Correlates of poor self-rated health among school-going adolescent girls in urban Varanasi, India.

BACKGROUND: The concept of self-rated health (SRH) has widely been studied among the adults and older population in developed as well as developing countries, including India. Also, studies are available in abundance examining the various concepts of SRH among adolescents. However, in India, studies on the SRH of adolescents remain scarce, especially those aiming to understand the correlates of SRH among school-going adolescent girls in an urban setting. Therefore, this study aims to determine the correlates of poor SRH among school-going adolescent girls in the urban setting of Varanasi, India. METHODS: This study is based on the primary data collected in the Varanasi district of Uttar Pradesh, India, from October 2019 to February 2020. Nearly 350 adolescent girls and their mothers were personally interviewed. Self-rated health was the primary outcome variable of this study. The exact wording of the question asked from the adolescent girls was, "In general, how would you say your health is?". RESULTS: Almost one-fifth (19.4%) of the adolescent girls reported poor SRH. Adolescent girls from Other Backward Class (OBC) [OR: 0.39; 95% CI: .18-.85] and Others caste [OR: 0.58; 95% CI: .23-0.87] were less likely to report poor SRH than their Scheduled Caste/Scheduled Tribe (SC/ST) counterparts. Girls residing in households where number of daughters were more than sons were more likely to report poor SRH [OR: 7.8; 95% CI: 1.5-39.5] than girls who belonged to the daughters only households. CONCLUSION: Composition of children was one of the important factors as outlined in this study. The role of mothers in improving the overall SRH of the girls is critical as they are involved in caring process of their daughters.

Exposure to the aryl hydrocarbon receptor agonist dioxin disrupts formation of the muscle, nerves, and vasculature in the developing jaw.

Human exposure to environmental pollutants can disrupt embryonic development and impact juvenile and adult health outcomes by adversely affecting cell and organ function. Notwithstanding, environmental contamination continues to increase due to industrial development, insufficient regulations, and the mobilization of pollutants as a result of extreme weather events. Dioxins are a class of structurally related persistent organic pollutants that are highly toxic, carcinogenic, and teratogenic. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is the most potent dioxin compound and has been shown to induce toxic effects in developing organisms by activating the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor targeted by multiple persistent organic pollutants. Contaminant-induced AHR activation results in malformations of the craniofacial cartilages and neurocranium; however, the mechanisms mediating these phenotypes are not well understood. In this study, we utilized the optically transparent zebrafish model to elucidate novel cellular targets and potential transcriptional targets underlying TCDD-induced craniofacial malformations. To this end, we exposed zebrafish embryos at 4 h post fertilization to TCDD and employed a mixed-methods approach utilizing immunohistochemistry staining, transgenic reporter lines, fixed and in vivo confocal imaging, and timelapse microscopy to determine the targets mediating TCDD-induced craniofacial phenotypes. Our data indicate that embryonic TCDD exposure reduced jaw and pharyngeal arch Sox10+ chondrocytes and Tcf21+ pharyngeal mesoderm progenitors. Exposure to TCDD correspondingly led to a reduction in collagen type II deposition in Sox10+ domains. Embryonic TCDD exposure impaired development of tissues derived from or guided by Tcf21+ progenitors, namely: nerves, muscle, and vasculature. Specifically, TCDD exposure disrupted development of the hyoid and mandibular arch muscles, decreased neural innervation of the jaw, resulted in compression of cranial nerves V and VII, and led to jaw vasculature malformations. Collectively, these findings reveal novel structural targets and potential transcriptional targets of TCDD-induced toxicity, showcasing how contaminant exposures lead to congenital craniofacial malformations.

Exposure to the persistent organic pollutant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, dioxin) disrupts development of the zebrafish inner ear.

