Abstract
Background
While extensive research exists on physical frailty, including in low- and middle-income countries like India, studies have yet to appraise whether perceived social standing is associated with physical frailty. As such, this study examines (1) the association between subjective social status (SSS) and physical frailty among older adults in India; and (2) whether this association is mediated and moderated by perceived discrimination and experiences of III-treatment.
Methods
Data came from the Longitudinal Aging Study in India with a sample of 31,464 older adults aged 60 and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression models along with Karlson–Holm–Breen (KHB) methodology were employed to examine the direct association, mediational pathways, and the interactions.
Results
The prevalence of frailty was 30.65% and those with lowest SSS reported higher prevalence of frailty (42.06%). After adjusting for several confounders, odds of frailty were lower among persons with high SSS relative to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. Moreover, the association between SSS and frailty was mediated and moderated by perceived discrimination and III-treatment.
Conclusions
Our findings underscore that when examining the association between socioeconomic status (SES) and physical frailty, it is important to consider SSS given that perceived social status likely reflects the less apparent psychosocial components associated with SES, and that perceived discrimination and III-treatment both mediate and moderate the association between SSS and physical frailty is critical to identifying those older Indians most susceptible to the functional health implications of lower SSS.
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Data availability
The study uses secondary data which is available at the Gateway to Global Aging Data (www.g2aging.org).
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Acknowledgements
The Longitudinal Aging Study in India Project is funded by the Ministry of Health and Family Welfare, Government of India, the National Institute on Aging (R01 AG042778, R01 AG030153), and United Nations Population Fund, India.
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Conceived and designed the research paper: MP and TM, analyzed the data: TM, Wrote the manuscript: MP, Refined the manuscript: MP and TM. Both the authors reviewed, read and approved the manuscript.
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Muhammad, T., Pai, M. Association between subjective social status and physical frailty in older adults in India: perceived discrimination and III-treatment as mediators and moderators. Aging Clin Exp Res 35, 2517–2530 (2023). https://doi.org/10.1007/s40520-023-02531-7
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DOI: https://doi.org/10.1007/s40520-023-02531-7