Resources for Ageing in India: An Annotated Bibliography

Muhammed Thareekh Bin Basheer and Priya Raj Kaur
Interns, UNESCO Chair in Vulnerability Studies

Ageing, in its broadest sense, refers to the cumulative changes that occur over a lifespan.

Along with an increase of the overall population, India is currently experiencing a significant growth in the elderly population. ‘Elderly population’ is usually considered as the population over the age of 60 years. The global trend is also similar, but India is witnessing a substantial increase which could be attributed to the development of the healthcare system and family planning measures. This is leading to increased longevity with decreased family size. The country is on the brink of a profound transition towards an older society.

Though there is a current upward trajectory in education, income, activity, and technological advancements in the country, the sensitization about issues faced by older adults is minimally addressed. These factors, in turn increase the adversities faced by elderly population, creating an intergenerational divide and insecurity for them. There are no considerable initiatives to amplify voices of older adults which are likely to be ignored by decision-makers and political and social actions that are favorable to their needs and concerns may become unlikely.

The need for services and support catering to the particular needs of the elderly rises along with the increase in the older adult population. Access to current and reliable information is essential for policymakers, service delivery organizations, campaigners, and researchers in order to properly inform their work.

Some of the major studies include the Longitudinal Ageing Study in India (LASI), Study on Global Ageing and Adult Health (SAGE), Building a Knowledge Base on Population Ageing in India (BKPAI). But in order to expand the ageing studies network in India there is a need for specialized information sources in various disciplines in the field. This bibliography combines specialized and multidisciplinary resources.

By promoting the development of resources on ageing, we can bridge the gap between disciplines and provide essential information easily accessible to those involved in policy formulation, service delivery, advocacy, and research in India.

The sources included in this bibliography draw upon select resources on ageing in India. It is not an exhaustive compilation, and the chosen sources are mainly from peer reviewed journals. We have also referred to an existing bibliography and where available the article abstract has been used.

The concept of ageing has been approached and defined by various domain experts. In this bibliography, ageing within the context of India and a sociological perspective to ageing has been emphasized. However, the sources documented here cover the biological, social, psychological, socio-political, and economic aspects of ageing.

Relevant retrieval headings are provided in all cases.

 

General Reading

There is a rapid population ageing taking place in all countries, especially in low-and middle-income countries with a projected increase of people over 60 years, 12% to 22% from 2015 to 2050. Though there is cellular damage in ageing process biologically, the variables are not strictly linked to chronology. There are multiple health issues and sensory decline along with frailty, incontinence etc. The UN’s Decade of Healthy Ageing seeks to challenge ageism and to build a support ecosystem for older individuals.

 

Bjorn Andersson, Asia-Pacific Regional Director, United Nations Population Fund

This article places emphasis on the concerns regarding the Asia-Pacific region being vulnerable to global population ageing phenomena. In order to tackle the issues, the author suggests policy reforms incorporating rights-based ageing policies, a life cycle approach to combat gender discrimination and foster investment for lifelong stages early on etc. Through working out these initiatives, the author aspires for a better future for all where no one is left behind. 

  • Changing Needs of Older People in India With Special Focus on Current Old Age Care & Support Scenario: A Review

https://social.un.org/ageing-working-group/documents/Changing-Needs-of-Old-People-In-India-March-2021.pdf      

Agewell foundation (In Special Consultative Status with the ECOSOC at United Nations since 2011) -Associated NGO Status with UN-DP (special focus on old age care and current scenario)

This study aims to analyze the needs of older adults, evaluate support systems and anticipate future challenges. The study observed the need to address multifaceted issues faced by the elderly such as health, well-being, security and dignity. The conclusion emphasized the importance of valuing older adults as resources and suggested empowering them with opportunities. Various study recommendations included measures like enhanced healthcare services, empowerment programs, helplines and fostering intergenerational connections.

  • Dey S, Nambiar D, Lakshmi JK, Sheikh K, Reddy KS. Health of the elderly in India: challenges of access and affordability. In Ageing in Asia: Findings from new and emerging data initiatives. National Academies Press (US).

The article discusses the challenges of access and affordability of healthcare for elderly population in India. The factors contributing to the hardships faced by elderly in accessing healthcare services and affording medical treatments were found to be social determinants like gender, marital status, religion, caste, and high out of pocket expenditure, absence of insurance coverage, lack of social security schemes. The authors highlight the need for Universal Health Coverage (UHC) and control over price of essential medicines to improve the healthcare outcomes of elderly. 

  • Kumar, S., Kumar, K.A. Living Arrangement and Economic Dependency among the Elderly in India: A Comparative Analysis of EAG and Non EAG States. Ageing International 44, 352–370 (2019). https://doi.org/10.1007/s12126-019-9344-3

This study aims to compare the living arrangements and economic dependency of elderly individuals in the Empowered Action Group (EAG) states and non-EAG states in India. The study observed that  only a small percentage (4%) of elderly individuals live alone, while the rest co-reside with others. About 72% of elderly individuals are not economically independent. Factors such as age, gender, economic status, education etc. determined economic independence. Non-EAG states have a higher likelihood of living alone and economic dependency. The limitations include reporting bias and also excluding institutionalized elderly from the study.

  • Malik C, Khanna S, Jain Y, Jain R. Geriatric population in India: Demography, vulnerabilities, and healthcare challenges. Journal of Family Medicine and Primary Care. 2021 Jan;10(1):72-76.

