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Context: Chronic diseases are growing in India and largely affecting the middle-aged and elderly population; many of them are in working age. Though a large number of studies estimated the out-of-pocket payment and financial catastrophe due to this condition, there are no nationally representative studies on productivity loss due to health problems. This paper examined the pattern and prevalence of productivity loss, due to chronic diseases among middle-aged and elderly in India., Methods: We have used a total of 72,250 respondents from the first wave of Longitudinal Ageing Study in India (LASI), conducted in 2017-18. We have used two dependent variables, limiting paid work and ever stopped work due to ill health. We have estimated the age-sex adjusted prevalence of ever stopped working due to ill health and limiting paid work across MPCE quintile and socio- demographic characteristics. Propensity Score Matching (PSM) and logistic regression was used to examine the effect of chronic diseases on both these variables., Findings: We estimated that among middle aged adults in 45-64 years, 3,213 individuals accounting to 6.9% (95%CI:6.46-7.24) had ever-stopped work and 6,300 individuals accounting to 22.7% (95% CI: 21.49-23.95) had limiting paid work in India. The proportion of ever-stopped and limiting work due to health problem increased significantly with age and the number of chronic diseases. Limiting paid work is higher among females (25.1%), and in urban areas (24%) whereas ever-stopped is lower among female (5.7%) (95% CI:5.16-6.25 ) and in urban areas (4.9%) (95% CI: 4.20-5.69). The study also found that stroke (21.1%) and neurological or psychiatric problems (18%) were significantly associated with both ever stopped work and limiting paid work. PSM model shows that, those with chronic diseases are 4% and 11% more likely to stop and limit their work respectively. Regression model reveals that more than one chronic conditions had a consistent and significant positive impact on stopping work for over a year (increasing productivity loss) across all three models., Conclusion: Individuals having any chronic disease has higher likelihood of ever stopped work and limiting paid work. Promoting awareness, screening and treatment at workplace is recommended to reduce adverse consequences of chronic disease in India., (© 2022. The Author(s).)

Aging is a natural phenomenon that is irrevocable. The older adult population is increasing rapidly in India, projected to increase from 6% to nearly 20% in 2050. Clinical conditions found among the elderly that do not fit into discrete disease categories and result from accumulated impairments in multiple systems are called geriatric syndromes. The authors have done a literature search of research papers from indexed and nonindexed journals e databases, Google Scholar, PubMed, and Scopus, Science Direct, Research Gate, and Cochrane. The search terms included were geriatric population, geriatric syndrome, geriatric care, elderly health problem, and comprehensive approach. The management of geriatric syndromes is a challenge to modern geriatric clinical practice. The comprehensive assessment of older adults using standardized tools must be carried out in any healthcare facility to ensure that their needs are met through care and treatment. Evidence‑based standards of practice need to be implemented to provide nursing care for dealing with the therapeutic challenges of various geriatric syndromes. [ABSTRACT FROM AUTHOR]

The changing population age structure has a significant influence on the economy, society, and numerous other aspects of a country. This paper has innovatively applied the method of compositional data forecasting for the prediction of population age changes of the young (aged 0–14), the middle-aged (aged 15–64), and the elderly (aged older than 65) in China, India, and Vietnam by 2030 based on data from 1960 to 2016. To select the best-suited forecasting model, an array of data transformation approaches and forecasting models have been extensively employed, and a large number of comparisons have been made between the aforementioned methods. The best-suited model for each country is identified considering the root mean squared error and mean absolute percent error values from the compositional data. As noted in this study, first and foremost, it is predicted that by the year 2030, China will witness the disappearance of population dividend and get mired in an aging problem far more severe than that of India or Vietnam. Second, Vietnam’s trend of change in population age structure resembles that of China, but the country will sustain its good health as a whole. Finally, the working population of India demonstrates a strong rising trend, indicating that the age structure of the Indian population still remains relatively “young”. Meanwhile, the continuous rise in the proportion of elderly population and the gradual leveling off growth of the young population have nevertheless become serious problems in the world. The present paper attempts to offer crucial insights into the Asian population size, labor market and urbanization, and, moreover, provides suggestions for a sustainable global demographic development. [ABSTRACT FROM AUTHOR]

Sedentary lifestyle and high visceral adiposity have elevated the risk of type 2 diabetes (T2DM) among Indians at younger age. In this study, we aimed to investigate the association of oxidative stress and chronic inflammatory mediators with ageing with special reference to the biological ageing marker cyclin-dependent kinase inhibitor 2A (CDKN2A) among middle-aged (31-50 years) Indian healthy and T2DM subjects. Malondialdehyde (MDA), oxidized LDL (oxLDL), interleukin-6 (IL-6), interleukin 1 β (IL-1 β ), tumor necrosis factor α (TNF- α ), monocyte chemoattractant protein-1 (MCP-1), and CDKN2A were measured in T2DM patients ( n = 80) and controls ( n = 80) aged 31-50 years, further grouped into G1: 31-40 years and G2: 41-50 years. IL-6, TNF- α , MCP-1, and CDKN2A showed a significant association with ageing among both T2DM patients and controls. But the strength of the association of MCP-1 and CKDN2A with ageing was significantly stronger in T2DM patients than the controls. All the oxidative stress and proinflammatory mediators showed nonsignificant associations with CDKN2A in the controls. However, IL-6, TNF- α , and MCP-1 showed a strong association with CDKN2A in T2DM patients. An increased risk of high levels of CDKN2A was found in G1 T2DM patients (OR: 3.484 (95% CI: 1.246-9.747) p = 0.017) and G2 T2DM patients (OR: 5.000 (95% CI: 1.914-13.061), p = 0.001) with reference to the respective control groups. Our study reveals that the middle-aged Indians with T2DM are at higher risk of biological ageing. The development of T2DM is more common among middle-aged Indians. T2DM may exacerbate the ageing process and may subsequently predispose Indians to various age-related complications at a much early age., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2020 Joyita Banerjee et al.)

