Dataset Information

The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India.

ABSTRACT:

Objective

To estimate frailty prevalence and its relationship with the socio-economic and regional factors and health care outcomes.

Methods

In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) were included. The frailty index (FI) was calculated using a 32-variable deficit model, with a value of ≥ 25% considered as frail. Data on demographic (including caste and religion) and socioeconomic profiles and health care utilization were obtained. The state-wise health index maintained by the government based on various health-related parameters was used to group the participants' residential states into high-, intermediate-, and low-performing states. Multivariable and zero-inflated negative binomial regression was used to assess the relationship of frailty index with sociodemographic characteristics, health index, and health care expenditure or hospitalization.

Results

Among the 3953 eligible participants, the prevalence of frailty was 42.34% (men = 34.99% and women = 49.35%). Compared to high-performing states, intermediate- and low-performing states had a higher proportion of frail individuals (49.7% vs. 46.8% vs. 34.5%, P < 0.001). In the adjusted analysis, frailty was positively associated with age, female sex, rural locality, lower education level, and caste (scheduled caste and other backward classes). After adjusting for the socio-economic profile, FI was inversely associated with the composite health index of a state (P < 0.001). FI was also significantly correlated with total 1-year health care expenditure and hospitalization (P < 0.001 and 0.020, respectively).

Conclusion

There is a high prevalence of frailty among older Indian adults that is associated with sociodemographic factors and regional health care performance. Furthermore, frailty is associated with increased health care utilization and expenditure.

SUBMITTER: Singhal S

PROVIDER: S-EPMC10498834 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India.

Singhal Sunny S Singh Sumitabh S Dewangan Gevesh Chand GC Dey Sharmistha S Banerjee Joyita J Lee Jinkook J Upadhyaya Ashish Datt AD Hu Peifeng P Dey Aparajit Ballav AB

Aging medicine (Milton (N.S.W)) 20230807 3

<h4>Objective</h4>To estimate frailty prevalence and its relationship with the socio-economic and regional factors and health care outcomes.<h4>Methods</h4>In this study, participants from the harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) were included. The frailty index (FI) was calculated using a 32-variable deficit model, with a value of ≥ 25% considered as frail. Data on demographic (including caste and religion) and socioeconomic profiles ...[more]

PMID: 37711262

Similar Datasets

Project description:Background & objectives Frailty is a geriatric syndrome with clinical and public health implications. It represents the state of increased vulnerability. This study aimed to estimate the prevalence of frailty and pre-frailty by demographic characteristics and geographical regions in India. Furthermore, it also aimed to examine the association of this prevalence with selected health outcomes using data from the Longitudinal Ageing Study of India (LASI). Methods This is a secondary analysis of LASI wave-1 data. A total of 26,058 respondents aged ≥60 yr were included for analysis. Frailty was assessed using Fried's frailty phenotype, including slowness, shrinking, low physical activity, weakness, and low endurance. Descriptive statistics were used to study frailty distribution. The odds ratio (OR) of health events across the frailty categories was computed using ordinal logistic regression. Results The findings of this study suggest that the prevalence of frailty and pre-frailty was 29.2 and 58.8 per cent, respectively. The prevalence of frailty was higher among women (37.3%), illiterate (37%) and rural residents (31%). It ranged between 14.5 per cent in Uttarakhand and 41.3 per cent in Arunachal Pradesh. Frailty was strongly associated with depression [OR: 2.09, Confidence Interval (CI): 1.98-2.21] and activities of daily living (ADL) difficulty (OR: 1.75, CI: 1.64-1.86). Higher odds were reported for fracture (OR: 1.24, CI: 1.01-1.51) and multimorbidity (OR: 1.18, CI: 1.04-1.33) among frailty. Interpretation & conclusions The heterogeneity of frailty prevalence across States indicates the need for population-specific strategies. A sharp age-related increase in prevalence highlights the need for preventive measures. Furthermore, the high prevalence of frailty among women, illiterate and rural residents indicates the target population for receiving preventive interventions. Lastly, a heterogeneity in frailty prevalence across different States indicates the scope for region-specific programmes.

