Prevalence and Correlates of Functional Disability among Community-Dwelling Older Adults in India: Results of a National Survey in 2017-2019

Introduction: Aging may increase physical or functional limitations, and India has a rapidly aging population. This study aimed to assess the prevalence and correlates of difficulties with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) among older adults in India. Methods: The cross-sectional sample consisted of 31,477 individuals (≥ 60 years) from the Longitudinal Aging Study in India, Wave 1 in 2017-2019. Functional disability was measured with 6 items of ADL and 7 items of IADL. Results: The prevalence of at least one ADL difficulty was 23.8%, at least one IADL difficulty was 48.4%, and at least one ADL/IADL difficulty was 52.0% (43.2% among men, and 60.0% among women). In the adjusted logistic regression analysis, older age, and food insecurity were positively and male sex and having a health insurance were negatively associated with both ADL and IADL difficulty. No formal education was positively and urban residence and married were negatively associated with IADL difficulty. Poor or faith self-rated health status, chronic conditions, insomnia symptoms, major depressive disorder, physical pain, poor distant vision, poor near vision and poor word recall were positively associated with both ADL and IADL difficulty. Body underweight and hearing or ear problem increased the odds for IADL difficulty. In univariate analysis, vigorous physical activity and higher social network were protective against both ADL and IADL difficulty. Conclusion: Almost one in four older adults in India had ADL difficulty and almost half had IADL difficulty and several associated factors were identified that can be targeted in interventions.