Functional limitation and cardiometabolic health: a cross-sectional exploration in adults aged 30 and older in rural Punjab, India

We investigated the distribution of cardiometabolic health outcomes in people with and without functional limitation in rural India. In a cross-sectional, population-based sample of 3,023 adults aged ≥ 30 years in a rural setting in Punjab, India, functional limitation was classified using the Barthel Index. Cardiometabolic health measures included objectively measured obesity, hypertension, and diabetes status, as well as health behaviors and psychosocial factors that relate to cardiometabolic health. We compared the prevalence of each cardiometabolic health measure by functional limitation status. The prevalence of functional limitation was 2.71% (females 3.06%, males 2.30%). The prevalence of hypertension (70.7% vs. 54.5%) and diabetes (29.3% vs. 12.3%) was higher in people with functional limitation (PWFL) compared with people without functional limitation (PWoFL), but no differences existed after age- and sex-adjustment. Age and sex-adjusted prevalence differences (aPDs) in health indicators between PWFL and PWoFL showed that achieving ≥ 150 min/week physical activity was lower among PWFL (aPD=-13.5%; 95% CI: -25.9, -1.0), while sitting for > 3 h/day was higher (aPD = 35.0%; 95% CI: 26.2, 43.7). PWFL also had higher difficulty in doing daily work (aPD = 15.9%; 95% CI: 3.5, 28.3), higher hospitalization in the past year (aPD = 19.7%; 95% CI: 9.0, 30.5), more depressive symptoms (mean difference = 1.8; 95% CI: 1.0, 2.5), and lower self-rated health [range:0-100] (mean difference=-15.0; 95% CI: −18.8, − 11.2). Roughly 3% of adults reported functional limitation. PWFL reported worse cardiometabolic health behaviors and self-rated health. Given the limited data on functional limitation in rural India, these findings offer a starting point for tailored screening and interventions to improve health and well-being in this population.