Association between indoor air pollution and cognitive function of older adults in India: a cross-sectional multilevel analysis

Aim Over half the world's population, mostly from developing countries, use solid fuel for domestic purposes and are exposed to very high concentrations of harmful air pollutants with potential health effects. The effect of indoor air pollution becomes much more severe for older adults because of their weakened immune system with multiple health risk factors. Compared with ambient air pollution, little is known about cognitive health in relation to indoor air pollution. Therefore, this study explores the association between indoor air pollution due to solid fuel use and cognitive function of older adults in India. Subject and methods The study used data from wave 1 of the WHO Study on global AGEing and adult health (SAGE). Bivariate analysis and a two-stage multilevel linear regression model were applied. Results Our findings indicated that indoor air pollution is strongly associated with cognitive function. Results show lower cognitive function scores among older adults in households using solid fuel, women with lower or no education, and belonging to the disadvantaged section of the society. Older adults from poor socioeconomic backgrounds were more exposed to indoor air pollution compared to their counterparts, which indirectly increases the risk of poor cognitive function. Conclusion Indoor air pollution from solid fuel use may be a salient factor for the cognitive health of older adults in India. A large proportion of India's population relies on solid fuel pointing to the need for urgent intervention programmes to reduce the usage of solid fuel in the country.