Frailty among middle-aged and older women and men in India: findings from Wave 1 of the Longitudinal Aging Study in India
File(s)
Published version
Author(s)
Ghosh, Arpita
Kundu, Monica
Jha, Vivekanand
Woodward, Mark
Type
Journal Article
Abstract
Objectives: Few studies have examined frailty in Indian adults, despite an increasing
population of older adults and an escalating burden of chronic diseases. We aimed to study
the prevalence and correlates of frailty in middle-aged and older Indian adults.
Setting: Cross-sectional data from Wave 1 of Longitudinal Ageing Study in India, conducted
in 2017-2018 across all states and union territories, were used.
Participants: The final analytical sample included 57,649 participants aged 45 years and
above who had information on frailty status.
Primary outcome measure: The deficits accumulation approach to measuring frailty was
employed, creating a frailty index between 0 and 1, based on 40 deficits. Individuals with a
frailty index of 0.25 or more were defined as ’frail’.
Results: Prevalence of frailty among 45-plus adults was 30%. 60-plus women were twice as
likely to be frail compared to 60-plus men, after adjusting for a wide range of
sociodemographic, economic and lifestyle factors. The sex difference was more pronounced
in 45-59-year-olds. Odds of hospitalization in the last 12 months, and having falls in the past
two years, were twice as high in frail adults compared to non-frail adults. Frail middle-aged
and older adults had 33% and 39% higher odds, respectively, of having poor cognition than
non-frail adults. The relative increase was higher in women for all three outcomes, although
not statistically significant.
Conclusions: There needs to be careful consideration of sex differences when addressing
frailty, particularly for optimizing frailty interventions. Frailty, although typically assessed in
older adults, was shown in this study to be also prevalent and associated with adverse
outcomes in middle-aged Indian adults. More research into assessment of frailty in younger
populations, its trajectory and correlates may help develop public health measures for
prevention of frailty.
population of older adults and an escalating burden of chronic diseases. We aimed to study
the prevalence and correlates of frailty in middle-aged and older Indian adults.
Setting: Cross-sectional data from Wave 1 of Longitudinal Ageing Study in India, conducted
in 2017-2018 across all states and union territories, were used.
Participants: The final analytical sample included 57,649 participants aged 45 years and
above who had information on frailty status.
Primary outcome measure: The deficits accumulation approach to measuring frailty was
employed, creating a frailty index between 0 and 1, based on 40 deficits. Individuals with a
frailty index of 0.25 or more were defined as ’frail’.
Results: Prevalence of frailty among 45-plus adults was 30%. 60-plus women were twice as
likely to be frail compared to 60-plus men, after adjusting for a wide range of
sociodemographic, economic and lifestyle factors. The sex difference was more pronounced
in 45-59-year-olds. Odds of hospitalization in the last 12 months, and having falls in the past
two years, were twice as high in frail adults compared to non-frail adults. Frail middle-aged
and older adults had 33% and 39% higher odds, respectively, of having poor cognition than
non-frail adults. The relative increase was higher in women for all three outcomes, although
not statistically significant.
Conclusions: There needs to be careful consideration of sex differences when addressing
frailty, particularly for optimizing frailty interventions. Frailty, although typically assessed in
older adults, was shown in this study to be also prevalent and associated with adverse
outcomes in middle-aged Indian adults. More research into assessment of frailty in younger
populations, its trajectory and correlates may help develop public health measures for
prevention of frailty.
Date Issued
2023-07-31
Date Acceptance
2023-07-11
Citation
BMJ Open, 2023, 13 (7), pp.1-12
ISSN
2044-6055
Publisher
BMJ Publishing Group
Start Page
1
End Page
12
Journal / Book Title
BMJ Open
Volume
13
Issue
7
Copyright Statement
© Author(s) (or their
employer(s)) 2023. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
employer(s)) 2023. Re-use
permitted under CC BY-NC. No
commercial re-use. See rights
and permissions. Published by
BMJ.
License URL
Identifier
https://bmjopen.bmj.com/content/13/7/e071842
Publication Status
Published
Article Number
e071842
Date Publish Online
2023-07-31