Background: Considering India's diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India. Methods: Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions. Results: 39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination. Conclusions: That low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health. [ABSTRACT FROM AUTHOR]

Background: Several observational studies have reported the prevalence of cerebral microbleeds (CMBs) and their risk factors in an elderly population. Any information in this regard is currently lacking from India. Aim of this study was to estimate the prevalence, risk factors of CMBs, and association with cognition in an Indian urban population aged 50 years and above. Methods: Household surveys were conducted as part of ongoing Longitudinal Cognition and Aging Research on Population of the National Capital Region (LoCARPoN) study in areas of urban Delhi. Magnetic resonance imaging of the brain was performed in 2599 participants. Using standard neuropsychological battery, mean Z-scores for each domain (memory, executive, information) were derived. Binary and stepwise logistic regression models were used to determine associated risk factors for the presence of CMB and its association with cognitive domains. Results: The prevalence of CMBs was 14.42% (95% confidence interval [CI]: 13.06-15.73). Of these, 203 (7.81%) participants had single CMBs and 172 (6.61%) had multiple microbleeds (≥2). Higher prevalence was observed in older age (6070 years: odds ratio [OR]: 1.25 [95% CI: 0.93-1.67]; 70-80 years: OR: 2.05 [95% CI: 1.48-2.84]; ≥80 years: OR: 3.27 [95% CI: 1.97-5.44]) compared to individuals in the age group 50-60 years. History of stroke (OR: 2.97 [95% CI: 1.56-5.66]), hypertension (OR: 1.36 [95% CI: 1.05-1.75]), and smoking (OR: 1.43 [95% CI: 1.11-1.85]) was associated with at least one CMB. Multiple CMBs were associated with worse scores in memory and executive domains. Conclusion: Older age, hypertension, history of stroke, and history of smoking emerged as important risk factors for the presence of multiple CMBs. Follow-up study is required to determine implications of CMBs. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to compare the new Census 2011 results with the results of the previous Censuses and assess the progress in trends of population growth, literacy rate, and sex ratio imbalance and also to highlight the critical socioeconomic issues based on short-term trends and patterns. Design/methodology/approach – The paper is structured in a "commentary and perspective" format. The paper assesses key demographic and socioeconomic features of India's population using 2011 Census data, and compares progress in population and social trends with the results of previous Censuses. The paper also uses data from the National Family Health Survey (2005-2006) and the United Nations World Population Prospects (2008) to complement Census results and understand the underlying reasons for the progress or deterioration in critical demographic and socioeconomic indicators. Findings – The provisional results of the 2011 Census data reveal a mixed bag of insights. On the positive side, there has been steady progress in population stabilization and a swift ascent in female literacy since 1991. These encouraging trends, among others, represent major driving forces of demographic and economic returns for India in the coming decades. However, on the negative side, the 2011 Census reveals a deplorable deterioration in the female-male ratio of the child population aged 0-6 years, despite India's enforcement of targeted policy measures following the 2001 Census. The country needs to take careful stock of this issue, as its advancing demographic transition and changing socioeconomic circumstances are rapidly translating into an adverse trend of girl child discrimination. Originality/value – This study compares India's most recent two Censuses and provides original analytical insights into India's progress in population stabilization and development, and the setbacks it faces in terms of gender inequalities. Region and state-wise analyses are additional contributions based on disaggregated state level data from the recent two Censuses. [ABSTRACT FROM AUTHOR]

This paper deals with quantifying the resilience of a network of pavements. Calculations were carried out by modeling network performance under a set of possible damage--meteorological scenarios with known probability of occurrence. Resilience evaluation was performed a priori while accounting for optimal preparedness decisions and additional response actions that can be taken under each of the scenarios. Unlike the common assumption that the pre-event condition of all system components is uniform, fixed, and pristine, component condition evolution was incorporated herein. For this purpose, the health of the individual system components immediately prior to hazard event impact, under all considered scenarios, was associated with a serviceability rating. This rating was projected to reflect both natural deterioration and any intermittent improvements due to maintenance. The scheme was demonstrated for a hypothetical case study involving LaGuardia Airport. Results show that resilience can be impacted by the condition of the infrastructure elements, their natural deterioration processes, and prevailing maintenance plans. The findings imply that, in general, upper bound values are reported in ordinary resilience work, and that including evolving component conditions is of value. [ABSTRACT FROM AUTHOR]

