Willingness to pay for a COVID-19 vaccine for oneself and one's child among individuals attending a tertiary care centre in West Bengal, India.

Background: The free-of-cost supply could not meet the demand for coronavirus disease-2019 (COVID-19) vaccines in India, so the government approved an injection option with a price. We aimed to determine how much money an individual would be willing to pay for a COVID-19 vaccine for themselves and their children and assess the factors determining it. Methods: We conducted a study among all adults visiting the outpatient department of a government tertiary care hospital in West Bengal, India, in August 2021. Trained nursing officers combined bidding game and open-ended question methods during personal interviews to estimate the willingness-to-pay (WTP) values. Results: The mean (standard deviation) age of 1565 participants was 40.8 (12.2) years with 46.5% (n = 727) males, 70.4% (n = 1102) parents, 50.0% (n = 783) educated upto class 12 and 30.9% (n = 483) belonging to upper-middle socio-economic scale (SES). The median (inter-quartile range [IQR]) WTP amount for the first dose and the subsequent/booster dose among the unvaccinated (50.2%, n = 785) and vaccinated (49.8%, n = 780) participants were ₹0 (0-100) and ₹0 (0-200), respectively. The median (IQR) WTP for inoculating children with any COVID-19 vaccine was ₹50 (0-300) in both groups. Significant differences were found in the WTP prices for adult vaccines in both groups concerning age category (P = 0.02), education (P < 0.01) and SES (P < 0.01). Conclusion: Although more than half of the respondents were unwilling to pay for themselves, WTP for COVID-19 vaccination was higher for their children. Policy-makers should consider income, education and age to cap the private sector vaccination price.

Excess Screen Time and its Associated Factors among Young Men in a Rural Community of North India.

Screen-based media usage among young people is blooming rapidly due to technological and digital revolution. We conducted community-based cross-sectional study to determine the prevalence of excess screen time and its association with sociodemographic and behavioral patterns in a rural block of Haryana, India. A semi-structured interview schedule was administered by trained physicians to ascertain screen time in a typical day and various socioeconomic and behavioral factors among a random sample of 860 young men aged 18-24 years. The prevalence of excess screen time was 61.8% (95% confidence interval [CI] 58.4-65.1). It was significantly associated with education (adjusted odds ratio [AOR] 1.7, 95% CI 1.1-2.6) and occupation (AOR 2.2, 95% CI 1.2-3.9) of the father and their sleep duration of ≤8 h (AOR 1.6, 95% CI 1.2-2.3). Limiting the screen time as per international standards and behavioral interventions are needed for this young population.

A Smart Biometric Identity Management Framework for Personalised IoT and Cloud Computing-Based Healthcare Services.

This paper proposes a novel identity management framework for Internet of Things (IoT) and cloud computing-based personalized healthcare systems. The proposed framework uses multimodal encrypted biometric traits to perform authentication. It employs a combination of centralized and federated identity access techniques along with biometric based continuous authentication. The framework uses a fusion of electrocardiogram (ECG) and photoplethysmogram (PPG) signals when performing authentication. In addition to relying on the unique identification characteristics of the users' biometric traits, the security of the framework is empowered by the use of Homomorphic Encryption (HE). The use of HE allows patients' data to stay encrypted when being processed or analyzed in the cloud. Thus, providing not only a fast and reliable authentication mechanism, but also closing the door to many traditional security attacks. The framework's performance was evaluated and validated using a machine learning (ML) model that tested the framework using a dataset of 25 users in seating positions. Compared to using just ECG or PPG signals, the results of using the proposed fused-based biometric framework showed that it was successful in identifying and authenticating all 25 users with 100% accuracy. Hence, offering some significant improvements to the overall security and privacy of personalized healthcare systems.

Internet of Things and Machine Learning for Healthy Ageing: Identifying the Early Signs of Dementia.

Identifying the symptoms of the early stages of dementia is a difficult task, particularly for older adults living in residential care. Internet of Things (IoT) and smart environments can assist with the early detection of dementia, by nonintrusive monitoring of the daily activities of the older adults. In this work, we focus on the daily life activities of adults in a smart home setting to discover their potential cognitive anomalies using a public dataset. After analysing the dataset, extracting the features, and selecting distinctive features based on dynamic ranking, a classification model is built. We compare and contrast several machine learning approaches for developing a reliable and efficient model to identify the cognitive status of monitored adults. Using our predictive model and our approach of distinctive feature selection, we have achieved 90.74% accuracy in detecting the onset of dementia.

