Abstract
The association of physical frailty and psycho-social health is well established. However, it appears no study on the interaction of these conditions in determining the Health-related Quality of Life (HRQoL) has yet been attempted in India. Hence, present study aims to investigate the interaction effects of physical frailty and psycho-social health in determining the HRQoL. A cross-sectional survey was conducted on 500 community-dwelling rural older adults from West Bengal, India. The modified Fried’s Frailty instrument was assessed physical frailty status. Psycho-social characteristics investigated were depression, anxiety and stress using the 21-item DASS instrument, loneliness using the UCLA Loneliness instrument, and cognitive function using the Mini-Mental State Examination instrument. HRQoL was assessed by the 36-items Short Form health survey questionnaire. Overall prevalence of frail, pre-frail and non-frail was 26.2%, 60.2%, and 13.6%, respectively. One-way ANOVA highlighted that mean scores of psycho-social traits are significantly differed among different physical frailty status groups (p < 0.01). All the participants were clustered with their psycho-social characteristics instrument scores as clustering variables using Hierarchical Cluster Analysis to understand psycho-social health of the participants. Two-way ANCOVA showed significant interaction of physical frailty status (frail, pre-frail and non-frail) and empirically occurring clusters of psycho-social health (low, moderate and good) in determining the overall HRQoL [F(8,491) = 8.904,p < 0.01]. Thus, the study findings suggest that consideration of physical frailty and psycho-social health status will be a prudent approach for a better diagnosis of HRQoL and challenges related to the same.
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Ahmad, N. S., Hairi, N. N., Said, M. A., Kamaruzzaman, S. B., Choo, W. Y., Hairi, F., Othman, S., Ismail, N., Peramalah, D., Kandiben, S., Mohd Ali, Z., Ahmad, S. N., Razak, I. A., & Bulgiba, A. (2018). Prevalence, transitions and factors predicting transition between frailty states among rural community- dwelling older adults in Malaysia. PLoS ONE, 13(11), e0206445. https://doi.org/10.1371/journal.pone.0206445
Ailshire, J. A., & Crimmins, E. M. (2011). Psycho-social factors associated with longevity in the United States: Age differences between the old and oldest-old in the health and retirement study. Journal of Aging Research, 2011, 530534. https://doi.org/10.4061/2011/530534
Bansod, D. W., Phad, S., & Kundu, J. (2021). Elder Abuse and Its Implications on Health Status of the Elderly in India. Ageing Issues in India (pp. 361–380). Singapore: Springer. https://doi.org/10.1007/978-981-16-5827-3_21
Biritwum, R. B., Minicuci, N., Yawson, A. E., Theou, O., Mensah, G. P., Naidoo, N., & WHO Sage Collaboration. (2016). Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas, 91, 8–18. https://doi.org/10.1016/j.maturitas.2016.05.012
Butler, J., & Ciarrochi, J. (2007). Psychological acceptance and quality of life in the elderly. Quality of Life Research, 16(4), 607–615. https://doi.org/10.1007/s11136-006-9149-1
Chaudhary, M., & Arokiasamy, P. (2019). Patterns of Frailty and Quality of Life Among Older Adults: Comparative Analysis Using SAGE States of India. Journal of Population Ageing, 12(1), 1–23. https://doi.org/10.1007/s12062-017-9201-7
Chen, C. Y., Wu, S. C., Chen, L. J., & Lue, B. H. (2010). The prevalence of subjective frailty and factors associated with frailty in Taiwan. Archives of Gerontology and Geriatrics, 50, S43–S47. https://doi.org/10.1016/S0167-4943(10)70012-1
Crocker, T. F., Brown, L., Clegg, A., Farley, K., Franklin, M., & Young, J. (2019). Quality of life is substantially worse for community-dwelling older people living with frailty: Systematic review and meta- analysis. Quality of Life Research, 28(8), 2041–2056. https://doi.org/10.1007/s11136-019-02149-1
Dubey, A., Bhasin, S., Gupta, N., & Sharma, N. (2017). A Study of Elderly Living in Old Age Home and Within Family Set-up in Jammu. Studies on Home and Community Science, 5(2), 93–98. https://doi.org/10.1080/09737189.2011.11885333