Dioxins are a class of highly toxic and persistent environmental pollutants that have been shown through epidemiological and laboratory-based studies to act as developmental teratogens. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most potent dioxin congener, has a high affinity for the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor. TCDD-induced AHR activation during development impairs nervous system, cardiac, and craniofacial development. Despite the robust phenotypes previously reported, the characterization of developmental malformations and our understanding of the molecular targets mediating TCDD-induced developmental toxicity remains limited. In zebrafish, TCDD-induced craniofacial malformations are produced, in part, by the downregulation of SRY-box transcription factor 9b (sox9b), a member of the SoxE gene family. sox9b, along with fellow SoxE gene family members sox9a and sox10, have important functions in the development of the otic placode, the otic vesicle, and, ultimately, the inner ear. Given that sox9b is a known target of TCDD and that transcriptional interactions exist among SoxE genes, we asked whether TCDD exposure impaired the development of the zebrafish auditory system, specifically the otic vesicle, which gives rise to the sensory components of the inner ear. Using immunohistochemistry, in vivo confocal imaging, and time-lapse microscopy, we assessed the impact of TCDD exposure on zebrafish otic vesicle development. We found exposure resulted in structural deficits, including incomplete pillar fusion and altered pillar topography, leading to defective semicircular canal development. The observed structural deficits were accompanied by reduced collagen type II expression in the ear. Together, our findings reveal the otic vesicle as a novel target of TCDD-induced toxicity, suggest that the function of multiple SoxE genes may be affected by TCDD exposure, and provide insight into how environmental contaminants contribute to congenital malformations.

Exposure to the persistent organic pollutant 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD, dioxin) disrupts development of the zebrafish inner ear.

Dioxins are a class of highly toxic and persistent environmental pollutants that have been shown through epidemiological and laboratory-based studies to act as developmental teratogens. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most potent dioxin congener, has a high affinity for the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor. TCDD-induced AHR activation during development impairs nervous system, cardiac, and craniofacial development. Despite the robust phenotypes previously reported, the characterization of developmental malformations and our understanding of the molecular targets mediating TCDD-induced developmental toxicity remains limited. In zebrafish, TCDD-induced craniofacial malformations are produced, in part, by the downregulation of SRY-box transcription factor 9b ( sox9b ), a member of the SoxE gene family. sox9b , along with fellow SoxE gene family members sox9a and sox10 , have important functions in the development of the otic placode, the otic vesicle, and, ultimately, the inner ear. Given that sox9b in a known target of TCDD and that transcriptional interactions exist among SoxE genes, we asked whether TCDD exposure impaired the development of the zebrafish auditory system, specifically the otic vesicle, which gives rise to the sensory components of the inner ear. Using immunohistochemistry, in vivo confocal imaging, and time-lapse microscopy, we assessed the impact of TCDD exposure on zebrafish otic vesicle development. We found exposure resulted in structural deficits, including incomplete pillar fusion and altered pillar topography, leading to defective semicircular canal development. The observed structural deficits were accompanied by reduced collagen type II expression in the ear. Together, our findings reveal the otic vesicle as a novel target of TCDD-induced toxicity, suggest that the function of multiple SoxE genes may be affected by TCDD exposure, and provide insight into how environmental contaminants contribute to congenital malformations. Highlights: The zebrafish ear is necessary to detect changes in motion, sound, and gravity.Embryos exposed to TCDD lack structural components of the developing ear.TCDD exposure impairs formation of the fusion plate and alters pillar topography.The semicircular canals of the ear are required to detect changes in movement.Following TCDD exposure embryos fail to establish semicircular canals.

Exposure to Pornographic Content Among Indian Adolescents and Young Adults and Its Associated Risks: Evidence from UDAYA Survey in Bihar and Uttar Pradesh.