In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems. [ABSTRACT FROM AUTHOR]

Background: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India.Methods: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010).Results: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33).Conclusions: The country comparison reflects major public policy differences underpinned by divergent political and ideological frameworks. The DM epidemic poses huge public health challenges for China and India. Ensuring equitable and affordable access to medications for DM is fundamental for healthy ageing cohorts, and is consistent with the global agenda for universal healthcare coverage. [ABSTRACT FROM AUTHOR]

Background: Injuries have become a major public health concern. Recent data show that globally over 5 million people lose their life due to injury every year. Especially in low- and middle-income countries, people living below the poverty line are drastically scathed due to injuries. Objective: The objective of this paper is to find the magnitude and risk factors of fall among the elderly in India. Materials and Methods: A systematic search was done by using Google Scholar and PubMed. Results: The selected studies revealed that the prevalence of fall ranges from 26% to 37% across various regions, fall injuries are associated with poor vision, vertigo, imbalance, fear of falling, history of fall, presence of osteoarthritis, visual impairment, hearing impairment, and depression. This study has shown the risk of fall was higher among female elderly population. Conclusion: The major contributing factors for fall injuries are aging, visual impairment, previous history of fall, depression, and gait problem. Females have a higher risk of fall comparatively to males. [ABSTRACT FROM AUTHOR]

Introduction: The recent development of robust indices to quantify biological aging, along with the dynamic epidemiological transitions of population aging generate the unmet need to examine the extent up to which potential interventions can delay, halt or temporarily modulate aging trajectories. Methods and analysis: The study is a two-armed, open label randomised controlled trial. We aim to recruit 166 subjects, aged 60–75 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). Intervention will include yoga sessions tailored for the older adults, 1 h per day for 5 days a week, spread for 12 months. Data would be collected at the baseline, 26th week and 52nd week. The primary outcome of the study is estimation in biological age with yoga practice. The secondary outcomes will include cardinal mechanistic indicators of aging- telomere length, interleukin-6 (IL-6), tumor necrosis factor receptor II (TNF-RII), high sensitivity c-reactive protein (hsCRP)], insulin signaling [insulin and IGF1], renal function [cystatin], senescence [growth differentiating factor 15 (GDF-15)] and cardiovascular function [N-terminal B-type natriuretic peptides (NT-proBNP)]. Analyses will be by intention-to-treat model. Ethics & dissemination: The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID:RES/IEC-SVYASA/242/2022). Written informed consent will be obtained from each participant prior to inclusion. Trial registration number: CTRI/2022/07/044442. [ABSTRACT FROM AUTHOR]

According to Intergenerational Flow of Wealth Theory of J.C. Cladwell (1976), the decision of having high fertility in the developing countries is very rational from the point of view of the elderly. They are believed to truly act as a long-lasting support system to their parents when they get old in every aspect of life, but the scenario is changing rapidly. With rapid modernization of our society children are no longer the fixeddeposit of support of elderly even in a country like India. Isolation and helplessness have become the part and parcel of life of elderly even in modern India which adversely impacts their wellbeing. This paper is an effort to quantify the level of care and support provided by the children to the elderly of the country and how this quality of care finally affects their wellbeing through their subjective health. This paper has used the data of the recent large scale project of ageing conducted by ISEC, Bangalore and IEG, Delhi in sponsorship of UNFPA, India, named "Building Knowledge Base on Aging in India". The survey is conducted to develop a knowledge base in regard to the demographic, social and economic conditions, health needs and living arrangements and entitlements. Multinomial logit estimation is used to show the impact of socio-economic factors on the different care and support aspect and also on the wellbeing of the elderly. Marginal effect shows that quality of care and support to elderly is fast decreasing. With the expected bulge of elderly population in the coming decades, government must take some steps in advance to combat with this situation. In the light of empirical results, some policy prescription has been suggested for benefit of the elderly. [ABSTRACT FROM AUTHOR]

Introduction: Baseline expression of p16INK4a characterises cellular senescence. Similarly, the measurement of 1-Gamma-H2AX (1-H2AX) foci levels in cells provides a reliable method for quantification of Deoxyribonucleic Acid (DNA) damage. Aim: To explore the role of p16INK4a and 1-H2AX as biomarkers of senescence in skin tissue. Materials and Methods: This was a cross-sectional study conducted in the Department of Anatomy, PGIMER, Chandigarh, Punjab, India from June 2022 to January 2023. Skin tissue was obtained from 30 cadavers, aged 20-90 years, from the anterior abdominal wall. The time duration of sample collection after death varied from six hours to 12 hours. Samples were divided into two groups: Group-I <30 years and Group-II >70 years, with n=15 in each group. The relative change in the expression pattern of p16INK4a and 1H2AX markers, as well as the microstructure of the skin (thickness of epidermis and dermis, distribution of collagen I/II/III fibres, architecture of sebaceous glands), were statistically analysed using an unpaired t-test. Results: Intense staining was observed with p16INK4a in Group-II, showing positivity in 60.75% of the cells, while Group-I depicted a weak staining pattern (15%). On immunostaining with 1-H2AX, only Group-II cells showed intense positivity (45%). Significant differences were observed in the epidermal and dermal thickness: Group-I (165.5267±37.73 µm; 2394.6±874.13 µm); Group-II (54.6±22.79 µm; 566.67±242.23 µm), and collagen Type-II/III fibres were found predominantly in aging skin tissue. Conclusion: The present study provides comprehensive data regarding age-associated changes between p16INK4a, 1-H2AX, and skin microstructure, which result in decreased repair and regenerative capacity of skin tissue and various age-related skin diseases. [ABSTRACT FROM AUTHOR]