Project description:INTRODUCTION:The main strategy for decreasing maternal morbidity and mortality has been antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and the fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote a healthy lifestyle. This study aims to analyze interregional disparities in ≥4 ANC visits during pregnancy in Indonesia. METHODS:Data was acquired from the 2017 Indonesian Demographic and Health Survey (IDHS). The unit of analysis was women aged 15-49 years old, and a sample of 15,351 women was obtained. In addition to ANC as the dependent variable, the other variables analyzed in this study were a place of residence, age, husband/partner, education, parity, wealth status, and health insurance. For the final analysis, binary logistic regression was used to determine disparity. RESULTS:With the Papua region as a reference, all regions showed a gap except for the Maluku region, which was not significantly different in the use of ANC compared to the Papua region. Women in the Nusa Tenggara have 4.365 times the chance of making ≥4 ANC visits compared to those in the Papua region (95% CI 3.229-5.899). Women in Java-Bali have 3.607 times the chance of making ≥4 ANC visits compared to women in the Papua region (95% CI 2.741-4.746). Women in Sumatra have 1.370 times the chance of making ≥4 ANC visits compared to women in the Papua region (95% CI 1.066-1.761). Women in Kalimantan have 2.232 times the chance of making ≥4 ANC visits compared to women in the Papua region (1.664-2.994). Women in Sulawesi have 1.980 times more chance of making ≥4 ANC visits compared to women in the Papua region (1.523-2.574). In addition to the region category, other variables that contributed to the predictor were age, husband/partner, education, parity, wealth and insurance. CONCLUSION:There were disparities in ANC utilization between the various regions of Indonesia. The structured policy is needed to reach regions that have low coverage of ≥4 ANC. Policymakers need to use the results of this study to take the necessary policies. Policies that focus on service equality to reduce disparities.

Project description:BackgroundTo further reduce maternal and neonatal mortality, it is essential for mothers and newborns to fully utilize all essential services within the continuum of maternal and newborn care. However, research on maternal and child health services in India has not sufficiently examined geographical disparities in the full utilization of these services and the factors influencing the full utilization, particularly in rural areas. This study aims to address this critical gap.MethodsUtilizing data from 130,312 mothers collected in the National Family Health Survey-5 (2019-21), this study employed spatial analysis to uncover geographical disparities in the full utilization of the continuum of maternal and newborn healthcare services in rural India. Additionally, binary logistic regression was used to identify the factors associated with this utilization.ResultsIn rural India, 54.3% mothers recieved four or more antenatal care visits, 88.6% received skilled birth attendance, and 75.5% of mothers and 79.8% of newborns received postnatal care within 48 hours of birth. However, only 43.5% mothers-newborn dyads in rural India utilized all four services of the continuum of maternal and newborn healthcare. There were significant geographical disparities in the full utilization of the continuum of maternal and newborn healthcare services. Hotspots were primarily identified in districts of southern states, western Maharashtra, and central Odisha, while cold spots were evident in the northeastern states of Arunachal Pradesh, Meghalaya, Assam, and Nagaland, as well as in the Empowered Action Group states of Bihar, Uttar Pradesh, and Jharkhand. Key determinants influencing the full utilization of the continuum of care in rural India included maternal education, household wealth, parity, health insurance coverage, and exposure to mass media. Specifically, the odds of fully utilizing the continuum of care were significantly lower among women without formal education (adjusted odds ratio = 0.60, 95% CI = 0.56-0.65), those from the poorest wealth quintile (0.65, 0.61-0.69), and mothers with six or more children (0.42, 0.37-0.47), compared to mothers with higher education, those in the richest wealth quintile, and mothers with a single child, respectively. Additionally, mothers from the southern region were more than twice as likely (2.11, 1.99-2.20) to fully utilize the continuum of healthcare services compared to mothers from the northern region.ConclusionThe significant geographical disparities in the full utilization of maternal and newborn healthcare services in rural India highlight the necessity for tailored, region-specific interventions. Future programs should focus on addressing the barriers to care by prioritizing vulnerable groups, including those who are poor, uninsured, less educated, adolescents, and women with high parity.

