Multimorbidity combinations and their association with functional disabilities among Indian older adults: evidence from Longitudinal Ageing Study in India (LASI)

Abstract

ObjectiveThis study aims to identify the unique multimorbidity combinations (MMCs) and their associations with the functional disability of Indian older adults. Moreover, the population attributable fractions (PAFs) were calculated to assess the potential impact of additional diseases in the nested groups on disability.DesignA cross-sectional data were analysed in this study.Setting and participantsThe present study uses data from the first wave of the Longitudinal Ageing Study in India (2017–2018). The sample for the study consists of 27 753 aged 60 years and over.Primary and secondary outcome measuresThe primary outcome variable was functional disability, measured by the combined activities of daily living (ADL)-instrumental activities of daily living (IADL) index.ResultsOut of 197 uniquely identified MMCs, the combination of hypertension and high depressive symptoms (HDS) was the most prevalent (10.3%). Overall, all MMCs were associated with increased functional limitation. Specifically, the combination of hypertension, arthritis and HDS was associated with greater ADL-IADL disability than any other MMC. The addition of HDS in group 3 (hypertension and arthritis) (incidence rate ratios (IRR)=1.44; 95% CI 1.26 to 1.64) and the addition of arthritis in group 1 (hypertension, HDS) (IRR=1.48; 95% CI 1.28 to 1.71) and group 2 (hypertension, diabetes) (IRR=1.49; 95% CI 1.22 to 1.82) significantly increases the rates of ADL-IADL disability. The estimated PAFs of the group 1 (hypertension and HDS), group 3 (hypertension and arthritis) and group 4 (arthritis and HDS) for ADL-IADL disability were 22.5% (19.2–25.5), 21.6% (18.7–24.4) and 23.5% (20.6–26.3), respectively.ConclusionThe findings from this study underscore the importance of addressing the morbidity combinations which are more disabling than the others in older adults. Understanding the somatic and psychological relevance of the morbidities in functional health is necessary and can help reduce disabilities among older adults.