Feroz, A. H., Islam, M. N., ten Klooster, P. M., Hasan, M., Rasker, J. J., & Haq, S. A. (2012). The Bengali Short Form-36 was acceptable, reliable, and valid in patients with rheumatoid arthritis. Journal of Clinical Epidemiology, 65(11), 1227–1235. https://doi.org/10.1016/j.jclinepi.2012.05.004
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., & McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series a: Biological Sciences and Medical Sciences, 56(3), M146–M157. https://doi.org/10.1093/gerona/56.3.M146
Gobbens, R. J., & van Assen, M. A. (2014). The prediction of quality of life by physical, psychological and social components of frailty in community-dwelling older people. Quality of Life Research, 23(8), 2289–2300. https://doi.org/10.1007/s11136-014-0672-1
Herrera-Badilla, A., Navarrete-Reyes, A. P., Amieva, H., & Avila-Funes, J. A. (2015). Loneliness is associated with frailty in community-dwelling elderly adults. Journal of the American Geriatrics Society, 63(3), 607–609. https://doi.org/10.1111/jgs.13308
Kabir, Z. N., & Herlitz, A. (2000). The Bangla adaptation of Mini-Mental State Examination (BAMSE): An instrument to assess cognitive function in illiterate and literate individuals. International Journal of Geriatric Psychiatry, 15(5), 441–450. https://doi.org/10.1002/(SICI)1099-1166(200005)15:5%3c441::AID-GPS142%3e3.0.CO;2-O
Kashikar, Y., & Nagarkar, A. (2016). Prevalence and Determinants of Frailty in Older Adults in India. Indian Journal of Gerontology, 30(3), 364–381.
Kelaiditi, E., Cesari, M., Canevelli, M., Van Kan, G. A., Ousset, P. J., Gillette-Guyonnet, S., & Vellas, B. (2013). Cognitive frailty: Rational and definition from an (IANA/IAGG) international consensus group. The Journal of Nutrition, Health and Aging, 17(9), 726–734. https://doi.org/10.1007/s12603-013-0367-2
Lohman, M., Dumenci, L., & Mezuk, B. (2016). Depression and frailty in late life: Evidence for a common vulnerability. Journals of Gerontology Series b: Psychological Sciences and Social Sciences, 71(4), 630–640. https://doi.org/10.1093/geronb/gbu180
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U
Ma, L., Zhang, L., Sun, F., Li, Y., & Tang, Z. (2019). Cognitive function in Prefrail and frail community-dwelling older adults in China. BMC Geriatrics, 19(1), 1–7. https://doi.org/10.1186/s12877-019-1056-8
Maslow, A. H. (1999). Toward a Psychology of Being (3rd ed.). New York: John Wiley & Sons.
Mehrabi, F., & Béland, F. (2020). Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: A sco** review. Archives of Gerontology and Geriatrics, 90, 104119. https://doi.org/10.1016/j.archger.2020.104119
MHA. (2011). Census 2011. Govt of West Bengal & Census of India. Govt. of India. Ministry of Home Affairs. Office of the Registrar General & Census Commissioner, India. Retrieved July 20, 2021, from https://censusindia.gov.in/2011-common/censusdata2011.html
Mhaolain, A. M. N., Fan, C. W., Romero-Ortuno, R., Cogan, L., Cunningham, C., Kenny, R. A., & Lawlor, B. (2012). Frailty, depression, and anxiety in later life. International Psychogeriatrics, 24(8), 1265–1274. https://doi.org/10.1017/S1041610211002110
MoS&PI. (2016). Elderly in India. Central Statistics Office. Ministry of Statistics and Programme Implementation. Government of India. India. Retrieved June 1, 2022, from http://mospi.nic.in/sites/default/files/publication_reports/ElderlyinIndia_2016.pdf
Mumu, S. J., Ali, L., Barnett, A., & Merom, D. (2017). Validity of the global physical activity questionnaire (GPAQ) in Bangladesh. BMC Public Health, 17(1), 1–10. https://doi.org/10.1186/s12889-017-4666-0
Nemitz, J. (2022). Increasing longevity and life satisfaction: Is there a catch to living longer? Journal of Population Economics, 35(2), 557–589. https://doi.org/10.1007/s00148-021-00836-3
Prakash, I. J. (2021). Ageing India: Psychological Concerns and Responses. Gerontological Concerns and Responses in India (p. 26). Singapore: Springer. https://doi.org/10.1007/978-981-16-4764-2_4
Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472. https://doi.org/10.1037/0022-3514.39.3.472
Sagar, V., Paswan, D. K., Singh, S., & Kujur, A. (2021). Challenges in Treatment of Geriatric Patients in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand. IOSR Journal of Dental and Medical Sciences, 20(10), 33–38. https://doi.org/10.9790/0853-2010093338
