Pai Manacy, Muhammad T, Adeagbo Adedayo, Ali Waad
Department of Sociology and Criminology, Kent State University, Kent, Ohio, United States of America.
Department of Human Health and Family Studies, Pennsylvania State University, University Park, Pennsylvania, United States of America.
PLOS Glob Public Health. 2025 Sep 24;5(9):e0005151. doi: 10.1371/journal.pgph.0005151. eCollection 2025.
We examined the associations between perceived neighborhood safety, crime exposure, and the prevalence of chronic conditions and multimorbidity among older adults in India. Moreover, we examined whether these associations varied by functional disabilities measured by difficulties in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Data came from the World Health Organization's Study on Global AGEing and Adult Health (SAGE), India Wave 2, conducted in 2015. Neighborhood safety was measured by perceptions of safety at home and while walking after dark, whereas crime exposure was assessed through reports of household victimization by violent crime in the past year. Chronic conditions were self-reported physician diagnoses of hypertension, diabetes, stroke, arthritis, angina, asthma, and lung disease, with multimorbidity defined as the presence of more than two chronic diseases. Multivariable regression analyses were used to examine the main associations and interaction terms to test the moderating role of ADL/IADL disabilities. The mean score of neighborhood safety (on a scale of 0-10) was 7.72 (SD: 2.05). Approximately 6% of the participants reported that they or someone in their household had been victims of violent crime in the previous year. Older adults with perceived neighborhood safety reported a lower number of chronic conditions (adjusted beta: -0.03, confidence interval [CI]: -0.04 to 0.01) and lower odds of multimorbidity (adjusted OR: 0.95, CI: 0.91 - 0.99). Those with crime exposure reported a higher number of chronic conditions (adjusted beta: 0.10, CI: 0.02 - 0.19). These associations were significantly more pronounced among those with ADL/IADL disabilities. Perceived neighborhood safety and crime exposure were significantly linked to chronic diseases and multimorbidity among older adults in India, particularly among those with functional disabilities. These findings underscore the need for targeted strategies to improve neighborhood safety and support among older Indians with functional disabilities.
我们研究了印度老年人所感知的社区安全、犯罪暴露与慢性病患病率及多种慢性病共存之间的关联。此外，我们还研究了这些关联是否因日常生活活动（ADL）和工具性日常生活活动（IADL）困难所衡量的功能残疾而有所不同。数据来自世界卫生组织的全球老龄化与成人健康研究（SAGE）印度第二轮调查，于2015年开展。社区安全通过对在家中及夜间行走时的安全感认知来衡量，而犯罪暴露则通过过去一年家庭遭受暴力犯罪侵害的报告来评估。慢性病由医生自我报告诊断的高血压、糖尿病、中风、关节炎、心绞痛、哮喘和肺病，多种慢性病共存定义为存在两种以上慢性病。采用多变量回归分析来检验主要关联和交互项，以测试ADL/IADL残疾的调节作用。社区安全平均得分（0 - 10分制）为7.72（标准差：2.05）。约6%的参与者报告称他们或其家庭中的某个人在前一年曾是暴力犯罪的受害者。感知到社区安全的老年人报告的慢性病数量较少（调整后的β系数：-0.03，置信区间[CI]：-0.04至0.01），多种慢性病共存的几率较低（调整后的比值比：0.95，CI：0.91 - 0.99）。有犯罪暴露经历的人报告的慢性病数量较多（调整后的β系数：0.10，CI：0.02 - 0.19）。这些关联在有ADL/IADL残疾的人群中更为显著。在印度，老年人所感知的社区安全和犯罪暴露与慢性病及多种慢性病共存显著相关，尤其是在有功能残疾的人群中。这些发现强调了采取针对性策略来改善印度有功能残疾的老年人的社区安全和支持的必要性。
