Objective: To estimate frailty prevalence and its relationship with the socio‐economic and regional factors and health care outcomes.Methods: In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI‐DAD) were included. The frailty index (FI) was calculated using a 32‐variable deficit model, with a value of ≥ 25% considered as frail. Data on demographic (including caste and religion) and socioeconomic profiles and health care utilization were obtained. The state‐wise health index maintained by the government based on various health‐related parameters was used to group the participants' residential states into high‐, intermediate‐, and low‐performing states. Multivariable and zero‐inflated negative binomial regression was used to assess the relationship of frailty index with sociodemographic characteristics, health index, and health care expenditure or hospitalization.Results: Among the 3953 eligible participants, the prevalence of frailty was 42.34% (men = 34.99% and women = 49.35%). Compared to high‐performing states, intermediate‐ and low‐performing states had a higher proportion of frail individuals (49.7% vs. 46.8% vs. 34.5%, P < 0.001). In the adjusted analysis, frailty was positively associated with age, female sex, rural locality, lower education level, and caste (scheduled caste and other backward classes). After adjusting for the socio‐economic profile, FI was inversely associated with the composite health index of a state (P < 0.001). FI was also significantly correlated with total 1‐year health care expenditure and hospitalization (P < 0.001 and 0.020, respectively).Conclusion: There is a high prevalence of frailty among older Indian adults that is associated with sociodemographic factors and regional health care performance. Furthermore, frailty is associated with increased health care utilization and expenditure.

Genome-wide association studies (GWAS) conducted in European ancestry (EA) have identified hundreds of single-nucleotide polymorphisms (SNPs) associated with general cognitive function and/or Alzheimer’s disease (AD). The association between these SNPs and cognitive function has not been fully evaluated in populations with complex genetic substructure such as South Asians. This study investigated whether SNPs identified in EA GWAS, either individually or as polygenic risk scores (PRSs), were associated with general cognitive function and 5 broad cognitive domains in 932 South Asians from the Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD). We found that SNPs identified from AD GWAS were more strongly associated with cognitive function in LASI-DAD than those from a GWAS of general cognitive function. PRSs for general cognitive function and AD explained up to 1.1% of the variability in LASI-DAD cognitive domain scores. Our study represents an important stepping stone toward better characterization of the genetic architecture of cognitive aging in the Indian/South Asian population and highlights the need for further research that may lead to the identification of new variants unique to this population.

Background: Geriatric syndromes (GS) are multi‐factorial conditions that make older adults vulnerable to morbidities and poor outcomes. The main objective was to observe the frequency of GS in older patients with COPD.Methods: A case‐control study was conducted in the Geriatric department of a tertiary care hospital in India to evaluate geriatric syndromes including falls, cognitive impairment, frailty, functional impairment, urinary incontinence, malnutrition, and depression in patients with COPD and controls without COPD. The factors having a significant association with the occurrence of these GS in COPD patients were observed.Results: In this study, 150 cases and 150 controls were included. The mean age of the participant was 65.85±5.54, with 76% males. Functional impairment, cognitive impairment, frailty, urinary incontinence, and malnutrition were significantly higher in COPD patients. The independent variables which increased the odds of geriatric syndromes were dyspnoea (≥2 mMRC grade) (AOR:3.54,95% CI:1.06‐11.8) and low socioeconomic status (AOR: 4.14, 95% CI: 1.03‐16.54), while male gender showed inverse association (AOR: 0.08,95% CI: 0.01‐0.99).Conclusion: Geriatric syndromes are common in older COPD patients, and assessment for them should be done routinely in these patients.

Objectives Since the onset of the COVID-19 pandemic, behavioural interventions to reduce disease transmission have been central to public health policy worldwide. Sustaining individual protective behaviour is especially important in low-income and middle-income settings, where health systems have fewer resources and access to vaccination is limited. This study seeks to assess time trends in COVID-19 protective behaviour in India. Design Nationally representative, panel-based, longitudinal study. Setting We conducted a panel survey of Indian households to understand how the adoption of COVID-19 protective behaviours has changed over time. Our data span peaks and valleys of disease transmission over May–December 2020. Participants Respondents included 3719 adults from 1766 Indian households enrolled in the Harmonised Diagnostic Assessment of Dementia for the Longitudinal Ageing Study in India. Analysis We used ordinary least squares regression analysis to quantify time trends in protective behaviours. Results We find a 30.6 percentage point (95% CI (26.7 to 34.5); p<0.01) decline in protective behaviours related to social distancing over the observation period. Mask wearing and handwashing, in contrast, decreased by only 4.3 percentage points (95% CI (0.97 to 7.6); p<0.05) from a high base. Our conclusions are unchanged after adjusting for recorded COVID-19 caseload and nationwide COVID-19 containment policy; we also observe significant declines across socioeconomic strata spanning age, gender, education and urbanicity. Conclusion We argue that these changes reflect, at least in part, ‘COVID-19 fatigue,’ where adherence to social distancing becomes more difficult over time irrespective of the surrounding disease environment.

Background: Frailty is a major challenge for healthcare systems in ageing societies. This dynamic state of health is a reflection of reduced reserve in various organ systems and enhanced vulnerability to stressors. Research in this area of geriatrics and gerontology is limited in low- and middle-income countries (LMICs) like India. This study is directed at development of a culturally appropriate and validated assessment scale for frailty among older Indians. Methods: After extensive review of the literature on existing scales, a preliminary draft scale was formed. This draft was pre- and pilot-tested to check feasibility and modified accordingly. The final scale was validated on 107 older adults by confirmatory factor analysis and was named the Frailty Assessment and Screening Tool (FAST). The Fried’s frailty phenotype was also administered on the same 107 older adults and scores of both were co-related. Suitable cut-off scores were found for frail and pre-frail older adults. Results: The final version of the FAST consisted of 14 questions pertaining to 10 domains. It has good reliability. Cronbach’s alpha co-efficient was 0.99; test–retest reliability was 0.97 and validity by confirmatory factor analysis was adequate. The Kaiser–CMeyer–Olkin (KMO) of sampling adequacy was 0.699, and Bartlett’s test of sphericity was significant (χ² = 353.471, p < 0.001). FAST scores had a cut-off of ≥ 7/14 for frail and ≥ 5/14 for pre-frail elderly. Conclusion: The FAST is a validated tool with good psychometric properties. It is expected that it will be helpful in screening pre-frail and frail older adults in India and other LMICs and guide in clinical decision making for intervention.