Breathlessness and Beyond: Cross-Sectional Associations Between Physician-Diagnosed and Symptom-Based Asthma,...

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.

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.

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.

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.

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.