2020BMJ OpenOpen access

Association between frailty and disability among rural community-dwelling older adults in Sri Lanka: a cross-sectional study

Dhammika Deepani Siriwardhana, Manuj C. Weerasinghe, Greta Rait, Shaun Scholes, Kate Walters

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Abstract

OBJECTIVE: We examined the association between frailty and disability in rural community-dwelling older adults in Kegalle district of Sri Lanka. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 746 community-dwelling adults aged ≥60 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Frailty was assessed using the Fried phenotype. Disability was operationalised in terms of having one or more activity limitation/s in instrumental activities of daily living (IADL) and basic activities of daily living (BADL). RESULTS: The median age of the sample was (median 68; IQR 64-75) years and 56.7% were female. 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 IADL limitations was high, 84.4% among frail adults. 38.7% of frail adults reported ≥1 BADL limitations. Over half of frail older adults (58.3%) reported both ≥1 physical and cognitive IADL limitations. Being frail decreased the odds of having no IADL limitations, and was associated with a higher count of IADL limitations. No significant association was found between prefrailty and number of IADL limitations. CONCLUSIONS: The prevalence of ≥1 IADL limitations was high among rural community-dwelling frail older adults. Findings imply the greater support and care required for rural Sri Lankan frail older adults to live independently in the community.

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OBJECTIVE: We examined the association between frailty and disability in rural community-dwelling older adults in Kegalle district of Sri Lanka. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 746 community-dwelling adults aged ≥60 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Frailty was assessed using the Fried phenotype. Disability was operationalised in terms of having one or more activity limitation/s in instrumental activities of daily living (IADL) and basic activities of daily living (BADL). RESULTS: The median age of the sample was (median 68; IQR 64-75) years and 56.7% were female. 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 IADL limitations was high, 84.4% among frail adults. 38.7% of frail adults reported ≥1 BADL limitations. Over half of frail older adults (58.3%) reported both ≥1 physical and cognitive IADL limitations. Being frail decreased the odds of having no IADL limitations, and was associated with a higher count of IADL limitations. No significant association was found between prefrailty and number of IADL limitations. CONCLUSIONS: The prevalence of ≥1 IADL limitations was high among rural community-dwelling frail older adults. Findings imply the greater support and care required for rural Sri Lankan frail older adults to live independently in the community.

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Available abstract

OBJECTIVE: We examined the association between frailty and disability in rural community-dwelling older adults in Kegalle district of Sri Lanka. DESIGN: A population-based cross-sectional study. PARTICIPANTS: A total of 746 community-dwelling adults aged ≥60 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Frailty was assessed using the Fried phenotype. Disability was operationalised in terms of having one or more activity limitation/s in instrumental activities of daily living (IADL) and basic activities of daily living (BADL). RESULTS: The median age of the sample was (median 68; IQR 64-75) years and 56.7% were female. 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 IADL limitations was high, 84.4% among frail adults. 38.7% of frail adults reported ≥1 BADL limitations. Over half of frail older adults (58.3%) reported both ≥1 physical and cognitive IADL limitations. Being frail decreased the odds of having no IADL limitations, and was associated with a higher count of IADL limitations. No significant association was found between prefrailty and number of IADL limitations. CONCLUSIONS: The prevalence of ≥1 IADL limitations was high among rural community-dwelling frail older adults. Findings imply the greater support and care required for rural Sri Lankan frail older adults to live independently in the community.

Key concepts: Activities of daily living, Medicine, Gerontology, Cross-sectional study, Odds, Odds ratio, Geriatrics, Population

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Association between frailty and disability among rural community-dwelling older adults in Sri Lanka: a cross-sectional study — Research Paper | ScholarLens