Financial distress amongst older adults with gastrointestinal (GI) malignancies.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 517-517 ◽  
Author(s):  
William Varnado ◽  
Kelly Kenzik ◽  
Andrew Michael McDonald ◽  
Mariel Parman ◽  
Ravi Kumar Paluri ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Financial Distress ◽  
Daily Living ◽  
Adult Population ◽  
Comorbid Condition ◽  
Cancer Type ◽  
Chi Square ◽  
Related Factors ◽  
Patient Reported

517 Background: Many patients with cancer report financial distress (FD); however, the magnitude of FD in the growing number of older adults with cancer remains less clear, particularly in those with GI malignancies. The purpose of this study was to evaluate the proportion of older adults with GI malignancies reporting FD and to characterize geriatric assessment (GA) and cancer-related factors associated with FD. Methods: Older adults ( ≥ 60yrs) seen in the GI oncology clinic at the University of Alabama Birmingham (UAB) were asked to fill out a patient-reported GA, entitled the Cancer & Aging Resilience Evaluation (CARE), at their visit. The CARE includes questions pertaining to patient’s independence in Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), falls, physical function, polypharmacy, and comorbidity. A single item question regarding FD from the patient satisfaction questionnaire (PSQ-18) was included. FD was defined as agreement with the phrase “Do you have to pay for more medical care than you can afford.” Demographic and GA characteristics were compared between those with and without FD using Chi-square and t-tests. Results: 233 patients completed the CARE a median of 71 days after diagnosis. Median age 68y (60-96); 54.5% male and 76.0% non-Hispanic white. Most common cancer types included colorectal (39.1%) and pancreatic cancers (20.6%). A total of 62 patients (26.6%) had FD. Patients with FD were more likely to be younger (68.1 vs. 70.1y, p = 0.04), of black race (37.1% vs. 15.8%, p = 0.007), have low education ( ≤ high school: 74.2% vs. 59.6%, p = 0.02), have one or more falls (31.5% vs. 19.9%, p = 0.077), to be limited a lot in walking 1 block (54.4% vs. 27.4%, p = 0.0003), take more than 4 medications (88.3% vs. 70.8%, p = 0.007), to have more than one comorbid condition (93.1% vs. 82.6%, p = 0.052), to report impaired IADLs (61.3% vs. 43.9%, p = 0.055), and impaired ADL (27.4% vs. 14.6%, p = 0.069). No associations were found with GI cancer type or stage, marital status, time from diagnosis, or hearing/vision impairments. Conclusions: Over a quarter of the older adult population with GI malignancies report FD. Several GA and demographic factors were associated with FD that may help identify older patients at risk for FD.

The association of polypharmacy with functional status impairment, frailty, and health-related quality of life in older adults with gastrointestinal malignancy: Results from the Cancer and Aging Resilience Evaluation (CARE) registry.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 118-118
Author(s):  
Darryl Alan Outlaw ◽  
Chen Dai ◽  
Mustafa Al-Obaidi ◽  
Smith Giri ◽  
Smita Bhatia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Daily Living ◽  
Cancer Type ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

118 Background: The majority of new cancer diagnoses occur in adults greater than 65 years of age. Polypharmacy is a common and potentially devastating problem amongst older adults; however, its prevalence and impact in older adults with gastrointestinal (GI) malignancy is poorly understood. Our objective was to examine the prevalence of polypharmacy and its association with functional status impairments, frailty, and health-related quality of life (HRQoL) in older adults with GI malignancy. Methods: The Cancer and Aging Resilience Evaluation (CARE) registry at the University of Alabama at Birmingham (UAB) is an ongoing prospective cohort study that uses a brief geriatric assessment (CARE survey) in older adults with cancer. We evaluated older adults diagnosed with GI malignancy prior to starting cancer therapy. Our primary outcomes of interest were functional status impairments, including dependence in activities of daily living (ADL) and instrumental activities of daily living (IADL), frailty (as defined by a frailty index derived using the principles of deficit accumulation), and HRQoL (assessed via PROMIS 10 global that includes physical and mental scores). Patients were dichotomized into those taking ≥9 vs. < 9 medications. Multivariable analyses examined associations between polypharmacy and the above-listed outcomes, adjusted for age, sex, race, cancer type, cancer stage, and comorbidities. Results: Overall, 357 patients met eligibility criteria; mean age: 70.1 years; primary diagnoses: colorectal (33.6%), pancreatic (24.6%), hepatobiliary (16.2%), gastroesophageal (10.9%), other (14.6%). Patients reported taking a mean of 6.2 medications: 27.7% with 0-3 medications, 48.2% with 4-8 medications, and 24.1% with ≥ 9 medications. Patients taking ≥ 9 medications were more likely to report limitations in ADL (adjusted odds ratio [aOR] 3.29, 95% CI 1.72-6.29) and IADL (aOR 2.86, 95% CI 1.59-5.14). Polypharmacy was also associated with frailty (aOR 3.06, 95% CI 1.73-5.41) and lower physical (aOR 2.82, 95% CI 1.70-4.69) and mental (aOR 1.73, 95% CI 1.03-2.91) HRQoL. Conclusions: Independent of comorbid conditions, polypharmacy was associated with functional status limitations, frailty, and reduced HRQoL in older adults with GI malignancy. Further study of specific medications and interactions is warranted in order to reduce the negative consequences of polypharmacy in this growing and vulnerable population.

Integrating geriatric assessment into routine gastrointestinal (GI) consultation: The Cancer and Aging Resilience Evaluation (CARE).

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 667-667 ◽  
Author(s):  
Grant Richard Williams ◽  
Kelly Kenzik ◽  
Mariel Parman ◽  
Gabrielle Betty Rocque ◽  
Andrew Michael McDonald ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Daily Living ◽  
Performance Status ◽  
Stage Iv ◽  
Routine Care ◽  
Aging Research ◽  
Patient Reported ◽  
Tumor Types

667 Background: Integrating Geriatric Assessment (GA) in the management of older adults with cancer is recommended, yet rarely practiced in routine oncologic care. In this report, we describe the feasibility of integrating the routine incorporation of GA in the management of older adults with GI malignancies and characterize GA impairments. Methods: CARE was adapted from the Cancer and Aging Research Group GA with modifications to create a completely patient-reported version. The CARE assesses self-reported functional status, physical function, nutrition, social support, anxiety/depression, cognitive function, comorbidities, and social activities. Patients ≥ 60yo referred for consultation to the GI Oncology clinic were asked to complete the CARE (paper/pencil) on their first visit. The completed CARE was collected during nurse triage and submitted to the clinical team prior to the physician encounter. Feasibility was defined as completion of the CARE by ≥ 80% of eligible patients during the initial consultation. Results: Between September 2017 and August 2018, 199 eligible new patients attended the GI Oncology Clinic, 192 (96.5%) were approached, and 181 (90.4%) completed the CARE. Most patients (79.6%) felt the length of time to complete was appropriate (median time of 10 minutes [IQR 10-15 minutes]). The mean age was 70y (range 60-96), 54.3% were male, and 75.1% were non-Hispanic white. Common tumor types included colon (27.8%), pancreatic (21.2%), and rectal (10.2%) cancer; predominately advanced stage diseases (stage III: 26.9%; stage IV: 40.0%). GA impairments were prevalent: 48.6% reported dependence in Instrumental Activities of Daily Living, 18.0% reported dependence in Activities of Daily Living, 22.5% reported ≥ 1 fall, 29.4% reported a performance status ≥ 2, 51.3% were limited in walking one block, 75.7% reported polypharmacy (≥ 4 medications), and 84.3% had ≥ 1 comorbidity. Conclusions: Performing a GA in the routine care of older adults with GI malignancies is feasible, and GA impairments are common among older adults with GI malignancies. A fully patient-reported GA such as the CARE may facilitate broader incorporation of GA in the routine clinic work flow.

scholarly journals Patient-reported comorbidity and survival in older adults with cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10033-10033
Author(s):  
Grant Richard Williams ◽  
Allison Mary Deal ◽  
Jennifer Leigh Lund ◽  
YunKyung Chang ◽  
Hyman B. Muss ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Functional Limitation ◽  
Mortality Data ◽  
Comorbid Condition ◽  
Cancer Type ◽  
Comorbid Conditions ◽  
Risk Of Death ◽  
The North ◽  
Patient Reported

