Complex multimorbidity refers to the co-occurrence of three or more chronic illnesses across >2 body systems, which may identify persons in need of additional medical support and treatment. There is a scarcity of evidence on the differences in patient outcomes between non-complex (≥2 conditions) and complex multimorbidity groups. We evaluated the prevalence and patient outcomes of complex multimorbidity and compared them to non-complex multimorbidity. We included 30,489 multimorbid individuals aged ≥45 years from the Longitudinal Ageing Study in India (LASI) from wave-1 conducted in 2017–2018. We employed a log link in generalised linear models (GLM) to identify possible risk factors presenting the adjusted prevalence–risk ratio (APRR) and adjusted prevalence–risk difference (APRD) with 95% confidence interval. The prevalence of complex multimorbidity was 34.5% among multimorbid individuals. Participants residing in urban areas [APRR: 1.10 (1.02, 1.20)], [APRD: 0.04 (0.006, 0.07)] were more likely to report complex multimorbidity. Participants with complex multimorbidity availed significantly higher inpatient department services and had higher expenditure as compared to the non-complex multimorbidity group. Our findings have major implications for healthcare systems in terms of meeting the requirements of people with complicated multimorbidity, as they have significantly higher inpatient health service utilisation, higher medical costs, and poorer self-rated health.

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity.

Most evidence on multimorbidity is drawn from an individual level assessment despite the fact that multimorbidity is modulated by shared risk factors prevailing within the household environment. Our study reports the magnitude of family-level multimorbidity, its correlates, and healthcare expenditure among older adults using data from the Longitudinal Ageing Study in India (LASI), wave-1. LASI is a nationwide survey amongst older adults aged ≥45 years conducted in 2017–2018. We included (n = 22,526) families defined as two or more members coresiding in the same household. We propose a new term, “family-level multimorbidity”, defined as two or more members of a family having multimorbidity. Multivariable logistic regression was used to assess correlates, expressed as adjusted odds ratios with a 95% confidence interval. Family-level multimorbidity was prevalent among 44.46% families, whereas 41.8% had conjugal multimorbidity. Amongst siblings, 42.86% reported multimorbidity and intergenerational (three generations) was 46.07%. Family-level multimorbidity was predominantly associated with the urban and affluent class. Healthcare expenditure increased with more multimorbid individuals in a family. Our findings depict family-centred interventions that may be considered to mitigate multimorbidity. Future studies should explore family-level multimorbidity to help inform programs and policies in strategising preventive as well as curative services with the family as a unit.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Snakebite envenoming (SBE) is a neglected tropical disease-causing significant morbidity and mortality, with an estimated 81,410–137,880 deaths annually, primarily in rural, low-resource settings. Digital health interventions, particularly mobile applications (mobile based health applications), offer innovative solutions to improve snakebite management through real-time guidance, anti-venom stock tracking, and telemedicine. Objective: This scoping review aims to: (i) Systematically map existing digital mobile based health interventions for snakebite management. (ii) Evaluate their key functionalities, accessibility, and geographical distribution. Methods: A systematic search (January 2024) across PubMed, Google Scholar, Research Gate, Google Search Engine, and Google Play Store. The results were screening using the following criteria: mobile based health applications providing structured guidance for snakebite management (first aid, treatment protocols, anti-venom mapping) were included while studies other than English language, and studies on applications lacking clinical guidance were excluded. Data extraction focused on app features (snake identification, first-aid protocols), accessibility (OS compatibility, cost), multilingual support, and user feedback. Regional application availability was verified via VPN for country-specific stores (e.g., India, Nigeria). Narrative synthesis categorized findings by functionality, regional distribution, and implementation challenges. The results were presented using a PRISMA flow diagram to illustrate the screening process, complemented by summary tables for a clear and detailed overview of the findings. Results: The search resulted in a total of 237 records, out of which 227 underwent primary screening after removing duplicates. Full-text review excluded 135 reports, resulting in inclusion of total 16 applications. All the applications provided first-aid protocols (16 applications, 100%), with most including snake identification tools (14, 87.5%), such as AI-driven photo recognition. Additionally, over half mapped anti-venom stocks (9, 56.25%), and a majority integrated emergency contact (11, 68.75%). 15 applications (93.75%) had free access, while 10 (62.5%) supported Android. A significantly large number of applications were available in India (11, 68.75%), while South Africa had very few, despite the burden, highlighting a clear geographical disparity. Urban users praised real-time guidance (85% positive reviews), but in rural usability was hindered due to internet dependency (40% of rural users) and language barriers (65% misinterpretation in studies other than English language regions). Conclusions: Digital health applications demonstrate potential to reduce snakebite mortality through education and emergency support. However, scalability requires: (i) Infrastructural Adaptations: Offline functionality and low-data interfaces. (ii) Equity-Driven Design: Regional customization (e.g., Sub-Saharan African snake species) and hyper-local language integration. (iii) Policy Action: Standardized development guidelines, subsidized smartphone access, and digital literacy programs. These steps are critical to achieving WHO’s 2030 targets and ensuring equitable global impact.

Objective: This study aimed to assess the prevalence and patterns of sleep disorders among older adults in India and examine the influence of depression, functional status (ADL and IADL) and physical activity on sleep health. Methods: A secondary analysis of the 2017-2018 Longitudinal Ageing Study in India (LASI) was conducted among adults aged ≥60 years with complete sleep-related data. Sleep disorder was defined as self-reported frequent sleep disturbances. Weighted prevalence estimates and multivariable logistic regression accounting for complex survey design were used to identify sociodemographic, behavioural and health-related determinants. Results are presented as Adjusted Odds Ratios (AORs) with 95% Confidence Intervals (CIs). Results: The prevalence of frequent sleep disorder among older adults was 0.95% as per the symptom-based definition. However, a substantially larger proportion reported occasional sleep disturbances, indicating a broader burden of sleep-related complaints. In adjusted analysis, depression emerged as a strong independent predictor of sleep disorder. Older adults with depressive symptoms had higher odds of reporting a sleep disorder compared to those without depression. Multimorbidity (2 or more chronic conditions) was also truly associated with increased odds of sleep disorder. Physical inactivity was identified as an additional modifiable risk factor. Sociodemographic factors such as age, sex and marital status were not associated with sleep disorders after adjusting for health-related variables. Conclusion: Despite low prevalence under the LASI definition, sleep disorders remain important among older Indians. Mental health, chronic diseases and lifestyle factors outweigh demographics, highlighting the need for integrated sleep, mental health and geriatric care.