This review article summarizes the present situation of elderly in India in terms of demography, healthcare challenges and associated vulnerabilities faced by them. The study utilized United Nation Population Division(UNPD) data and Global Burden of Diseases(GBD), Census data etc. to underscore the demographic shift phenomena, various vulnerabilities faced by elderly such as non-communicable diseases, respiratory diseases and mental health issues such as cognitive decline etc. The study emphasized on raising awareness, providing training and enhancing skills among primary care physicians in geriatric health along with need for integrated policies and programs for elderly.

The aim of this study is to analyze the prevalence of chronic diseases among elderly in India. The study used data from the 75th round of the National Sample Survey Office (NSSO), with a sample of participants aged above 60 years. The study found that about 21% of elderly population in India has at least one chronic disease. Risk factors that correlated with the prevalence include urban residence, age, education, caste, religion, wealth status, living arrangements and economic dependency. The study implications recommend policy decisions to improve healthcare, the environment and promote healthier lifestyles. The study being cross-sectional in nature, fails to establish causal relationships and also fails to explore factors like dietary habits and physical activity which are known to have definite impact on an individual’s health.

  • Pilania, M., Yadav, V., Bairwa, M. et al. Prevalence of depression among the elderly (60 years and above) population in India, 1997–2016: a systematic review and meta-analysis. BioMed Central Public Health 19, 832 (2019). https://doi.org/10.1186/s12889-019-7136-z.

This study is aimed at estimating the prevalence of depression among older adults in India. The study included 51 studies from 16 states in India which used various screening tools to assess depression . The methodology followed was a meta-analysis and the authors estimated the pooled prevalence of depression to be 34.4% among elderly population in India. The variables used for subgroup analyses include gender, area of residence, geographic region, sampling methods and screening tools. Though sensitivity analyses found no alteration in pooled prevalence, the drawbacks for the study include publication bias, variation in the tools used, cultural diversity etc.

Social and Cultural Perspectives on Ageing

The study aims to explore the prevalence and determinants of elderly abuse, violence and neglect among the elderly population. The study used a national-survey called “Building Knowledge base of Population Ageing in India (BKPAI) conducted in 2011 among elderly households aged above 60 across seven states in India. The study observed that around 11% of elderly experienced abuse of one form or another, verbal abuse (90%), disrespect (52.5%) and neglect (45.21%). The determinants of abuse were found to be education, wealth quintile, living arrangements and presence of chronic conditions. The study recommends measures like raising awareness, establishing helplines, strengthening social security for elderly and promoting intergenerational relationships to address the issue. The study failed to acknowledge representation from all the states, hence the findings cannot be generalized.

 

·       D’Cruz, Migita and Debanjan Banerjee.  ‘An invisible human rights crisis’: The marginalization of older adults during the COVID-19 pandemic – An advocacy review, Psychiatry Research, Volume 292,2020,113369,ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2020.113369

The authors acknowledge that there are distinct vulnerabilities confronted by older adults including physical and psychological risks during COVID-19. The author emphasizes the need to consider social dimensions alongside biological factors in addressing challenges faced by older adults during the pandemic. The author also describes the burden of health issues faced by elderly. The study relates the pandemic event with previous biological disasters and challenges faced by the elderly at that time. The study conclusion argues that the outcome of all these barriers serves to marginalize the elderly and calls for a targeted intervention to alleviate their condition. This comprehensive review provides valuable insights to the psychosocial vulnerabilities confronting the elderly during COVID-19 pandemic and offers recommendations for effectively addressing these challenges.

 

  • Srivastava, S., Muhammad, T., Sulaiman, K.M. et al. Types of household headship and associated life satisfaction among older adults in India: findings from LASI survey, 2017–18. BioMed Central Geriatrics 22, 78 (2022).

The study investigates the relationship between different types of household headship and life satisfaction among older adults in India. The study used data from Longitudinal Ageing Study in India (2017-18). The findings suggest nearly 1.3% of older males and 1.5% of older females have nominal headship status in their households, but they exhibited low life satisfaction. The results emphasize the importance of involving active participation of elderly in household decision-making which could contribute to their mental well-being. The variables used in this study is not sufficient to understand well-being of elderly

·       Chanda, S., Mishra, R. Impact of transition in work status and social participation on cognitive performance among elderly in India. BioMed Central Geriatrics 19, 251 (2019).

The study analyses the impact of changes in work and social participation on the cognitive performance of elderly in India. The study used the World Health Organization’s Study on global Ageing and adult health (Wave 1). A composite cognitive score is created to assess cognitive performance among the elderly. The results suggested that working elderly have higher cognitive scores than their counterparts. The study concluded by recommending the need for policies to mitigate declining cognitive outcomes among the elderly.

Policies, Programmes and Schemes on Ageing
  • Integrated Programme for Senior Citizens (IPSrC)

     https://pib.gov.in/PressReleasePage.aspx?PRID=1844991

IPSrC is a central government initiative led by the Ministry of Social Justice and Empowerment under Atal Vayo Abhyuday Yojana (AVYAY), aimed at enhancing the lives of senior Citizens. The scheme offers financial assistance, Continuous Care Homes, mobile Medicare units, physiotherapy clinics etc. The scheme also encourages Active Ageing by offering entertainment opportunities and activities to engage senior citizens.

  • Rashtriya Vayoshri Yojana (RVY)

         https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1944673

The scheme is introduced under the Ministry of Social Justice and Empowerment and aimed at providing assisted living devices to senior citizens suffering from ageing-related disabilities. Artificial Limbs Manufacturing Corporation (ALIMCO), a public Sector Undertaking is assigned for  the production. The scheme targets those below the poverty line (BPL) as well as seniors with a monthly income under Rs. 15,000 are the beneficiaries.