Effectiveness of intravenous ferric carboxymaltose in improving hemoglobin level among postpartum women with moderate-to-severe anemia at a secondary care hospital in Faridabad, Haryana - An interventional study.

BACKGROUND: Postpartum anemia is associated with postpartum anxiety, depression, poor cognitive interaction, and delayed infant development. Oral iron is the currently recommended therapy but is associated with gastrointestinal complaints and poor compliance. Parenteral iron dextran may cause serious side effects, whereas iron sucrose requires repeated visits. Intravenous ferric carboxymaltose (FCM) is given as an infusion in a single setting, which is logistically convenient both to patients and health system. It can be particularly beneficial for postpartum women who are usually discharged from health facility 48 h after delivery. OBJECTIVES: The objectives of this study were to estimate the change in mean hemoglobin (Hb) level 6 weeks after administration of intravenous FCM and to document any adverse events following administration among postpartum women. METHODS: A prospective, interventional follow-up study was conducted from August to December 2018. One hundred eligible postpartum women with Hb level of 5-9.9 g/dl were administered a calculated dose of intravenous FCM based on Ganzoni's formula with Hb target of 12 g/dl. Hb and serum ferritin were measured at baseline and at 6 weeks after FCM infusion and compared for mean increase. RESULTS: There was a significant increase in Hb and serum ferritin levels after administration of FCM. The mean (95% confidence interval) increase in the Hb and serum ferritin after 6 weeks was 4.2 (3.9-4.5) g/dl and 137.3 (113.6-161.0) ng/ml, respectively. No major adverse events were reported. CONCLUSION: Administration of FCM was safe and effective in the treatment of moderate-to-severe anemia among postpartum women.

Access and utilization of sanitation facilities in a Rural Area of Haryana, North India.

BACKGROUND: Ensuring universal access to sanitation in households is essential for public health. OBJECTIVES: The objective of the study was to assess the availability of sanitary latrine at the household level and its use at the individual level in a rural area and factors associated with availability and use of sanitary latrine. METHODS: This cross-sectional study was conducted from December, 2016 to January 2017 (mention month and year) at the rural Health and Demographic Surveillance Site, Ballabgarh, in district Faridabad, Haryana, North India. A total of 16,896 households were studied. House-to-house visits were made by trained health workers who conducted interviews regarding availability and pattern of use of sanitary latrine in the household. The health worker also observed the type of sanitation facility, its functional status, availability of water, and hand-washing facility. RESULTS: Individual household latrine (IHL) was present in 87.3% of the households. An improved sanitation facility was available in 84.8% of the households, while 15.2% of the households had unimproved or no sanitation facility. Hand-washing facility along with improved sanitation was present in 70.4% of the households. Nonavailability of latrine among socially disadvantaged communities (scheduled caste households) was significantly higher (19.4%) as compared to other castes (10.4%) (P < 0.001). A significantly higher proportion of households below poverty line (28.9%) lacked IHL as compared to those above the poverty line (11.0%) (P < 0.001). Nearly 11% of the individuals reported open defecation. CONCLUSION: The availability of sanitary latrines in the study area was high. Nonavailability of in-house sanitary latrine was higher among economically poor households and those belonging to socially disadvantaged communities.

Did Inclusion of informed consent affect the observed hiv prevalence rate among injecting drug users during hiv sentinel surveillance 2017 in Delhi, Uttar Pradesh, Uttarakhand, and Jharkhand States of Central Zone of India?

BACKGROUND: In 2017, the sampling procedure for HIV sentinel surveillance (HSS) among all high-risk groups was changed from the consecutive sampling to random sampling along with the introduction of linked anonymous testing strategy with informed written consent. OBJECTIVE: The objective of this study was to assess whether the inclusion of informed consent affects the HIV positivity rate among the participants and nonparticipants injecting drug users (IDU) in HSS 2017 in four states of Central Zone of India. METHODS: This study was a cross-sectional study. All sentinel sites from Delhi, Uttar Pradesh, Jharkhand, and Uttarakhand located at targeted intervention facilities in 2017 were included in the study. Information about the participation and nonparticipation of each high-risk individual at the sentinel site was gathered from the master list, respective registers, and website portal of the National AIDS Control Organization. A total of 8639 individuals were included in the analysis. RESULTS: Overall, 16 sites in four states were included in the study. Overall, the nonparticipation rate of IDUs was 14.3%; highest being for Delhi (17.2%), followed by Uttar Pradesh (14.6%), Uttarakhand (10.9%), and Jharkhand (4.4%). Overall, the HIV-positivity rate among nonparticipants (9.6%) was significantly higher (P = 0.009) compared to the participants (6.7%). CONCLUSION: Change in methodology and seeking written informed consent might have an effect on the nonparticipation in all four states. This, in turn, could have led to the underestimation of HIV-positivity rates among IDU in the states.

