Globally, the life expectancy at birth has increased from 66.5 years in 2000 to 72 years in 2016 (Patel et al., 2019). On the back of improvements in the educational system, health facilities, and life expectancy, the percentage of elderly in India had risen from 5.3 percent in 1971 to 5.7 percent in 1981 and further from 6 percent in 1991 to 8 percent in 2011 [1]. Furthermore, the decline in fertility levels and increase in life expectancy has led to an increase in an absolute number of elderly in India [2]. Ageing across the countries has been increased for more than 35 years on policy discourse [3]. However, the focus across countries was on demographic transition instead of ageing [4]. The developed countries have moved ahead in providing both healthy and quality life to their citizens than developing countries [5].
Over 1 billion (15%) individuals worldwide have experienced one or more disability conditions. The global trends among the ageing population and the risk of disability lead to a higher disabled population [6]. The higher disability rates result from health risks across various diseases, chronic illness, and injury [1]. Globally, a person with disabilities faces many hindrances in their life. It includes attitudinal, environmental, and institutional barriers which prevent their full participation in any aspects of life [6]. Agenda 2030 for Sustainable Development pledges that no one will be left behind. Its integral part is to promote and protect older adults' rights and dignity and facilitate their full support in society [7]. India is a country where different religions and cultures co-exist; a country where the traditions constructed by the society have the upper hand still believes in the joint family system, which is closely knit.
India's population is ageing with an increase in the number and proportion of older adults in its population. This phenomenon is expected to have significant implications and demands care in terms of health and financial security. While 8% of India's population was in the age group 60 and above as per Census 2011, it is likely to increase to nearly 20% by 2050 [1]. With this count, the responsibility lies in prioritizing the required services for them concomitant by the social protection for the older adults, protecting senior citizens' rights, and providing them with the practical opportunities to contribute efficiently in the development sector.
The contemporary household settings, especially in the more urbanized localities where different generations are co-residing and where the household lady is bestowed to take care of the senior citizens. The loneliness and insecurity are often felt by the older adults in India due to the decreased inter-generational bonding and changing lifestyles. With the efforts to reduce gender disparity and, eventually, the females contributing equally to economic development and less involvement in the household chores, older adults often feel neglected by their young caregivers. In the 21st century, the low and middle-income countries have experienced an upward shift in life expectancy [6]. Thus, it leads to an increase in longevity and leads to multiple comorbidity conditions, commonly referred to as 'multimorbidity condition', and has become more common among the older adult population [8]. Both high and low-income countries show that older adults are at high risk for multiple chronic diseases [9–11].
Socioeconomic status is strongly associated with the prevalence of morbidity where the socioeconomic status is measured through education [12–13], occupation [14], income [15], or whether it is found to be an area-based deprivation [16]. A study focused on East-Mediterranean countries, a review of 26 studies on multimorbidity, resulted in a low level of education, low income, and unemployment associated with the higher prevalence of multimorbidity among older adults [17]. It is also associated with adverse health outcomes like reduced physical function [18], poor quality of life [19], and self-rated health as poor [20] and mortality [21].
Many studies were conducted for older adults, which measured their functional performance through self-reported activities of daily living (ADL) and instrumental activities of daily living (IADL) based on their daily activities. However, unfortunately, the tools do not provide a clear picture of the actual functional capacity of an older person [22]. Thus, in this study, we have tried to examine various indicators among the older adults of India. The indicators include- gender, age, education, marital status, living arrangement, place of residence, wealth index, health insurance, use of tobacco (self-rated health), and physical activity performed by the older adults. All these indicators will be measured through activities of daily living (ADL) and instrumental activities of daily living (IADL) disability conditions basically through three categories- severe ADL disability, moderate ADL disability, and no ADL disability. Therefore, these crops up the requirement of understanding the burden felt by the new generation, their views about taking care of the older adults, the contribution of the older adults dependents in the household activities/resources, and the coping mechanisms adopted by the caregivers to lessen their burden. The study results are expected to help implement efficient and effective policies and programs to address the issues and challenges faced by older adults and inculcate them with the need for care.