This paper investigates the influence of service aging on transformer insulating oil. Samples of 10 working power transformers of 16 to 20 MVA installed at different substations in Punjab, India have been taken. Various properties of transformer insulation oil such as breakdown voltage (BDV), moisture, resistivity, tan delta, interfacial tension and flash point have been measured using different national and international standards. In this paper, the various properties of insulating oil have been graphically presented with service aging. [ABSTRACT FROM AUTHOR]

Ensuring healthy ageing for the Indian population is a major challenge awaiting its policymakers, particularly as older persons comprise an increasing share of the population. Given the country's inadequate health and social security system, support provided to the elderly by their families is crucial in determining the health status of older persons. In this context, the increasing integration of the Indian economy with global markets is expected to have complex effects, eroding traditional family structures while simultaneously creating new economic opportunities, which in turn may enhance the economic independence of older persons. Based on data collected in 2004 during the all-India survey of the National Sample Survey Organization, this paper examines the impact of economic independence and family support on the perceived health status of elderly. The results are controlled for demographic and socio-economic variables, such as age and per capita income. Ordered logit regression models are estimated for the all-India sample, classified by gender and place of residence. Subsequently, the model is re-estimated for major Indian states. The study finds that economic independence has a positive impact on perceived health status, while support from a spouse constitutes the major (if not the only) form of family support. This study provides important pointers for policymakers. Among other things, it highlights the importance of the joint family system and lifelong social and physical activity in ensuring a healthy ageing process, as well as the need to strengthen the bonds between older persons and subsequent generations through integrated inter-generational relations, two-way flows and interactions, and the education of younger generations on the symbolic role of elderly persons within the family. [ABSTRACT FROM AUTHOR]

In this paper, the individual biological sequence of change with age in a sample taken in metropolitan city, Calcutta, West Bengal, is discussed. The study comprises a few anthropometric measurements (stature, weight, biacromial breadth, nasal length, nasal breadth, upper facial height) taken on the same population at an interval of five years (first in the year 1982 and again in the year 1987). The study reveals that the amount of increment or decrement of some characters (the above mentioned traits) are different for different chronological age; and these differences can only be identified with the help of a longitudinal study which is free from the effect of secular change in the younger generations.

Purpose: Aging is one of the most important risk factors for a number of human diseases. Epigenetic alterations, including changes in DNA methylation patterns, have been reported to be one of the hallmarks of aging. Being a malleable process, the role of site-specific DNA methylation in aging is being extensively investigated; however, much less attention has been given to alterations in global DNA methylation with aging at the population level. The present study aims to explore overall and sex-specific variations in global DNA methylation patterns with age. Methods: A total of 1,127 adult individuals (792 females) aged 30-75 years belonging to Haryana, North India, were recruited. Socio-demographic data was collected using a pretested interview schedule. Global DNA methylation analysis, of peripheral blood leucocyte (PBL) DNA, was performed using the ELISA-based colorimetric technique. Results: Though the overall correlation analysis revealed a weak inverse trend between global DNA methylation and age, the adjusted regression model showed no significant association between global DNA methylation and age. In agestratified analysis, global DNA methylation levels were found to be fairly stable until 60 years of age, followed by a decline in the above-60 age group. Further, no significant difference in DNA patterns methylation pattern was observed between males and females. Conclusion: Overall, the study suggests a lack of association between global DNA methylation and age, especially until 60 years of age, and a similar DNA methylation pattern between males and females with respect to age. [ABSTRACT FROM AUTHOR]

The population of the elderly in the world will double from 2015 to 2050, reaching nearly 2.1 billion. The ageing population suffers from physical, mental health, and psychological well -being. There is no such customized policy that caters to helping the ageing population. The current examination studies ageing women, their health, and their quality of life (QoL) in India. The study tried to capture the two major and vast diversified areas. Respondents were randomly selected from four south and north Indian states. The present investigation covered 64 cities in these four states and collected 1,100 samples. The data analysis revealed that QoL has a significant difference with different demographic factors as well as health status, Literacy level, marital status, socioeconomic status, and health status of elderly women. Most of them suffer from diabetes, hypertension, and digestive system issues, so they need regular medical care and attention. Further data analysis unearthed that most ageing women belong to middle and lower socioeconomic backgrounds. The government should focus more on their financial assistance and food security and arrange proper counselling therapy for their mental health to improve their QoL. The study contributes to the constructive and reflective handling of the health and well -being of the ageing female population. Policymakers must look into the health issues of the elderly population and make customised policies and actions that can assist the elderly population. [ABSTRACT FROM AUTHOR]