Effect of directly observed oral iron supplementation during pregnancy on iron status in a rural population in Haryana: A randomized controlled trial.

BACKGROUND: In India, more than half of the pregnant women suffer from anemia. Low compliance to iron supplementation is one of the important reasons. OBJECTIVES: The objective of the study is to estimate the reduction in the prevalence of anemia, improvement in iron status, and to compare the compliance to oral iron supplementation during pregnancy between directly observed iron-folic acid (IFA) supplementation group and control group. METHODS: This was a community-based open labeled parallel block-randomized controlled trial including 400 pregnant women in a rural setting of north India. In the intervention group, the first dose of IFA every week was supervised by ASHA and women were instructed to take the remaining tablets during the week as per the prescription. In control group, IFA tablets were supplemented without direct supervision. RESULTS: After 100 days of IFA supplementation, the reduction in anemia in the intervention group was 6% higher as compared to control group (P = 0.219). The increase in the mean hemoglobin level over and above control group was 0.52 g/dl in intervention group (P < 0.001). However, the mean increase in serum ferritin level in the intervention group was similar to the control group. The mean percentage compliance in the intervention group was almost 9% higher than that of control group (P = 0.001). CONCLUSION: Directly supervised oral iron (IFA) supplementation improves compliance to oral iron (IFA) supplementation and also improves hemoglobin status among pregnant women. However, the mean increase in serum ferritin and reduction in the prevalence of anemia in the intervention group were not higher than the control group.

Directly observed iron supplementation for control of iron deficiency anemia.

Anemia is major public health problem affecting 1.6 billion people worldwide. The poor compliance of iron supplementation remains main contributor for high prevalence of anemia. The current paper reviewed the effectiveness of direct observation of oral iron supplementation on anemia. A systematic search was performed through electronic databases and local libraries. Search strategies used subject headings and key words "directly observed" and "iron supplementation." Searches were sought through April 2014. A total of 14 articles were included in the study. Findings were presented in three categories. First, all of those reported an improvement in compliance of iron supplementation. Second, reduction in the prevalence of anemia was reported by all and third, all except one reported increased blood hemoglobin level. Directly observed an iron supplementation is an effective approach for prevention and management of anemia in vulnerable groups. However, larger trials are needed before concluding that scaling up directly observed iron supplementation through community health volunteers would be beneficial.

Influence of social media on health-related decision-making among adults attending an outpatient department of a tertiary care centre in India: A cross-sectional analytical study.

Background Social media platforms, especially Facebook and WhatsApp, can spread public health information effectively. We aimed to estimate the influence of health-related messages circulated through these social media platforms on health-related decision-making and its associated factors. Methods We did a cross-sectional analytical study among adults (aged >18 years) who visited the outpatient department of a tertiary care hospital in suburban West Bengal, during July-September 2021. A structured questionnaire was used regarding receiving health-related messages on social media and the subsequent effect on health-related decision-making in the past year. Results A total of 673 individuals participated in the study. Their mean (SD) age was 34.4 (10.2) years and 56.8% (382) were men, 50.8% (342) were graduates, 63.6% (428) were from rural areas and 82.9% (558) were active users of more than one social media platform. A total of 474 (70.4%; 95% CI 67.0-73.9) study participants reported health-related decision-making based on social media messages, whereas 44.7% (301) reported checking the authenticity of forwarded messages or posts or updates with healthcare professionals before making a decision. On adjusted analysis, participants who had secondary education (adjusted prevalence ratio [aPR] 1.40; 95% CI 1.01-1.94), used both the media (aPR 1.31; 95% CI 1.09-1.58) and checked the authenticity of the messages with a healthcare professional (aPR 1.52, 95% CI 1.38-1.68) were significantly more influenced by the messages, posts or updates received on social media platforms. Conclusion WhatsApp forwards or updates and Facebook posts or updates influence health-related decision-making among the Indian adult population.