Adolescence is period characterized by sexual development, increasing romantic relationships, and the initiation of sexual activity. To enhance the exploration of their sexuality, adolescents may look into sexual resources such as pornography. There has been little research in India to understand how much adolescents are exposed to Internet pornography and what are the associated risk factors. This study examined the level of exposure to pornography among adolescents and the associated factors which determine the exposure to pornography in Uttar Pradesh and Bihar. Understanding the Lives of Adolescents and Young Adults (UDAYA) survey data collected in 2015-2016 was used for this study. The study was based on 3885 adolescent boys and 7766 adolescent girls aged 15-19 years. The mean age for adolescent boys was 16.66 years (SD: 1.3), and for girls it was 16.67 years (SD: 1.3). About 47% of adolescent boys but only 6% of girls were exposed to pornography. The likelihood of exposure to pornography was 1.69 times and 2.27 times more likely among adolescents and girls who had their own personal mobile phones, respectively, compared to those who did not have their own personal mobile phones. The odds of exposure to pornography were significantly higher among adolescent boys who had frequent media exposure than those who had no/rare exposure. Programs on life skills and comprehensive sexuality education need to be prioritize.

Urban-rural and gender differential in depressive symptoms among elderly in India.

Background: To date, evidence remained inconclusive explaining rural-urban and male-female differential in depression. Unlike other previous research on the association of several risk factors with depressive symptoms among the elderly, this study focussed on the socio-economic status-related inequality in the prevalence of depression among the elderly along with focussing urban-rural and male-female gradients of depression among the elderly. Methods: This study used data from Longitudinal Ageing Study in India (LASI) Wave-I, 2017-18, survey. The outcome variable for this study was self-reported depression. Bivariate analysis was used to understand the prevalence by sociodemographic clusters. Fairlie decomposition analysis has been done to measures rural-urban inequalities for depression among older men and women. Results: Results found that around 22 percent of urban elderly and 17 percent of rural elderly reported depression. A higher proportion of female elderly (22.6% vs. 18.4%) reported depression than male elderly. Almost one in every five elderly (20.6%) reported depression in India. The results found that a higher percentage of women in rural and urban areas reported depression than their male counterparts. While examining SES-related inequality in the prevalence of depression, education was a significant factor explaining the SES-related inequality in the prevalence of depression among female elderly and not in male elderly. Conclusion: Given the large proportion of elderly reporting depression, this study highlights the need for improving health care services among the elderly. The increasing burden of depression in specific sub-populations also highlights the importance of understanding the broader consequences of depression among rural and female elderly.

Proper modulation of AHR signaling is necessary for establishing neural connectivity and oligodendrocyte precursor cell development in the embryonic zebrafish brain.

2,3,7,8-tetrachlorodibenzo-[p]-dioxin (TCDD) is a persistent global pollutant that exhibits a high affinity for the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor. Epidemiological studies have associated AHR agonist exposure with multiple human neuropathologies. Consistent with the human data, research studies using laboratory models have linked pollutant-induced AHR activation to disruptions in learning and memory as well as motor impairments. Our understanding of endogenous AHR functions in brain development is limited and, correspondingly, scientists are still determining which cell types and brain regions are sensitive to AHR modulation. To identify novel phenotypes resulting from pollutant-induced AHR activation and ahr2 loss of function, we utilized the optically transparent zebrafish model. Early embryonic TCDD exposure impaired embryonic brain morphogenesis, resulted in ventriculomegaly, and disrupted neural connectivity in the optic tectum, habenula, cerebellum, and olfactory bulb. Altered neural network formation was accompanied by reduced expression of synaptic vesicle 2. Loss of ahr2 function also impaired nascent network development, but did not affect gross brain or ventricular morphology. To determine whether neural AHR activation was sufficient to disrupt connectivity, we used the Gal4/UAS system to express a constitutively active AHR specifically in differentiated neurons and observed disruptions only in the cerebellum; thus, suggesting that the phenotypes resulting from global AHR activation likely involve multiple cell types. Consistent with this hypothesis, we found that TCDD exposure reduced the number of oligodendrocyte precursor cells and their derivatives. Together, our findings indicate that proper modulation of AHR signaling is necessary for the growth and maturation of the embryonic zebrafish brain.

