The majority (43.45%) of the participants belonged to the 60-69 years age group, followed by 34.52% in the 70-79 years age group, and 22.02% in the 80 years and above age group. The participants were predominantly female, accounting for 61.9% of the sample. The largest group was from the Other Backward Classes (OBC) at 41.67%, followed by Scheduled Caste (39.88%), others (13.1%), and Scheduled Tribe (5.36%). The majority of participants (74.4%) had health insurance (Table 1).
|
Table 1
|
|
Socio-demographic Characteristics
|
(N=168)
n (%)
|
|
Age (n=168)
|
60-69
|
73 (43.45%)
|
|
70-79
|
58 (34.52%)
|
|
≥80
|
37 (22.02%)
|
|
Gender
(n=168)
|
Male
|
64 (38.1%)
|
|
Female
|
104 (61.9%)
|
|
Ethnicity(n=168)
|
Scheduled Caste
|
67 (39.88%)
|
|
Scheduled Tribe
|
9 (5.36%)
|
|
OBC
|
70 (41.67%)
|
|
Others
|
22 (13.1%)
|
|
Marital Status
(n=168)
|
Married
|
43 (25.6%)
|
|
Widow
|
88 (52.4%)
|
|
Widower
|
37 (22%)
|
|
Health insurance (n=168)
|
Insurance present
|
125 (74.4%)
|
|
No health insurance
|
43 (25.6%)
|
|
Completed education (in years) (n=168)
|
0
|
102 (60.7%)
|
|
1-5
|
42 (25%)
|
|
6-8
|
14 (8.3%)
|
|
9-10
|
9 (5.4%)
|
|
11-12
|
0
|
|
>12
|
1 (0.6%)
|
Prevalence of Chronic Conditions
The overall burden of chronic conditions was substantial, with 89.3% of participants reporting at least one chronic condition and 67.3% having multimorbidity (two or more conditions). The mean number of chronic conditions per participant was 2.4 (SD±1.8).
Musculoskeletal Disorders: Arthritis/rheumatism was the most prevalent condition (48.21%, 95% CI: 40.7-55.8%), followed by chronic backache (29.17%, 95% CI: 22.5-36.5%). These conditions significantly impacted daily functioning and mobility.
Sensory Impairments: Hearing impairment affected 32.14% (95% CI: 25.2-39.7%) of participants, while visual impairment was present in 19.64% (95% CI: 13.9-26.4%). These sensory deficits contribute to social isolation and reduced quality of life.
Cardiovascular and Metabolic Conditions: Hypertension was reported by 23.81% (95% CI: 17.6-30.9%) of participants, while diabetes mellitus affected 7.14% (95% CI: 3.7-12.2%). The relatively lower prevalence of diabetes may reflect survival bias or underdiagnosis.
Gastrointestinal Conditions: Acid peptic disease was reported by 25.6% (95% CI: 19.2-32.9%) of participants, possibly related to dietary factors and medication use.
Mental Health Conditions: Depression, dementia, and other mental health conditions were reported by 6.55% (95% CI: 3.1-11.8%) of participants, though this likely represents an underestimate due to stigma and underdiagnosis.
Other Conditions: Chronic respiratory diseases (4.76%), stroke/paralysis (2.98%), and chronic kidney disease (0.6%) were less prevalent but represented significant health challenges for affected individuals (Table 2).
Age-Related Associations
Multivariable logistic regression analysis revealed significant age-related patterns for major chronic conditions:
Arthritis: Individuals aged ≥80 years had significantly higher odds of arthritis compared to those aged 60-69 years (AOR: 2.98, 95% CI: 1.14-7.80, p=0.025). This finding aligns with the degenerative nature of joint diseases.
Chronic Backache: The strongest age association was observed for chronic backache, with those aged ≥80 years having 4.38 times higher odds compared to the youngest age group (AOR: 4.38, 95% CI: 1.58-12.13, p=0.004).