NiADA (Non-invasive Anemia Detection App), a Smartphone-Based Application With Artificial Intelligence to Measure Blood Hemoglobin in Real-Time: A Clinical Validation.

Background  Anemia is a severe public health problem in India affecting more than half of the population. To reduce its burden on the population, the Government of India under the Anemia Mukt Bharat program has adopted a monitoring strategy for the diagnosis and treatment of anemia. Point-of-care testing (POCT) devices play a pivotal role in testing hemoglobin at a community level where sophisticated laboratory instruments are not available. The majority of the currently available POCT devices are invasive in nature which have their own limitations. A non-invasive method of hemoglobin estimation will address many of the limitations of an invasive POCT instrument, which will further improve people's acceptability for hemoglobin testing. The Non-Invasive Anemia Detection App (NiADA) (Monere AI Private Limited, Kolkata, West Bengal, India), a non-invasive POCT application, uses artificial intelligence (AI) to predict the hemoglobin level from lower eyelid images. This real-time, point-of-care, low-cost solution uses a custom computer vision deep-learning algorithm to determine blood hemoglobin value.  Method  The study validates an AI-based smartphone application NiADA against laboratory hemoglobin estimation and a widely used point-of-care hemoglobin estimation instrument (HemoCue Hb 301; HemoCue AB, Angelholm, Skane County, Sweden). The study was conducted in a tertiary care hospital in Eastern India and recruited a total of 556 participants. These included 58 pediatric patients, 51 pregnant women, 214 adult females, and 224 adult males. Statistical analysis was performed using Python (Python Software Foundation, Wilmington, Delaware, United States). A p-value of < 0.05 was taken to be significant.  Result  The mean difference observed between NiADA and laboratory-estimated hemoglobin values came out to be -0.29 g/dL and -0.89 g/dL for adult females and males respectively, and 0.61 g/dL for pregnant women and -0.69g/dL for the pediatric population. The limits of agreement for NiADA were narrow at 2.77 to -2.18 g/dL for adult females, 3.76 to -1.96 g/dL for adult males, 1.89 to -3.29 g/dL for pregnant women, and 3.28 to -2.08 g/dL for the pediatric population. The sensitivity and specificity of the NiADA application against the laboratory estimation method were 75.8% and 53.8% for adult females, 70.0% and 48.3% for adult males, 23.8% and 90% for pregnant females, and 75% and 57% for the pediatric population.  Conclusion  As a non-invasive application, NiADA's performance is satisfactory and comparable with minimally invasive tools like HemoCue Hb 301 and other POCT devices.

Impact of supplementation with iron-folic acid (IFA) and vitamin D3 compared with IFA alone on haemoglobin levels in elderly people with mild-to-moderate anaemia: protocol for the double-blind, randomised, placebo-controlled Iron and vitamin D trial in Elderly Anemia (IDEA).

INTRODUCTION: Anaemia in the elderly is often difficult to treat with iron supplementation alone as prevalence of anaemia of chronic disease (ACD) alone or mixed with iron-deficiency anaemia (IDA) is high in this age group. Hepcidin remains high in ACD, preventing utilisation of iron for heme synthesis. Vitamin D3 has shown hepcidin suppression activity in both in vitro and in vivo studies. As there is no study assessing the effect of iron-folic acid (IFA) with vitamin D3 on haemoglobin levels in the elderly in India, we want to conduct this study to estimate the impact of supplementation of a therapeutic package of IFA and vitamin D3 on haemoglobin levels in the elderly with mild-to-moderate anaemia in comparison with IFA only. The study will also assess the impact of the proposed intervention on ferritin, hepcidin, 25-hydroxyvitamin D, C reactive protein (CRP) and parathyroid hormone (PTH) levels. METHODS AND ANALYSIS: This study is a community-based, double-blind, placebo-controlled, randomised trial. The study will be done in the Kalyani municipality area. Individuals aged ≥60 years with mild-to-moderate anaemia and normal vitamin D3 levels will be randomised into the intervention (IFA and vitamin D3 supplementation) group or the control group (IFA and olive oil as placebo). All medications will be self-administered. Follow-up will be done on a weekly basis for 12 weeks. The calculated sample size is 150 in each arm. Block randomisation will be done. The primary outcome is change in haemoglobin levels from baseline to 12 weeks. Secondary outcome is change in serum ferritin, 25-hydroxyvitamin D, hepcidin, CRP and PTH levels from baseline to 12 weeks. ETHICS AND DISSEMINATION: Ethical approval from the Institutional Ethics Committee of All India Institute of Medical Sciences Kalyani has been obtained (IEC/AIIMS/Kalyani/Meeting/2022/03). Written informed consent will be obtained from each study participant. The trial results will be reported through publication in a reputable journal and disseminated through health talks within the communities. TRIAL REGISTRATION NUMBER: CTRI/2022/05/042775. PROTOCOL VERSION: Version 1.0.

