Geriatric syndromes, multimorbidity, and life satisfaction among older adults in India: a cross-sectional analysis of the Longitudinal Ageing Study in India (LASI)

Background. Older adults in low- and middle-income countries are increasingly affected by both chronic-disease multimorbidity (MM) and geriatric syndromes (GS), but evidence on their joint impact on subjective well-being from the Indian subcontinent is limited. We examined the prevalence of MM and GS, and quantified their independent and joint associations with life satisfaction, in a nationally representative sample of older Indians. Methods. We conducted a cross-sectional analysis of Wave 1 of the Longitudinal Ageing Study in India (LASI, 2017–18), restricted to community-dwelling adults aged 60 years or older (n = 30,811 with complete data on key variables; weighted mean age 68.6 years, SD 7.3). Multimorbidity was defined as two or more of nine self-reported physician-diagnosed chronic conditions. Geriatric syndromes were defined as the presence of at least one of seven syndromes: cognitive impairment (general cognitive factor score below the 10th weighted percentile), hearing impairment, vision impairment (poor self-rated near or distance vision), falls in the past 2 years, urinary incontinence, depression (Center for Epidemiologic Studies Depression-10 score ≥ 4 symptoms), and underweight (body-mass index < 18.5 kg/m²). Life satisfaction was measured using the 5-item Satisfaction with Life Scale (SWLS). All analyses applied LASI individual analysis weights. Associations were estimated using sequentially adjusted weighted linear regression with sandwich-estimator standard errors. Results. The weighted prevalence of MM was 23.4 % and of any GS 70.5 %. State-level MM prevalence ranged from 4.1 % in Arunachal Pradesh to 55.7 % in Kerala. After full adjustment, the presence of any GS was associated with a 2.36-point lower life satisfaction score (95 % CI − 2.61 to − 2.11; p < 0.001), with a clear dose–response by GS count (1 GS: β = − 1.52; 2 GS: β = − 2.89; ≥ 3 GS: β = − 4.33; all p < 0.001). In contrast, MM was not independently associated with life satisfaction in the adjusted model (β = + 0.08; 95 % CI − 0.33 to + 0.49; p = 0.71), nor was the MM × GS interaction term (β = − 0.19; 95 % CI − 0.69 to + 0.30; p = 0.44). Higher education, greater wealth, co-residence with family, urban residence, and female sex were independently associated with higher life satisfaction. Findings were robust to a sensitivity analysis excluding depression from the GS composite (GS β = − 1.48; 95 % CI − 1.72 to − 1.23). Conclusions. In community-dwelling older Indians, geriatric syndromes, not multimorbidity are the principal correlate of reduced life satisfaction, with a graded dose–response by number of syndromes. Primary-care programmes for older adults in India, including the National Programme for Health Care of the Elderly and the Ayushman Bharat Health and Wellness Centres, should prioritise structured screening and management of geriatric syndromes alongside chronic-disease care, particularly in rural and lower-wealth populations where GS prevalence is highest but specialist access is most limited. Trial registration: Not applicable. This study is a secondary analysis of observational survey data and did not involve a health-care intervention.