Early life factors associated with old age physical frailty: evidence from India

Background

Physical frailty is one of the most important phenotypes used to understand the vulnerable nature of older adults. The paper examined the association of childhood factors, including birth order, childhood socioeconomic status, and other exposures with old age physical frailty. The study further explored the gender dimensions of physical frailty prevalence.

Methods

Data from the Longitudinal Ageing Study in India (LASI, 2017-18), wave-1 were used. The sample size for the study was 24,513 older adults aged 60 years and above (12,510 females and 12,003 males). Physical frailty was assessed using the measurement approach proposed by Fried and colleagues.

Results

The results indicated significant gender difference in the prevalence of physical frailty with 39.03% of older women and 32.49% of men being frail. Older adults with lower levels of mothers’ (adjusted odds ratio (aOR): 1.26; 95% confidence interval (CI):1.01–1.58) or fathers’ education (aOR: 1.33; 95% CI:1.18–1.50) or poor childhood health status (aOR: 1.48; 95% CI:1.27–1.71) had higher odds of physical frailty. Compared to older women with a well-off childhood financial condition, women with average childhood financial status had 38% (aOR: 1.38, 95% CI:1.01-1.89) higher odds of reporting physical frailty. In contrast, older men with poor childhood financial status had lower odds (aOR: 0.73; 95% CI:0.56-0.96) of physical frailty than older men with well-off childhood financial status.

Conclusion

Early life disadvantages in health, financial condition and lack of parental education had significant positive associations with old age physical frailty. The findings suggest the importance of childhood factors in policy and practice in terms of addressing old age physical frailty.