Association of food insecurity with frailty among older adults in India

Background

Past investigations in different nations have demonstrated that food insecurity may lead to frailty among older adults; however, there is no evidence concerning these associations in India. Our investigation tries to fill this gap utilizing WAVE I of WHO SAGE 2007 information.

Objectives

To examine the independent effect of food insecurity on frailty. To assess differences in frailty and other correlates between food secure and insecure older individuals.

Methods

The Fried phenotype approach was used to create a frailty index using the presence of five indicators among older adults: exhaustion, weight loss, physical activity, weakness, and walking speed. Respondents were called robust, pre-frail, or frail based on the presence of zero, one, or two or more indicators from the five indicators, respectively. Individuals were classified as food insecure based on their responses to two five-point Likert scale-type questions: if they had less food than required because there was not enough food and if they had been hungry but did not eat because they could not afford food in more than 1 or 2 months in the last 12 months. Bivariate analysis was performed to determine the differences in all the correlates and frailty among older adults with food security and insecurity. Step-by-step logistic regression analysis was performed to estimate the effect of food insecurity on frailty.

Results

Bivariate results show that from a total of 6650 adults aged 50 years or older, 16.05% are food insecure, and of them, 19% are frail. In addition, frailty is significantly associated with food insecurity (p < 0.001). These findings are further corroborated by multivariate analysis results showing that food insecure older adults have higher odds of being frail compared to their counterparts (OR = 1.31, 95% CI 1.10; 1.65, P < 0.001) in the adjusted model for all the correlates. Education and wealth are also among major factors aggravating frailty among older adults.

Conclusion

Based on our results, we conclude that, after controlling for correlates, food insecurity is associated with frailty, which further prevents older adults from accessing nutritious food and causes them to lose their independence. Thus, the government needs to introduce focused sustenance programs for the elderly population who do not have regular access to food and are frail to prevent early disability and mortality.