Publications

2020
The Longitudinal Ageing Study in India 2017-18 - national report. International Institute for Population Sciences, National Programme for Health Care of Elderly, Ministry of Health and Family Welfare, Harvard T. H. Chan School of Public Health, and the University of Southern California; 2020. lasi_india_report_2020.pdf
2015
Lee J, McGovern ME, Bloom DE, Arokiasamy P, Risbud A, O'Brien J, Kale V, Hu P. Education, gender, and state-level disparities in the health of older Indians: Evidence from biomarker data. Economics & Human Biology. 2015;19 :145-156. Publisher's VersionAbstract

Using new biomarker data from the 2010 pilot round of the Longitudinal Aging Study in India (LASI), we investigate education, gender, and state-level disparities in health. We find that hemoglobin level, a marker for anemia, is lower for respondents with no schooling (0.7 g/dL less in the adjusted model) compared to those with some formal education and is also lower for females than for males (2.0 g/dL less in the adjusted model). In addition, we find that about one third of respondents in our sample aged 45 or older have high C-reaction protein (CRP) levels (>3 mg/L), an indicator of inflammation and a risk factor for cardiovascular disease. We find no evidence of educational or gender differences in CRP, but there are significant state-level disparities, with Kerala residents exhibiting the lowest CRP levels (a mean of 1.96 mg/L compared to 3.28 mg/L in Rajasthan, the state with the highest CRP). We use the Blinder–Oaxaca decomposition approach to explain group-level differences, and find that state-level disparities in CRP are mainly due to heterogeneity in the association of the observed characteristics of respondents with CRP, rather than differences in the distribution of endowments across the sampled state populations.

2014
Lee J, Shih R, Feeney K, Langa KM. Gender Disparity in Late-life Cognitive Functioning in India: Findings From the Longitudinal Aging Study in India. The Journals of Gerontology: Biological Sciences and Medical Sciences. 2014. Publisher's VersionAbstract

This study uses baseline interviews of a prospective cohort study of 1,451 community-residing adults 45 years of age or older in four geographically diverse states of India (Karnataka, Kerala, Punjab, Rajasthan). Data collected during home visits includes cognitive performance tests, and rich sociodemographic, health, and psychosocial variables. The cognitive performance tests include episodic memory, numeracy, and a modified version of the Mini-Mental State Examination.

Bloom DE, Hu P, Arokiasamy P, Risbud A, Sekher TV, Mohanty SK, Kale V, O’Brien J, Chien CS, Lee J. LongitudinalAging Study in India: Biomarker Data Documentation . PGDA Working Paper . 2014;114. Publisher's Version
Cramm JM, Lee J. Smoking, physical activity and healthy aging in India. BMC Public Health. 2014. Publisher's VersionAbstract

Background

To identify levels of physical inactivity and smoking and examine their relationships to health among older people in India.

Methods

In 2010, Longitudinal Aging Study in India researchers interviewed 1,683 older adults in randomly sampled households with members aged ≥ 45 years in eight stratified districts in four states (90.9% response rate). We first used descriptive analyses to characterize older people in poor and good health. Differences between groups were established using chi-squared and t-tests. Multivariate logistic regression analyses were then performed to determine whether physical inactivity and smoking led to poor health while controlling for district of residence, caste, age, gender, marital status, and educational level. Regression analyses were also used to identify significant relationships between socio-demographic characteristics and health behaviors.

Results

Larger proportions of older people in poor health were smokers (26.1% vs. 16.9%; p ≤ 0.001) and physically inactive (vigorous activities: 88.7% vs. 70.7%, p ≤ 0.001; moderate activities: 67.1% vs.57.1%, p ≤ 0.01). Smoking (p ≤ 0.05) and lack of vigorous physical activity (p ≤ 0.001) increased the likelihood of poor health. Low educational level was significantly related to smoking and the lack of moderate physical activity (both p ≤ 0.001). Female gender decreased the likelihood of smoking. Male gender increased the likelihood of vigorous physical activity but decreased the likelihood of moderate physical activity.

Conclusions

Smoking and physical inactivity have important impacts on the health of older people in India. Policy attention is needed to improve these modifiable health behaviors.

 

Lee J, Smith JP. Regional disparities in adult height, educational attainment, and late-life cognition: Findings from the Longitudinal Aging Study in India (LASI). The Journal of the Economics of Aging. 2014. Publisher's VersionAbstract

State policies over time in India may have led to significant differences by sex in population health and cognition. In this paper, we use data from the pilot wave of the Longitudinal Aging Study in India, conducted in Karnataka, Kerala, Punjab, and Rajasthan, to examine state variations in health, educational attainment, and male preference, and how these variations contribute to gender differences in late-life cognition in India. We find men and women born in Punjab are taller than those elsewhere, but do not find any gender differences in height across states with differential male preference. We do find a significant gap in educational attainment that correlates with male preference. We find paternal education benefits both sons and daughters, while maternal education contributes to daughters' educational attainment. Finally, we find that paternal education benefits daughters' late-life cognition, while maternal education benefits sons' late-life cognition, and that children's education has positive association with older adults' cognitive functioning as well.

