Prevalence and Determinants of Communicable, Non-Communicable, and Dual Disease Burden among Older Adults in India: Evidence from LASI Wave I

Most existing studies on the double burden of communicable (CDs) and non-communicable diseases (NCDs) among older adults in India report these conditions separately, often leading to overlapping categories and obscuring their true distribution. This study, analyzed the distinct contribution of CDs alone, NCDs alone, and their coexistence, along with the associated determinants, which are essential for health planning. This study used nationally representative data from Wave I of the Longitudinal Aging Study in India (2017–18), including 31,347 adults aged ≥60 years. Respondents were classified into three mutually exclusive categories: only CDs (OCD), only NCDs (ONCD), and both (ONCD & OCD). Chi-square tests and piecewise binary logistic regression were used to examine associations with socio-demographic, lifestyle, and regional factors. Prevalence of OCD, ONCD, and ONCD & OCD was 11.8%, 39.3%, and 15.1%, respectively; overall, 66.2% of older adults had at least one communicable disease, at least one non-communicable disease, or the coexistence of both. Females and overweight individuals were more likely to experience ONCD and ONCD & OCD, whereas underweight individuals had higher odds of OCD. Urban residents showed higher odds of ONCD but lower odds of OCD. Substantial state-level variation was observed, with the highest prevalence of ONCD & OCD in Haryana (29%), ONCD in Kerala (68%), and OCD in Chhattisgarh (33%). These non-overlapping estimates provide important insights into the disease profile of India’s elderly and emphasize the need for integrated, elderly-focused interventions addressing both communicable and non-communicable disease risks.