Project description:ObjectivesTo determine the association of the frailty phenotype with subsequent healthcare costs and utilization.DesignProspective cohort study (Study of Osteoporotic Fractures (SOF)).SettingFour U.S. sites.ParticipantsCommunity-dwelling women (mean age 80.2) participating in SOF Year 10 (Y10) examination linked with their Medicare claims data (N=2,150).MeasurementsAt Y10, frailty phenotype defined using criteria similar to those used in the Cardiovascular Health Study frailty phenotype and categorized as robust, intermediate stage, or frail. Participant multimorbidity burden ascertained using claims data. Functional limitations assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization ascertained during 12 months after Y10.ResultsMean total annualized cost±standard deviation (2014 dollars) was $3,781±6,920 for robust women, $6,632±12,452 for intermediate stage women, and $10,755 ± 16,589 for frail women. After adjustment for age, site, multimorbidity burden, and cognition, frail women had greater mean total (cost ratio (CR)=1.91, 95% confidence interval (CI)=1.59-2.31) and outpatient (CR=1.55, 95% CI=1.36-1.78) costs than robust women and greater odds of hospitalization (odds ratio (OR)=2.05, 95% CI=1.47-2.87) and a skilled nursing facility stay (OR=3.85, 95% CI=1.88-7.88). There were smaller but significant effects of the intermediate stage category on these outcomes. Individual frailty components (shrinking, poor energy, slowness, low physical activity) were also each associated with higher total costs. Functional limitations partially mediated the association between the frailty phenotype and total costs (CR further adjusted for self-reported limitations=1.32, 95% CI=1.07-1.63 for frail vs robust; CR=1.35, 95% CI=1.18-1.55 for intermediate stage vs robust women).ConclusionIntermediate stage and frail older community-dwelling women had higher subsequent total healthcare costs and utilization after accounting for multimorbidity and functional limitations. Frailty phenotype assessment may improve identification of older adults likely to require costly, extensive care.

Project description:ObjectivesTo determine the association of the frailty phenotype with subsequent healthcare costs and utilization.DesignProspective cohort study (Osteoporotic Fracture in Men [MrOS]).SettingSix US sites.ParticipantsA total of 1,514 community-dwelling men (mean age = 79.3 years) participating in the MrOS Year 7 (Y7) examination linked with their Medicare claims data.MeasurementsAt Y7, the frailty phenotype was operationalized using five components and categorized as robust, pre-frail, or frail. Multimorbidity and a frailty indicator (approximating the deficit accumulation index) were derived from claims data. Functional limitations were assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization were ascertained during 36 months following Y7.ResultsMean of total annualized costs (2018 dollars) was $5,707 (standard deviation [SD] = 8,800) among robust, $8,964 (SD = 18,156) among pre-frail, and $20,027 (SD = 27,419) among frail men. Compared with robust men, frail men (cost ratio [CR] = 2.35; 95% confidence interval [CI] = 1.88-2.93) and pre-frail men (CR = 1.28; 95% CI = 1.11-1.48) incurred greater total costs after adjustment for demographics, multimorbidity, and cognitive function. Associations of phenotypic pre-frailty and frailty with higher total costs were somewhat attenuated but persisted after further consideration of functional limitations and a claims-based frailty indicator. Each individual frailty component was also associated with higher total costs. Frail vs robust men had higher odds of hospitalization (odds ratio [OR] = 2.62; 95% CI = 1.75-3.91) and skilled nursing facility (SNF) stay (OR = 3.36; 95% CI = 1.83-6.20). A smaller but significant effect of the pre-frail category on SNF stay was present.ConclusionPhenotypic pre-frailty and frailty were associated with higher subsequent total healthcare costs in older community-dwelling men after accounting for a claims-based frailty indicator, functional limitations, multimorbidity, cognitive impairment, and demographics. Assessment of the frailty phenotype or individual components such as slowness may improve identification of older community-dwelling adults at risk for costly extensive care.

