Prevalence and Determinants of Cognitive Impairment in Elderly Urban Slum Residents of Eastern India

Background: Population aging is accelerating globally, with a disproportionate impact in low- and middle-income countries where socioeconomic inequities persist. Cognitive impairment (CI) is a major threat to functional independence and quality of life among older adults, yet evidence remains limited for highly marginalized groups such as urban slum–dwelling elderly populations. Study Design: This was an observational, cross-sectional, analytical epidemiological study. Methods: The study was conducted from April to September 2023 among 238 adults aged ≥60 years residing in urban slums of an eastern Indian district. Participants were selected using a 30-cluster sampling technique. Cognitive function was assessed using the Bangla adaptation of Mini-Mental State Examination, and depression using the Five-Item Geriatric Depression Scale. Sociodemographic, economic, dietary, and clinical variables were collected through face-to-face interviews. Bivariate analyses followed by multivariable logistic regression were used to identify independent predictors of CI. Results: Overall, 65.5% of participants had mild-to-severe CI. After adjustment, individuals aged 60–79 years (adjusted odds ratio [AOR] = 1.91; P = 0.001), those belonging to SC/OBC caste (AOR = 1.83; P < 0.001), economically dependent older adults (AOR = 1.60; P = 0.016), and those with depression (AOR = 2.12; P < 0.001) had significantly higher odds of CI, and these factors remained statistically significant independent predictors. Conclusions: CI is highly prevalent among urban slum–dwelling older adults. Social disadvantage, financial dependency, and depression substantially increase vulnerability, underscoring the need for integrated, equity-oriented interventions focusing on mental health care, social protection, and cognitive screening to promote healthy aging in marginalized urban populations.