INTRODUCTION We characterized modifiable risk and protective factors for cognitive decline in India.METHODS Using the first nationally representative population-based longitudinal sample of N = 6168 older adults in India, we evaluated associations of risk factors (demographic characteristics, self-reported and objective health characteristics, health behaviors, and sensory function) for late-life cognitive decline with up to 6.4 years of follow-up (range: 2.8 to 6.4 years).RESULTS The mean rate of general cognitive decline was -0.029 SD per year and was progressively steeper with age. Most risk factors, particularly demographic and cardiovascular characteristics, were associated with steeper cognitive decline in expected directions: Associations of history of high cholesterol or heart attack on rate of cognitive decline, for example, were comparable to being 8 to 10 years older.DISCUSSION Most risk factors were associated with change in expected directions, highlighting the potential generalizability to India of previously identified risk factors for dementia.

BACKGROUND:Characterizing the correlates of adult mortality can lend insights into the factors associated with consequential health outcomes among older adults. In India, the importance of adult mortality has grown given trends in population aging, but prior research has been limited by a lack of high-quality longitudinal data. METHODS:We used new data from Waves 1 (2017-2019) and 2 (2022-2024) of the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) study (N = 3871) to evaluate associations between all-cause mortality and 27 socioeconomic and clinical factors using Cox proportional hazards models. We also evaluated gender differences and the impact of COVID-19. RESULTS:The estimated mortality rate was 6.0 (95% confidence intervals [95% CI]: 5.6-6.4) deaths per 100 person-years. A broad range of factors were associated with mortality, but cardiometabolic and cognitive phenotypes had some of the strongest -associations; those with dementia had a 2.84 (95% CI: 2.12-3.81) times greater risk of death than those with -normal -cognitive functioning. Associations with socioeconomic factors tended to be stronger for men than women (eg, wealth quintile; χ2  p = .046), whereas associations with clinical factors tended to be stronger for women than men (eg, diabetes; χ2  p = .033). We observed some evidence of excess mortality due to COVID-19. CONCLUSIONS:Findings emphasize the multifaceted nature of health among older adults in India and illustrate the need for solutions that recognize the importance of a wide range of social factors and clinical health conditions. Results also showcase the importance of dementia as a key factor associated with survival among older adults.

BACKGROUND:Low- and middle-income countries experience some of the highest fine particulate matter (PM2.5) exposures globally, with emissions from sources like residential combustion, industry, and transportation continuing to increase in many locations. While total PM2.5 has been linked to cognitive decline, little is known about the relative importance of PM2.5 from different emission sources, especially in low and middle-income settings. METHODS:We used cognitive performance data from the 2017-2019 and 2022-2024 waves of the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) and 5-year average PM2.5 concentrations of total mass and mass from 9 emission sources estimated at each participant's residential location using spatiotemporal models. We then quantified associations of these exposures with cognitive performance and decline using generalized estimating equation models accounting for survey weights and clustering, as well as adjusted for age, gender, individual and community-level socioeconomic status, urbanicity, place-related covariates, fuel type use, and co-pollutants. RESULTS:Among 5,699 participants (mean age: 70±8 years), we observed total PM2.5 concentrations ranging from 16 to 206 μg/m3. Higher concentrations of total PM2.5 were not associated with cognitive performance at baseline but were associated with faster declines over time (-0.012/year per SD, 95 % CI: -0.021, -0.004). Among PM2.5 from different sources, PM2.5 from energy production, industry, and residential combustion were associated with steeper cognitive declines over time, whereas PM2.5 from agriculture, transportation, wildfires, and windblown dust were associated with slower cognitive declines. CONCLUSION:Higher long-term total ambient PM2.5 concentrations and those from residential combustion sources were associated with accelerated cognitive declines. This suggests that intervention in residential sources might reduce or delay the onset of dementia and promote healthier aging in low and middle-income settings.