The fund is established under the Finance Act,2015 with an aim of promoting the welfare of senior citizens in accordance with the National Policy on Older Persons. The fund is handled by the Ministry of Social Justice and Empowerment, unclaimed funds from sources such as Small Savings Schemes, Employees Provident Fund, Public Provident Fund, insurance policies and Coal Mines Provident Fund are transferred to the  SCWF. The fund is utilized for healthcare, social support and financial security of elderly.

  • National Helpline for Senior Citizen (14567)- Elderline

Under the Ministry of Social Justice and Empowerment, the Government of India had launched a toll free helpline number for addressing the grievances of older adults. This is expected to be utilized by the elderly for various assistance such as information, guidance, support and intervention required from the government. The toll free is accessible all days of the week from 8 a.m. to 8 p.m.

Earlier known as National Council for Older Persons, which was established in accordance with National Policy for Older Persons under the Ministry of Social Justice and Empowerment, it is aimed at advocating government policies and programs for the elderly. Recently suggested advice include amendment in Maintenance and Welfare of Parents and Senior Citizens Act, 2007 and expanding the reach of the Rashtriya Vayoshri Yojana.

Every year the Ministry of Social Justice and Empowerment calls for nominations for Vayoshreshtha Samman awards, which are presented in 13 categories to appreciate both individuals and institutions that have made significant contributions to the welfare of elderly individuals. The award nominations are invited through Rashtriya Puruskar Portal and will be distributed on October 1, commemorating International Day of Older Persons. Some of the areas of competence include Best District Panchayat, Research in Ageing, Senior Citizen Services, Centenarian Award etc.

Under the Ministry of Rural Development,  for the beneficiaries of the National Social Assistance Program (NSAP) through PMGKY the Government of India  offers a monthly pension of Rs. 300/- to widows aged 40 to 79, disabled individuals aged 18-79, and Rs. 200/- to elderly citizens aged 40-79, all from below poverty line households. Upon reaching 80 years, the pension for these beneficiaries is increased to Rs. 500/- per month. Additionally, under the National Family Benefit Scheme, Rs. 20,00/- is given to families of deceased primary breadwinners aged 18-60.

  • Annapurna Scheme

https://pib.gov.in/PressReleseDetail.aspx?PRID=1576186#:~:text=Annapurna%20Scheme%20%3A%2D%20Under%20Annapurna,Age%20Pension%20Scheme%20(IGNOAPS).

Under the Ministry of Rural Development, Annapurna Scheme is an initiative aiming to address the nutritional requirements of various vulnerable sections through state governments and Union Territory administrations  in the country. In the case of elderly, it focuses on providing essential nutrition to those who are left without coverage of the Indira Gandhi National Old Age Pension Scheme (IGNOAPS). Under this scheme, individuals above 65 years of age are entitled to 10 kg of food grains every month.

  • Pradhan Mantri Vaya Vandana Yojana (PMVVY)

https://pib.gov.in/newsite/PrintRelease.aspx?relid=175361#:~:text=The%20scheme%20ena bles%20old%20age,per%20annum%20for%2010%20years.  

Under the Ministry of Finance, Government of India launched PMVVY to ensure financial security for individuals aged 60 and above, safeguarding them from potential declines in interest income due to market conditions. The benefit is administered through Life Insurance Corporation of India (LIC). The scheme offers a guaranteed annual return of 8% for a period of 10 years. Pensions are disbursed periodically according to the chosen frequency-monthly, quarterly, half-yearly, or yearly. The scheme has got various tax waivers as well.

  • National Programme for Health Care of Elderly (NPHCE)

https://pib.gov.in/PressReleasePage.aspx?PRID=1806506

The program was launched under the Ministry of Health & Family Welfare in 2010 with an aim to provide specialized healthcare services to those aged more than 60 years. The objectives include delivering accessible, affordable and high-quality comprehensive care to the ageing population across primary, secondary and tertiary healthcare levels. National Health Mission(NHM) is facilitating the facilities to provide primary and secondary care through District Hospitals, Community Health Centres and Primary Health Centres etc.

  • Senior Able Citizens for Re-Employment in Dignity (SACRED)

https://pib.gov.in/PressReleasePage.aspx?PRID=1806506 

A portal developed in collaboration with National Informatics Centre(NIC) is an IT initiative for senior citizens seeking employment and organizations offering job opportunities. The senior citizens could register their education, experience, skills and interests. Job providers such as firms, companies, partnerships and voluntary organizations can also register, specifying the tasks and the required number of senior citizens. NIC is actively engaged in spreading awareness about this initiative.

  • Senior Care Ageing Growth Engine (SAGE)

 https://pib.gov.in/PressReleasePage.aspx?PRID=1759616

Facilitated by the Ministry of Social Justice and Empowerment (MoSJE), the main objectives of SAGE is to cater the needs of senior citizens by identifying, supporting, and consolidating a comprehensive range of elderly care products and services. The project envisions diverse participation such as social entrepreneurship, tech-based start-ups, legal and financial services etc. 

  • Maintenance and Welfare of Parents and Senior Citizens Act (MWPSC)

Under the Ministry of Social Justice and Empowerment (MoSJE), the Government of India initiated MWPSC in 2007. This legal framework ensures financial security and wellbeing of elderly parents and senior citizens, empowering them with the capability to seek maintenance from their own children or relatives once they are neglected. The penal provisions include imprisonment for up to three months or fine up to Rs. 5000/- or both.

