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= Longitudinal Ageing Study in India (LASI) =

The Longitudinal Ageing Study in India (LASI) is a partnership between the International Institute for Population Sciences (IIPS), Harvard T. H. Chan School of Public Health (HSPH) and University of Southern California (USC). Launched under the aegis of the '''[https://main.mohfw.gov.in/ Ministry of Health and Family Welfare (MoHFW), Govt. of India]''', LASI Wave 1 was financially supported by Ministry of Health and Family Welfare (MoHFW), National Institute on Aging (NIA/NIH), USA and United Nations Population Fund, India.

LASI focuses on the health, economic, and social well-being of India's elderly population. The concept of LASI is comparable to the Health and Retirement Study (HRS) in the United States and is appropriately harmonized with other health and retirement studies such as SHARE, ELSA & MHAS, including its sister surveys in Asia. The most recent are the Korean Longitudinal Study on Ageing (KLoSA), the Japanese Study of Aging and Retirement (JSTAR), and the China Health and Retirement Longitudinal Study (CHARLS). This comparability allows cross-country comparison of these surveys. Additionally, LASI considers the features that are unique to India, including its institutional and cultural characteristics. The LASI is India’s first and the largest amongst the global HRS family.

LASI is a national landmark in the scientific research, which facilitates an improved comprehension of India’s adult health problems and population aging processes and the design of appropriate evidence-based policies for adults and older people. This study provides sufficient statistical information required to test hypotheses in subpopulations of interest. LASI data can improve scientific knowledge and enlighten policymakers in India as well as around the world. The internationally harmonized data are useful for cross-national comparative research studies on aging.

The LASI is a full-scale national survey of scientific investigation of the health, economic, and social determinants and consequences of population aging in India. The LASI is a nationally representative survey over 72,000 older adults age 45 and above across all states and union territories of India. LASI is envisioned to be conducted every 3 years for the next 25 years. It is well-positioned to evaluate the effect of changing policies on the behavioural outcomes in India.

LASI Goals
The main goal of LASI is to collect credible scientific data on the burden of disease, mental health, functional health, health care, social and economic well being of the elderly population. LASI data is being collected based on internationally comparable research design, tools and adopts state of the art scientific methods to provide the foundation for credible and acceptable data – for national and state level policy making and long-term scientific research.

LASI Objectives
The main objective of LASI is to provide comprehensive longitudinal evidence base on health, social and economic wellbeing of the elderly population in India. LASI will provide data on demographics, household economic status, health and biomarkers, health insurance and health care utilization, family and social network, social security schemes, work and employment, retirement and pension, life satisfaction and expectations. LASI is designed to cover scientific data on five major subject and policy domains of the adult and older population of India namely:


 * 1) Health: Disease burden & risk factors (reported and measured)
 * 2) Health care and health care financing
 * 3) Social: Family and social network
 * 4) Economic: Income, wealth, expenditure, employment, retirement and pension
 * 5) Welfare programs for Elderly

Geographic Coverage and Sampling Design
LASI wave-I covers all states and union territories of India with a panel sample of 72,000 older adults aged 45 years and above. The long-term goal of LASI is to continue this survey for the next 25 years with the first wave was undertaken in 2017-18 and second wave planned for 2021-22. LASI aims to obtain all the indicators for the states and union territories. In addition, LASI aims at obtaining indicators for each of the four metropolitan cities of Delhi, Kolkata, Mumbai and Chennai.

Sample design: The target sample for LASI is non-institutionalized Indian residents aged 45 and older and their spouses (irrespective of age). LASI adopts multistage clustering sampling design; three-stage sample design in rural areas and a four-stage sample design in urban areas. In each state, at first stage, involved selection of Primary Sampling Units (PSUs), i.e., sub-districts (Tehsils/Talukas); the second stage involved the selection of Secondary Sampling Units (SSUs) i.e. villages from rural areas and ward from urban areas of the selected PSUs. In rural areas, at the third stage, households are selected from selected villages. However, sampling in urban areas involved one more stage. From each selected urban ward, one Census Enumeration Block (CEB) was randomly selected in the third stage. At the fourth stage, households from this CEB will be selected. The main reason for adopting a four-stage sample design in urban areas is that urban wards are quite large, making it difficult to list all the households in a ward.

LASI Innovations
LASI is the first study in India that will provide a longitudinal database for designing policies and programs for the older population in the broad domains of social, health and economic wellbeing and allow researchers to investigate in sufficient detail the dynamic links among ageing, health, and physical, social and economic environments. LASI adopts the following state of the art of large-scale survey protocols and field implementation.

Computer-Assisted Personal Interviewing (CAPI)

LASI employs computer-assisted personal interviewing (CAPI) technique to record the responses of survey participants. This method requires field teams to be outfitted with laptop computers, pre-loaded with survey questions asked of respondents in a face-to-face interview. Field teams input responses directly into a laptop computer, thereby limiting data entry processes as well as minimizing data recording and entry errors. This also allows real time monitoring of quality of data. Supervisors were given 10% of the completed HHs for validation with a randomly selected set of questions. Field teams were provided feedback based on direct observations, supervisor validations, and quality control analyses to minimize errors. CAPI use and daily data transfers were also provided to give feedback to field agencies and survey teams to help ensure data quality.

Comprehensive Range of Biomarkers

Another innovative feature of the LASI survey instrument is the collection of biomarkers, which can be analysed to provide data on direct health examinations. Given the lack of access in our sample to health care and proper diagnoses, we directly measure biological markers and performance measures instead of relying solely on self-reports. We also recognize the widespread use of healers and traditional medicine, differentiating between types of health care providers. Biomarkers include:


 * 1) Physiological Assessments - blood pressure, lung function test, vision test;
 * 2) Anthropometric Measurements- height and weight, waist and hip circumference;
 * 3) Performance-Based Measurements- grip strength, balance test, and timed walk; and
 * 4) Molecular Markers- hs_C- reactive protein, glycosylated hemoglobin, hemoglobin, cytomegalovirus/Epstein-Barr virus.

Use of IT-based Technologies

IT based technologies and including Global positioning system (GPS), will be used for thematic mapping and community analysis to collect the information at community level. Photographic identification and barcode technology were used for matching and anonymizing data.