International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
BMC Geriatr. 2022 Mar 14;22(1):201. doi: 10.1186/s12877-022-02891-1.
The Indian population is rapidly aging with huge proportion of illiterate and socioeconomically disadvantaged people and there is a dearth of research on the relationships between factors of socioeconomic vulnerability and frailty in older people. The present study examined the cross-sectional associations between socioeconomic vulnerability and physical frailty in community-dwelling older individuals in India.
The data for the study were obtained from the Longitudinal Aging Study in India (LASI), which was conducted in 2017-18. The effective sample size was 14,652 older males and 15,899 older females aged 60 and over. The outcome variable was physical frailty phenotype measured from exhaustion, unintentional weight loss, weak grip strength, low physical activity, and slow walking time. The main explanatory variable was vulnerability status based on education, wealth and caste. The study carried out bivariate analysis to observe the association between vulnerability status and physical frailty. Further, multivariable binary logistic regression analysis was conducted to fulfil the objective of the study.
A proportion of 10.5 and 14.4% of older males and females respectively were in the overall vulnerable category. The prevalence of physical frailty was high among older males from vulnerable population (31.4% vs 26.9%; p < 0.001). The adjusted estimates from multivariate analysis revealed that older adults from vulnerable category had 14% significantly higher odds of being frail in comparison to non-vulnerable category [AOR: 1.14; CI: 1.06,1.24]. The adjusted model further revealed that there were no significant gender differentials in physical frailty among older adults. Model-3 (adjusted model) revealed that older males and females from vulnerable population had 18% [AOR: 1.18; CI: 1.04,1.34] and 8% [AOR: 1.08; CI: 1.01,1.21] significantly higher odds of being physically frail in comparison to older males from non-vulnerable population respectively.
Adverse socioeconomic circumstances such as low education, lower wealth and caste status that are associated with increased prevalence of physical frailty raise urgent questions both for public health practitioners and clinicians. The current findings may help to adapt public policies focusing on screening physical frailty in the clinical settings, especially among vulnerable populations as a marker of a possibly reversible vulnerability to adverse outcomes in old age.
印度人口迅速老龄化，文盲和社会经济弱势群体的比例巨大，关于社会经济脆弱因素与老年人虚弱之间关系的研究很少。本研究探讨了印度社区居住的老年人中社会经济脆弱性与身体虚弱之间的横断面关联。
本研究的数据来自于 2017-18 年进行的印度纵向老龄化研究（LASI）。有效样本量为 14652 名 60 岁及以上的老年男性和 15899 名老年女性。结局变量为通过疲惫、非计划性体重减轻、握力弱、体力活动少和行走速度慢测量的身体虚弱表型。主要解释变量是基于教育、财富和种姓的脆弱状态。本研究进行了单变量分析，以观察脆弱状态与身体虚弱之间的关系。此外，还进行了多变量二元逻辑回归分析，以实现研究目标。
分别有 10.5%和 14.4%的老年男性和女性属于整体脆弱人群。在脆弱人群中，老年男性身体虚弱的患病率较高（31.4%对 26.9%；p<0.001）。多变量分析的调整估计显示，与非脆弱人群相比，脆弱人群的老年成年人身体虚弱的可能性高 14%[优势比（AOR）：1.14；95%置信区间（CI）：1.06，1.24]。调整后的模型进一步显示，老年人身体虚弱在两性之间没有显著差异。模型 3（调整模型）显示，脆弱人群中的老年男性和女性与非脆弱人群中的老年男性相比，身体虚弱的可能性分别高 18%（AOR：1.18；95%CI：1.04，1.34）和 8%（AOR：1.08；95%CI：1.01，1.21）。
与身体虚弱的患病率增加相关的不利社会经济环境，如教育程度低、财富和种姓地位低，这引发了公共卫生从业者和临床医生的紧迫问题。目前的研究结果可能有助于制定公共政策，重点关注在临床环境中筛查身体虚弱，特别是在脆弱人群中，作为老年不良后果可能逆转的脆弱性的标志物。
