Associations between intrinsic capacity, functional difficulty, and fall outcomes among older adults in India

Abstract

The construct of intrinsic capacity (IC) in the context of integrated care for older adults emphasizes functional assessment from a holistic perspective. It provides reliable and comparable insights on subsequent functioning and disability. Given the paucity of research on IC and health outcomes in low- and middle-income countries (LMICs), the present study examined the association of IC with geriatric conditions of functional limitations and multiple fall outcomes among older adults in India. The data used for analysis come from the first wave of the Longitudinal Aging Study in India (LASI), 2017–2018. The final sample size contains 24,136 older adults (11,871 males and 12,265 females) age 60 years or above. Multivariable binary logistic regression is employed to examine the association of IC and other explanatory factors with outcome variables of difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL), falls, fall injury, and multiple falls. Of the total sample, 24.56% of older adults were observed to be in the high IC category. The prevalence of ADL difficulty, IADL difficulty, falls, multiple falls and fall-related injury is estimated to be 19.89%, 45.00%, 12.36%, 5.49% and 5.57%, respectively. Older adults who reported high IC had a significantly lower prevalence of ADL difficulty (12.26% vs 22.38%) and IADL difficulty (31.13% vs 49.52%) than those who reported low IC. Similarly, a lower prevalence of falls (9.42% vs 13.34%), fall-related injury (4.10% vs 6.06%) and multiple falls (3.46% vs 6.16%) were reported among those who had high IC. After adjusting for a large number of confounders such as age, sex, health-related attributes and lifestyle behaviors, older adults with high IC had significantly lower odds of ADL difficulty [aOR: 0.63, CI: 0.52–0.76], IADL difficulty [aOR: 0.71, CI: 0.60–0.83], falls [aOR: 0.80, CI: 0.67–0.96], multiple falls [aOR: 0.73, CI: 0.58–0.96] and fall-related injury [aOR: 0.78, CI: 0.61–0.99]. That a high IC was independently associated with a lower risk of functional difficulty and fall outcomes in later life is of enormous value in predicting subsequent functional care needs. More specifically, the findings here imply that because regular IC monitoring can predict poor health outcomes in older adults, improvements in IC should be prioritized while formulating disability and fall prevention strategies.

Chronic disease and multimorbidity in the Chinese older adults’ population and their impact on daily living ability: a cross-sectional study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

“…The negative impact of declining ADLs on older adults' mental health can potentially be mitigated by better social networks [ 33 ]; the presence of neighborhood resources in the community for older adults in China is an important protective factor for the mental health of older adults, and may reduce the effects of depressive conditions on declining ADLs. A fall in the elderly may result in a decline in physical, psychological, or social function, while a severe fall may result in impaired daily living abilities and even disability as a result of the fall [ 34 , 35 ]. ADLs and IADLs were negatively affected by falls in older adults in this study, which examined whether falls occurred in the past year.…”

The bidirectional relationship between activities of daily living and frailty during short-and long-term follow-up period among the middle-aged and older population: findings from the Chinese nationwide cohort study

“…A cross-sectional study of older adults residing in Brazilian communities in 2015–2016 found that the prevalence of IADL and BADL disabilities was 45.1 and 13.5%, respectively ( 26 ). A study conducted in India population aged ≥60 years revealed the prevalence of ADL and IADL were 19.89 and 45.00%, respectively ( 27 ). Other studies have described a prevalence rate of 48.5% for ADL disability among middle-aged and older individuals with chronic obstructive pulmonary disease (COPD) ( 28 ), the prevalence of IADL and BADL disability among cancer patients was reported as 54.6 and 36.7%, respectively ( 29 ).…”

Examining the rural–urban differentials in yoga and mindfulness practices among middle-aged and older adults in India: secondary analysis of a national representative survey

“…Studies have report that physical inactivity stimulates overweight, impairs bodily function, and increases the incidence of noncommunicable diseases (NCDs) 4 , 6 , 7 . Age-related factors affect changes in the sensorimotor and neuromuscular systems, thus negatively affecting performance in static and dynamic postural control even in healthy older adults, leading to an increased risk of falls 8 – 11 . Thus, evidence suggests, appropriate physical activity throughout life is the key requirement of healthy ageing and a predictor of reduced mortality 12 , 13 .…”