Disability and Chronic Disease Among Older Adults in India: Detecting Vulnerable Populations Through the WHO SAGE Study
Sanjay Basu,Abby C. King +1 more
TLDR
The findings indicate that NCD prevalence surveillance studies in low- and middle-income countries should expand beyond self-reported diagnoses to include more extensive symptom- and examination-based surveys, given the likely high rate of surveillance bias due to barriers to diagnosis among vulnerable populations.Abstract:
Chronic noncommunicable diseases (NCDs) are now prevalent in many low- and middle-income countries and confer a heightened risk of disability. It is unclear how public health programs can identify the older adults at highest risk of disability related to NCDs within diverse developing country populations. We studied nationally representative survey data from 7,150 Indian adults older than 50 years of age who participated in the World Health Organization Study on Global Aging and Adult Health (2007–2010) to identify population subgroups who are highly disabled. Using machine-learning algorithms, we identified sociodemographic correlates of disability. Although having 2 or more symptomatic NCDs was a key correlate of disability, the prevalence of symptomatic, undiagnosed NCDs was highest among the lowest 2 wealth quintiles of Indian adults, contrary to prior hypotheses of increased NCDs with wealth. Women and persons from rural populations were also disproportionately affected by nondiagnosed NCDs, with high out-of-pocket health care expenditures increasing the probability of remaining symptomatic from NCDs. These findings also indicate that NCD prevalence surveillance studies in low- and middle-income countries should expand beyond self-reported diagnoses to include more extensive symptom- and examination-based surveys, given the likely high rate of surveillance bias due to barriers to diagnosis among vulnerable populations.read more
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The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal?
Perianayagam Arokiasamy,Uttamacharya Uttamacharya,Kshipra Jain,Richard B. Biritwum,Alfred Yawson,Fan Wu,Yanfei Guo,Tamara Maximova,Betty Manrique Espinoza,Aaron Salinas Rodriguez,Sara Afshar,Sanghamitra Pati,Gillian H. Ice,Sube Banerjee,Melissa A. Liebert,J. Josh Snodgrass,Nirmala Naidoo,Somnath Chatterji,Paul Kowal,Paul Kowal +19 more
TL;DR: The prevalence of 1+ ADL limitation, poor self-rated health, and depression increased whereas quality of life declined markedly with an increase in number of diseases, highlighting the challenge of multimorbidity in LMICs, particularly among the lower socioeconomic groups.
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World Health Organization disability assessment schedule 2.0: An international systematic review
TL;DR: The extent of international dissemination and use of WHODAS 2.0 is established and psychometric research on its various translations and adaptations is analyzed to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument.
Journal ArticleDOI
Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults
Pascal Geldsetzer,Jennifer Manne-Goehler,Jennifer Manne-Goehler,Michaela Theilmann,Justine Davies,Justine Davies,Ashish Awasthi,Sebastian Vollmer,Sebastian Vollmer,Lindsay M. Jaacks,Lindsay M. Jaacks,Till Bärnighausen,Till Bärnighausen,Rifat Atun +13 more
TL;DR: Evidence on the variations in prevalence by state, age group, and rural vs urban location is critical to effectively target diabetes and hypertension prevention, screening, and treatment programs to those most in need.
Journal ArticleDOI
Impact of Multimorbidity on Disability and Quality of Life in the Spanish Older Population
Noe Garin,Beatriz Olaya,Maria Victoria Moneta,Marta Miret,Antonio Lobo,José Luis Ayuso-Mateos,Josep Maria Haro +6 more
TL;DR: Depression, anxiety and stroke were found to have the greatest impact on outcomes and Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability.
Journal ArticleDOI
Redesigning primary care to tackle the global epidemic of noncommunicable disease.
TL;DR: How primary care can be redesigned to tackle the challenge of NCDs in resource-constrained countries is discussed and it is suggested that four changes will be required: integration of services, innovative service delivery, a focus on patients and communities, and adoption of new technologies for communication.
References
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Posted Content
Estimating Wealth Effects without Expenditure Data or Tears: With an Application to Educational Enrollments in States of India
TL;DR: This work estimates the relationship between household wealth and children’s school enrollment in India by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights, and shows that this index is robust to the assets included, and produces internally coherent results.
Journal ArticleDOI
Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application to Educational Enrollments in States of India
Deon Filmer,Lant Pritchett +1 more
TL;DR: In this paper, a method for estimating the effect of household economic status on educational outcomes without direct survey information on income or expenditures is proposed and defended, which uses an index based on household asset ownership indicators.
Journal ArticleDOI
The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).
TL;DR: An overview of the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (CIDI) is presented and a discussion of the methodological research on which the development of the instrument was based is discussed.
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Depression, chronic diseases, and decrements in health: results from the World Health Surveys
TL;DR: Depression produces the greatest decrement in health compared with the chronic diseases angina, arthritis, asthma, and diabetes, and the urgency of addressing depression as a public-health priority is indicated to improve the overall health of populations.
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