The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental health needs will be increasingly important. We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement. We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, Scopus and Web of Science. Data on population demographics, human resources, health funding and social protection for older people were extracted. Local informants were consulted to supplement and verify the data. In the study countries, the number of health professionals with expertise in elderly care was largely unknown, with minimal postgraduate training programmes available in elderly medicine or psychiatry. Older adults are therefore cared for by general physicians, nurses and community health workers, all of whom are present in insufficient numbers per capita. Total average healthcare expenditure was 2.5–5.5% of GDP, with 48.1–72.0% of healthcare costs covered by out-of-pocket payments. Pakistan did not have a social pension; only India and Nepal offered financial assistance to people with dementia; and all countries had disproportionately low numbers of care elderly homes. Inadequate healthcare funding, a shortage of healthcare professionals and insufficient government pension and social security schemes are significant barriers to achieving universal health coverage in LMICs. Governing bodies must expand training programmes for healthcare providers for older adults, alongside increasing social protection to improve access to those in need and to prevent catastrophic health expenditure. [ABSTRACT FROM AUTHOR]

Introduction: The COVID‐19 pandemic resulted in a wide variety of adverse consequences, including disruption of long‐term, human research studies globally. Two long‐term, prospective, aging cohort studies, namely, Srinivaspura Aging, Neurosenescence and COGnition (SANSCOG) study and Tata Longitudinal Study of Aging (TLSA), conducted in rural and urban India, respectively, had to be suspended during first and second waves of COVID‐19. Methods: We conducted telephonic assessments to screen for depression and anxiety in the above two cohorts comprising of adults ≥45 years, during the first wave (2020) and second wave (2021) lockdown periods in India. Further, we included depression assessments data from two additional time periods—pre‐COVID (2019) and the "inter‐wave" period (between the first and second waves) to compare proportions of depression in these cohorts, during four distinct time periods—(i) pre‐COVID, (ii) COVID first wave lockdown, (iii) inter‐wave period, and (iv) COVID second wave lockdown (rural: 684, 733, 458, 611 and urban: 317, 297, 204, 305 respectively). Results: During COVID first wave, 28.8% and 5.5% had depression and anxiety, respectively in the rural cohort. Corresponding figures in the urban cohort were 6.5% and 1.7%. During second wave, 28.8% of rural subjects had depression and 3.9% had anxiety, whereas corresponding figures in urban subjects were 13.1% and 0.66%. During the above‐mentioned four time periods, proportions of depression were: rural—8.3%, 28.8%, 16.6%, 28.8%; urban—12%, 6.1%, 8.8%, 13.1%. Conclusions: Multi‐fold increase in depression among aging, rural Indians during first and second waves, with high depression among subjects ≥65 years and those with comorbidities during the first wave, is concerning. Urgent public health measures are needed to address this added mental health burden and thereby, prevent further potential adverse consequences. [ABSTRACT FROM AUTHOR]

Vaccination is undoubtedly the most effective and economical way of dealing with the diseases which can affect masses. Pediatric immunization against vaccine preventable disease (VPD) is being supported by most of the international health agencies, making them accessible and affordable to even the poorest of the countries. However, adult vaccination is needed to protect the most productive age group and improve the quality of life of the aging population and is left to those who can afford it. In most of the low- and middle-income countries including India, adult vaccination did not even find a mention in national vaccination policies. Although recommendation exists from various health associations in India for adult vaccination, they have not been given enough publicity as data on burden of VPDs and cost-effectiveness of these vaccines in adults are not available. Most of the general population and a substantial proportion of health care professionals in India lack awareness on the availability and need for these adult vaccinations. Now with improved childhood immunization and increased life expectancies, many diseases are showing epidemiological shift to the later part of life, thereby bringing the focus on adult immunization through the life course approach to reduce morbidity and mortality because of VPDs in adults and improve the quality of life of those left vulnerable because of aging or their existing medical condition. [ABSTRACT FROM AUTHOR]

Aging is the foremost challenge in recent times, given the demographic shift in populations across the world. It implies the costs of healthcare burden and involves economic and social security challenges through shortage of labor supply, consumption–saving paradox, increase in expenditure on healthcare, and most importantly, social capital among the developing countries. Furthermore, there is a likely challenge of old age security in terms of income and expenditure due to increasing healthcare costs and low earning incentives at older ages. India currently has the second largest population globally, with >9% of its population accounting for aging. Based on the multidimensional aging index (AI) using the latest longitudinal survey data of older adults in India, we examined the possible challenges of the economics of aging in India while examining the economic health and social outcomes of the elderly. Our results found that the elderly in India are highly exposed to negative impacts due to vulnerability in socio-economic and health spheres of life. Low labor force participation, lack of skills, and low literacy are the prevalent challenges faced by the elderly Indian population, particularly women. Similarly, the fiscal challenges include increased income tax and insurance coverage for the elderly, while health challenges imply a greater proportion of the disabled and multi-morbid, leading to more burden on the health and welfare system of India. Thus, given the possible short- and long-term effects of aging on the path of economic growth in India, policy incentives are required to minimize the impact and avert the burden of population aging in the country. [ABSTRACT FROM AUTHOR]

