Gore-Langton Georgia R, Mansfield Kathryn E, Ravi Prithvee, Doubatty Arrisonia, Alladi Suvarna, Kinra Sanjay, Warren-Gash Charlotte
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
School of Health and Care Sciences, University of Lincoln, Lincoln, UK.
BMC Public Health. 2025 Jul 2;25(1):2244. doi: 10.1186/s12889-025-23490-w.
Infections may be associated with an increased risk of poor brain health and frailty among older people, but evidence from low-and-middle-income countries (LMICs) is limited. We aimed to investigate associations between nine infections and cognition, depression, and frailty in India.
We conducted a cross-sectional study using data from Wave 1 (2017–2019) of the Longitudinal Aging Study in India (LASI) survey of adults (≥ 45years) from 35 of India’s 36 states and union territories. Data were collected via face-to-face interviews and direct health measurements. We investigated the association between nine infections, either self-reported ever (periodontal disease) or in the two years before interview (jaundice/hepatitis, malaria, tuberculosis, typhoid, chikungunya, diarrhoea/gastroenteritis, dengue, urinary tract infection [UTI]), and measured global cognitive function, depression, and frailty. We used survey-weighted multivariable logistic regression to compare odds of impaired cognition, depression, and frailty in people with and without infections, overall and for individual infections.
We included 64,682 respondents; median age 59 years (IQR:50–67), 53.5% female, 35% reported at least one infection. After controlling for demographic, social/environmental and lifestyle factors, and chronic health conditions, we saw evidence of associations between infection and both depression (OR: 1.28 [95%CI: 1.22–1.35]) and frailty (OR: 1.74 [95%CI: 1.65–1.84]). UTIs were associated with the highest odds of both depression (OR: 1.33 [95%CI: 1.14, 1.55) and frailty (OR: 2.94 [95%CI: 2.51, 3.44]). Reporting at least one infection was associated with reduced odds of impaired cognition (OR: 0.80 [95%CI: 0.74–0.86]).
Our results suggest infections are associated with increased depression and frailty in adults over 45 in India. Our finding of association between reported infections and better cognition, is potentially explained by preferential infection recall in those with better cognition. Longitudinal studies are needed to investigate potential causal links between infections and adverse brain health and frailty and guide interventions to improve the health of older people in India and other LMICs.
The online version contains supplementary material available at 10.1186/s12889-025-23490-w.
感染可能会增加老年人脑健康状况不佳和身体虚弱的风险，但来自低收入和中等收入国家（LMICs）的证据有限。我们旨在调查印度九种感染与认知、抑郁和身体虚弱之间的关联。
我们利用印度纵向老龄化研究（LASI）第1波（2017 - 2019年）的数据进行了一项横断面研究，该研究对象为印度36个邦和联邦属地中35个地区的成年人（≥45岁）。数据通过面对面访谈和直接健康测量收集。我们调查了九种感染（自我报告曾经患有的牙周病，或访谈前两年内患有的黄疸/肝炎、疟疾、结核病、伤寒、基孔肯雅热、腹泻/肠胃炎、登革热、尿路感染[UTI]）与测量的全球认知功能、抑郁和身体虚弱之间的关联。我们使用调查加权多变量逻辑回归来比较有感染和无感染人群中认知障碍、抑郁和身体虚弱的几率，整体以及针对个体感染进行比较。
我们纳入了64,682名受访者；年龄中位数为59岁（四分位距：50 - 67岁），女性占53.5%，35%的人报告至少有一种感染。在控制了人口统计学、社会/环境和生活方式因素以及慢性健康状况后，我们发现感染与抑郁（比值比：1.28 [95%置信区间：1.22 - 1.35]）和身体虚弱（比值比：1.74 [95%置信区间：1.65 - 1.84]）之间存在关联的证据。尿路感染与抑郁（比值比：1.33 [95%置信区间：1.14, 1.55]）和身体虚弱（比值比：2.94 [95%置信区间：2.51, 3.44]）的最高几率相关。报告至少有一种感染与认知障碍几率降低相关（比值比：0.80 [95%置信区间：0.74 - 0.86]）。
我们的结果表明，感染与印度45岁以上成年人抑郁和身体虚弱的增加有关。我们发现报告的感染与更好的认知之间存在关联，这可能是由于认知较好的人对感染的优先回忆所致。需要进行纵向研究来调查感染与不良脑健康和身体虚弱之间的潜在因果关系，并指导干预措施以改善印度和其他低收入和中等收入国家老年人的健康状况。
在线版本包含可在10.1186/s12889-025-23490-w获取的补充材料。