Determinants of substance use among young people attending primary health centers in India.

Background: Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods: A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results: The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement. Conclusions: High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue.

Why do Mothers from Remote Rural Areas opt for Cesarean Delivery: An Observational Analytical Study from West Bengal, India.

Background: The percentage of cesarean section (C-section) deliveries has doubled in the last two decades in India. Although C-section delivery is a life-saving intervention, multiple maternal and neonatal morbidities are often associated with this procedure, adversely affecting the quality of life of both the mother and child. Material and Methods: This community-based cross-sectional study was conducted to assess the point of view of mothers who delivered from January 2020 to June 2021. Results: The mean (standard deviation (SD)) age of the 866 study participants at delivery was 24.5 (4.8) years, and 60.2% were primigravidas. A total of 613 (70.8%; 95% CI: 67.8-73.8) C-sections were conducted, of which 65.9% (n = 404) were planned and 21.9% were done on maternal request. C-sections were significantly associated with private institutes (adjusted prevalence ratio (aPR) 1.90; 95% CI: 1.70-2.11), at-risk pregnancy (aPR 1.37; 95% CI: 1.26-1.49), and primigravida (aPR 1.16; 95% CI: 1.05-1.29). About 55.3%, 29.8%, and 14.9% of women considered vaginal delivery to be risky, painful, and inconvenient, respectively. Conclusion: It is imperative to generate awareness regarding modes of delivery during antenatal care (ANC) so that mothers can make better-informed choices.

Cognitive reserve and other determinants of cognitive function in older adults: Insights from a community-based cross-sectional study.

Background: India will be the home of 323 million elderly persons by 2050. This means a surge in the dependent population primarily due to age-related cognitive decline. Evidence suggests that life course factors may have a modulatory role on cognitive function. The present study explores such potential influence by investigating the effect of cognitive reserve (a latent construct using education and occupation) and physical, psychological, and social determinants on cognitive function in community dwelling elderly. Methods: A community-based cross-sectional study was conducted in urban areas of West Bengal (India) among elderly aged ≥60 years. Data was collected by personal interviews for socio-demographic and medical profile. Cognitive function was assessed using Bangla Adaptation of Mini-Mental State Examination (BAMSE). Educational level and occupational complexity were used as proxy indicators for calculating cognitive reserve. Results: Of the 370 elderlies interviewed (mean age = 68.9 years), cognitive function was abnormal in 13.5%. The cognitive function had a significant inverse relationship with depression symptoms, loneliness, hypertension, anemia, and basic activities of daily living. There was a significant difference in the cognitive reserve of the elderly with normal and abnormal cognitive function (mean 33.7 and 26.8, respectively). In the presence of covariates like sleep quality, depression, hypertension, and hemoglobin levels, the effect of age on cognitive function had a significant mediation influence of cognitive reserve - total effect = -0.2349; 95% CI = (-0.2972 to -0.1725) and direct effect = -0.2583; 95% CI = (-0.3172 to -0.1994). Conclusion: The quantum of effect of the age on cognitive function decreases with good cognitive reserve as a cognitive reserve has a significant mediation effect on the relationship between age and cognitive function.

Prevalence of Anemia Among the Elderly in India: Evidence From a Systematic Review and Meta-Analysis of Cross-Sectional Studies.

Anemia is a leading cause of increased morbidity and mortality among the elderly population. In spite of numerous interventions and strategies rolled out to tackle the growing burden of anemia, lesser importance is being given to this age group. There is a lack of data on the national level burden of anemia among elderly persons (≥ 60 years) in India. We aimed at estimating the prevalence of anemia among elderly persons (≥ 60 years) in India by conducting a systematic review and meta-analysis. We searched PubMed, Embase, Cochrane Library, Google Scholar, and IndMed, and included cross-sectional studies reporting data on the prevalence of anemia among elderly persons in India and used random effects model to estimate pooled point prevalence with 95% confidence interval (CI), To explore the heterogeneity further, we did sub-group analyses based on zonal divisions of India (region), rural or urban, study setting, method of hemoglobin estimation and sampling strategy. Out of 22 studies, one study was of high quality of bias, 11 of moderate, and 10 were of low quality of bias. The pooled estimate of anemia was 68.3% (95%CI: 60.7 to 75.9), I2 = 99.0%, and Q=2079.2 (p-value <0.001). The pooled prevalence of anemia among the elderly in India was found to be high and necessary actions need to be taken at the policy level to achieve "active and healthy ageing".

