School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
Department of Family & Generations, International Institute for Population Sciences, Mumbai, India.
BMC Geriatr. 2023 Sep 14;23(1):563. doi: 10.1186/s12877-023-04264-8.
Identifying people with early and late onset of chronic conditions might help target the subpopulations that are more vulnerable to negative mental, physical and functional health outcomes. The current study aimed to examine the association of early and late onset of chronic single and multiple morbidities with self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults.
Cross-sectional study was conducted using data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018). The total sample size for the present study was 31,386 older adults age 60 years or older. Multivariable binary logistic regression analysis was used to establish the association between the outcomes (poor perceived physical/mental health, functional difficulty and physical inactivity) and explanatory variables (early [ = < 50 years of age] and late [> 50 years]) onset of chronic illnesses such as hypertension, diabetes, heart attack, heart disease, stroke, cancer, lung disease, arthritis, osteoporosis and psychiatric disease).
Overall, 24.21% of the sample population had poor self-perceived physical health, whereas 8.67% of participants had poor self-perceived mental health. The prevalence of difficulty in ADL, difficulty in IADL, and physical inactivity was 23.77%, 48.36%, and 68.9%, respectively. Odds of poor perceived mental health were higher for the respondents with early as well as late onset of hypertension, stroke, and arthritis; while individuals with late onset of diabetes, and heart disease had higher odds of poor perceived mental health than those without chronic disease. Individuals with early onset of single morbidity were more likely to report ADL difficulty (adjusted odds ratio [AOR]: 1.33, confidence interval [CI]: 1.06-1.67); while those with late onset of single (AOR: 1.34, CI: 1.17-1.53) and multimorbidity (AOR: 1.91, CI: 1.63-2.24) were more likely to report ADL difficulty compared with individuals without morbidity. Individuals with early as well as late-onset of multimorbidity had more than two times higher odds of reporting poor physical health, poor mental health and IADL difficulty compared with individuals without chronic disease.
The present study revealed that early and/or late onset of chronic single and/or multiple morbidities significantly predicted poor self-perceived physical and mental health, functional limitations and physical inactivity among older Indian adults. The findings further suggest that late onset of chronic diseases such as cancer and stroke and multi-morbidity had stronger associations with physical inactivity that may help identify high risk groups for screening and support.
识别慢性疾病早发和晚发的人群，可能有助于针对那些更容易出现负面精神、身体和功能健康结果的亚人群。本研究旨在调查慢性单一和多种疾病早发和晚发与印度老年成年人自我感知的身体和心理健康、功能障碍和身体活动不足之间的关联。
本研究使用来自印度纵向老龄化研究（LASI）第 1 波（2017-2018 年）的数据进行横断面研究。本研究的总样本量为 31386 名年龄在 60 岁或以上的老年人。采用多变量二项逻辑回归分析，确定结局（自我感知的身体/心理健康不良、功能障碍和身体活动不足）与解释变量（早发[ = < 50 岁]和晚发[> 50 岁]）之间的关联，这些解释变量包括高血压、糖尿病、心脏病发作、心脏病、中风、癌症、肺部疾病、关节炎、骨质疏松症和精神疾病等慢性疾病。
总体而言，24.21%的样本人群自我感知身体不健康，而 8.67%的参与者自我感知心理健康不良。日常生活活动（ADL）困难、工具性日常生活活动（IADL）困难和身体活动不足的患病率分别为 23.77%、48.36%和 68.9%。早发和晚发高血压、中风和关节炎的受访者出现心理健康不良的几率更高；而晚发糖尿病和心脏病的患者出现心理健康不良的几率高于无慢性疾病的患者。患有单一疾病早发的个体更有可能报告 ADL 困难（调整后的优势比[OR]：1.33，置信区间[CI]：1.06-1.67）；而单一疾病晚发（OR：1.34，CI：1.17-1.53）和多种疾病晚发（OR：1.91，CI：1.63-2.24）的个体更有可能报告 ADL 困难，与无疾病的个体相比。与无慢性疾病的个体相比，早发和晚发多种疾病的个体报告身体不健康、心理健康不良和 IADL 困难的几率高出两倍以上。
本研究表明，慢性单一和/或多种疾病的早发和/或晚发显著预测了印度老年成年人自我感知的身体和心理健康、功能障碍和身体活动不足。研究结果进一步表明，癌症和中风等慢性疾病的晚发和多种疾病与身体活动不足的关联更强，这可能有助于识别高危人群进行筛查和支持。