2013
Chien CS, Feeney KC, Liu J, Meijer E, Lee J. Harmonized LASI Pilot Data Documentation (Version A). RAND Working Paper WR-1018. 2013. Publisher's VersionAbstract

This codebook documents the Harmonized Longitudinal Aging Study in India (LASI) file. The Harmonized LASI file is a user-friendly version of the LASI pilot data specifically designed for harmonization with the RAND version of the Health and Retirement Study (RAND HRS) and its sister studies, including the Harmonized English Longitudinal Study on Ageing (Harmonized ELSA), the Harmonized Survey of Health, Ageing, and Retirement in Europe (Harmonized SHARE), the Harmonized Korean Longitudinal Study of Aging (Harmonized KLoSA), the Harmonized Japanese Study of Aging and Retirement (Harmonized JSTAR), and the Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS).

Arokiasamy P, Uttamacharya U. Multiple Chronic Diseases and Co-Morbidities Among Older Adults in India: New Insights from Lasi Pilot, 2010. Social Science Research Network. 2013. Publisher's Version
2012
Angrisani M, Lee J. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Wealth Measures. RAND Working Paper WR-861/6. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of household and individual wealth in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Indonesian Family Life Survey (IFLS), The Irish Longitudinal Study on Aging (TILDA), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, expectations, transfers, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Zamarro G, Lee J. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Employment and Retirement Measures. RAND Working Paper WR-861/4. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of employment and retirement status in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Chinese Health and Retirement Longitudinal Study (CHARLS), the Indonesian Family Life Survey (IFLS), The Irish Longitudinal Study on Aging (TILDA), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, expectations, transfers, income, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Angrisani M, Lee J. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Income Measures. RAND Working Paper WR-861/2. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of household and individual income in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Indonesian Family Life Survey (IFLS), The Irish Longitudinal Study on Aging (TILDA), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, expectations, transfers, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Delavande A, Lee J, Yoong JK. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Expectations. RAND Working Paper WR-861/3. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of subjective economic and health expectations in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Aging (ELSA), the Survey of Health, Aging, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, employment and retirement, transfers, income, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Zissimopoulos J, Lee J, Carroll J. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Financial Transfer. RAND Working Paper WR-861/2. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of financial transfers in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, employment and retirement, expectations income, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Shih RA, Lee J, Das L. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Cognition. RAND Working Paper WR-861/7. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of cognitive health and decline in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Chinese Health and Retirement Longitudinal Study (CHARLS), the Mexican Health and Aging Study (MHAS), the Indonesian Family Life Survey (IFLS), The Irish Longitudinal Study on Aging (TILDA), Study on Global Aging (SAGE), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, employment and retirement, expectations, transfers, income, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Hu P, Lee J. Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Chronic Medical Conditions. RAND Working Paper WR-861/1. 2012. Publisher's VersionAbstract

This paper summarizes and compares measures of chronic diseases and medical conditions in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., cognition, employment and retirement, expectations, transfers, income, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations.

Berkman LF, Sekher TV, Capistrant B, Zheng Y. Social Networks, Family, and Care Giving Among Older Adults in India. Aging in Asia: Findings from New and Emerging Data Initiatives. 2012. Publisher's Version
2011
Lee J, Shih RA, Feeney KC, Langa KM. Cognitive Health of Older Indians: Individual and Geographic Determinants of Female Disadvantage. RAND Working Paper WR-889. 2011. Publisher's VersionAbstract

India is experiencing a rapid demographic and epidemiologic transition. Among a growing aging population, non-communicable diseases, including dementia, are increasingly prevalent, but our understanding of cognitive health is quite limited. Recent studies suggest that women in developed countries perform as well or better than men on cognitive functioning tests, though research from developing countries shows the opposite. This gender disparity in developing settings may be attributable to that fact that women are traditionally not given equal access to education, health services, economic opportunity, and social engagement. Furthermore, in countries such as India, discrimination against women may play a role in the gender disparity. To address this issue, the authors examine cognitive function of older Indians, using cross-sectional data from the 2010 pilot round of the Longitudinal Aging Study in India, fielded across Punjab and Rajasthan in the north and Kerala and Karnataka in the south. They found gender disparities in cognitive function and suggest that female cognitive disadvantage could be explained by disparities in education, health and social engagement in southern India. However, female disadvantage persisted in northern states where discrimination against women has been notably acute even after controlling for education and other key risk factors of poor cognitive function.

Arokiasamy P, Bloom DE, Feeney KC, Ozolins M. Longitudinal Aging Study in India: Vision, Design, Implementation, and Some Early Results. PGDA Working Paper #81.2011. 2011. Publisher's Version
Lee J, Chandra A, Hu P, Liu J, Feeney KC, Arokiasamy P. Markers and Drivers: Cardiovascular Health of Middle-Age and Older Indians. RAND Working Paper WR-888. 2011. Publisher's VersionAbstract

Using the 2010 pilot study of the Longitudinal Aging Study in India (LASI), the authors examine the socioeconomic and behavioral risk factors for poor cardiovascular health among middle-aged and older Indians, focusing on self-reported and directly measured hypertension. The LASI pilot survey (N=1,683) was fielded in four states: Karnataka, Kerala, Punjab, and Rajasthan. These four states were chosen to capture regional variations and socioeconomic and cultural differences. They find significant inter-state differences across multiple measures of cardiac health and risk factors for hypertension, including body mass index, waist-to-hip ratio, and health behaviors. In contrast to the findings from developed countries, they find education and other markers of higher socioeconomic status (SES) to be positively associated with hypertension. Among the hypertensive, however, they find that those at higher SES are less likely to be undiagnosed and more likely to be in better control of their blood pressure than respondents with low SES. They also find significant inter-state variations in hypertension prevalence, diagnosis, and management that remain even after accounting for socio economic differences, obesity, and health behaviors. They conclude by discussing these findings and their implications for public health and economic development in India and the developing country context more generally.