Hearing and vision difficulty and sequential treatment among older adults in India.

Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [ß = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [ß = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.

Burden of communicable and non-communicable diseases-related inequalities among older adults in India: a study based on LASI survey.

BACKGROUND: A rising proportion of elderly in India has infused notable challenges to the healthcare system, which is already underdeveloped. On one side, NCDs are increasing among the elderly in India; however, on the other side, CDs are also a cause of concern among the elderly in India. While controlling the outbreak of communicable diseases (CDs) remained a priority, non-communicable diseases (NCDs) are placing an unavoidable burden on the health and social security system. India, a developing nation in South Asia, has seen an unprecedented economic growth in the past few years; however, it struggled to fight the burden of communicable and non-communicable diseases. Therefore, this study aimed at examining the burden of CDs and NCDs among elderly in India. METHODS: Data from Longitudinal Ageing Study in India (LASI Wave-I, 2017-18) were drawn to conduct this study. The LASI is a large-scale nationwide scientific study of the health, economics, and social determinants and implications of India's aged population. The LASI is a nationally representative survey of 72,250 aged 45 and over from all Indian states and union territories. Response variables were the occurrence of CDs and NCDs. The bi-variate and binary logistic regression were used to predict the association between communicable and non-communicable diseases by various socio-demographic and health parameters. Furthermore, to understand the inequalities of communicable and non-communicable diseases in urban and rural areas, the Fairlie decomposition technique was used to predict the contribution toward rural-urban inequalities in CDs and NCDs. RESULTS: Prevalence of communicable diseases was higher among uneducated elderly than those with higher education (31.9% vs. 17.3%); however, the prevalence of non-communicable diseases was higher among those with higher education (67.4% vs. 47.1%) than uneducated elderly. The odds of NCDs were higher among female elderly (OR = 1.13; C.I. = 1-1.27) than their male counterparts. Similarly, the odds of CDs were lower among urban elderly (OR = 0.70; C.I. = 0.62-0.81) than rural elderly, and odds of NCDs were higher among urban elderly (OR = 1.85; C.I. = 1.62-2.10) than their rural counterparts. Results found that education (50%) contributes nearly half of the rural-urban inequality in the prevalence of CDs among the elderly. Education status and current working status were the two significant predictors of widening rural-urban inequality in the prevalence of NCDs among the elderly. CONCLUSION: The burden of both CD and NCD among the elderly population requires immediate intervention. The needs of men and women and urban and rural elderly must be addressed through appropriate efforts. In a developing country like India, preventive measures, rather than curative measures of communicable diseases, will be cost-effective and helpful. Further, focusing on educational interventions among older adults might bring some required changes.

How do responses vary between mothers and their daughters on measuring daughter's self-rated health (SRH): a study among school-going adolescent girls in the primary setting of Varanasi, India.

OBJECTIVE: How self-rated health (SRH) varies when the response on SRH is recorded from the respondent herself (adolescent girl) and her mother on her behalf. This study examines the prevalence of SRH among adolescent girls from her point of view as well as from her mother's point of view. This insight could help us interpret the differences in opinion of girls and their mothers while measuring the girls' self-rated health. RESULTS: Almost one-fifth (19.4%) of the girls reported poor SRH. In contrast, only one in eight mothers (12.3%) could report their daughters under the category of poor SRH. Nearly one-third (76.5%) of the mothers reported their daughter's SRH as good when daughters themselves rated poorly on SRH and another one-tenth (9.6%) reported their daughter's SRH as poor when daughters themselves categorized in the good SRH category [χ2 = 9.900; p < 0.002]. More than 90 percent of the Rich and Middle wealth index women, women in the household with only daughters and no son, women whose husbands had higher education, women with higher secondary education, and non-working women visualized their daughter's SRH as good when daughters themselves reported poor SRH.

Correction: Gender differential in low psychological health and low subjective well-being among older adults in India: With special focus on childless older adults.