Association of Serum Hepcidin With Preeclampsia: A Systematic Review and Meta-Analysis.

The objective of the present systematic review and meta-analysis was to compare the levels of serum hepcidin in women who developed pre-eclampsia with those who did not. The databases PubMed, Embase, Scopus, Cochrane, and references of retrieved articles published till September 2020 were searched with no language restriction. Mean differences in iron regulating protein (hepcidin) were compared using a random-effects model based on the level of heterogeneity. A total of 760 individuals were included in the analysis from seven studies. The pooled estimate showed that mean hepcidin levels were significantly higher in women who developed pre-eclampsia [0.3 ng/ml, 95% confidence interval (CI): 0.01-0.59, p=0.003] as compared to women who did not develop pre-eclampsia. Further research can be done to assess the levels of various iron parameters in different trimesters of pregnancy and their association with pre-eclampsia.

Prevalence of Anemia Among Elderly Population Residing in an Urban Area of West Bengal: A Community-Based Cross-Sectional Analytical Study.

Context: India is experiencing a rapid increase in the elderly population (aged 60 years and above) compared to the last decade. The multifactorial condition of anemia grossly influences the health-related quality of life and mortality in this age group. We aimed to estimate the prevalence of anemia and its associated factors among older adults residing in an urban area of West Bengal, India. Materials and Methods: The community-based cross-sectional analytical study was conducted in Kalyani Municipality, West Bengal, from March to April 2021. A simple random sampling technique was adopted to select study participants. Hemoglobin (Hb) was measured using a digital hemoglobinometer (HemoCue301), and data were collected using EpiCollect5 software. Results: The mean (SD) age of 457 participants was 68.9 (7.3) years with 52.1% (n = 238) being males, 71.9% (n = 329) graduates, and 64.3% (n = 294) currently married. The prevalence of anemia was 65% (95% CI: 60.4-69.3). The prevalence of mild (Hb 11-11.9 gm/dL in females and 11-12.9 gm/dL in males), moderate (Hb 8-10.9 gm/dL), and severe anemia (Hb <8 gm/dL) was 41.6%, 22.8% and 0.7%, respectively. Anemia was significantly associated with age group (P < 0.01) and sex (P < 0.01), with the highest prevalence in the 80 years and above age category (85.2%) and in females (71.2%). Conclusion: The prevalence of anemia is very high in older adults. There is an urgent need to include the elderly age group in the existing health programme for anemia, i.e., Anemia Mukt Bharat.

Underweight is an important predictor for functional impairment among the older adults in Urban West Bengal, India: A cross sectional analytical study.

Objectives: To estimate the prevalence, pattern, and factors associated with functional impairment among elders. Materials and Methods: A community-based cross-sectional analytical study was conducted among older adults (aged ≥60 years) residing in the urban blocks of West Bengal. An interview was conducted using a structured questionnaire, which included Katz index and half-arm span to measure functional impairment and body mass index (BMI), respectively. Results: The mean (SD) age (in years) of 457 participants was 69.0 (7.3) years and 52% were males, 72% were graduates, 52% were obese, and 55% had hypertension. The prevalence of functional impairment was 7.4% (95% confidence interval [CI]: 5.21-10.24). The most common aid or appliance used was spectacles (93%) followed by a denture (20%). The functional impairment was more common among the oldest-old (≥85 years) (adjusted prevalence ratio (aPR) 8.26, 95% CI: 2.50-27.28), middle-old (75-84 years) age group (aPR 3.85, 95% CI: 1.44-10.31), underweight (BMI < 18.50 kg/m2) (aPR 3.60, 95% CI: 1.44-9.00), and among the individuals using walking sticks (aPR 3.47, 95% CI: 1.60-7.51). Conclusion: The burden of functional impairment is low among older adults in the urban area of West Bengal. Policies need to be framed at the household level to reduce the extent of disability among the oldest-old and elders who are underweight and use walking aids.