Books

Cohen, Lawrence. No Aging in India: Alzheimer’s, The Bad Family, and Other Modern Things

University of California Press, 2000.

ISBN:9780520224629, 0520224620.

https://www.ucpress.edu/book/9780520224629/no-ageing-in-india

This book is a blend of theoretical concepts as well as ethnographic narratives related to ageing scenario of India. The ethnographic studies in the book help the reader to understand local worlds of India, the impact of globalization, family dynamics etc.  This book is one of a kind as this is a blend of medical anthropology, gerontology and ethnographic writing. The book also describes the  complexities of ageing through medical anthropology, psychoanalysis and postcolonial studies.

 Shankardass, MK. (ed.). Ageing Issues and Responses in India. Springer Nature

Singapore, 2020.

ISBN 978-981-15-5186-4 ISBN 978-981-15-5187-1

https://link.springer.com/book/10.1007/978-981-15-5187-1

The book addresses emerging issues related to ageing population in the Indian context. The book describes various vulnerabilities faced by older adults such as health care and caregiving, social, legal and economic issues etc. It also attempts to critically analyze the existing policies and programmes relevant to the context. The book is presented with 15 chapters, containing inputs from researchers from various backgrounds such as geriatrics, social work, anthropology, sociology, psychiatry, economics, law and mental health.  This diverse arrangement would help readers to get a multifaceted view about ageing related challenges in India.

Shankardass MK, Irudaya Rajan, S. (eds.). Abuse and Neglect of the Elderly in India. Springer

Nature Singapore, 2018.

ISBN 978-981-10-6115-8 ISBN 978-981-10-6116-5

https://link.springer.com/book/10.1007/978-981-10-6116-5

This book addresses the issue of elder abuse and neglect in India. It explains various forms of abuse faced by older adults and also proposes strategies for prevention, intervention and management. The book also attempts to establish a conceptual framework to understand the elderly abuse scenario of the country. The book also explores rural and urban differences across the states, abuse experienced by older adults belonging to various demographic segments and societal groups. The book’s scope includes theoretical frameworks, empirical case studies and recommendations.

Irudaya Rajan, S., and Mishra, Udaya S. Senior Citizens of India: Emerging Challenges and

Concerns. Springer Nature Singapore, 2020.

ISBN:9789811577406, 9811577404

https://link.springer.com/book/10.1007/978-981-15-7740-6

The book provides a comprehensive view about ageing and related problems across various states of the country. The main theme covered in this book includes health, dependency, disability and living arrangements of elderly population. Various data explored in this book include Kerala Ageing Survey (KAS), National Sampling Survey Organisation(NSSO) etc. As the chapters are contributed by researchers from various fields such as sociology, demography, economics and development studies, the book comprehensively provides a multifaceted view on the issue.

Irudaya Rajan, S., Balagopal, G.. (eds.). Elderly Care in India: Societal and State Responses

Singapore, Springer Nature Singapore, 2017.

ISBN:9789811034398, 9811034397

https://link.springer.com/book/10.1007/978-981-10-3439-8

The book outlines various topics from legal and policy-driven construction of elderly care to the role of formal care workers in addressing the needs of the ageing population. The book critically examines the lack of support from the state and society for older adults. It also presents various case studies related to challenges faced by older adults from different states of the country. The book also covers themes such as diminishing traditional support networks available for elderly, trajectory of old age homes, elderly care within local communities etc.

Shankardass, MK. (ed.). Ageing Issues in India: Practices, Perspectives and Policies

Springer Nature Singapore, 2021.

ISBN:9789811658273, 9811658277

https://link.springer.com/book/10.1007/978-981-16-58273#:~:text=About%20this%20book,of%20existential%20dimensions%20of%20ageing.  

This book comprises 23 chapters which focus on multifaceted aspects of ageing in India, which explores the issue from both theoretical and empirical viewpoints. Encompassing social, health, gender, economic, psychological and emotional dimensions, the book helps in understanding ageing related issues holistically. The book describes in detail about the ageing landscape of India, encompassing issues like demographic shifts, gender dynamics, retirement challenges, health issues etc. The book also examines legal measures, rights protection and the need for geriatric mental health services in the country.

Chatterjee, Suhita Chopra, and Sengupta, Jaydeep. Death and Dying in India: Ageing and End-Of-Life Care of the Elderly.  Taylor & Francis, 2019.

ISBN:9780367886172, 0367886170

https://www.routledge.com/Death-and-Dying-in-India-Ageing-and-end-of-life-care-of-the-

elderly/Chatterjee-Sengupta/p/book/9780367886172.   

The book highlights the current scenario of end-of-life experiences for the elderly in India. The disturbing situation for elderly to be on tubes and machines, related catastrophic health expenditure followed by emotional, social, and financial burdens on the patients and caregivers is addressed in this book. It also examines diverse settings where elderly people pass away, such as hospitals,family homes, and palliative care facilities. The book also attempts to question existing biomedical approach and advocates a holistic approach for end-of-life care in India.

Giridhar, G., Sathyanarayana, K.M., Kumar, S., James, K.S., Alam, M. (eds). Population Ageing in India.  Cambridge University Press, 2014.

ISBN:9781107073326, 1107073324

https://www.cambridge.org/core/books/population-ageing-in  india/234535AF28EA6A828D0CB390D1ECF0DF#fndtn-information

This book addresses the important issue of demographic transition in India. Along with population ageing, the book also describes the socio-economic aspects including health of older adults, participation in the workforce, and their contribution in generating income. The book also assesses implementation of national policies and initiatives for elderly. It also underscores the importance of changes to be done at individual, societal and country level.