BACKGROUND:In India, studies of anaemia in older populations are lacking despite the adverse effect on cognitive function and dementia. The Longitudinal Ageing Study in India-Harmonized Diagnostic Assessment of Dementia (LASI-DAD) dataset contains detailed measures to allow better understanding of anaemia as a potential risk factor for dementia. METHOD:Linear regression was applied in the LASI-DAD cohort (n = 2758) between blood measures (including anaemia and haemoglobin concentration (g/dL)) with 11 cognitive tests. All models were adjusted for age and gender (full model includes rural location, education, smoking, region, BMI and population weights). The USA-based Health and Retirement Study (HRS) cohort (n = 5720) was used to replicate associations between blood and global cognition. RESULTS:In LASI-DAD, we showed an association between anaemia and poor memory (p-value = 0.0054). We found a positive association between haemoglobin concentration and ten cognitive tests (β = 0.041-0.071,p-value<0.05). The strongest association with haemoglobin was identified for memory-based tests (β = 0.061-0.071,p-value<0.005). Positive associations were shown between the general cognitive score and red blood count tests including mean corpuscular haemoglobin concentration (MCHC,β = 0.06,p-value = 0.0001) and red cell distribution width (RDW,β = -0.11,p-value<0.0001). In the HRS, associations were replicated between general cognitive score and other blood count tests (Red Blood Cell, MCHC, RDW, p-value<0.05). CONCLUSIONS:We have established in a South Asian population that low haemoglobin and anaemia are associated with low cognitive function, therefore indicating that anaemia could be an important modifiable risk factor for dementia. We have validated this result demonstrating both the variability of this risk factor cross-nationally and its generalizable association with cognitive outcomes.

It is predicted that low-and- middle-income countries like India will bear the maximum brunt of global aging in the near future. Aging societies are increasingly facing higher incidence of cognitive decline and dementia. Research on the potential of dietary patterns as a modifiable lifestyle factor for protection of cognitive health has gained momentum. This study aims at developing a dietary assessment tool-food frequency questionnaire (FFQ) for older Indian adults in the community. An FFQ was developed for the diverse, older population in India to collect data on their food intake over the past 12 months. This was pre and pilot tested leveraging the sample of an ongoing longitudinal study of late life cognition in older adults in India – Longitudinal Aging Study in India- Harmonized Diagnostic Assessment of Dementia (LASI-DAD). The FFQ was pilot tested during the first wave of the study (2017–2020) on a sample of 1125 respondents, updated and modified and finally implemented in the second wave of the study on 4465 respondents (2022–2024). An electronic Computer Assisted personal interview (CAPI) system with the use of tablets was implemented. The LASI-DAD FFQ was translated to 12 Indian languages for collecting accurate data from different regions of the country. A diverse range of food products and list of local food from different parts of India were included. The challenges faced, lessons learnt and modifications helped shape the final LASI-DAD FFQ. This was implemented in 24 Indian states. It had 4 sections: (A) Food consumption habits (B) Food frequency section (C) Herbal /non herbal/ayurvedic supplements (D) Spice intake. The final questionnaire had 88 food items and median time taken to complete was 31 min. Response rate varied from 97 to 100

Anemia among older adults aged ≥ 60 years is a well-described risk factor that increases the risk of falls, cardiovascular diseases, and mortality. In India, objectively measured national estimates of anemia prevalence and the causes of anemia among older adults are lacking. The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) collected venous blood samples from a nationally representative sample of 3,252 individuals in wave 2 of the study. Out of these, 3,009 samples were used to estimate national prevalence and regional differences in anemia prevalence and its underlying causes. Anemia was defined as hemoglobin < 13 mg/dl in males and < 12 mg/dl in females and further categorized into nutritional and non-nutritional anemia based on several nutritional (ferritin, Vitamin B12, and folate), inflammatory (ferritin, C-reactive protein), and renal (serum creatinine) biomarkers. The overall national anemia prevalence was 49.92

The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is a nationally representative in-depth study of cognitive aging and dementia. We present a publicly available dataset of harmonized cognitive measures of 4,096 adults 60 years of age and older in India, collected across 18 states and union territories. Blood samples were obtained to carry out whole blood and serum-based assays. Results are included in a venous blood specimen datafile that can be linked to the Harmonized LASI-DAD dataset. A global screening array of 960 LASI-DAD respondents is also publicly available for download, in addition to neuroimaging data on 137 LASI-DAD participants. Altogether, these datasets provide comprehensive information on older adults in India that allow researchers to further understand risk factors associated with cognitive impairment and dementia.