[This corrects the article DOI: 10.1371/journal.pone.0247943.].

Prevalence and predictors of anaemia among adolescents in Bihar and Uttar Pradesh, India.

In adolescents, anaemia has been linked to affecting physical disorders, growth, and mental retardation and also increases reproductive morbidities among adolescent girls during their womanhood. It is believed that with increasing age, females are more prone to anaemia than their male counterparts. Unfortunately, the anaemia intervention program, such as the National Nutrition Anaemia Prophylaxis Programme, primarily targets infants, young children, pregnant and lactation women, and not adolescents. Therefore, this study tries to fill this gap and study the prevalence of anaemia and the associated factors among adolescent boys and girls residing in Uttar Pradesh and Bihar, India. Secondary data analysis was performed on cross-sectional survey data from the Understanding the Lives of Adolescents and Young Adults survey. The sample size was 20,594 adolescents aged 10-19 years in Uttar Pradesh and Bihar, India. The outcome variable was anaemia, and the explanatory variables were age, education, working status, media exposure, marital status, received IFA and deworming tablets, BMI status, stunting status, wealth index, caste, religion, residence, and States. Descriptive statistics and bivariate analysis were used to find the preliminary results. Multinomial regression analysis was carried out to provide the adjusted estimates. Overall, anaemia was more prevalent among adolescent girls than adolescent boys (20% vs. 8.7%). Moderate/severe anaemia was 0.24 and 0.49 times less likely among adolescent boys and girls, respectively, who had 10 and above years of schooling than adolescents with no schooling (p < 0.01). Rural adolescent boys were 1.49 times (p < 0.05) more likely to suffer from moderate/severe anaemia than urban counterparts. The odds for moderate/severe anaemia among adolescent boys were relatively higher among late adolescents, with no mass-media exposure, stunted, and rural adolescents. Similarly, odds for moderate/severe anaemia among adolescent girls were higher among late adolescents and adolescents without schooling and mass-media exposure. Prevalence of anaemia was higher among adolescent girls than in boys. Lower education status, rural residence, late adolescence, no exposure to mass media, and stunting were the predictors of moderate/severe anaemia among adolescents. Anaemia among adolescents must be addressed through effective public health policy targeting adolescents residing in rural areas. There is a need to disseminate information about anaemia-related programs, such as National Iron Plus Initiative (NIPI), through mass media, and subsequently, the public health system may be prepared to tailor the needs of adolescent boys and girls.

What causes loneliness among household heads: a study based in primary setting in Mumbai, India.

BACKGROUND: With the pace of urbanization, symptoms of loneliness emerge as one of the most devastating mental illnesses among city dwellers in the modern age. The present study has tried to identify the potential factors and correlates which affect loneliness vulnerability. METHODS: The data for this study were collected from three different areas of Mumbai (i.e., Dadar, Bandra, and Chembur).This study was conducted through a cross-sectional household survey of household heads in the five different housing typologies/ localities between January and June 2016.A total of 450 household data were collected using the quota sampling method. Loneliness was the main dependent variable. The bivariate analysis was used to see the percentage of loneliness among respondents. Bivariate analysis for categorical data was carried out using the chi-square (χ2) test. Logistic regression analysis was performed to explore the correlates of loneliness among household heads. The probability of significance was set at 5%. RESULTS: It was found that around 7 percent of respondents often feel lonely, and 21 percent of respondents sometimes feel lonely in the last seven days preceding the survey date. Household heads with two or more chronic diseases had higher odds (OR = 4.87, CI = 1.52-15.57) of loneliness than household heads without any chronic disease. The odds of loneliness were almost 3 times higher (OR = 3.05; CI = 1.11-8.38) among females as compared to males. Household heads living alone (single) had higher odds (OR = 19.99; CI = 4.14-96.59) to suffer from loneliness than those living in a joint family. CONCLUSION: Finding reveals that level of loneliness symptomatology in urban dwellers may be attributed significantly by individual (i.e., morbidity status and sex of respondent), social (i.e., personal relation) and residing locality characteristics. Community psychological intervention along with enhanced civic engagement can reduce level of loneliness in existing slum rehabilitees.