Chatterjee, Prasun. Health and Wellbeing in Late Life: Perspectives and Narratives from

India.  Springer Singapore, 2019.

ISBN:9789811389382, 9811389381

https://link.springer.com/book/10.1007/978-981-13-8938-2

The book presents a comprehensive exploration of late old age which includes various health issues faced by elderly including common ones such as Constipation, Stroke, Fall, Frailty, Cancer etc. The book provides a holistic view through the views of family, care givers, clinical setup etc. to the issue. The 10 chapters in the book are various case studies pertaining to the issues of health of older adults. The book gives a special emphasis on successful ageing and reinforces that it is not only an individual responsibility but that society should also create an environment for it.

Agarwal, A., Lubet, A., Mitgang, E., Mohanty, S., Bloom, D.E. “Population Ageing in India: Facts, Issues, and Options”, In: Poot, J., Roskruge, M. (eds) Population Change and Impacts in Asia and the Pacific. Springer Nature Singapore, 2020.

ISBN:9789811002298, 9811002290

https://doi.org/10.1007/978-981-10-0230-4_13

This article provides an overview of the demographic trends of population ageing in India which states about increased life expectancy and decreased fertility and highlights key issues including challenges of non-communicable diseases and multi-morbidity, gender issues like feminization of ageing, Income insecurity among elderly and policies like Swavalamban Scheme after retirement, National Program for Health Care of Elderly for healthcare etc to address the challenges associated with an ageing population. The article also mentions poor healthcare accessibility in case of infrastructure and recommends use of necessary technologies to address the issue such as telemedicine.

‘Work stress, health and wellbeing: evidence from the older adults labor market in India.’ Malik, M.A., Singh, S.P., Jyoti, J. et al. Humanities and Social Sciences Communications 9, 204 (2022).

This study used the data from United Nations population fund for ageing (UNFPA) survey ‘Building Knowledge-based on Population ageing in India (BKPAI) to bring out the relationship between work stress and well-being of older adults in India, showing higher prevalence of work stress among women and also with increase in age but lower prevalence of work stress with higher education level and high socio-economic background.

Social Security and Pensions:

Goli, Srinivas, et al. “Economic independence and social security among India’s elderly.” Economic and Political Weekly 54.39 (2019): 32-41.

https://www.epw.in/journal/2019/39/perspectives/economic-independence-and-social-security-among.html

This article presents a brief overview of current and future ageing challenges such as lack of decent living arrangements, economic independence and social support to ensure active ageing and old-age social security policies in India and in its states. Also, authors suggest measures to tackle these challenges including re-evaluation of existing multisectoral policy initiatives, inter-ministry coordination for social security benefits of the older population etc.

 Caregiving and Long-term Care:

Vaitheswaran S, Lakshminarayanan M, Ramanujam V, Sargunan S, Venkatesan S. ‘Experiences and needs of caregivers of persons with dementia in India during the COVID-19 pandemic—A qualitative study.’ The American journal of geriatric psychiatry. 2020 Nov 1;28(11):1185-94.

The study focus on direct issues related to caregiving such as preventing disabled people from getting infected and taking care of them once infected and also indirect issues related to caregiving managing daily household chores and supplies, disruption of work and financial worries etc. faced by caregivers during covid 19 pandemic

 Elder Abuse and Neglect:

‘Contextualizing Elder Abuse and Neglect in Institutional and Home Settings: Case Studies from India,’ Jahangir, S., Nikhil, P.N.N., Bailey, A., Datta, A. (2018). Contextualizing Elder Abuse and Neglect in Institutional and Home Settings: Case Studies from India. In: Shankardass, M., Irudaya Rajan, S. (eds) Abuse and Neglect of the Elderly in India. Springer.

The study qualitatively highlights the growing crisis of elderly abuse and neglect among older adults in India. The study conducted In-depth Interviews from 116 participants, non-participant observation and field diary across Kolkata, Delhi and Kerala states. The study followed a conceptual framework for the types of abuse as Mental abuse, Emotional abuse of verbal and non-verbal and Financial abuse which included cheating, theft and forgery. The study reported that elderly had experienced more than one type of abuse in their lifetime. Other key findings include neglect and forceful relocation to institution-based care.

Age-friendly Cities and Communities:

Out-of-Home Mobility of Senior Citizens in Kochi, India.

Munshi, T., Sankar, M., Kothari, D. (2018). In: Curl, A., Musselwhite, C. (eds) Geographies of Transport and Ageing. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-76360-6_7.

This article focuses on the mobility and independence challenges faced by senior citizens in Indian cities, specifically in Kochi, Kerala. Through semi-structured interviews the study reveals inadequate mobility infrastructure for elderly. The article highlights the barriers posed by transportation infrastructure and urban design, such as restricted accessibility to essential services, fear of unsafe roads, and the growing number of private automobiles. The article also advocates for inclusive urban planning, senior-friendly design, improved walking and public transportation infrastructure, and the implementation of policies that promote active senior living.

Financial Planning and Retirement Savings:

Baker HK, Tomar S, Kumar S, Verma D. Are Indian professional women financially literate and prepared for retirement? Journal of Consumer Affairs. 2021 Dec;55(4):1416-41.
https://doi.org/10.1111/joca.12332.