Background: Losing teeth has been considered as part of normal aging. However, in developing countries, tooth loss among older adults is shown to be more negatively associated with self-image and quality of life compared to their western counterparts. This study examines the association of tooth loss with self-rated health and psychological and subjective wellbeing among older adults in India.Methods: Data were derived from the "Building Knowledge Base on Population Ageing in India" (BKPAI) survey which was carried out in 2011. The final sample size for the analysis was 9231 older adults. Descriptive statistics and bivariate analysis along with binary logistic regression analysis were conducted to fulfil the objective of the study.Results: A proportion of 12.3% of older adults reported complete tooth loss. It was found that older adults who reported tooth loss were 2.38 times significantly more likely to have poor self-rated health (SRH) [2.38; CI: 1.99,2.83] than older adults who did not report tooth loss. The odds of low psychological health were high among older adults who suffered from tooth loss than their counterparts [OR: 1.59; CI: 1.33,1.91]. Older adults who reported tooth loss had 65% significantly higher odds of low subjective well-being than older adults who did not report tooth loss [OR: 1.65; CI: 1.38,1.97].Conclusion: Complete loss of teeth is associated with older individuals' poor SRH as well as low psychological and subjective well-being, but such a consequence is avoidable by practising the efforts to maintain good oral health. [ABSTRACT FROM AUTHOR]

The present paper reports the changes in body fat and lean body mass during 20 to 80 years. The data consist of 502 Jat-Sikh and 510 Bania females. The body fat has been calculated by applying Durnin & Womersley's (1974) formulae. The body fat reaches a maximum value of 20.06 kg at age-group 60-64 in Jat-Sikh females and 22.15 kg at age-group 45-49 in Bania females followed by a decline, reaching a value of 15.28 kg in Jat-Sikhs and 14.93 kg in Banias in the 70+ age group. The redistribution of fat with ageing has also been observed from skinfold measurements and changing body contours. The lean body mass reaches a maximum value of 35.64 kg in Jat-Sikhs and 36.22 kg in Bania at age-group 35-39 followed by a steady decrease reaching a value of 30.47 kg in Jat-Sikhs and 28.27 kg in Banias at age-group 70+. The females of the present study possess significantly lesser body fat and lean body mass as compared to American and British females. But in terms of percentages the Jat-Sikh females of the present study possess the largest lean body mass and the least body fat.

The research paper deals with the age changes and comparison of somatotype components of Jat-Sikh and Bania females during 20 to 80 years. The former community is traditionally engaged in farming, while the latter is specialized in business and commerce. Anthropometric data on 502 Jat-Sikh and 510 Bania females have been collected from different villages and cities of Punjab. Each subject has been somatotyped using the Heath-Carter method (Heath & Carter, 1967). The Bania females have higher ratings of endo- and mesomorphic components than Jat-Sikh females at all ages, but the differences are significant only up to the sixties. The ectomorphic component is significantly larger in Jat-Sikh females at all ages. The different physical activity, dietary habits, and genetical factors may be responsible for a different physique of the two communities. The changes in somatotypes with age are of a minor nature. Significant differences exist in only a few groups. The endomorphic component remains dominant throughout the period of study in both the communities.

Rapid rise in the population of older adults in India will lead to the need for increased health care services related to diagnosis, management, and long-term care for those with dementia and cognitive impairment. A direct approach for service provision through memory clinics can be an effective, successful, and sustaining means of delivering specialized health care services. We have established a memory clinic in Mumbai, India by employing the diverse clinical skills available in Indian academic institutions, diagnostic and research expertise of clinicians and psychologists, and the support of the U.S. National Institutes of Health. Our project involved recruitment of patients, clinical and neuropsychological assessment, and standardized diagnostic procedures, demonstrating the feasibility of using research methods to develop a memory clinic. In this paper, we describe the development of a community-based memory clinic in urban India, including linguistic and cultural factors and present detailed results, including diagnostic characterization, on 194 subjects with various stages of cognitive deficits. Our findings support the feasibility of developing a memory clinic in a public hospital and successful use of research diagnostic criteria to categorize cognitive deficits observed in this population, which may be used to inform the development of other such clinics. [ABSTRACT FROM AUTHOR]

Background: Aging is the decline in efficiency of various physiological processes which is continues and irreversible. The age related changes affect maintenance of balance control in steady state balance, reactive balance and anticipatory balance. The purpose of the study was to find out the effectiveness of single task and dual task balance training in improving the quality of life among elderly with impaired balance. Objectives: To compare the effectiveness of single and dual task training in improving the quality of life of elderly with balance impairment and to compare the single and dual task balance training in elderly with impaired balance Study Design: Pre-post experimental study design Method Thirty-four elderly adults with impaired balance were assigned into two groups, one group underwent single task training and other dual task training of about 4 weeks. Baseline measurement were taken pre and post training by using TUG, BBS and SF-36. Results: Dual task training was more effective in improving quality of life and balance in elder adults with impaired balance than the single task training. The TUG scores showed improvement in both the groups. The group which performed dual task training showed significant difference from pre to post measure that with mean 0.51(p=0.005). The single task training group showed an improvement of mean 0.337(p=0.069). The SF-36 score showed significant improvement in both the groups except certain components. Conclusion: Dual task training improves quality of life and balance in elderly adults with impaired balance than single task training. [ABSTRACT FROM AUTHOR]

