Disability among India's elderly much higher than census estimates

December 6, 2018, International Institute for Applied Systems Analysis
Credit: CC0 Public Domain

New estimates of disability among India's elderly population, based on the ability to carry out three basic living activities—walking, dressing, and toileting—show that the scale of the problem is much larger than suggested by the Indian national census.

A new paper coauthored by IIASA researcher Nandita Saikia found that 17.91% of males and 26.21% of females aged 60 and above, experience disability in these areas, equating to 9m elderly men and 14m elderly women. The most recent census, from 2011, suggests that just 5% of the elderly population suffer from a disability. The prevalence of disability is much higher among widowed women, and among the poor and illiterate.

Saikia and Mukesh Parmar from Jawaharlal Nehru University also found a statistically significant connection between chronic morbidity, or long-term health conditions, and disability. They studied three such conditions—diabetes, , and heart disease. Diabetes had the highest correlation to disability, followed by high blood pressure and heart disease.

"We found that the likelihood of disability is always the highest among diabetes patients, whereas the disability rate is the lowest among elderly persons with heart disease. This may be due to high mortality among heart patients," says Saikia. "Diabetes patients, on the other hand, may live for longer periods with disability. These results are helpful for both patients and healthcare providers in terms of taking preventive measures at the onset of morbidities."

Previous studies of morbidity and disability in India were carried out using primary sample surveys, limiting them to small areas of India with a small sample size. They can therefore not be used to gain a generalized picture across the whole nation, as India is so large and varied. In addition, they tend to focus on the association between a specific type of morbidity and a specific disability, so cannot give a broader picture.

Saikia and Parmar took a different approach to cover the whole country and give a broad picture for the first time. They used data from the second round of the Indian Human Development Survey which was carried out by the University of Maryland, US, and the National Council of Applied Economic Research, India. This was a survey covering more than 42,000 households across India, selected using a stratified random sampling technique, and covered various topics including health, employment, economy, and education. The second round of the survey also included questions about chronic morbidity and disability.

The researchers defined disability as difficulty or inability to perform three specific activities of daily living- walking 1 km, going to the toilet without help, and dressing without help, and looked at the data for people aged over 60. In the survey, respondents could answer "no difficulty", "can do with difficulty", and "unable to do it". Each answer was assigned a score, which allowed Saikia and Parmar to calculate what is known as the Katz Index of Independence, which takes into account multiple disabilities. As the survey also asked questions about long-term health conditions, the researchers were able to connect the to specific conditions.

The researchers say that acting in a timely way to address chronic morbidity will help to minimize the huge associated burden of disability.

"Due to improved socioeconomic conditions, there is a steady increase in life expectancy and consequently aging among Indians. However, this may not translate into a , particularly when they suffer chronic diseases like diabetes. In order to prepare for a healthy old age, a social environment should be created for early detection and postponing the onset of morbidity as the later stages of life approaches, by focusing on a from the beginning of adulthood," says Saikia.

She adds that policymakers should look at ways to promote healthy lifestyles among India's adult population, such as providing sufficient transport and infrastructure, increasing taxes on tobacco and alcohol, and raising awareness of the benefits of healthy diets and physical activity. The government should also consider offering more assistance to families with elderly members, particularly as family structures and society values change. All stakeholders, including the government, community health workers, and society as a whole must be involved.

Explore further: 1 in 4 in U.S. has a disability, CDC reports

More information: Mukesh C. Parmar et al, Chronic morbidity and reported disability among older persons from the India Human Development Survey, BMC Geriatrics (2018). DOI: 10.1186/s12877-018-0979-9

Related Stories

1 in 4 in U.S. has a disability, CDC reports

August 16, 2018
(HealthDay)—One in four American adults (61 million people) has a significant physical or mental disability, the federal government reported Thursday. And these disabilities are more prevalent among women, people in the ...

Cognitive disability most prevalent type in young adults

August 20, 2018
(HealthDay)—Cognitive disability is the most prevalent disability type among young adults, while middle-aged and older adults have the highest prevalence of mobility disability, according to a report published in the Aug. ...

Disability, reduced social participation associated with chronic conditions in middle-age

November 9, 2016
Middle-age adults living with a combination of arthritis, heart disease or diabetes, and depression are more likely to experience disability and limited involvement in society, new research from McMaster University has found.

Intensive lifestyle interventions cut long-term disability in T2DM

March 26, 2018
(HealthDay)—For overweight or obese adults with type 2 diabetes, a long-term weight loss intervention is associated with a reduction in long-term disability, according to a study published online March 15 in Diabetes Care.

CDC: 20 percent of U.S. adults have a disability

August 1, 2015
(HealthDay)—More than 50 million Americans live with a physical or mental disability, according to research published in the July 31 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality ...

India needs 'giant leap' to meet 2030 targets in reducing child mortality rates

August 2, 2018
IIASA researchers have found that almost half of the districts in India are not on track to reduce the mortality rates of newborns and meet the target set out under Sustainable Development Goal 3 (SDG3) for 2030, while a ...

Recommended for you

A co-worker's rudeness can affect your sleep—and your partner's, study finds

December 14, 2018
Rudeness. Sarcastic comments. Demeaning language. Interrupting or talking over someone in a meeting. Workplace incivilities such as these are becoming increasingly common, and a new study from Portland State University and ...

A holiday gift to primary care doctors: Proof of their time crunch

December 14, 2018
The average primary care doctor needs to work six more hours a day than they already do, in order to make sure their patients get all the preventive and early-detection care they want and deserve, a new study finds.

Teens get more sleep with later school start time, researchers find

December 12, 2018
When Seattle Public Schools announced that it would reorganize school start times across the district for the fall of 2016, the massive undertaking took more than a year to deploy. Elementary schools started earlier, while ...

Large restaurant portions a global problem, study finds

December 12, 2018
A new multi-country study finds that large, high-calorie portion sizes in fast food and full service restaurants is not a problem unique to the United States. An international team of researchers found that 94 percent of ...

Receiving genetic information can change risk

December 11, 2018
Millions of people in the United States alone have submitted their DNA for analysis and received information that not only predicts their risk for disease but, it turns out, in some cases might also have influenced that risk, ...

Yes please to yoghurt and cheese: The new improved Mediterranean diet

December 11, 2018
Thousands of Australians can take heart as new research from the University of South Australia shows a dairy-enhanced Mediterranean diet will significantly increase health outcomes for those at risk of cardiovascular disease ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.