Wealth disparity and frailty among community-dwelling older adults in India

Abstract

Background Due to the vast socioeconomic diversity among its residents, studying health inequality in India is of particular interest. This study aimed to investigate the wealth-based inequalities in physical frailty and to quantify the contributions of potential predictors of frailty to this inequality. Methods Data were drawn from the first wave of the Longitudinal Ageing Study in India (LASI) conducted during 2017–18. Logistic regression analysis was used to examine the association between wealth status and frailty. We used the concentration index to measure the magnitude of wealth-related inequality in frailty. A decomposition analysis based on the logit model was used to assess the contribution of each predictor to the total inequality. Results The prevalence of physical frailty was significantly higher among the older adults in the poor group than in the non-poor group [Difference (poor vs. non-poor): 6.4%; p < 0.001]. Regression results indicated that older adults in the poorest group were 23% more likely to be physically frail than those in the richest category [Adjusted odds ratio (AOR) = 1.23; 95% confidence interval (CI): 1.11, 1.38]. The overall concentration index of frailty was 0.058 among the older adults, indicating that frailty is more concentrated among older adults with poor wealth status. Body mass index, wealth index, educational status, and region were the major and significant contributors to the socioeconomic status (SES) related inequalities in frailty. Conclusions Results suggest the need for formulating effective prevention and intervention strategies to decelerate the development of physical frailty among older adults in India, especially those with poor socioeconomic background.

Long-term inequalities in health among older Mexican adults: An outcome-wide analysis

“…Research has recently been carried out on trends associated with health inequalities, although most have been conducted in high-income countries in the northern hemisphere ( Katikireddi et al, 2020 ; Saravanakumar et al, 2022 ; Tsimbos, 2010 ). It has been consistently observed that wealth is strongly associated with mortality throughout adult life ( Katikireddi et al, 2020 ; Makaroun et al, 2017 ), although some studies suggest that this association tends to attenuate in old age ( Huisman, 2004 ; Reques et al, 2015 ).…”

“…For instance, a recent study examined the magnitude of oral health inequalities among older people using longitudinal data from Japan and Singapore, reporting that oral health inequalities increased over time in both countries, but mainly in Singapore ( Kiuchi et al, 2023 ). Nevertheless, studies on health inequalities with older adults have been primarily cross-sectional, and the results have shown that frailty, depression, functional limitations, chronic conditions, falls, low muscle mass, and cognitive impairment are concentrated in older people with a disadvantaged socioeconomic level ( Azizabadi et al, 2022 ; Katikireddi et al, 2020 ; Makaroun et al, 2017 ; Salinas-Rodríguez et al, 2019 ; Saravanakumar et al, 2022 ; Shang & Wei, 2023 ; Sharma & Pradhan, 2023 ; Tsimbos, 2010 ).…”

Gender differences in the association between physical frailty and life satisfaction among older adults in India

“…Frailty is associated with escalated health care costs, 4 driven by an inflated risk for acute illness, falls, injuries, disability, hospitalisation, institutionalisation, and mortality 5 . As such, physical frailty is a serious public health issue worldwide and particularly so in India given that the prevalence of frailty among Indians is significantly higher relative to their counterparts in other low and middle‐income countries (LMICs) 6–9 . Nonetheless, we are yet to ascertain the relevance of physical frailty for life satisfaction among older Indians and whether this association varies for men and women.…”