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Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study
  1. Kirubakaran Kesavan Kendhapedi,
  2. Niveditha Devasenapathy
  1. Indian Institute of Public Health - Delhi, Public Health Foundation of India, Gurgaon, India
  1. Correspondence to Kirubakaran Kesavan Kendhapedi; karan.kendhapedi{at}


Objective There is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.

Design Community based cross-sectional study.

Setting Four villages in Thanjavur district of Southern India.

Participants Random sample of adults aged 60 years and above from four villages.

Methods We sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.

Results Among the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.

Conclusion Prevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

  • frailty
  • prevalence
  • determinants
  • older people
  • falls
  • fear of falling

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  • Contributors ND and KK conceived and designed the study. KK collected the data. ND and KK analysed the data. KK wrote the first draft of the manuscript. ND critically revised the manuscript. Both authors agreed to the final version.

  • Funding This is a non-funded study completed as a part of KK Master’s thesis at the Indian Institute of Public Health – Delhi (IIPH – D) and degree awarded by Academy of Scientific and Innovative Research (AcSIR).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Institutional Ethics Committee of Indian Institute of Public Health – Delhi (IIPHD_IEC_S_51_2018).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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