10033 Background: Our ability to optimize the care of older adults with cancer and comorbid illnesses is insufficient as most clinical trials lack systematic measurement of comorbidities. The primary purpose of this study was to evaluate the prevalence and impact of patient-reported comorbidity on survival using various comorbidity scoring algorithms. Methods: We utilized a unique linkage of the Carolina Senior Registry, an institutional registry (NCT01137825) that contains geriatric assessment data, with the North Carolina Central Cancer Registry to obtain mortality data. Comorbidity was assessed using a patient-reported version of the Older Americans Resources and Services Questionnaire (OARS) Physical Health subscale that includes information regarding 13 specific comorbid conditions and the degree to which each impairs function (“not at all” to “a great deal”). Multivariable Cox proportional hazard regression models were used to evaluate the association between comorbidities and all-cause mortality. Results: 539 patients were successfully linked to mortality data. Median age 72, 72% female, 85% Caucasian, 47% breast cancer, and 12% lung cancer. 92% of participants reported at least one comorbid condition, mean of 2.7 conditions (range 0-10), with arthritis and hypertension the most common (52 and 50%, respectively). 62% of patients with a comorbid illness reported a functional limitation related to comorbidity. Both the presence of 3 or more total comorbidities (hazard ratio (HR) 1.44, CI 1.08-1.92) and 2 or more comorbidities impacting function (HR 1.46, CI 1.09-1.95) increased mortality. After adjusting for age, cancer type, and stage, the risk of death increased 12% for each comorbid condition impacting function (HR 1.12, CI 1.02-1.24), but did not significantly increase for the number of comorbid conditions alone (HR 1.07, CI 0.99-1.15). Conclusions: Comorbid conditions in older adults with cancer are highly prevalent, frequently impair function, and impact survival. Comorbid conditions that impair function have a greater impact on survival than the presence of comorbidity alone. Comorbidity assessment should be incorporated in clinical trials and can be measured via a simple one-page patient-reported questionnaire.

scholarly journals Association of Polypharmacy and Potentially Inappropriate Medications With Physical Functional Impairments in Older Adults With Cancer

2021 ◽  
Vol 19 (3) ◽  
pp. 267-274
Author(s):  
Mostafa R. Mohamed ◽  
Erika Ramsdale ◽  
Kah Poh Loh ◽  
Huiwen Xu ◽  
Amita Patil ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Physical Function ◽  
Daily Living ◽  
Youden Index ◽  
Potentially Inappropriate Medications ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Patient Reported ◽  
Inappropriate Medications

Background: Polypharmacy and potentially inappropriate medications (PIMs) are prevalent in older adults with cancer, but their associations with physical function are not often studied. This study examined the associations of polypharmacy and PIMs with physical function in older adults with cancer, and determined the optimal cutoff value for the number of medications most strongly associated with physical functional impairment. Methods: This cross-sectional analysis used baseline data from a randomized study enrolling patients aged ≥70 years with advanced cancer starting a new systemic cancer treatment. We categorized PIM using 2015 American Geriatrics Society Beers Criteria. Three validated physical function measures were used to assess patient-reported impairments: activities of daily living (ADL) scale, instrumental activities of daily living (IADL) scale, and the Older Americans Resources and Services Physical Health (OARS PH) survey. Optimal cutoff value for number of medications was determined by the Youden index. Separate multivariate logistic regressions were then performed to examine associations of polypharmacy and PIMs with physical function measures. Results: Among 439 patients (mean age, 76.9 years), the Youden index identified ≥8 medications as the optimal cutoff value for polypharmacy; 43% were taking ≥8 medications and 62% were taking ≥1 PIMs. On multivariate analysis, taking ≥8 medications was associated with impairment in ADL (adjusted odds ratio [aOR], 1.64; 95% CI, 1.01–2.58) and OARS PH (aOR, 1.73; 95% CI, 1.01–2.98). PIMs were associated with impairments in IADL (aOR, 1.72; 95% CI, 1.09–2.73) and OARS PH (aOR, 1.97; 95% CI, 1.15–3.37). A cutoff of 5 medications was not associated with any of the physical function measures. Conclusions: Physical function, an important component of outcomes for older adults with cancer, is cross-sectionally associated with polypharmacy (defined as ≥8 medications) and with PIMs. Future studies should evaluate the association of polypharmacy with functional outcomes in this population in a longitudinal fashion.

Impact of hearing and visual impairment in older adults with cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10036-10036
Author(s):  
Enrique Soto Perez De Celis ◽  
Can-Lan Sun ◽  
William P. Tew ◽  
Supriya Gupta Mohile ◽  
Ajeet Gajra ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Visual Impairment ◽  
Cognitive Deficits ◽  
Daily Living ◽  
Cognitive Deficit ◽  
Cancer Type ◽  
Impaired Hearing ◽  
Cross Sectional ◽  
Anxiety Depression