Hearing Impairment: While not statistically significant in multivariable analysis, hearing impairment showed a trend toward higher prevalence in older age groups, consistent with age-related hearing loss. (Table 3)
Sociodemographic Associations
Gender differences were observed for several conditions, with females showing higher prevalence of arthritis and chronic backache, possibly reflecting longer life expectancy and hormonal factors. Health insurance status showed mixed associations, with some conditions more prevalent among insured participants, possibly indicating better access to diagnosis and care.
Educational attainment showed inverse associations with some conditions, though confidence intervals were wide due to small subgroup sizes. Ethnicity-related differences were noted but require cautious interpretation due to potential confounding factors.
Multimorbidity Patterns
Common multimorbidity patterns included:
- Arthritis + hearing impairment (18.5%)
- Arthritis + chronic backache (16.1%)
- Hypertension + arthritis (11.3%)
- Hearing impairment + visual impairment (8.9%)
These patterns suggest shared risk factors and potential synergistic effects of multiple conditions on functional outcomes.
|
Table 2
|
|
Chronic diseases
|
n (%)
|
|
Arthritis/Rheumatism/Osteoporosis/Other joint disease
|
81 (48.21%)
|
|
Diabetes
|
12 (7.14%)
|
|
Hypertension
|
40 (23.81%)
|
|
Chronic Respiratory Disease (Asthma/emphysema/COPD/Bronchitis)
|
8 (4.76%)
|
|
Acid Peptic Disease
|
43 (25.6%)
|
|
Chronic Back Ache
|
49 (29.17%)
|
|
Stroke/Paralysis
|
5 (2.98%)
|
|
Visual Impairment
|
33 (19.64%)
|
|
Hearing impairment
|
54 (32.14%)
|
|
Depression/Dementia/Alzheimer’s/Unipolar/Bipolar disorders/Parkinson’s Disease
|
11 (6.55%)
|
|
Chronic Kidney Disease
|
1 (0.6%)
|
|
Epilepsy
|
1 (0.6 %)
|
|
Thyroid Disorder
|
4 (2.38%)
|
|
Filariasis
|
4 (2.38%)
|
|
TABLE.3- Adjusted Odds Ratio
|
Arthritis
|
Diabetes
Mellitus
|
Hypertension
|
CRD
|
APD
|
Chronic Backache
|
Stroke/
paralysis
|
VI
|
HI
|
Dementia
|
CKD
|
Epilepsy
|
Thyroid
|
Filariasis
|
|
Age
|
60-69
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
70-79
|
1.99 (0.93-4.24)
|
0.39 (0.09-1.73)
|
0.66 (0.28-1.57)
|
0.79 (0.12-5.46)
|
0.75 (0.32-1.75)
|
0.88 (0.38-2.05)
|
0.50 (0.04-6.38)
|
1.20 (0.48-2.99)
|
2.15 (0.95-4.84)
|
2.18 (0.49-9.82)
|
18.20
|
1
|
0.57 (0.05-7.31)
|
5.02 (0.22-115.53)
|
|
|
≥80
|
2.98 (1.14-7.80)
|
0.75 (0.12-4.64)
|
0.92 (0.31-2.74)
|
1.69 (0.24-12.10)
|
1.31 (0.45-3.83)
|
4.38 (1.58-12.13)
|
1.84 (0.18-18.74)
|
0.88 (0.29-2.71)
|
2.09 (0.77-5.68)
|
0.60 (0.04-8.43)
|
357.15
|
1
|
1.86 (0.12-29.58)
|
3.23 (0.08-129.38)
|
|
Gender
|
Female
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
