Household air pollution and cognitive health among Indian older adults: Evidence from LASI.

BACKGROUND: Previous shreds of evidence have suggested that ambient air pollution is negatively associated with cognitive health among older adults, but whether indoor air pollutants such as cooking fuel, tobacco smoke, and incense burning exposure affect the cognitive score is unknown, especially in limited-resource areas. METHOD: The study has utilized the recently released data from the Longitudinal Ageing Study of India (LASI), Wave 1, conducted from 2017 to 2018. A total of 63,883 (≥45 years) older adults were considered for the analysis. Descriptive statistics, bivariate analysis and ordinary least squares regression were employed in the study. RESULTS: The estimated mean cognitive score was 25.4 and the percentage of solid fuel users was 45.6 in India. The cognitive score gap between the two groups was more remarkable in Tamil Nadu (clean fuels: 29.7; solid fuels: 23.9). A significant cognitive score gap was observed for all indoor air pollutants, i.e., cooking fuel (clean: 29.7 and solid fuels: 23.9), exposure to tobacco smoke (not exposed: 25.7 and exposed: 24.4), and exposure to daily incense burning (not exposed: 25.9 and exposed: 24.8). The unadjusted model found that a one-unit increase of using charcoal/lignite/coal reduces the cognitive score by 5 (95% CI: -5.36, -4.61). A similar effect of exposure to tobacco smoke (ß = -0.79, 95% CI: -0.89, -0.68) and incense burning (ß = -0.28, 95% CI: -0.30, -0.26) was explored in the study. After adjusting socioeconomic and demographic characteristics, indoor air pollution was found to be a significant determinant of cognitive health. CONCLUSIONS: The study has identified exposure to indoor air pollution as a risk factor for cognitive impairment among older adults. Therefore, we suggest an urgent need of promoting existing schemes like the Pradhan Mantri Ujjwala Yojana and creating awareness about the adverse effects of indoor air pollutants for a better future.