Background: There is a higher burden of functional disability for Indian older adults with substantial variations across different geographic regions and socioeconomic groups as compared to other ageing Asian countries. Thus, using a national sample of older adults aged 60+ years, we aim to explore how common is acquiring of disability and recovery from disability among the older population of a developing country like India, and how do the various socioeconomic and health-related conditions impact this transition in disability status.Method: The current study uses two waves of the India Human Development Survey (IHDS) and is based on panel data of 10,527 older adults. Both bivariate and multiple variable regression analysis were performed using two binary outcome variables in this study - whether older adults acquired disability and recovered from disability between round-I and round-II, respectively.Results: Nearly 31.5% and 4.4 % of older adults have acquired and recovered disability across the two rounds respectively. About 38.5%  and 45.8 % of female older adults' disability status changes to disable and recovered in round-II respectively. A lesser proportion of older adults have recovered from a disability who have a chronic disease in round-I. Cataract chronic conditions among older adults in round-I had shown 1.45 times (CI: 1.07-1.97) a significantly higher likelihood of acquiring disability in round-I. Older adults who were unmarried and were not working in round-I have 1.12 times (CI: 1.01-1.25) and 1.21 times (CI: 1.06-1.39) higher likelihood of acquiring disability in round-II respectively. Recovering from disability was mostly seen among older adults who belong to the richest (OR: 2.38, CI: 1.31-4.33) and medium (OR: 2.16, CI: 1.27-3.69) wealth quintile households. Older adults residing in the central region of India have 2.72 times (CI: 2.31-3.19) significantly higher chance of acquiring disability than those who were residing in northern regions.Conclusion: Appropriate measures are required to highlight the importance of chronic physical diseases and several socio-demographic factors that may negatively affect the trajectory of disability in older ages. [ABSTRACT FROM AUTHOR]

Background: Aging is an inevitable biological change, but understanding the process of aging of face is important to customize the treatment options for facial rejuvenation. Evidence-based estimation of global facial aging is necessary for the validation of various treatment modalities.Aims: Classification and implementation of a scoring system for aging face based upon volume loss and surface changes as evident by drooping of different areas of the face and appearance of fine and deep wrinkles, respectively, and to apply this drooping-wrinkles classification on 54 participants to evaluate and understand the validity of scoring.Methods: An observational study was conducted, and scores were calculated based on 13 parameters (7 areas of drooping and 6 areas of wrinkles on the face) at Aura Skin Institute, Chandigarh, India. Accordingly, age was divided in different age groups followed by clinical estimation of facial age and calculation of scores.Results: According to our classification and scoring system, 61% (33 out of 54) of the participants were correlated with their chronological age group. Out of the remaining 21 (39%) participants who were aging faster, 13 (24%) were in the age group of 25-35 years. Approximately one-fourth of the patients in the age groups 36-45 and 46-55 years were aging faster. Only 1 patient had scores showing younger age in comparison to chronological age. Overall, there was a good correlation between the calculated score and the chronological age of patients. Moreover, a gradual increase in scores was noticed with increasing age groups.Conclusions: This is a new clinical classification and scoring system for facial age which is much easier to apply in daily clinical practice for easy calculation of baseline scores and customizing their antiaging treatment options. Moreover, it will also make it easier to compare the efficacy of treatment in their future follow-ups. The limitation of this study is that it has been proposed for all skin types but validation has been done only for Indian participants. [ABSTRACT FROM AUTHOR]

Background: China and India are the world's two most populous countries. Although their populations are growing in number and life expectancies are extending they have different trajectories of economic growth, epidemiological transition and social change. Cross-country comparisons can allow national and global insights and provide evidence for policy and decision-making. The aim of this study is to measure and compare disability in men and women, and in urban and rural dwellers in China and India, and assess the extent to which social and other factors contribute to the inequalities.Methods: National samples of adults aged 50 to 79 years in China (n = 11,694) and India (n = 6187) from the World Health Organization (WHO) longitudinal Study on global AGEing and adult health (SAGE) Wave 1 were analysed. Stratified multiple linear regressions were undertaken to assess disability differences by sex and residence, controlling for other biological and socioeconomic determinants of disability. Oaxaca-Blinder decomposition partitioned the two-group inequalities into explained and unexplained components.Results: In both countries women and rural residents reported more disability. In India, the gender inequality is attributed to the distribution of the determinants (employment, education and chronic conditions) but in China about half the inequality is attributed to the same. In India, more than half of the urban rural inequality is attributed to the distribution of the determinants (education, household wealth) compared with under 20% in China.Conclusions: Education and employment were important drivers of these measured inequalities. Overall inequalities in disability among older adults in China and India were shaped by gender and residence, suggesting the need for policies that target women and rural residents. There is a need for further research, using both qualitative and quantitative methods, to question and challenge entrenched practices and institutions and grasp the implications of global economic and social changes that are impacting on population health and ageing in China and India. [ABSTRACT FROM AUTHOR]

