Overlap and Determinants of Sarcopenia and Frailty among Rural and Urban Community-Dwelling Older Adults in Doiwala Block, Dehradun, Uttarakhand: A Cross-Sectional Study

Background: Frailty and sarcopenia are two separate but closely related geriatric diseases that hasten death, institutionalization, and functional deterioration. There is a dearth of community-based comparison data between rural and urban older adults in sub-Himalayan regions, despite the impact being highlighted in worldwide literature. Material and Methods: A community-based cross-sectional study was conducted among 210 elderly adults selected via multistage random sampling with probability proportional to size (PPS). The Asian Working Group for Sarcopenia 2019 consensus was used to classify sarcopenia. Frailty was measured using the Tilburg Frailty Indicator (TFI; cutoff ≥ 6). The Mini Nutritional Assessment-Short Form (MNA-SF) was used to assess nutritional status, and Lawton's IADL scale and the Katz Index of ADL were used to assess functional impairment. Results: The overall prevalence of frailty was 62.8% (n=132), with no statistically significant difference between rural (65.7%) and urban (60.0%) areas (p=0.310). According to AWGS 2019 criteria, sarcopenia was present in 86.7% of the participants. Advanced stages were significantly more prevalent in rural settings (44.7% and 11.4%) compared to urban areas (29.5% and 7.6%). 58.1% (n=122) of the participants suffered from both conditions concurrently. Multivariable logistic regression revealed that living with family, polypharmacy, malnourishment/risk of malnutrition and IADL dependency were independently associated with frailty. Conclusions: Sarcopenia and frailty are highly prevalent and closelly linked among community-dwelling older adults in North India.