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Spousal multimorbidity and depressive symptoms among older Indian couples: Do one’s own health status and sex matter?

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Abstract

With the aging population, increases in non-communicable diseases that require chronic management pose a substantial economic and social burden to individuals with multimorbid conditions and their spousal caregivers. However, little is known about the crossover effect of spousal multimorbidity on mental health outcomes in the context of low- and middle-income countries, and whether it depends on one’s own health status and sex. We examined the association between spousal multimorbidity and depressive symptoms using data on 6,158 older couples (12,316 individuals aged 60 years or above) from the Longitudinal Aging Study in India (LASI) 2017–18. Overall, 23.4% of the sample were multimorbid and 27.0% reported having depressive symptoms in the past week. Multivariable logistic regression models showed that spousal multimorbidity was associated with depressive symptoms, even after accounting for one’s own multimorbidity status (OR: 1.23; 95% CI: 1.06–1.44). However, this association varied by sex. Among males, their own multimorbidity status was associated with 60% higher odds of having depressive symptoms (OR: 1.60; 95% CI: 1.28–2.00), but spousal multimorbidity was not. Furthermore, for males, the association between spousal multimorbidity and depressive symptoms was contingent upon the presence of their own multimorbidity. Among females, spousal multimorbidity was significantly associated with depressive symptoms, regardless of their own multimorbidity status. Our findings indicate that interventions to promote healthy aging should expand the formal caregiving system and consider family-based approaches to minimize the crossover health consequences of chronic morbidity in conjugal relationships, especially for females.

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Data availability

Longitudinal Aging Study in India (LASI) data are available at: https://www.iipsindia.ac.in/content/LASI-data (requiring a simple application). STATA codes are available upon request.

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Author information

Authors and Affiliations

  1. Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea

    Soohyeon Ko

  2. Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea

    Soohyeon Ko, Jinho Kim & Rockli Kim

  3. Division of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea

    Sungchul Park, Jinho Kim & Rockli Kim

  4. BK21 Four R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea

    Sungchul Park

  5. Harvard Center for Population and Development Studies, Cambridge, MA, USA

    S. V. Subramanian

  6. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    S. V. Subramanian

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  1. Soohyeon Ko
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  2. Sungchul Park
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  3. Jinho Kim
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  4. S. V. Subramanian
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  5. Rockli Kim
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Contributions

Ko and R. Kim conceptualized the study. Ko did data management, analysis, and reporting and led the writing of the manuscript. Park, J. Kim, Subramanian, and R. Kim contributed to the manuscript’s writing and provided a critical review of the data analysis and manuscript drafting. R. Kim provided overall supervision.

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Correspondence to Rockli Kim.

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This project used publicly accessible secondary data obtained from Longitudinal Aging Study in India (LASI). The LASI data are not collected specifically for this study and no one on the study team has access to identifiers linked to the data. These activities do not meet the regulatory definition of human subject research. As such, an Institutional Review Board (IRB) review is not required.

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Ko, S., Park, S., Kim, J. et al. Spousal multimorbidity and depressive symptoms among older Indian couples: Do one’s own health status and sex matter?. GeroScience 46, 885–896 (2024). https://doi.org/10.1007/s11357-023-00822-5

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  • DOI: https://doi.org/10.1007/s11357-023-00822-5

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