The Prevalence of Frailty and Associated Factors, Including Food Security in Community Dwelling Older Adults with Multimorbidity: A Cross-Sectional Analysis from the Longitudinal Aging Study in India.
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Abstract
Background: The global increase in multimorbidity among older adults is a result of ongoing epidemiological and demographic transitions. This study focuses on the prevalence and determinants of frailty in this demographic in India, accounting for the potential mediating role of food insecurity.
Objectives: To determine the prevalence and determinants of frailty among older Indian adults with multimorbidity, and to ascertain the mediating effect of food insecurity on frailty.
Design: Cross-sectional analysis of cohort study data.
Setting: Analysis of data from the Longitudinal Aging Study in India (LASI) Wave 1 (2017-2018).
Participants: 31,902 individuals aged 60 and above of whom 7900 were categorized as having multimorbidity.
Measurements: Frailty was assessed using a modified Fried scale. Details on sociodemographic factors, lifestyle choices, and health-related variables were collected through face-to-face participant interviews. Multimorbidity was defined as the presence of two or more chronic conditions such as hypertension, diabetes, cancer, chronic lung disease, chronic heart disease, stroke, bone disease, neurological or psychiatric problems, and high cholesterol. Statistical analysis was conducted using Stata 15.1.
Results: The weighted prevalence of frailty in individuals with multimorbidity was 30.31% (95% CI: 28.17, 32.54), significantly higher than those without multimorbidity (23.81%, 95% CI: 22.90, 24.74) (P<0.001). Frailty prevalence was higher in women (33.27%) than in men (26.56%) among those with multimorbidity. In the group with multimorbidity, age ≥75 (years), middle MPCE quintile, lower educational attainment, unemployment, and low body mass index was associated with higher odds of frailty. Mediation analysis showed that 3.47% of the association between multimorbidity and frailty was mediated by food insecurity.
Conclusion: Frailty is prevalent among older adults with multimorbidity in India, with significant disparities based on gender, age, socioeconomic status, and body mass index. Food insecurity partially mediates the relationship between multimorbidity and frailty, highlighting the need for targeted interventions addressing both health and nutritional insecurities in this population.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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