Data:
The Longitudinal Ageing Study in India (LASI) is a multidisciplinary, internationally recognized panel study of 45 and above, conducted in all 35 states (except Sikkim) and union territories in India. LASI provides comprehensive information on the critical economic, social, and health characteristics of the elderly in India. LASI is the world’s most extensive and India’s first longitudinal study, which was carried out for the elderly population.
The LASI survey instruments consist of the household schedule, individual schedule, biomarker, and community schedule. The household schedule comprises a key informant in each household and an individual and biomarker schedule administered to each selected respondent.
The LASI adopted a multistage stratified area cluster sampling design to select the representative sample. The survey has adopted a three-stage sampling design for rural areas and four stages for the urban area within each state. The first stage included the primary sampling unit (PSU), sub-district (Tehsils/Talukas) in each state/UTs. The second stage included the selection of villages in rural areas and wards in rural areas urban area. In the third stage, the selection of household was made in rural areas; however, an additional stage was added in urban areas. In urban areas, census enumeration blocks (CEBs) were randomly selected in each urban ward. In the fourth and final stage of the sampling, households were selected in each CEB.
The survey covered a panel sample of 72,250 population aged 45 years and above and their spouses, including 31,464 elderly aged 60 years and above and 6,749 oldest persons aged 75 years and above. Our study is concerned with 60 years and above population.
The survey followed three primary instruments to cover the estimated sample as Household survey schedule, individual survey schedule, and community survey schedule. The household survey schedule was carried out to one per household to all consenting randomly, collecting information on household roster, housing and environment, household consumption, household assets and debts, household income, and household health in insurance. Individual survey schedule was administered to each consenting respondent aged 45 years and above, including their eligible spouses. The individual was prepared to collect comprehensive information on demography, the work retirement and pension module, overall health and specific chronic diseases, mental health module, utilization of healthcare services, the family and social networks, the social welfare scheme module, the experimental module, and biomarkers. In last, the community schedule collected information on population characteristics, infrastructure and common resources, the accessibility and availability of healthcare services, and the coverage of health and social welfare programmes.
Geriatric impairment
Ageing is known as many physical and emotional changes that can affect the level of function and well-being of the elderly. These changes can lead to impairment among the elderly, subject to a multidimensional assessment to evaluate functional ability, physical health, cognition, mental health, hearing, visual, speech, and socioenvironmental circumstances. Physical or functional impairment includes upper or lower limb loss or impairment, manual dexterity, and impairment in coordination with different body organs. Mental and cognition impairment, also known as instinctual impairment, occurred when a person has certain cognitive functions, limitations, and skills like communication, learning, self-help, and social skills. Visual impairment can be defined as the problems in functions of the visual system, and hearing impairment consider hearing loss that prevents an individual from partial or total receiving sounds through the ear. Speech impairment refers to an inability to produce sounds or verbal communications.
Study Variables:
Outcome variable
The study considered geriatric impairment as an outcome variable which was divided into five categories like Physical impairment such as lower body or upper body, cognitive impairment such as intellectual, cognition, or learning impairment, Hearing impairment, Visual impairment; and Speech impairment such as speech production and language comprehension. All the impairment was self-reported as responses were observed in multiple forms. Further, geriatric impairments have been divided into the number of impairments (0, 1, 2, and ≥3) to understand the association between impairments and socio-economic and health characteristics. Further, geriatric impairment was categorized in binary form as “yes” and “no” to assess the likelihood of impairment by socio-demographic and health factors.
Predictors:
The predictors for this study are age (60-69 and 70 years and above); sex (male and female), marital status (currently married, never married, Divorced/Separated/Deserted/Widowhood), education (No education, below primary, primary, secondary, and higher); place of residence (rural and urban); living arrangements (living alone, with spouse and with others); currently working (yes and no); wealth index (poorest, poorer, middle, richer and richest); and self-rated health (poor and good). Further, activities of daily living (ADL) impairment was achieved from five indicators, namely bathing, dressing, mobility, feeding, and toileting. The instrumental activities of daily living (IADL) impairment scale was achieved from seven instrumental activities: preparing a hot meal (cooking and serving), shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, managing money, such as paying bills and keeping track of expenses and getting around or finding an address in an unfamiliar place. Both the ADL and IADL impairment was categorized into the three categories as “severe,” “moderate,” and “no impairment” based on the scale given in previous studies [31], [32].
Statistical analysis:
For the deceptive purpose, we have compared socio-demographic and health characteristics between elderly with physical, cognitive, hearing, visual, and speech impairment to check the proportion of geriatric impairment. Again, we have compared socio-demographic and health characteristics with 0, 1, 2, and 3 or more geriatric impairment among older persons. To assess the association between any geriatric impairment with socio-demographic and health characterizes, we used binary logistic regression with unadjusted and adjusted odds ratio as the formula is given below,
Where, p is the probability of success, α is the intercept, b is the regression coefficient, and ε is the random error.