10036 Background: Hearing and visual impairment increase the risk of psychological, functional, and cognitive deficits in older adults. However, little is known about their impact in older patients (pts) with cancer. Methods: This is a cross-sectional analysis of 2 prospective studies of pts ≥65 with cancer (Hurria et al. JCO 2011 & 2016) which identified risk factors for chemotherapy (CT) toxicity. Relationships between self-reported hearing/visual impairment (fair, poor or deaf/blind) and the need for assistance in instrumental activities of daily living (IADL, i.e. shopping), or activities of daily living (ADL, i.e. bathing); anxiety; depression and cognitive deficit (>11 on Blessed OMC test) were assessed (adjusted for age, sex, race, education, cancer type/stage, comorbidity, falls & medication). Results: Among 750 pts (median age 72, range 65-94) with solid tumors (28% lung, 27% GI, 30% breast/GYN; 58% stage IV), 28% (n = 213) reported 1 impairment (61% hearing, 39% visual) and 7% (n = 55) both. On multivariate analysis, impaired hearing was associated with IADL dependency, anxiety and depression. Visual impairment was associated with IADL dependency, ADL limitation and depression. Impairment in both was associated with IADL dependency, anxiety, depression and cognitive deficit. Conclusions: Older pts with cancer and hearing/visual impairment are at higher risk of functional, psychological and cognitive deficits. Interventions aimed at improving vision and hearing of older adults with cancer should be studied. [Table: see text]

scholarly journals The association between intrinsic capacity and activities of daily living among older adults in China

2020 ◽  
Author(s):  
Mingyue Hu ◽  
Hengyu Hu ◽  
Xinhui Shu ◽  
Hui Feng
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Univariate Analysis ◽  
Sensory Function ◽  
Related Factors ◽  
Term Care ◽  
The Core ◽  
Intrinsic Capacity ◽  
Community Dwellers

Abstract Background: The Intrinsic capacity (IC) has been considered the core of older adults’ functional ability. However, there is little study on IC from China, Asia. Methods: Data were drawn from the Long-term Care Demand Assessment (LCDA), a population-based face-to-face survey of 60 years old or over from Southern, Western, Central, Northern, Easton China. Results: A total of 2016 individuals were included in the final analysis. Independent variables were composed of demographic characteristics, four IC domains, health-related factors, and common diseases. The outcome was known as activities of daily living (ADL). Logistic regression analysis was used to explore the association between IC and ADL. Univariate analysis showed that each IC domains were significantly associated with ADL. Multivariate analysis showed that the association between sensory function and ADL was not stable. Nursing home elders (odds ratio [OR] = 0.58; 95% confidence interval [CI] 0.52-0.64) with low nutrition score were more likely to have ADL impairment than community dwellers (OR = 0.86, 95%CI 0.80-0.13). Community dwellers with depression were more likely to suffer ADL impairment (OR = 1.11, 95%CI 1.07-1.14). Conclusion: IC is the core of the ADLs among Chinese older adults. However, the magnitude of the contribution of each IC domain to ADL is partly influenced by living conditions.

scholarly journals Dialysis-Related Factors Affecting Activities of Daily Living among Hemo-dialysis Patients in Erbil City

2021 ◽  
Vol 4 (1) ◽  
pp. 1-14
Author(s):  
Sideeq Ali ◽  
◽  
Vian Naqshbandi ◽  
Shihab Sedeeq ◽  
◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Cross Sectional Study ◽  
Maintenance Hemodialysis ◽  
Chi Square ◽  
Related Factors ◽  
Cross Sectional ◽  
Middle Income ◽  
Factors Affecting ◽  
Chi Square Test

Background and objectives: Hemodialysis procedure is one of the important replacement therapies for patients with renal failure. Maintenance hemodialysis is associated with many complications that play a significant role in the activities of daily living. The present study aimed to find out the factors affecting activities of daily living among patients with maintenance hemodialysis in Erbil City in the Kurdistan Region of Iraq. Methods: The cross-sectional study was conducted on 268 patients undergoing mainte-nance hemodialysis for more than two months, and at least two times per a week at two dialysis centres in Erbil City from December 2019 to April 2020. The activities of daily living and complications from the hemodialysis procedure questionnaire to collect research da-ta. The data analysis was conducted using descriptive statistical approach including fre-quency, percentages, and inferential statistical analysis consisting chi-square test. Results: According to the findings of the study, the majority of participants were above 51 years of age, able to read and write, with middle income, and from an urban area. Almost half of the study sample were males, and most were on hemodialysis between one and three years. The majority of them had hypertension and complications associated with he-modialysis such as headache and hypotension, and more than half had back pain. A highly significant association was found between dependency in activities of daily living and some socio-economic and clinical variables. Furthermore, a significant association was found be-tween dependency in activities of daily living and some hemodialysis complications with P<0.001. Conclusion: According to the result of the study, the researchers concluded that partici-pants suffered from chronic diseases, hemodialysis complications and low level of activities of daily living. The complications of hemodialysis treatment were significantly affecting the activities of daily living. Haemodialysis patients need more education and nursing care to reduce treatment complications and to increase their activities.

