Association of social factors with physical frailty in community dwelling older adults: a cross-sectional study in Northern India

Frailty is a multifaceted geriatric syndrome encompassing physical, social, cognitive, and psychological components, with social factors gaining prominence as critical determinants. Social isolation, lack of support, and reduced participation are linked to adverse outcomes like increased morbidity, premature mortality, and higher institutionalisation rates which lead to development of frailty in older adults. In the Indian context, changing familial dynamics, urbanisation, and migration are exacerbating the social vulnerabilities among older adults, contributing to the prevalence of physical frailty. This cross-sectional study, conducted from January 2021 to June 2022 in the Dehradun district of Northern India, examined the association between social factors and physical frailty among community-dwelling older adults. Using simple random sampling, two Gram Sabha villages from two blocks were selected, yielding 712 participants aged ≥ 60 years. Physical frailty was assessed using Fried Frailty Criteria, and social factors were evaluated through a 10-item questionnaire covering aspects like social isolation, emotional support, and financial independence. Data analysis included Chi-square tests and multivariate logistic regression to identify significant associations. The mean age of participants was 69.89 years, with 49.7% classified as frail and 46.6% as pre-frail. Frailty prevalence was significantly higher among women, widows, and individuals with low education levels. In the fully adjusted logistic regression model, older age was associated with greater odds of frailty (OR 1.08, 95% CI 1.05–1.11). Infrequent social participation (OR 2.63, 95% CI 1.65–4.19), lack of perceived usefulness (OR 2.56, 95% CI 1.60–4.08) and frequent boredom (OR 2.61, 95% CI 1.53–4.43) were independently associated with frailty. The fully adjusted model demonstrated good discrimination (AUC = 0.794). This study underscores the pivotal role of social determinants in influencing physical frailty among older adults. Addressing factors such as infrequent social participation, lack of perceived usefulness, frequent boredom can mitigate frailty risk. Tailored interventions focusing on enhancing social connectedness are essential to improve the quality of life for older adults and reduce healthcare burdens associated with frailty.