Previously submitted to: Online Journal of Public Health Informatics (no longer under consideration since Oct 27, 2025)
Date Submitted: Jun 22, 2024
Open Peer Review Period: Jul 2, 2024 - Aug 27, 2024
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Depression and Multimorbidity Among Older Indians Residing in Front-runner, Achiever and Aspirant States: Insight From Longitudinal Aeging Study in India (LASI) – Wave I
ABSTRACT
Background:
Multimorbidity is gaining prominence as a global public health challenge, with demographic and epidemiologic transitions. Epidemiologically, a bi-directional link exists between depression and multimorbidity, and it is influenced by biological, psycho-social and care-related factors. Variations are expected in the different States with differential performances in the NITI Aayog Annual Health Index.
Objective:
The objective is to study the association of depression with multimorbidity among the older Indian population living in front-runner, achiever and aspirant States.
Methods:
This is an analytical cross-sectional study, analyzing secondary data collected during the Longitudinal Ageing Study in India (LASI)-1st wave (2017–18). A total of 66,606 Indian participants aged >45 years were included in the analysis. Based on their NITI Aayog Annual Health Index score, the States and UTs are classified into front-runner (top one-third), achiever (middle one-third) and aspirant (lowest one-third). For this study, the Health Index Round IV 2019-20 was used for categorisation of the states. Depression was the outcome variable, classified according to the Composite International Diagnostic Interview-Short Form (CIDISF). Multivariable logistic regeression analysis was conducted to calculate adjusted odds of association between depression and multimorbidity. Association between multimorbidity and depression was stratified according to the categorisation of States into front-runner, achiever and aspirants.
Results:
Among those with atleast two co-morbidites, depression was reported in 8.74%. Among those with atleast 4 multimorbidities, depression was reported in 15.56%. Depression was found to most commonly occur along with hypertension (35.8%) and musculoskeletal disorders (21.67%), and least commonly along with cancer (1.09%) and chronic renal failure (1.31%). There was a strong association between depression and multimorbidity in front-runner [aOR = 3.77; 95% C.I. 2.02-7.03], achiever [aOR = 2.10; 95% C.I. 1.84-2.45] and aspirant States [aOR = 3.27; 95% C.I. 1.79-5.95].
Conclusions:
Strong association between depression and multimorbidity across all three State categories indicates a need for inclusion of mental health care components in the composite annual health index. Incorporation of routine and high risk screening for depression among patients with multimorbidity into the Ayushman Bharat Comprehensive Primary Health Care (CPHC) package needs to be tested with health technology assessment studies as potential future policy change. Clinical Trial: NA
Citation
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