PROMIS Physical Function 10-Item Short Form for Older Adults in an Emergency Setting

2019 ◽  
Vol 75 (7) ◽  
pp. 1418-1423
Author(s):  
G W Conner Fox ◽  
Sandra Rodriguez ◽  
Laura Rivera-Reyes ◽  
George Loo ◽  
Ariela Hazan ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Status ◽  
Physical Function ◽  
Daily Living ◽  
Short Form ◽  
Emergency Setting ◽  
General Function ◽  
Convenience Sample ◽  
Patient Reported

Abstract Background Functional status in older adults predicts hospital use and mortality, and offers insight into independence and quality of life. The Patient-Reported Outcome Measurement Information System (PROMIS) was developed to improve and standardize patient-reported outcomes measurements. The PROMIS Physical Function (PROMIS PF) 10-Item Short Form was not created specifically for older adults. By comparing PROMIS with the Katz Index of Activities of Daily Living (Katz), we evaluated PROMIS for measurement of physical function versus general function in an older adult population seen in the ED. Methods A prospective, convenience sample of ED patients 65 years and older (from January 1, 2015 to June 30, 2015) completed Katz and PROMIS PF. Both were compared for scoring distributions and conventional scoring thresholds for severity of impairment (eg, minimal, moderate, severe). We assessed convergence through Spearman correlations, equivalents of conventional thresholds and ranges of physical function, and item-response frequencies. Results A total of 357 completed both function surveys. PROMIS PF and Katz have a modest positive correlation (r = .50, p &lt; .01). Mean PROMIS PF scores within Katz scoring ranges for minimal (43, SD = 10), moderate (32, SD = 7), and severe (24, SD = 7) impairment fell within respective PROMIS PF scoring ranges (severe = 14–29, moderate = 30–39, mild = 40–45), indicating convergence. PROMIS identified impairment in 3× as many patients as did Katz, as PROMIS assesses vigorous physical function (eg, running, heavy lifting) not queried by Katz. However, PROMIS does not assess select activities of daily living (ADLs; eg, feeding, continence) important for assessment of function in older adults. Conclusions There is a modest correlation between PROMIS and Katz. PROMIS may better assess physical function than Katz, but is not an adequate replacement for assessment of general functional status in older adults.

scholarly journals Technology Used to Recognize Activities of Daily Living in Community-Dwelling Older Adults

2020 ◽  
Vol 18 (1) ◽  
pp. 163
Author(s):  
Nicola Camp ◽  
Martin Lewis ◽  
Kirsty Hunter ◽  
Julie Johnston ◽  
Massimiliano Zecca ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Wearable Technology ◽  
Community Dwelling ◽  
Use Of Technology ◽  
Key Stakeholders ◽  
Environmental Technologies ◽  
Current Monitoring ◽  
Future Work

The use of technology has been suggested as a means of allowing continued autonomous living for older adults, while reducing the burden on caregivers and aiding decision-making relating to healthcare. However, more clarity is needed relating to the Activities of Daily Living (ADL) recognised, and the types of technology included within current monitoring approaches. This review aims to identify these differences and highlight the current gaps in these systems. A scoping review was conducted in accordance with PRISMA-ScR, drawing on PubMed, Scopus, and Google Scholar. Articles and commercially available systems were selected if they focused on ADL recognition of older adults within their home environment. Thirty-nine ADL recognition systems were identified, nine of which were commercially available. One system incorporated environmental and wearable technology, two used only wearable technology, and 34 used only environmental technologies. Overall, 14 ADL were identified but there was variation in the specific ADL recognised by each system. Although the use of technology to monitor ADL of older adults is becoming more prevalent, there is a large variation in the ADL recognised, how ADL are defined, and the types of technology used within monitoring systems. Key stakeholders, such as older adults and healthcare workers, should be consulted in future work to ensure that future developments are functional and useable.

scholarly journals Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. Muhammad ◽  
Shobhit Srivastava ◽  
T. V. Sekher
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Psychological Health ◽  
Daily Living ◽  
Basic Needs ◽  
Well Being ◽  
Asset Ownership ◽  
Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

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