Table 1

Summary of the characteristics of the included studies

Author (date)Study aimsMethods/ study designSample size and descriptionMain findings
Aminu et al (2017)17To estimate the prevalence and to identify the factors influencing depression among people with type 2 diabetes in Udupi Taluk, southern India.Community-based cross-sectional studyn=200, aged over 18 yearsThe prevalence of depression among people with diabetes in the community was found to be 38%. The prevalence of mild depression was 21% and 5% for severe depression. Female gender, rural residence, unemployment and being unmarried were associated with depression. The presence of diabetic complications and other chronic diseases such as hypertension and obesity were also found to be associated with depression. Age, educational status, socioeconomic status and type of treatment received were among the variables not found to be significantly associated with depression.
Arokiasamy et al (2015)18To explore the prevalence and correlates of multimorbidity in adults; to examine the associations between multimorbidity and self-rated health, depression, physical functioning and subjective well-being.Secondary analysis of previously published dataSAGE survey, 2007–201027, n=11 230The prevalence of having at least one chronic disease in India was 52%. The likelihood of multimorbidity was higher in older age groups and was lower in those with higher socioeconomic status.
Garin et al (2016)19To identify and describe multimorbidity patternsSecondary analysis of previously published dataSAGE27 and COURAGE survey,28 n=41 909 aged over 50 yearsThe prevalence of depression, diabetes and hypertension in India was 16%, 7% and 38%, respectively. Multimorbidity increased with age. 8% of people with depression had diabetes and 41% had hypertension. Of those with diabetes, 19% had depression and 65% had hypertension and in the case of people with hypertension, 17% had depression and 12% had diabetes.
Kulkarni and Shinde (2015)20To estimate the prevalence of depression and determine the factors associated with it in Indians aged 50 years and aboveSecondary analysis of previously published dataSAGE survey,27 n=12 198 aged 18 years and above from six states in India.Estimated prevalence of mild, moderate and severe depression in the past 12 months was 16%, 12%, and 8%, respectively. Functional disability, cognitive impairment, low quality of life, low wealth status and chronic conditions such as angina, asthma or chronic lung disease were significant risk factors for depression. Risk factors for severe depression found in the multivariate model were lower wealth condition; low quality of life; having angina, lung disease, or asthma; moderate/high cognitive impairment; medium/high functional disability; and residing in south, central, or north region of the country.
Lotfaliany et al (2019)21To explore the association between depression and other chronic conditions such as type 2 diabetes mellitus, arthritis, asthma, chronic lung disease, angina and strokeSecondary analysis of previously published dataSAGE survey,27 2007–2010, n=33 50844% of the study population had depression. There is a strong positive association between depression and type 2 diabetes mellitus, arthritis, asthma, chronic lung disease, angina and stroke.
Patel et al (2017)22To test the hypothesis that living with any household member who has a chronic condition-diabetes, common mental disorder, hypertension, obesity and/or high cholesterol-raises the risk of developing the same or another chronic condition in IndiaSecondary analysis of previously published dataDisha study,29 n=7522 with at least one co-residing household member with a chronic condition44% of adults had one or more chronic conditions such as diabetes, hypertension, high cholesterol, obesity and depression. The most common conditions were hypertension (23%), common mental disorders (13%) and diabetes (11%). Irrespective of familial relationship, adults who resided with another adult with any chronic condition had 29% higher adjusted relative odds of having one or more chronic conditions themselves. Statistically significant associations of diabetes, common mental disorder and hypertension with any chronic condition were found in the analysis of all co-residing household members. Of all associations examined, only the relationship between hypertension and diabetes in the adult-parent dyads was statistically significantly negative.
Patel et al (2019)23To identify the association of behavioural risk factors with self-reported and symptom or measured chronic diseases among adult population (18–69 years) in IndiaSecondary analysis of previously published dataSAGE survey,27 2007–2010, n=9839 aged 18–69Moderate and vigorous physical activity was less likely to be associated with self-reported depression. Adequate intake of fruits and vegetables had an increased odds of being associated (OR 3.45 (95% CI 1.99 to 5.97)) with self-reported depression; self-reported and measured hypertension and diabetes were associated with overweight while hypertension was associated with obesity.
Rajkumar et al (2009)24To establish the nature, prevalence and factors associated with geriatric depression in a rural south Indian communityCommunity-based cross-sectional studyn=1000, aged over 65 yearsPrevalence of geriatric depression within the previous 1 month was 13%. Low income, experiencing hunger, history of cardiac illnesses, transient ischaemic attack, past head injury and diabetes increased the risk for geriatric depression after adjusting for other determinants. Having more confidants was a significant protective factor. Age, female gender, cognitive impairment and disability status were not significantly associated with geriatric depression. Major depression was significantly correlated with experiencing hunger, diabetes, transient ischaemic attack, past head injury, more disability and less nourishment. Having more friends was a protective factor for depression.
Shukla et al (2014)25To examine the factors associated with obesity in four of the BRICS countries (China, India, Russia and South Africa) and to examine the linkage of obesity with selected morbiditiesSecondary analysis of previously published dataSAGE survey,27 2007–2010, n=10 915 aged over 18 yearsThe prevalence of obesity in India was 3%. The prevalence of obesity was significantly higher in women. Increased wealth was associated with being overweight. Being overweight or obese was positively associated with hypertension and diabetes. In India, obese respondents were significantly more likely than the normal respondents to have hypertension or diabetes. No relationship was found between obesity and depression.
Weaver (2016)26To explore interactions between middle-aged women with type 2
diabetes and their daughters in relation to their comorbid chronic illnesses in India.
Cross-sectional survey and qualitative interviewsTwo case studies were drawn from 30 in-depth interviews with women with diabetes, from a larger sample of 184 womenThe diabetic women in the larger sample were generally overweight, with an average body mass index of 28, placing them in the category of obese for South Asian populations based on the WHO estimates of the body mass index for South Asian communities.39 27% reported levels of anxiety symptoms suggesting a potential clinical disorder, while 18% did so for depression symptoms. The paper explores personal and interpersonal suffering in cases of comorbid chronic diseases based on two case studies.
  • COURAGE, Collaborative Research on Ageing in Europe; SAGE, Study on global AGEing and adult health.