Prevalence And Determinants Of Frailty Among Institutionalized Older Adults In The Kalyan-Dombivli Region: A Cross-Sectional Study

Abstract

Background: Frailty increases the risk of falls, hospitalization, institutionalization, and death, yet remains amenable to targeted interventions when detected early. Evidence from Indian care homes is limited.

Methods: We carried out a descriptive cross-sectional study (August – December 2024) in two old-age homes in Kalyan-Dombivli, India. All residents ≥ 60 years who were ambulant, cognitively intact, and consented were included (n = 248). Frailty was assessed with the Edmonton Frail Scale (EFS, 0–17). Sociodemographic data, comorbidities, assistive-device use, fall history, and concern about falling (Falls Efficacy Scale-International, FES-I) were recorded. Frailty was dichotomised (non-frail = EFS ≤ 5). Associations were explored with χ² tests and Spearman’s ρ (α = 0.05).

Results: Mean age was 73.1 ± 6.2 years; 50.4 % were women. Overall, 179 residents (72.2 %) were frail: mildly frail 38.7 %, moderately frail 25.4 %, severely frail 8.1 %. No significant association was found between frailty and sex, hypertension, diabetes, assistive-device use, or fall history (p > 0.05). Spearman’s analysis showed no correlation with age, body-mass index, length of stay, or number of falls, but a weak positive correlation with FES-I score (ρ = 0.14, p = 0.025). Residents reporting high concern about falling (69 %) were more often frail, although this narrowly missed conventional significance (p = 0.055).

Conclusion: Almost three-quarters of institutionalized older adults in this region are frail, yet classic risk markers such as age, sex, and comorbidity were not predictive. High fear of falling emerged as the only independent signal. Routine frailty screening combined with programmes that rebuild confidence and balance may therefore deliver greater benefit than disease-focused strategies alone.