Multidimensional Characteristics Associated with Functional Independence in the Oldest Old: A Cross-sectional Study from a Tertiary Geriatric Center in North India

Background: Functional independence (FI) in adults aged ≥80 years is influenced by physical, cognitive, nutritional, and psychosocial factors. However, evidence from low- and middle-income countries, particularly India, remains limited for the oldest old. This study aimed to examine multidimensional characteristics associated with FI among adults aged ≥80 years attending a geriatric outpatient clinic in northern India. Materials and Methods: We conducted a cross-sectional study with an exploratory analytical approach over 3 months (March–May 2024) among 40 adults aged ≥80 years attending a tertiary geriatric outpatient clinic. Functional status was classified using the Lawton Instrumental Activities of Daily Living Scale. Participants underwent multidimensional assessment, including physical performance (grip strength, Short Physical Performance Battery [SPPB]), cognition (Mini-Mental State Examination/Hindi Mental State Examination), nutritional status (MiniNutritional Assessment–Short Form [MNA-SF]), psychosocial factors, and geriatric syndromes. Between-group comparisons were performed using bivariate statistical tests. Results: The mean age was 84.1 years and 67.5% were male. Compared with independent individuals, dependent participants had lower grip strength (median 17.3 vs. 28.6 kg; P < 0.001) and SPPB scores (median 4 vs. 9.5; P < 0.001). Nutritional status (MNA-SF difference ~3.5 points; P < 0.001) and cognitive scores (difference ~ 5 points; P = 0.009) were lower in the dependent group. Depressive symptoms, loneliness, social isolation, and geriatric syndromes – including sarcopenia risk, frailty, and urinary incontinence – were more frequent among dependent participants. Conclusions: In this exploratory cross-sectional study, FI in the oldest old differed across multiple domains. These findings represent unadjusted associations, do not imply independent predictors, and highlight multidimensional vulnerability, generating hypotheses for future longitudinal studies.