This study explores the financial literacy levels of professional women in India and its impact on their retirement planning behavior. Findings indicate that the participants exhibit low levels of financial literacy, lacking awareness of both basic and advanced financial concepts. The study highlights that a woman’s age, income, profession (particularly in finance), and understanding of advanced financial concepts significantly influence their retirement planning behavior.

 

Technology and Ageing:

A survey of assistive robots and systems for elderly care

Santhanaraj, K.K., M.M., R. and D., D. (2021), Journal of Enabling Technologies, Vol. 15 No. 1, pp. 66-72. https://doi.org/10.1108/JET-10-2020-0043.
 The research highlights the requirement for intelligent assistive systems to deliver continuous holistic care and monitoring. It analyses assistive robots and systems designed for elderly care, interaction capabilities, and technological integration. The findings suggest that improved human-machine interactions and assistive robots can serve as potential alternatives to human caretakers.

 

Mental Health and Ageing:

Relationship between physical activity and cognitive functioning among older Indian adults

Kumar, M., Srivastava, S. & Muhammad, T. Scientific Reports 12, 2725 (2022).

The paper highlights that older adults engaged in frequent physical activity have greater cognitive functioning than older adults without physical activity. A proportion of 24.6% of older men and 12% of women in the current study found to be frequently physically active. Since the age group (mean age of 69.3 for males and 69.1 for females) in the study is vulnerable to lifestyle disorders, the proportion found to be quite low. There must be intervention from the government to address the issue and to create awareness among elderly about the importance of physical activity.

Intergenerational Relationships and Support:

‘Views and experiences of adult children concerning intergenerational relationships with their older kin: a qualitative study from South India.’Jothikaran TAJ, Meershoek A, Ashok L, Krumeich A (2021). Ageing & Society 1–20. https://doi.org/10.1017/S0144686X21000593.

This qualitative study highlights the tradition of intergenerational care and support exchanges in Indian families and its impact by modern life changes. The study investigates challenges faced by adult children from modern work life, older relatives’ preferences, and lack of flexibility. The study finds that adult children strive to uphold traditional values of caring for their older relatives and sharing emotional bonding. This inspiration helps them accept their older relatives, focus on benefits, and distribute care tasks effectively.

 Gender and Ageing:

Ageing and social networks: A perspective on gender disparity in India

Yatish Kumar & Priya Bhakat (2020): Ageing and social networks: A perspective on gender disparity in India, Journal of Women & Ageing, DOI: 10.1080/08952841.2020.1718581.

This research aims to analyze the gendered dimensions of population ageing in India, focusing on the changing patterns of elderly women in Indian families. The study examines the issues and concerns faced by elderly women in their old age, as well as the existing policies and schemes for the elderly population. The study also examines the role of social security measures in reinforcing the situation of older women in Indian society. The study reveals that older women, particularly widowed women, are more vulnerable physically, socially, and financially in old age. The study also highlights the impact of patriarchy on women’s social, economic, and cultural well-being.

 

Age Discrimination and Legal Protection:

 

Prevalence and correlates of perceived age-related discrimination among older adults in India

            Maurya, P., Sharma, P. & Muhammad, T. BioMed Central Public Health 22, 561 (2022).

The Study investigates perceived age discrimination among older Indian adults using cross-sectional data from the Longitudinal Ageing Study. The study shows that various socio-demographic, economic, and health variables precede a greater likelihood of perceived age discrimination. Health-related variables, such as difficulty in daily living activities and chronic conditions, were found to be significant associations with perceived age discrimination among older individuals. The study also revealed negative associations between perceived age discrimination and household wealth and education, with educated and wealthy people having less likelihood of experiencing it.

Healthcare Infrastructure and Access:

Determinants of rural-urban differential in healthcare utilization among the elderly population in India. Banerjee, S. BioMed Central Public Health 21, 939 (2021).

This study explores the factors contributing to the rural-urban gap in healthcare utilization among the elderly population using data from the 75th round National Sample Survey Organisation . It found that urban dwellers have a significantly higher rate of healthcare utilization compared to rural elderly. Older adults with high levels of education, those belonging to Other Backward Caste (OBC), richest wealth quartile and good living arrangement, and urban residents also found to have strong positive associations with healthcare utilization. Poor quality of rural health infrastructure and inaccessibility were major barriers to healthcare services for tribal populations.

Productive Ageing and Active Engagement:

Visaria A, Dommaraju P. Productive aging in India. Social Science & Medicine. 2019 May 1;229:14-21.

India’s sociocultural, institutional, and demographic contexts provide unique opportunities for studying ageing dynamics and productive ageing. This study used 2011 BKPAI data, conducted by UNFPA and the Institute for Social and Economic Change, analyzed data from 8329 households across seven Indian states, focusing on living arrangements, employment, social activities, and morbidity. The paper examined factors affecting productive ageing such as gender, family structure, socio-economic status, and health effects. Higher educated older individuals were less likely to work but were more active. Further research is needed on gendered aspects.

 End-of-Life Care and Palliative Services:

Jadhav AV. Rural elderly and access to palliative care: A public health perspective. Indian Journal of Palliative Care. 2020 Jan;26(1):116.

The study tries to explore various issues by elderly people of rural areas in accessing palliative care services such as migration of relatives,lack of service providers etc. The study also statistically computed an anticipated increase in the burden of Age-Related Diseases (ARDs) to a significant level in future. It also addresses the policy initiatives put forward in order to provide palliative care from government

 Cultural Perspectives on Ageing:

Chakravorty S, Goli S, James KS. Family demography in India: Emerging patterns and its challenges. Sage Open. 2021 Apr;11(2):21582440211008178.