Background The coronavirus disease (COVID) pandemic caused disruption globally and was particularly distressing in low- and middle-income countries such as India. This study aimed to provide population representative estimates of COVID-related outcomes in India over time and characterize how COVID-related changes and impacts differ by key socioeconomic groups across the life course. Methods The sample was leveraged from an existing nationally representative study on cognition and dementia in India: Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD). The wave-1 of LASI-DAD enrolled 4096 older adults aged 60 years and older in 3316 households from 18 states and union territories of India. Out of the 3316 LASI-DAD households, 2704 with valid phone numbers were contacted and invited to participate in the Real-Time Insights COVID-19 in India (RTI COVID-India) study. RTI COVID-India was a bi-monthly phone survey that provided insight into the individual’s knowledge, attitudes, and behaviour towards COVID-19 and changes in the household’s economic and health conditions throughout the pandemic. The survey was started in May 2020 and 9 rounds of data have been collected. Findings till date Out of the 2704 LASI-DAD households with valid phone numbers, 1766 households participated in the RTI COVID-India survey at least once. Participants were in the age range of 18–102 years, 49% were female, 66% resided in rural area. Across all rounds, there was a higher report of infection among respondents aged 60–69 years. There was a greater prevalence of COVID-19 diagnosis reported in urban (23.0%) compared to rural areas (9.8%). Respondents with higher education had a greater prevalence of COVID-19 diagnosis compared to those with lower or no formal education. Highest prevalence of COVID-19 diagnosis was reported from high economic status compared to middle and low economic status households. Comparing education gradients in experiencing COVID-19 symptoms and being diagnosed, we observe an opposite pattern: respondents with no formal schooling reported the highest level of experiencing COVID-19 symptoms, whereas the greatest proportion of the respondents with secondary school or higher education reported being diagnosed with COVID-19. Future plans The study group will analyse the data collected showing the real-time changes throughout the pandemic and will make the data widely available for researchers to conduct further studies.

Background:In India, anemia is widely researched in children and women of reproductive age, however, studies in older populations are lacking. Given the adverse effect of anemia on cognitive function and dementia this older population group warrants further study. The Longitudinal Ageing Study in India - Harmonized Diagnostic Assessment of Dementia (LASI-DAD) dataset contains detailed measures to allow a better understanding of anaemia as a potential risk factor for dementia.Method:2,758 respondents from the LASI-DAD cohort, aged 60 or older, had a complete blood count measured from venous blood as well as cognitive function tests including episodic memory, executive function and verbal fluency. Linear regression was used to test the associations between blood measures (including anemia and hemoglobin concentration (g/dL)) with 11 cognitive domains. All models were adjusted for age and gender with the full model containing adjustments for rural location, years of education, smoking, region, BMI and population weights.Results from LASI-DAD were validated using the USA-based Health and Retirement Study (HRS) cohort (n=5720) to replicate associations between blood cell measures and global cognition.Results:In LASI-DAD, we showed an association between anemia and poor memory (p=0.0054). We found a positive association between hemoglobin concentration and ten cognitive domains tested (β=0.041-0.071, p<0.05). The strongest association with hemoglobin was identified for memory-based tests (immediate episodic, delayed episodic and broad domain memory, β=0.061-0.071, p<0.005). Positive associations were also shown between the general cognitive score and the other red blood count tests including mean corpuscular hemoglobin concentration (MCHC, β=0.06, p=0.0001) and red cell distribution width (RDW, β =-0.11, p<0.0001). In the HRS cohort, positive associations were replicated between general cognitive score and other blood count tests (Red Blood Cell, MCHC and RDW, p<0.05).Conclusion:We have established in a large South Asian population that low hemoglobin and anaemia are associated with low cognitive function, therefore indicating that anaemia could be an important modifiable risk factor. We have validated this result in an external cohort demonstrating both the variability of this risk factor cross-nationally and its generalizable association with cognitive outcomes.