To maintain health and to cure diseases through Rasayana (rejuvenation) therapy along with main treatment is the unique approach of Ayurveda. The basic constituent unit of a living being is always a functional cell. Question arises from where it is generated? How it attains its final specific differentiation form? As age progresses, various changes occur at every cell level and cell undergoes to adaptation accordingly. Microenvironment for cell nourishment diminishes with age or as disease condition persists. In this context, Acharyas had contributed and documented various facts and theories through their insight wisdom. Hidden secretes in the basic principles of any medical system are needed to be explained in terms of contemporary knowledge. Contemporary research areas should be opened to include various explanations of different fields of ancient thoughts to support these new doctrines, if any. This review may be helpful to open the door of future research area in the field of reverse scientific approach of Ayurveda in the context of Dhatu Siddhanta (theory of tissues formation and differentiation) and theory of stem cell. [ABSTRACT FROM AUTHOR]

In the process of health transition, India is facing rapid pace of demographic aging. Rapid increase in older adult population posed serious concerns regarding health and health care utilization for them. However, very limited research documented resultant implications of demographic aging for health and health care use in the nexus of marital status and gender. With this perspective, the present study examined patterns in morbidity prevalence and health seeking behaviour among older widows in India. Multivariate logistic regression models were estimated to examine the effects of socio-demographic conditions on morbidity prevalence among older widows and their health care seeking behavior. Data from the latest 60th round of National Sample Survey (NSS), 2004 was used. Overall, morbidity prevalence was 13% greater among older widows compared to older widowers. Adjusted prevalence of communicable and non-communicable diseases was found 74 and 192 per 1000 older widows respectively. At the same time, likelihood of seeking health care services for reported morbidities was substantially lower among older widows. The findings of this study are important to support policy makers and health care providers in identifying individuals ‘at risk’ and could be integrated into the current programs of social, economic and health security for the older persons. [ABSTRACT FROM AUTHOR]

The authors reflect on the importance of geriatric dentistry to improve the health of older people in India. They suggest ways on how to prevent oral diseases among adults. They cite several factors that prevent access of older people to care and the role of the government. They also stress the responsibility of dental professions and dental educators to improve patient and community health outcome.

Background: Aging affects many functions including cognition. Changes in Memory, which is a cognitive function, occur in healthy aging. Aims & Objective: To determine the effect of aging on memory in normal non-demented subjects in South India using the Wechsler Memory Scale (WMS) and a test of Delayed Recall. Materials and Methods: The Wechsler Memory Scale and a test of Delayed Recall were administered to 50 controls aged 20-50 years (Group I), 50 subjects aged 60-75 years (Group II) and 50 subjects aged above 75 years (Group III). Results: There was a significant difference in the Wechsler Memory Scale raw scores of the controls (Group I) vs. subjects aged 60-75 years (Group II),with a p- value of 0.001; as well as between controls (Group I) vs. subjects aged above 75 years (Group III),with a p- value of 0.000. Comparison of the subset scores between controls and subjects (Group II + Group III) revealed a significant decline (p = 0.000) in all subsets except Orientation and Digit Span. Conclusion: Our study revealed that there were memory changes with aging with many aspects of memory declining with age and others showing no significant difference. [ABSTRACT FROM AUTHOR]

Background: Sexual function and activity in old age have been inadequately studied world over. It is important to know that aging processes are not confined to persons beyond the age of 60 years; many changes in elderly have their antecedents in the middle age. Aims: This study sought to determine the patterns of sexual activity and function in individuals over 50 years of age. It also sought to discuss barriers such as chronic illness that may interfere with sexual function. Materials and Methods: We conducted a study of subjects above the age of 50 years in various outpatient departments (OPDs) of a teaching municipal hospital in Mumbai, by interviewing 60 individuals who attended the OPDs, after taking their informed consent. Socio-demographic and other information on their sexual function and activities were obtained. Data was analyzed using statistical package for social sciences v15. Results: 72% individuals below 60 were sexually active, while only 57% above 60 were active. Others had become completely abstinent at some time in their lives. Statistical analysis revealed significant gender, health and educational status based differences in the sample. Conclusion: Our study showed significant presence of sexual desire, activity and function even after the age of 50 years; a decline by the age of 60 and above was a finding that reflected more in women. Chronic illness did affect sexual function and desire. [ABSTRACT FROM AUTHOR]

All the articles published in the Indian Journal of Psychiatry (IJP) from 1958 to 2009 on aging, dementia and other mental health issues of late life were systematically reviewed. There were only a limited number of research articles on dementia in the IJP. Most of the Indian studies on dementia were published elsewhere. People above the age of 60 years constitute about 5% of patients seen in tertiary care settings. High prevalence of psychiatric morbidity was reported among community resident older people. Depression was the commonest mental health problem in late life. We need to develop community-based interventions for management of common conditions like depression in late life. The effectiveness of these interventions needs to be established. It is important to identify risk factors for depression and dementia in our population. We could then try and modify these factors to reduce the prevalence of these conditions. [ABSTRACT FROM AUTHOR]

The article presents author's views on the problems on the relevance on the Act of 2007 by the Parliament of India on the ownership of property by elderly and their financial upkeep by relatives. The author informs that the act will make it legally compulsory for children and grandchildren to take care of the aged. Also, for childless persons, relatives who will inherit their property should look after them. Additionally, criticism and suggestions for the act are presented.