Association of frailty with indoor air pollution among older adults and elderly population as per gender and age group: insights from Longitudinal Aging Study in India (LASI-1 Wave).

BACKGROUND

In recent years indoor air pollution (IAP) has emerged as a critical public health and environmental issue and to highlight the need for coordinated efforts to promote healthy aging and sustainable development, this study determined the association between frailty and IAP among male and female and among older adults (45-59 years) and elderly (≥ 60 years) population in India.

METHODS

This study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017-18, Wave-1). Bivariate analysis and logistic regression were conducted to show the association of frailty (outcome variable) with IAP (explanatory variable). Multivariable logistic regression was performed, adjusting for covariates as per three models. P value < 0.05 was considered statistically significant. STATA version 17 was used for analysis.

RESULTS

The results revealed that males have shown a significant association with all the explanatory variables (fuel type, 'pollution generating source', 'vulnerable ventilation', 'household indoor smoking', and 'IAP') as compared to females, except for the impact of poor ventilation. However, the study reported a higher prevalence of frailty among females. Several factors are significantly associated with frailty in individuals aged ≥ 60 years. Particularly use of unclean or solid fuels was linked to an 11% significant risk of frailty (Adjusted OR: 1.11, 95% CI: 1.03-1.19), while higher pollution-generating sources and exposure to IAP both contributed to an 11-12% higher risk of frailty (Adjusted OR: 1.11, 95% CI:1.03-1.19) and Adjusted OR:1.12,, 95% CI:1.05-1.19) respectively). Additionally, vulnerable ventilation remained a significant factor, with an 11% increased likelihood of frailty (Adjusted OR: 1.11, 95% CI: 1.03-1.20) in this older age group.

CONCLUSION

Hence, a holistic approach is required for reducing IAP. This can be done by improving household infrastructure, raising awareness about the existing government scheme, promoting early screening for frailty, and enforcing stronger policies. Treating existing government programs like 'Pradhan Mantri Ujjwala Yojna (PMUY)', 'Unnat Jyoti by Affordable LEDs for All (UJALA)', 'Pradhan Mantri Sahaj Bijli Har Ghar Yojana - Saubhagya', 'Pradhan Mantri Awas Yojana - Gramin (PMAY-G)', National Clean Air Program (NCAP), The National Tobacco Control Programme (NTCP) and the amended the 'Cigarettes and other Tobacco Products Act (COTPA), 2020 etc. as base and by addressing the gaps in accessibility and affordability and focusing on vulnerable populations, India can create wholesome living environments. Fostering long-term behavioural changes and implementing targeted interventions will lead the way for improved health and well-being for everyone.