Multimorbidity and its associated risk factors among older adults in India.

BACKGROUND: Health at older ages is a key public health challenge especially among the developing countries. Older adults are at greater risk of vulnerability due to their physical and functional health risks. With rapidly rising ageing population and increasing burden of non-communicable diseases older adults in India are at a greater risk for multimorbidities. Therefore, to understand this multimorbidity transition and its determinants we used a sample of older Indian adults to examine multimorbidity and its associated risk factors among the Indian older-adults aged 45 and above. METHODS: Using the sample of 72,250 older adults, this study employed the multiple regression analysis to study the risk factors of multimorbidity. Multimorbidity was computed based on the assumption of older-adults having one or more than one disease risks. RESULTS: Our results confirm the emerging diseases burden among the older adults in India. One of the significant findings of the study was the contrasting prevalence of multimorbidity among the wealthiest groups (AOR = 1.932; 95% CI = 1.824- 2.032). Similarly women were more likely to have a multimorbidity (AOR = 1.34; 95% CI = 1.282-1.401) as compared to men among the older adults in India. CONCLUSION: Our results confirm an immediate need for proper policy measures and health system strengthening to ensure the better health of older adults in India.

Prevalence, factors and inequalities in chronic disease multimorbidity among older adults in India: analysis of cross-sectional data from the nationally representative Longitudinal Aging Study in India (LASI).

OBJECTIVE: This 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. DESIGN: Cross-sectional study; large nationally representative survey data. SETTING AND PARTICIPANTS: We 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 MEASURES: The 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. RESULTS: Almost 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. CONCLUSIONS: This 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.

Decomposing urban-rural differences in multimorbidity among older adults in India: a study based on LASI data.

BACKGROUND: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity; however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity. METHODS: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release cross-sectional data of the Longitudinal Ageing Study in India (LASI). Descriptive, bivariate, and multivariate decomposition analysis techniques were used. RESULTS: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p < 0.001). The multivariate decomposition analysis revealed that about 51% of the overall differences (urban-rural) in the prevalence of multimorbidity among older adults was due to compositional characteristics (endowments). In contrast, the remaining 49% was due to the difference in the effect of characteristics (Coefficient). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively. Work status and education were found to reduce the urban-rural gap in the prevalence of multimorbidity among older adults by 8% and 6%, respectively. CONCLUSIONS: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

Prevalence and determinants of activity of daily living and instrumental activity of daily living among elderly in India.

BACKGROUND: The increase in life expectancy has proliferated the number of elderly and subsequently increased the prevalence of disability among the elderly. This study assesses the prevalence of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) and analyzes determinants of ADL and IADL among elderly aged 60 and over living in India. METHODS: The study utilized the Longitudinal Ageing Study in India (LASI, 2017-18) data, and information was sought from 31,464 elderly aged 60 years and above. An index of ADL and IADL was created on a scale of three levels, exhibiting no, moderate, or severe levels of ADL/IADL disability. Multinomial logistic regression was used to determine the effect of socio-demographic parameters on ADL and IADL disability among the elderly. RESULTS: Around 3% of the elderly reported severe ADL disability, and 6% elderly reported severe IADL disability. Elderly who were not involved in any physical activity than their counterparts were more likely to report severe ADL (RRR = 2.68, C.I. = 1.66-4.32) and severe IADL (RRR = 2.70, C.I. = 1.98-3.67) than no ADL and no IADL, respectively. CONCLUSION: Amidst the study finding, the study emphasizes the importance of setting-up of geriatric care centers in rural and urban areas. It would be feasible to provide geriatric care under the umbrella of already functioning government health facilities in different parts of the country. Community interventions earmarking the elderly with a focus on physical activity, specifically based in group physical exercise and implemented through existing networks, are rewarding for the elderly.