This paper seeks to explore and enrich the field of family demography in India by studying the existing evidence in the field as well as allied fields to understand how family serves as the nuclei directing individuals and communities toward certain behaviours and choices which consequently translate into larger social, economic and demographic transitions. The study points out that ensuring good quality of life for the older population in India remains a challenge due to the changing intergenerational transfers, family formation, late childbearing, and living arrangements. Also, the study finds ageing and migration cause a large “left-behind” population in need of better economic security.

Policy and Advocacy for Older Adults:

The National Programme for Health Care of the Elderly: A Review of its Achievements and Challenges in India. Vaishnav LM, Joshi SH, Joshi AU, Mehendale AM. Annals of Geriatric Medicine and Research. 2022 Sep;26(3):183-195.

The study surveys the various policy initiatives by government of India for elderly which include National Programme for Health Care of Elderly (NPHCE) initiated in 2010 to address health-related challenges faced by the older population, The National Policy for Older Persons (1999) aims to protect older adults from exploitation and abuse while providing financial stability, food stability, and housing, The Maintenance and Welfare of Parents and Senior Citizens Act (2007) focuses on the needs of parents and older adults, The Rashtriya Varishth Jan Swasthya Yojana (RVJSY) provides government health insurance to families below the poverty line, The Pradhan Mantri Jan Arogya Yojana (PM-JAY) is a component of Ayushman Bharat, covering around 50 crore beneficiaries as on 2018. Also are other schemes for older adults such as Indira Gandhi National Old Age Pension Scheme (IGNOAPS) and Pradhan Mantri Vaya Vandana Yojana (PNVVY) etc.

 Future Challenges:

India’s Projected Aged Population (65+), Projected Life Expectancy at Birth and Insecurities Faced by Aged Population. Mishra, V. Ageing International 45, 72–84 (2020). https://doi.org/10.1007/s12126-019-09350-0

 

The study used data from National Sample Survey 60th round and Census 2011 and examines the future of elderly in India which include issues regarding elderly individuals and dependency, healthcare utilization etc along with certain other vulnerabilities faced by them. Findings from the study includes higher economic dependency among women, higher rate of healthcare seeking behaviour among women, also perception about bad health and poor living status was reported more by women than men. Since this study utilized cross sectional data, the causal relationship cannot be established.

 

The hidden grief of ageing. Lefevre, Carol. “Friday Essay: Homesick for Ourselves – The Hidden Grief of Ageing.” The Conversation, 14 Sept. 2023, 9.05pm BST, https://theconversation.com/friday-essay-homesick-for-ourselves-the-hidden-grief-of-ageing-202754.

The article discusses about the hidden grief of aging including homesickness to one’s youth. It also explores emotional impact of aging, nostalgia associated with old age and reflection of being aged by elderly. The author draws from personal experiences and conversations with people over the age of 70 to highlight the complex emotions and challenges that comes with aging.

 

 Longitudinal Ageing Study in India (LASI)

LASI is a national survey investigating health, economic and social factors related to the ageing population of India. The main objective of the study is to study the health status and socio-economic well-being of elderly individuals  in India. The study adopted a multistage stratified area probability cluster sampling design.

Here are some important and currently among the mostly cited works related to LASI:

  • The association of widowhood and living alone with depression among older adults in India

Srivastava S, Debnath P, Shri N, Muhammad T. Scientific Reports. 2021 Nov 4;11(1):21641.

The study investigates the relationship between widowhood, living alone and depression among older adults in India. It reported significant negative effects on physical, economic and emotional well-being, particularly in old age. The study utilized variables such as marital status, living arrangements, socioeconomic conditions and health issues contributing to depression. The limitations of the study include underrepresentation of living alone population (5.4%), Sampling bias i.e., exclusion of never married, divorced or separated, and cross-sectional design prevent the establishment of causal relationships in this study.

 

·       Number of chronic conditions and associated functional limitations among older adults: cross-sectional findings from the longitudinal ageing study in India.

               Sharma P, Maurya P, Muhammad T. BioMed Central Geriatrics. 2021 Dec;21(1):1-2.

This study explored the association between the number of chronic conditions and limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older adults in India. Some key findings include- the elderly suffers from 24% ADL limitations, with predominance among women than in men, association of factors such as education, work status, marital status and place of residence with functional limitations. The limitations pointing towards the study includes confounding factors such as lifestyle, social support and healthcare access. Also, the study overlooks complexity of multimorbidity pattern instead just focuses on the number of chronic conditions.

  • Association of late-life depression with cognitive impairment: evidence from a cross-sectional study among older adults in India. Muhammad T, Meher T. BioMed Central Geriatrics. 2021 Jun 15;21(1):364.

This study focuses on late-life depression (LLD) and cognitive impairment among older adults in India. The researchers aim to estimate the prevalence and correlates of LLD and cognitive impairment and explore their associations with various factors. The study found the prevalence of LLD and cognitive impairment to be 8.7% and 13.7% respectively. Poor self-reported health, difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL), and living in rural areas were associated with higher odds of LLD. The exclusion of institutionalized older adults and proxy- assisted respondents may introduce bias. The limitation of self-reported data and potential underreporting of cognitive problems add to shortcomings of the study. 

  • Association of elder abuse, crime victimhood and perceived neighbourhood safety with major depression among older adults in India: a cross-sectional study using data from the LASI baseline survey (2017–2018). Muhammad T, Meher T, Sekher TV. British Medical Journal Open. 2021 Dec 1;11(12):e055625.

