Prevalence of Functional Disability and Associated Factors among the Elderly Population Attending the Outpatient Department of a Tertiary Care Center in North India

Abstract

Functional disability is a significant cause of morbidity and a key determinant of quality of life among older adults. While national survey data are available, evidence from hospital-attending elderly populations in North India remains limited. This cross-sectional study enrolled 395 elderly individuals (age >60 years) attending the Medicine and Geriatric outpatient departments of a tertiary care hospital in New Delhi (May–June 2023). Functional disability was assessed using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) (simple scoring; cut-off >10; range 0–48) and frailty using the Edmonton Frailty Scale (cut-off >5, encompassing vulnerable [6–7] and frail [≥8] categories). Physical activity was assessed using the Global Physical Activity Questionnaire. Multivariable logistic regression with purposeful selection identified independent predictors of disability. The prevalence of functional disability was 37.2% [95% confidence interval (CI): 32.4–42.0%; n = 147/395). Among those with disability, the most commonly affected domains were life activities (25.2%) and community participation (21.8%). After multivariable adjustment, significant independent predictors of disability included: age >75 years [adjusted odds ratio (AOR) = 6.1; 95% CI: 1.4–25.8], multiple co-morbidities (AOR = 4.2; 95% CI: 1.9–12.3), and frailty (AOR = 5.7; 95% CI: 3.2–10.3). Graduate-level education (AOR = 0.1; 95% CI: 0.03–0.6) and physical activity [minimally active: AOR = 0.40; 95% CI: 0.20–0.82; health-enhancing physical active (HEPA): AOR = 0.31; 95% CI: 0.15–0.62] were independently protective. A high burden of functional disability exists among elderly outpatient attendees in North India. Frailty, advanced age, and multimorbidity are the most important independent predictors of disability. Routine frailty screening, promotion of physical activity, and integrated geriatric care in outpatient settings are urgently needed.