Does engagement in frequent physical activity improve diabetes mellitus among older adults in India? A propensity score matching approach.

BACKGROUND AND AIMS: Diabetes is a major chronic condition and was identified as one of the four priority non-communicable diseases that the United Nations targeted because of its increasing disease burden. The present study aims to examine the impact of physical activity on improving diabetes mellitus among older adults in India. METHODS: This study utilizes data from India's first nationally representative longitudinal ageing survey (2017-18). Descriptive along with bivariate analysis was used to present the preliminary results. Additionally, Propensity score matching (PSM) analysis was used. RESULTS: About 14% of older adults suffered from diabetes. Eighteen percent of older adults did frequent physical activity. The estimated average treatment effect on the treated (ATT) values in treated and control groups were 0.123 and 0.147, respectively, indicating that the prevalence of diabetes among older adults was reduced by 2.5% points because of frequent physical activity. The average treatment effect on the untreated (ATU) results indicates that among older adults who did not do frequent physical activity, if they did frequent physical activity, the prevalence of diabetes is likely to decrease by 2.2% points. CONCLUSION: Our findings show that frequent physical activity is associated with a lower risk of diabetes in older adults. The results underscore the need to develop strategies of promoting an active lifestyle by maintaining physical activity to combat the diabetes epidemic in the older population.

Exploring association between food insecurity and depression among older adults in India.

Background: Depression is a significant health concern that is yet to be recognised as an important public health challenge in India. Furthermore, given the critical condition of food insecurity among older people in India, it is likely that they are more vulnerable to depression. The interplay of depression among older people resulting from food insecurity is an under-explored phenomenon in the Indian context. Therefore, this study examines the association between food insecurity and depression among older people in India. Methods: The study used data from the Longitudinal Ageing Study in India (LASI). Food insecurity was measured with a set of questions formed into dichotomous variable and depression was measured with Center for Epidemiological Studies Depression (CES-D scale). Binary logistic regression was performed to confirm the findings. Results: Results showed that older adults who reported food insecurity were more likely to be depressed (OR= 1.20; C.I.=1.03-1.25) than their younger counterparts. Furthermore, older adults who were independent for Activity of Daily Living (ADL) were less likely (OR= 0.73; C.I.=0.53-1.00) to report depression, whereas, female (OR= 1.12; C.I.=1.00-1.26) and never married (OR= 2.11; C.I.=1.18-3.79) older adults were more likely to be depressed than their respective counterparts. Conclusion: It is important to integrate mental health with food insecurity. Future studies may consider including mental health services with food assistance programs or vice versa.

Self-care, Household Cleaning and Disinfection During COVID-19 Pandemic: A Study from Metropolitan Cities of India.

Hygiene has been noticed as one of the most effective procedures against COVID-19 cross-transmission, especially hand hygiene and covering the face with the mask. Therefore, this study tried to peek into the people movements and seeks to understand how people are handling their daily use items like fruits and vegetables, how people are managing unavoidable grooming services, how people are disinfecting themselves after coming from outside, and what all hygienic practices they are following during this pandemic. Furthermore, this study attempts to explore ways through which people are disinfecting their houses. At last, the study seeks to explore the knowledge/information people have about Coronavirus. The study collected primary data through a self-administered questionnaire. A quota sampling technique was used to collect the data. Bivariate analysis was carried out to reach the study findings. Based on the findings, it is the need of the hour to disseminate the information on the use of unhealthy disinfectants as they lack the knowledge about the safe use of various types of cleaners and disinfectants. It is also reiterated that there is an urgency to promote further information on risk factors of Coronavirus among people and compulsion to promote healthy hand hygiene and sanitation practices. There is a need to promote information through mass media and other modes of awareness, such as artwork and announcements.