The study aimed to explore the relationships between elder abuse, crime, victimhood, perceived safety and depression among older adults in India. Also, it emphasized on examining interactive effects of sex and place of residence on these associations. The key findings of the study included a prevalence of older adults experience an abuse of 5.22% in the past year, 1.33% were victims of violent crime and 14.30% perceived their neighborhoods as unsafe. The potential limitations include cultural stigma leading to underreporting of elder abuse and crime victimhood, recall bias during self-reporting and overlooking other confounders.

  • Factors associated with psychiatric disorders and treatment seeking behaviour among older adults in India. Srivastava S, Sulaiman KM, Drishti D, Muhammad T. Scientific Reports. 2021 Dec 16;11(1):24085.

The study focuses on late-life psychiatric disorders among older adults in India and their treatment-seeking behaviour. The study findings observed 2.8% of older adults had psychiatric disorders and out of those, 41.3% sought medical treatment. Also, it evaluated factors associated with higher probability of psychiatric disorders such as current job status, low life satisfaction, poor self-rated health, difficulty in daily activities and psychological distress. Some factors associated with low treatment-seeking behavior for psychiatric disorders include being in the oldest-old age group, female gender, poorest wealth quintile, belonging to Scheduled Tribe and residing in eastern region etc. Some drawbacks of the study include lack of differentiating psychiatric disorders, overlooking factors contributing to treatment-seeking behaviour such as stigma, cultural beliefs and accessibility to mental health services etc.

  • Association between daily activities and fall in older adults: an analysis of longitudinal ageing study in India (2017–18). Nagarkar A, Kulkarni S. BioMed Central Geriatrics. 2022 Dec;22(1):1-7.

The study aimed to investigate the association between functional decline and falls in older adults. The study reported 6,352 fall episodes in 3,270 participants over a 2-year period. The factors associated with increased fall risk included age, female gender, slow gait speed, and impaired balance. Difficulty in pushing and pulling objects, difficulty in arising from a chair found to be significantly associated with increased risk for falls. Though there is limited functional assessment and lack of contextual information contributed to the falls, the study highlights the importance of functional decline assessment in fall prevention programs.

  • Prevalence and predictors of water-borne diseases among elderly people in India: evidence from Longitudinal Ageing Study in India, 2017–18. Kumar P, Srivastava S, Banerjee A, Banerjee S. BioMed Central Public Health. 2022 May 17;22(1):993.

The study examines prevalence and predictors of water-borne diseases among elderly in India. The study findings concluded that prevalence of waterborne disease is higher in rural (22.5%) than urban areas (12.2%). Prevalence of diseases related to waterborne pathogens include diarrhoea (14.8%), typhoid (5.5%), jaundice (2.5%), overall waterborne diseases (19.5%).The central states in India have higher prevalence such as Chhattisgarh and Madhya Pradesh. Some risk factors found to correlate with waterborne diseases include female sex, low level of education, underweight, rural residence, poor toilet facilities etc. The study lacks clinical verification of reported diseases, yet there should be government intervention for safe water and proper awareness on hygiene practices.

 

  • The prevalence of vision impairment and blindness among older adults in India: findings from the Longitudinal Ageing Study in India. Ehrlich, Joshua R., et al. “The prevalence of vision impairment and blindness among older adults in India: findings from the Longitudinal Ageing Study in India.” Nature Aging11 (2022): 1000-1007.

The aim of the study is to understand the prevalence of visual impairment and blindness among older adults in India. The prevalence of vision impairment varies from 22.3% to 54.6% among different states. Near vision impairment had a prevalence of 13%(mild), 24%(moderate), and almost 6%(severe) or blindness. Women are more likely to be vision impaired than men in all states. Other factors correlating with visual impairments were older age, lower education, rural residence, presence of diabetes etc. Some of the drawbacks of the study includes measuring only Visual acuity, lack of eye examination, limited causative factors considered etc. Addressing vision impairment through policy interventions can improve quality of life for older adults.

  • Multimorbidity and Complex Multimorbidity in India: Findins from the 2017-2018 Longitudinal Ageing Study in India (LASI). Sinha A, Kerketta S, Ghosal S, Kanungo S, Lee JT, Pati S. International Journal of Environmental Research and Public Health. 2022 Jul 26;19(15):9091.

The study explores the prevalence and outcomes of complex multimorbidity among older people in India. About one-third of the participants with multiple chronic conditions had complex multimorbidity, i.e, illness across multiple body systems. The most common conditions were hypertension and diabetes. Several factors associated with complex multimorbidity included age over 75, urban residency, lower education levels, unemployment etc. The study underlines the concept of complex multimorbidity which help to prioritize healthcare interventions to elderly. 

  • Association of Oral Health with Multimorbidity among Older Adults: Findings from the Longitudinal Ageing Study in India, Wave-1, 2017-2019. Kanungo S, Ghosal S, Kerketta S, Sinha A, Mercer SW, Lee JT, Pati S. International Journal of Environmental Research and Public Health. 2021 Dec 6;18(23):12853.

The study aimed to investigate the prevalence of oral morbidity and its association with physical multimorbidity. The prevalence of oral morbidity was found to be 48.56% in participants. The physical multimorbidity defined as more than one chronic health condition in an individual was found to be 50.36%.There was odds of 1.60 times having oral morbidity for those with multimorbidity while compared to counterparts. The study underscores the importance of promoting oral hygiene and to include oral healthcare services in primary care settings.