Exploring the intersectional dynamics of co-morbidities and risk factors among the older population in India.

Abstract

Background: As the share of the older population is set to rise from 8% in 2011 to 16% by 2036 in India, the increasing burden of NCDs and the increasing co-morbidities among the older population need greater policy focus to ensure a healthier aging process. Given the structural shifts in the age structure of the population and decreasing family sizes, contextual factors take an even more important role in shaping the health status of the elderly. Therefore, the present study aims to study the intersectional dynamics of demographic, socioeconomic, lifestyle, and contextual factors on the prevalence of co-morbidities among the older population.

Methods: The data from the Indian Human Development Survey, 2012 (IHDS-II), were used to analyze the prevalence of co-morbidity and its confounding factors in India. Univariate analysis for sample distribution, bivariate analysis for the distribution of disease by different predictors with a chi-square test, and logistic regression analyses were used to assess the adjusted association of multimorbidity with different background variables.

Results: Overall, around 7% of the older population in India suffers from co-morbidities. We observe that the prevalence of co-morbidities is significantly higher among non-poor (People belonging to a non-poor household category based on the consumption quintiles) older females living alone, non-poor older females living jointly, and among non-poor older males living alone. The odds of having comorbidity among female non-poor and living alone are higher as compared to the female poor living alone. When all the co-variates are included in a single model, we observe that older adults living in nuclear families and residing in the North, Central, and Southern regions of India along with other factors discussed above show higher odds of having co-morbidities.

Conclusions: The research findings suggest that directing increased investments towards addressing multiple health issues in the elderly population, with a particular focus on non-poor women and men living alone, could be a more effective strategy in combating multimorbidity among older individuals in India.