclusion, i.e., exclusion from civic activity & social relations and exclusion from services, were considered in the study. The depressive symptom was calculated using the CES-D score. Using logistic regression models, the average marginal effects of selected covariates and domains of social exclusion on depressive symptoms were estimated to assess the links between social exclusion and depressive symptoms.ResultsWith the increase in the social exclusion score in the selected domains, the prevalence of depressive symptoms among older also increased. Elderly persons who do not vote or live alone in the domain of being excluded from civic & social activities and older adults excluded from services were observed to have a higher prevalence of depressive symptoms. Adjusting for sociodemographic factors, the average marginal effects suggested that older with four scores of civic activity & social relation exclusion, two scores of service exclusion and four scores of overall social exclusion were estimated to have a higher prevalence of depressive symptoms, respectively.ConclusionsThis study's findings shed light on social exclusion and its relationship to depressive symptoms among older Indians. Older health care services should be expanded in breadth while also addressing social exclusion, resulting in considerable improvements in older individuals' mental health.

Project description:ObjectiveTo explore the associations between obesity-related measures and multimorbidity among older Indian adults and the interactive effects of physical activity in those associations.DesignA cross-sectional study was conducted using large representative survey data.Setting and participantsThe present study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India.Primary and secondary outcome measuresThe outcome variable was multimorbidity among older adults coded as no and yes. Descriptive statistics along with bivariate analysis are presented in the paper. Additionally, binary logistic regression analysis was used to fulfil the study objectives.ResultsAbout 24% of older adults in the LASI cohort suffered from multimorbidity. Older adults who were overweight/obese (adjusted OR (AOR): 1.61, CI 1.48 to 1.74), had high-risk waist circumference (AOR: 1.66, CI 1.52 to 1.80) and had high-risk waist to hip ratio (AOR: 1.45, CI 1.33 to 1.59) were significantly more likely to suffer from multimorbidity compared with their counterparts. Older adults who were obese and physically inactive had significantly increased odds of suffering from multimorbidity compared with older adults who were obese and physically active. Similarly, older adults with high-risk waist circumference (AOR: 1.30, CI 1.11 to 1.53) and high-risk waist to hip ratio (AOR: 1.32, CI 1.20 to 1.46) along with being physically inactive had significantly higher odds of suffering from multimorbidity in comparison with older adults with high-risk waist circumference and waist to hip ratio along with being physically active.ConclusionWhile developing health strategies for older adults, physical activity needs to be recognised as a way of minimising comorbidities. Further, the study highlights the importance of using multiple obesity-related measures to predict chronic conditions in the older population.

Project description:ObjectiveThis study examines the prevalence, patterns and factors of chronic disease-related multimorbidity. Also, this study examines the inequality in the prevalence of multimorbidity among older adults in India.DesignCross-sectional study; large nationally representative survey data.Setting and participantsWe have used the first wave of a Longitudinal Ageing Study in India conducted in 2017-2018 across all the 35 states (excluded Sikkim) and union territories in India. This study used information from 31 373 older people aged 60+years in India.Primary and secondary outcome measuresThe outcome variable for this study is multimorbidity. The study used multinomial logistic regression to examine the risk factors for multimorbidity among older adults. To measure the inequality in multimorbidity, the slope of index inequality and relative index of inequality have been used to understand the ranked-based inequality.ResultsAlmost one-fourth (24.1%) reported multimorbidity. The relative risk ratio (RRR) of multimorbidity (RRR=2.12; 95% CI=1.49 to 3.04) was higher among higher educated older adults than uneducated older adults. Furthermore, the RRR of multimorbidity (RRR=2.35; 95% CI=2.02 to 2.74) was higher among urban older adults than their rural counterparts. Older adults in the richest wealth quintile were more likely to report multimorbidities (RRR=2.86; 95% CI=2.29 to 3.55) than the poorest older adults. Good self-rated health and no activities of daily living disability were associated with a lower risk of multimorbidities.ConclusionsThis study contributes to the comprehensive knowledge of the prevalence, factors and inequality of the chronic disease-related multimorbidity among older adults in India. Considering India's ageing population and high prevalence of multimorbidity, the older adults must be preferred in disease prevention and health programmes, however, without compromising other subpopulations in the country. There is a need to develop geriatric healthcare services in India. Additionally, there is a need to disseminate awareness and management of multimorbidity among urban and highly educated older adults.

Project description:IntroductionMetabolic syndrome is a significance driver of mortality and morbidity in India, but nationally representative data regarding disease burden and treatment status are lacking. Here, a cross-sectional study was undertaken to establish national and regional estimates of disease burden and explore reasons for lack of treatment of component conditions of metabolic syndrome in Indian older adults (45 years and older).MethodsA cross-sectional study was undertaken using data from the first wave of the Longitudinal Ageing Study in India (2017-2018). Data for 66 606 individuals aged 45 years and above were analysed. The primary outcome was metabolic syndrome prevalence, defined by the National Cholesterol Education Programme ATP III criteria as an individual having any three of four component conditions: diabetes mellitus (DM), hypertension, abdominal obesity and hypercholesterolaemia. The secondary outcome of this study was treatment status of patients with component conditions.ResultsMetabolic syndrome was found to have an overall weighted prevalence of 4.83% (n=3630, 95% CI 4.24 to 5.51). Females, urban residents, obese individuals and physically inactive people exhibited greater prevalence. The most prevalent component of metabolic syndrome was hypertension followed by abdominal obesity, DM and hypercholesterolaemia. 8.85% metabolic syndrome patient reported no treatment for component conditions, while 17.58% reported only partial treatment. Elderly individuals between 60 and 69 (crude relative risk ratios, cRRR 2.20, 95% CI 1.20 to 4.01) and 80 years and above (cRRR 7.48, 95% CI 1.99 to 28.16), urban residents (cRRR 2.45, 95% CI 1.48 to 4.05), those from richer monthly per capita consumption expenditure quintiles (cRRR 2.55, 95% CI 1.00 to 6.47) and those with additional comorbidities (cRRR 2.17, 95% CI 1.28 to 3.70) were more likely to report comprehensive treatment.ConclusionsThis study highlights a substantial prevalence of metabolic syndrome in older adults in India and reveals remarkable disparities in provision of treatment. Better prevention, earlier detection and improved provision of treatment are urgently required to combat the rising prevalence of metabolic syndrome and reduce the burden of cardiovascular disease in India.

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Dataset Information

Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study.

Objectives

Design and setting

Participants

Outcome measures

Results

Conclusion

Publications

Social determinants of diabesity and its association with multimorbidity among older adults in India: a population-based cross-sectional study.

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