Male
|
0.18 (0.04-0.83)
|
168378385
|
1.42 (0.30-6.78)
|
1.18
|
0.09 (0.01-0.57)
|
0.36 (0.08-1.71)
|
19731075.54
|
1.39 (0.24-8.03)
|
1.46 (0.29-7.30)
|
17267513.35
|
1
|
1248511.065
|
1
|
1
|
|
Health Insurance
|
Absent
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
Present
|
0.60 (0.28-1.32)
|
5.82 (0.62-54.40)
|
1.95 (0.72-5.28)
|
0.433(0.08-2.30)
|
1.04 (0.44-2.47)
|
0.59 (0.26-1.34)
|
44001817.79
|
2.03 (0.72-5.70)
|
1.78 (0.72-4.39)
|
0.75 (0.16-3.41)
|
1
|
13991819.72
|
1.42 (0.09-21.71)
|
0.11 (0.00-2.60)
|
|
Ethnicity
|
Others
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
SC
|
2.28 (0.71-7.34)
|
0.91 (0.06-13.09)
|
0.48 (0.13-1.78)
|
74078103.15
|
0.44 (0.13-1.51)
|
3.56 (0.88-14.40)
|
9166867.011
|
0.41 (0.11-1.55)
|
1.80 (0.46-7.14)
|
0.26 (0.03-2.13)
|
1.471E+13
|
47338.90
|
0.27 (0.01-5.13)
|
1
|
|
|
ST
|
0.70 (0.12-4.19)
|
1
|
0.44 (0.06-3.37)
|
0.73
|
0.39 (0.05-2.80)
|
2.02 (0.24-16.82)
|
0.286
|
1
|
7.81 (1.11-55.15)
|
1
|
8.685E+24
|
0.00
|
1
|
14.02 (0.13-1549.04)
|
|
|
OBC
|
1.11 (0.36-3.45)
|
1.16 (0.08-16.55)
|
0.44 (0.12-1.64
|
76186731.65
|
0.62 (0.18-2.11)
|
3.30 (0.82-13.24)
|
33168079.67
|
0.37 (0.10-1.38)
|
2.75 (0.72-10.48)
|
0.65 (0.09-4.66)
|
1.036E+12
|
0.01
|
0.28 (0.01-7.98)
|
1.52 (0.06-37.33)
|
|
Partner Status
|
Married
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
Widow
|
0.54 (0.16-1.76)
|
180116554.7
|
0.98 (0.29-3.36)
|
46878212.59
|
0.61 (0.19-1.96)
|
0.61 (0.18-1.99)
|
24873238.31
|
0.89 (0.21-3.76)
|
0.59 (0.16-2.10)
|
330413464.0
|
1.161
|
17572722.82
|
0.46 (0.04-5.38)
|
8836158.342
|
|
|
Widower
|
1.80 (0.56-5.76)
|
1
|
0.16 (0.04-0.74)
|
157360998.9
|
2.71 (0.53-13.90)
|
0.75 (0.21-2.62)
|
1.678 (0.122-23.020)
|
1.43 (0.39-5.19)
|
0.77 (0.23-2.55)
|
6.10 (0.06-645.21)
|
4.609E+10
|
1
|
0.25
|
71737837.58
|
|
Completed education
(In years)
|
0
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
REF
|
|
|
1-5
|
1.17 (0.51-2.72)
|
1.04 (0.18-6.10)
|
1.34 (0.50-3.61)
|
1.37 (0.25-7.42)
|
1.27 (0.49-3.26)
|
1.60 (0.66-3.89)
|
2.12 (0.24-18.74)
|
1.02 (0.37-2.84)
|
0.29 (0.11-0.80)
|
0.41 (0.04-4.00)
|
1.99
|
1
|
1
|
1
|
|
|
6-8
|
1.81 (0.48-6.80)
|
2.95 (0.34-25.73)
|
0.45 (0.07-2.78)
|
1
|
1.21 (0.27-5.53)
|
1.09 (0.24-4.88)
|
1
|
0.47 (0.08-2.74)
|
0.64 (0.15-2.65)
|
1
|
2.889E+14
|
0.10
|
1
|
10.77 (0.36-321.52)
|
|
|
=>9
|
1.86 (0.32-10.86)
|
1
|
1.44 (0.23-9.03)
|
1
|
2.96 (0.43-20.49)
|
2.77 (0.43-17.74)
|
1
|
0.54 (0.07-4.24)
|
0.65 (0.10-4.03)
|
15.10 (0.27-840.96)
|
0.36
|
0.07
|
1
|
1
|
*REF- Reference; CRD- Chronic Respiratory Disease; APD- Acid Peptic Disease; VI- Visual Impairment; HI- Hearing Impairment; CKD- Chronic Kidney Disease