Sembiah, S., Dasgupta, A., Taklikar, C. S., Paul, B., Bandyopadhyay, L., & Burman, J. (2020). Elder abuse and its predictors: A cross-sectional study in a rural area of West Bengal, eastern part of India. Psychogeriatrics, 20(5), 636–644. https://doi.org/10.1111/psyg.12550
Shalini, T., Chitra, P. S., Kumar, B. N., Madhavi, G., & Reddy, G. B. (2020). Frailty and Nutritional Status among Urban Older Adults in South India. Journal of Aging Research, 2020, 8763413. https://doi.org/10.1155/2020/8763413
Shimada, H., Lee, S., Bae, S., Tsutsumimoto, K., & Arai, H. (2019). Prevalence of psychological frailty in Japan: NCGG-SGS as a Japanese national cohort study. Journal of Clinical Medicine, 8(10), 1554. https://doi.org/10.3390/jcm8101554
Siriwardhana, D. D., Hardoon, S., Rait, G., Weerasinghe, M. C., & Walters, K. R. (2018). Prevalence of frailty and prefrailty among community-dwelling older adults in low- income and middle-income countries: A systematic review and meta-analysis. British Medical Journal Open, 8(3), e018195. https://doi.org/10.1136/bmjopen-2017-018195
Siriwardhana, D. D., Weerasinghe, M. C., Rait, G., Falcaro, M., Scholes, S., & Walters, K. R. (2019). Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: A population-based cross-sectional study. British Medical Journal Open, 9(1), e026314. https://doi.org/10.1136/bmjopen-2018-026314
Srivastava, S., & Muhammad, T. (2022). Socio-economic vulnerability and frailty among community-dwelling older adults: Cross-sectional findings from longitudinal aging study in India, 2017–18. BMC Geriatrics, 22(1), 1–11. https://doi.org/10.1186/s12877-022-02891-1
Thomas, M. B., James, K. S., & Sulaja, S. (2014). Does Living Longer Mean Living Healthier? Exploring Disability Free Life Expectancy in India. Indian Journal of Gerontology, 28(3), 321–347.
United Nations. (2013). World Population Aging 2013. Department of Economic and Social Affairs. United Nations publication. (ST/ESA/SER.A/348) Retrieved July 20, 2020, from https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2013.pdf
Vaingankar, J. A., Chong, S. A., Abdin, E., Picco, L., Chua, B. Y., Shafie, S., Ong, H. L., Chang, S., Seow, E., Heng, D., Chiam, P. C., & Subramaniam, M. (2017). Prevalence of frailty and its association with socio-demographic and clinical characteristics, and resource utilization in a population of Singaporean older adults. Geriatrics & Gerontology International, 17(10), 1444–1454. https://doi.org/10.1111/ggi.12891
Wani, R. T. (2019). Socio-economic Status Scales-Modified Kuppuswamy and Udai Pareekh’s Scale Updated for 2019. Journal of Family Medicine and Primary Care, 8(6), 1846. https://doi.org/10.4103/jfmpc.jfmpc_288_19
WHO. (2020). World health statistics 2020: Monitoring health for SDGs. Geneva: World Health Organization. Retrieved June 1, 2022, from https://www.who.int/data/gho/publications/world-health-statistics
Zhao, W., Zhang, Y., Liu, X., Yue, J., Hou, L., **a, X., & Ge, N. (2020). Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China health and aging trend study. Journal of Affective Disorders, 277, 970–976. https://doi.org/10.1016/j.jad.2020.08.070
Acknowledgements
We are gratefully acknowledging all of the participants for their generous cooperation. The authors are thankful to Dr Baidyanath Pal of the Indian Statistical Institute in Kolkata (India) for his valuable comments during data analyses. We thank ‘Itarai Asha Deep’ and Dr. Ketaki Das, Public Health Research Officer, West Bengal Voluntary Health Association for organising the fieldwork. We are indebted to the Indian Statistical Institute, Kolkata (India) for logistic support.
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The authors disclosed receipt of financial support from India's University Grants Commission [Award No. F.15–9(JULY 2016).2016(NET)] for this research.
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Das, S., Mukhopadhyay, S. & Mukhopadhyay, B. The Association between Physical Frailty and Psycho-Social Health in Determining Geriatric Health-Related Quality of Life in Rural West Bengal, India. Ageing Int 48, 984–998 (2023). https://doi.org/10.1007/s12126-022-09511-8
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DOI: https://doi.org/10.1007/s12126-022-09511-8