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Breathlessness and Beyond: Cross-Sectional Associations Between Physician-Diagnosed and Symptom-Based Asthma, Depression, Loneliness, and Sleep Difficulties in Older Indians

Year: 2025
Type: article
Abstract: OBJECTIVES: We examine whether physician-diagnosed and symptom-based asthma are associated with depression, loneliness, and sleep difficulties among older Indians, and whether these associations vary by rural-urban residence. METHODS: We used cross-sectional data from 4,214 adults aged 60 to 101 years (mean age = 68.4, SD = 7.0) from the WHO Study on Global Aging and Adult Health (SAGE, 2015). Asthma is gauged as physician-diagnosed and symptom-based. Multivariable regression and interaction models controlled for sociodemographic and health-related variables. RESULTS: 5.93% of older adults reported physician-diagnosed while 12.29% endured symptom-based asthma. Physician-diagnosed asthma was associated with higher odds of depression and sleep difficulties but not with loneliness. In contrast, symptom-based asthma was linked with greater odds of depression, loneliness, and sleep difficulties. Rural residence amplified the asthma-sleep association, with similar but non-significant trends for loneliness. CONCLUSIONS: Symptom-based asthma was more strongly associated with adverse mental health outcomes than physician-diagnosed asthma, highlighting the need for better asthma detection, management, and mental health support, particularly in resource-limited contexts. CLINICAL IMPLICATIONS: The findings underscore the need for comprehensive asthma care with regular mental health screening, especially for those without a formal asthma diagnosis who live in rural India.
Language: English
Subfield: Physiology
Field: Medicine
Open Access status: hybrid
OpenAlex ID: W4415245129
FWCI: 1.645
Cites: 114
Cited by: 3
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