Anemia is a condition characterised by low haemoglobin concentration, which is common in elderly populations. In India, anemia is widely researched in childhood development and women of reproductive age, although studies in older populations are lacking. The Longitudinal Ageing Study India - Diagnosis of Dementia (LASI-DAD) dataset is an ideal cohort to better understand the potential impact of anaemia and changes in blood haemoglobin and cognition in an elderly dataset. 2,758 respondents from the LASI-DAD cohort, aged 60 or older, had venous blood samples taken for complete blood count and harmonised cognitive function tests. Haemoglobin concentration was used as the exposure in the linear regression models. Cognition data from in-depth cognitive tests and informant interviews used the Harmonized Cognitive Assessment Protocol (HCAP). A summary value for each of the 11 tests was used as the outcome. We corrected for age and gender in the basic model with the full model also containing adjustments for rural location, smoking and BMI. Cases of anemia are more common in older and rural participants in the Indian population. We found a positive association between haemoglobin concentration and all the harmonised cognitive test measures except the visuospatial measures (b = 0.038 - 0.072 p < 0.05). The strongest association was identified for memory-based measures (immediate episodic, delayed episodic and recognition, b = 0.045 - 0.072 p < 0.05). This was supported by an association between the general cognitive score and the other red blood count tests including the derived measure mean corpuscular haemoglobin concentration (b = 0.06 p = 0.0001) and Red Cell Distribution Width (b = -0.11 p < 0.0001). We have established for the first time in a large South Asian population that anaemia may be an important potentially modifiable risk factor for low cognitive function. As the LASI-DAD cohort expands to include new timepoints it will be possible to run longitudinal analysis to examine the causal relationship between these measures.

ObjectivesSince the onset of the COVID-19 pandemic, behavioural interventions to reduce disease transmission have been central to public health policy worldwide. Sustaining individual protective behaviour is especially important in low-income and middle-income settings, where health systems have fewer resources and access to vaccination is limited. This study seeks to assess time trends in COVID-19 protective behaviour in India.DesignNationally representative, panel-based, longitudinal study.SettingWe conducted a panel survey of Indian households to understand how the adoption of COVID-19 protective behaviours has changed over time. Our data span peaks and valleys of disease transmission over May–December 2020.ParticipantsRespondents included 3719 adults from 1766 Indian households enrolled in the Harmonised Diagnostic Assessment of Dementia for the Longitudinal Ageing Study in India.AnalysisWe used ordinary least squares regression analysis to quantify time trends in protective behaviours.ResultsWe find a 30.6 percentage point (95% CI (26.7 to 34.5); p<0.01) decline in protective behaviours related to social distancing over the observation period. Mask wearing and handwashing, in contrast, decreased by only 4.3 percentage points (95% CI (0.97 to 7.6); p<0.05) from a high base. Our conclusions are unchanged after adjusting for recorded COVID-19 caseload and nationwide COVID-19 containment policy; we also observe significant declines across socioeconomic strata spanning age, gender, education and urbanicity.ConclusionWe argue that these changes reflect, at least in part, ‘COVID-19 fatigue,’ where adherence to social distancing becomes more difficult over time irrespective of the surrounding disease environment.

Introduction: Due to population aging, India is poised to experience a large increase in the burden of both dementia and vision impairment (VI). Prior studies from other settings suggest that VI may be a modifiable risk factor for cognitive decline and dementia. However, to date, no studies have examined the association of impaired visual acuity and cognition in India. Methods: A total of 3,784 participants in wave 1 of the population-based Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India underwent visual acuity testing and a cognitive test battery. Multivariable linear regression was used to model the cross-sectional associations of mild (<6/12-6/16), moderate (<6/18-6/60), and severe visual acuity impairment/blindness (<6/60) with cognitive performance scores corresponding to total cognition, orientation, memory, language/fluency, executive function, and informant-reported cognitive status. Models were adjusted for demographic, socioeconomic, and health characteristics. Results: The weighted percentage of participants with any VI was 52.6%. VI was independently associated with lower cognitive scores across all domains, even after adjustment for known dementia risk factors. In fully adjusted models of total cognition (mean score: 130.7), mild, moderate, and severe VI/blindness were associated with a significant change of -3.5 (95% CI: -6.3, -0.6), -8.2 (95% CI -10.5, -5.6), and -16.8 (95% CI -22.3, -11.3) units, respectively. A dose-response association between level of VI and cognitive function was observed for all cognitive outcomes except for language/fluency domain scores. Associations were robust when cognitive tests dependent on visual function were excluded. Across each fully adjusted model of total, domain-specific, and informant-reported cognitive performance, moderate VI was equivalent to 5-9 years of cognitive aging. Discussion/Conclusion: This study illustrates that VI is cross-sectionally associated with lower cognitive performance, largely in a dose-response pattern, across various cognitive domains in the Indian population. These findings are important for informing future longitudinal and interventional studies.