Project description:Despite increasing use, proton therapy (PT) remains a relatively limited resource. The purpose of this study was to assess clinical and demographic differences in PT use for prostate cancer compared to intensity modulated radiation therapy (IMRT) at a single institution.All patients with low- and intermediate-risk prostate cancer (N = 633) who underwent definitive radiation therapy between 2010 and 2015 were divided into PT (n = 508) and IMRT (n = 125) comparison groups and compared using ?2 and independent sample t tests. Univariable and multivariable logistic regression analyses were conducted to assess the associations between PT use and demographic, clinical, and treatment characteristics.The PT and IMRT cohorts varied by age, race, poverty, distance, treatment year, and treating physician. Patients who underwent IMRT were more likely to be older (mean age, 66 vs. 68 years), black (51% vs. 75%), and living in poverty or close to the facility (mean distance between residence and facility, 90 vs. 21 miles; P < .05). Prostate-specific antigen, prostate volume, and International Index of Erectile Function were significantly higher in the IMRT cohort (P < .05), but insurance type, risk group, tumor stage, Gleason score, and patient-reported urinary and bowel scores did not differ significantly (P > .05). Patients who underwent PT were more likely to receive hypofractionated therapy and less likely to receive androgen deprivation therapy (P < .01). On multivariable analysis, black (odds ratio [OR], 0.29; 95% confidence interval [CI], 0.15-0.57) and other race (OR, 0.42; 95% CI, 0.20-0.90); distance (OR, 1.14; 95% CI, 1.06-1.24); treatment years 2011 (OR, 4.87; 95% CI, 2.23-10.6), 2012 (OR, 8.27; 95% CI, 3.43-19.9), and 2014 (OR, 4.44; 95% CI, 1.94-10.2) relative to 2010; and a single treating physician (OR, 0.38; 95% CI, 0.18-0.81) relative to the reference physician with the highest rate of use were associated with PT use, whereas clinical factors such as prostate-specific antigen, prostate volume, International Index of Erectile Function, and androgen deprivation therapy were not.Sociodemographic disparities exist in PT use for prostate cancer at an urban academic institution. Further investigation of potential barriers to access is warranted to ensure equitable distribution across all demographic groups.

Project description:BACKGROUND:It has been shown in the past two decades that anxiety disorders are the most common mental disorders in general population across the world. This study sought to assess the prevalence of major anxiety disorders, their sociodemographic correlates and mental health service utilization as part of the Iranian Mental Health Survey (IranMHS). METHODS:A national household face-to-face survey was carried out on a representative sample of Iranian adults from January to June 2011 using Composite International Diagnostic Interview (CIDI 2.1). A total of 7886 subjects between 15 and 64 years who can understand Persian language were included. The 12-month prevalence of anxiety disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), their socio-demographic correlates, health service use and days out of role were measured in this study. RESULTS:The 12-month prevalence of anxiety disorders (not including specific phobias) was 15.6%. The prevalence was 12.0% in males and 19.4% in females. The three most prevalent anxiety disorders were generalized anxiety disorder (5.2%), obsessive-compulsive disorder (5.1%) and social phobia (3.2%), respectively. Factors found to be significantly associated with anxiety disorders were: female gender (OR?=?1.16, 95% CI: 1.09-1.23), middle (OR?=?1.23, 95%CI: 1.01-1.50) or low (OR?=?1.66, 95%CI: 1.31-2.10) socioeconomic status, unemployment (OR?=?1.98, 95%CI: 1.49-2.62), and urban residence (OR?=?1.31, 95%CI: 1.10-1.57). Comorbidity with non-anxiety disorders significantly increased service utilization. In all subgroups, service utilization was higher among females while the number of days out of role was higher among males. CONCLUSIONS:Anxiety disorders are common conditions with a higher prevalence among the female gender, unemployed individuals, and people with low socioeconomic conditions living in urban areas. Comorbidity of anxiety disorders with other psychological disorders aggravates the disability and significantly increases the number of days out of role.

Dataset Information

The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India.

Objective

Methods

Results

Conclusion

Publications

The prevalence of frailty and its relationship with sociodemographic factors, regional healthcare disparities, and healthcare utilization in the aging population across India.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets