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Multimorbidity and depression among older adults in India: Mediating role of functional and behavioural health

Ansari, Salmaan, Anand, Abhishek, Hossain, Babul (2022) Multimorbidity and depression among older adults in India: Mediating role of functional and behavioural health. PLoS ONE, . ISSN 1932-6203. (KAR id:104662)


Researchers have long been concerned about the association between depression and the prevalence of multiple chronic diseases or multimorbidity in older persons. However, the underlying pathway or mechanism in the multimorbidity-depression relationship is still unknown. Data were extracted from a baseline survey of the Longitudinal Ageing Survey of India (LASI) conducted during 2017–18 (N = 31,464; aged ≥ 60 years). Depression was assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10). Multivariable logistic regression was used to examine the association. The Karlson–Holm–Breen (KHB) method was adopted for mediation analysis. The prevalence of depression among older adults was nearly 29% (men: 26% and women 31%). Unadjusted and adjusted estimates in binary logistic regression models suggested an association between multimorbidity and depression (UOR = 1.28; 95% CIs 1.27–1.44 and AOR = 1.12; 95% CIs 1.12–1.45). The association was particularly slightly strong in the older men. In addition, the association was mediated by functional health such as Self Rated Health (SRH) (proportion mediated: 40%), poor sleep (35.15%), IADL disability (22.65%), ADL disability (21.49%), pain (7.92%) and by behavioral health such as physical inactivity (2.28%). However, the mediating proportion was higher among older women as compared to older men. Physical inactivity was not found to be significant mediator for older women. The findings of this population-based study revealed that older people with multimorbidity are more likely to suffer depressive symptoms in older ages, suggesting the need for more chronic disease management and research. Multimorbidity and depression may be mediated by certain functional health factors, especially in older women. Further longitudinal research is needed to better understand the underlying mechanisms of this association so that future preventive initiatives may be properly guided.

Item Type: Article
Uncontrolled keywords: behavioral and social aspects of health; elderly; activities of daily living; depression; pain; alcohol consumption; India; obesity;
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Funders: Serviço de Intervenção nos Comportamentos Aditivos e nas Dependências (
Depositing User: Salmaan Ansari
Date Deposited: 18 Jan 2024 11:00 UTC
Last Modified: 19 Jan 2024 12:03 UTC
Resource URI: (The current URI for this page, for reference purposes)

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Ansari, Salmaan.

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