BACKGROUND:The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is the first and only nationally representative study on late-life cognition and dementia in India (n=4096). LASI-DAD obtained clinical consensus diagnosis of dementia for a subsample of 2528 respondents.OBJECTIVE:This study develops a machine learning model that uses data from the clinical consensus diagnosis in LASI-DAD to support the classification of dementia status.METHODS:Clinicians were presented with the extensive data collected from LASI-DAD, including sociodemographic information and health history of respondents, results from the screening tests of cognitive status, and information obtained from informant interviews. Based on the Clinical Dementia Rating (CDR) and using an online platform, clinicians individually evaluated each case and then reached a consensus diagnosis. A 2-step procedure was implemented to train several candidate machine learning models, which were evaluated using a separate test set for predictive accuracy measurement, including the area under receiver operating curve (AUROC), accuracy, sensitivity, specificity, precision, F1 score, and kappa statistic. The ultimate model was selected based on overall agreement as measured by kappa. We further examined the overall accuracy and agreement with the final consensus diagnoses between the selected machine learning model and individual clinicians who participated in the clinical consensus diagnostic process. Finally, we applied the selected model to a subgroup of LASI-DAD participants for whom the clinical consensus diagnosis was not obtained to predict their dementia status.RESULTS:Among the 2528 individuals who received clinical consensus diagnosis, 192 (6.7% after adjusting for sampling weight) were diagnosed with dementia. All candidate machine learning models achieved outstanding discriminative ability, as indicated by AUROC >.90, and had similar accuracy and specificity (both around 0.95). The support vector machine model outperformed other models with the highest sensitivity (0.81), F1 score (0.72), and kappa (.70, indicating substantial agreement) and the second highest precision (0.65). As a result, the support vector machine was selected as the ultimate model. Further examination revealed that overall accuracy and agreement were similar between the selected model and individual clinicians. Application of the prediction model on 1568 individuals without clinical consensus diagnosis classified 127 individuals as living with dementia. After applying sampling weight, we can estimate the prevalence of dementia in the population as 7.4%.CONCLUSIONS:The selected machine learning model has outstanding discriminative ability and substantial agreement with a clinical consensus diagnosis of dementia. The model can serve as a computer model of the clinical knowledge and experience encoded in the clinical consensus diagnostic process and has many potential applications, including predicting missed dementia diagnoses and serving as a clinical decision support tool or virtual rater to assist diagnosis of dementia.

This User Guide provides basic information about the broad topic of physical functional health questions from the Harmonized Health and Retirement Study (HRS) and its sister harmonized surveys. These include: the US Health and Retirement Study (HRS), the Mexican Health & Aging Study (MHAS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Costa Rican Longevity and Health Aging Study (CRELES), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Irish Longitudinal Study on Ageing (TILDA), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). All of the surveys collected information on physical functional health, but varied in the spectrum and details of questions asked. We group the harmonized functional health measures into three categories: activities of daily living (ADLs), instrumental activities of daily living (IADLs), and other functional activities that are not in the purview of either ADLs or IADLs.

Abstract Longitudinal Aging Study in India is a nationally representative survey of the health, economic, and social wellbeing of the Indian population aged 45 and older. LASI-DAD is an in-depth study of late-life cognition and dementia, drawing a sub-sample of over 4,000 LASI respondents aged 60 or older. Respondents underwent a battery of cognitive tests, while their informants were interviewed about their cognitive and health conditions. A common set of cognitive tests was selected to enable international comparisons, and additional cognitive tests suitable for illiterate and innumerate populations were also selected. Rich data on risk factors of dementia were collected through health examinations, venous blood assays, and genotyping. The response rate was 82.9%, varying across sex, education, and urbanicity. LASI-DAD provides an opportunity to study late-life cognition and dementia and their risk factors in the older population in India and to gain further insights through cross-country analysis.

The Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India (LASI-DAD) is a population-representative, prospective cohort study of late-life cognition and dementia. It is part of an ongoing international research collaboration that aims to measure and understand cognitive impairment and dementia risk by collecting a set of cognitive and neuropsychological assessments and informant reports, referred to as the Harmonized Cognitive Assessment Protocol (HCAP). LASI-DAD provides nationally representative data drawn from a subsample of the ongoing Longitudinal Aging Study in India (LASI). One of LASI-DAD's distinctive features is its rich geriatric assessment, including the collection of venous blood samples and brain imaging data for a subsample of respondents. In this paper, we discuss the methodological considerations of developing and implementing the HCAP protocol in India. The lessons we learned from translating and applying the HCAP protocol in an environment where illiteracy and innumeracy are high will provide important insights to researchers interested in measuring and collecting data on late-life cognition and dementia in developing countries. We further developed an innovative blood management system that enables us to follow the collection, transportation, assay, and storage of samples. Such innovation can benefit other population surveys collecting biomarker data.

Abstract Vision impairment (VI) is associated with cognitive decline and dementia, however little research has been conducted in India. Using data from LASI-DAD, linear models tested the association of VI (better-seeing eye <20/60) with cognitive domains including orientation, learning/memory, language, attention, and total cognition. Models were adjusted for age, sex, geographic, and socioeconomic characteristics. VI was significantly associated with lower orientation (β=-0.47, p80% of VI in India is treatable, poor vision may represent a modifiable risk factor for cognitive decline and dementia.

OBJECTIVES:To introduce cost-effective expert clinical diagnoses of dementia into population-based research using an online platform and to demonstrate their validity against in-person clinical assessment and diagnosis.DESIGN:The online platform provides standardized data necessary for clinicians to rate participants on the Clinical Dementia Rating (CDR® ). Using this platform, clinicians diagnosed 60 patients at a range of CDR levels at two clinical sites. The online consensus diagnosis was compared with in-person clinical consensus diagnosis.SETTING:All India Institute of Medical Sciences (AIIMS), Delhi, and National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.PARTICIPANTS:Thirty patients each at AIIMS and NIMHANS with equal numbers of patients previously independently rated in person by experts as CDR is 0 (cognitively normal), CDR is 0.5 (mild cognitive impairment), and CDR is 1 or greater (dementia).MEASUREMENTS:Multiple clinicians independently rate each participant on each CDR domain using standardized data and expert clinical judgment. The overall summary CDR is calculated by algorithm. When there are discrepancies among clinician ratings, clinicians discuss the case through a virtual consensus conference and arrive at a consensus overall rating.RESULTS:Online clinical consensus diagnosis based on standardized interview data provides consistent clinical diagnosis with in-person clinical assessment and consensus diagnosis (κ coefficient = 0.76).CONCLUSION:A web-based clinical consensus platform built on the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India interview data is a cost-effective way to obtain reliable expert clinical judgments. A similar approach can be used for other epidemiological studies of dementia. J Am Geriatr Soc 68:S54-S59, 2020.

Background: International comparisons of disease prevalence have been useful in understanding what proportion of disease might be preventable and in informing potential policy interventions in different cultural and economic contexts. Using newly available, harmonized data from 20 countries, we compare disability and morbidity of older adults between the ages of 55 and 74. Methods: The Gateway to Global Aging Data, a data and information portal, provides access to easy-to-use individual-level longitudinal data from 10 surveys covering over 30 countries. Exploiting harmonized measures available from the Gateway, we descriptively examine how disability and morbidity differ across countries. Results: Significant cross-country differences are observed for several health indicators. Comparing countries with the highest and lowest prevalence rates, we observe that hypertension rates vary twofold and stroke rates vary threefold, while disability and arthritis rates vary more than fivefold. Among women, higher gross domestic product and life expectancy are related to lower diabetes, heart disease, and better functioning. Among men, national indicators of economic conditions are not significantly associated with reported disease prevalence. Conclusions: We document substantial heterogeneity in disability and morbidity across countries, separately for men and women and after controlling for population age composition and education. Rich data from various surveys across the world offers remarkable opportunities for cross-country analyses, calling for further investigation of what drives observed differences. The Gateway to Global Aging Data provides easy-to-use harmonized data files and tools to facilitate this type of research.