Impact of water related disasters on water related infectious disease risk among older adults in India

Abstract Climate change has intensified the frequency and severity of water-related disasters (WRDs), including floods and cyclones, heightening the burden of water-related infectious diseases (WRIDs) among vulnerable populations. Older adults, who experience age-related frailty and high chronic disease burden, may face disproportionate risks; however, evidence linking WRD exposure to WRIDs in India remains sparse. This study assessed the association between WRD exposure and WRID prevalence among older adults. The study analysed nationally representative data from 72,250 adults aged ≥ 45 years from the Longitudinal Ageing Study in India (LASI) Wave 1. Descriptive statistics, Pearson’s chi-square tests, multivariable logistic regression, and spatial analyses were performed. Overall, 21.3% of older adults reported at least one WRID, with higher prevalence in WRD-exposed individuals (28.9%). WRD exposure was significantly associated with increased WRID risk (AOR 1.28; 95% CI 1.22–1.35). Coastal/island regions showing markedly higher odds of WRIDs (AOR 6.68; 95% CI 3.42–13.07) than arid counterparts. Unsafe water, sanitation and hygeine (WASH) practices significantly linked with WRIDs (AOR 1.12; 95% CI 1.07–1.17). Tribal and poorest households were more likey vulnerable to WRIDs. Chronic illnesses, Activities of Daily Living (ADL) limitations, and open defecation practice (AOR 1.40; 95% CI 1.34–1.46) were risk factors of WRIDs. Urban residence showing lower likelihood of WRIDs (AOR 0.66; 95% CI 0.63–0.69) than rural counterparts. WRD exposure substantially increases WRID vulnerability. Strengthening climate-resilient WASH systems and integrating disaster-sensitive health strategies into geriatric care are essential to mitigate disease risks and advance progress toward SDG 3 targets.