Functional disability among middle-aged adults in India: Prevalence and correlates of a national study

Introduction: There is a lack of research in investigating functional disability (FD) among middle-aged populations. The aim of the study was to estimate the prevalence and correlates of FD among middle-aged persons in India. Methods: The national cross-sectional sample consisted of 34,098 persons (45–59 years) from the Longitudinal Aging Study in India Wave 1 in 2017–2018. FD was assessed with difficulties of six items in activities in daily living (ADL) and seven items in instrumental activities in daily living (IADL). Results: The prevalence of 0 ADL/IADL was 70.7%, 1 ADL/IADL 10.4%, and 2 or more ADL/IADL 18.9%. The overall prevalence of ADL difficulty was 9.9% and IADL difficulty 26.5%. In the adjusted logistic regression analysis, older age (55–59 years) (adjusted relative risk ratio: 1.45, 95% confidence interval [CI] 1.23–1.70), having no education (adjusted odds ratio [AOR]: 1.79, 95% CI: 1.54–2.07), poor or fair self-rated health status (AOR: 2.06, 95% CI: 1.81–2.34), 2 or more chronic conditions (AOR: 1.67, 95% CI: 1.39–2.01), insomnia symptoms (AOR: 1.86, 95% CI: 1.57–2.20), major depressive disorder (AOR: 1.66, 95% CI: 1.39–1.99), physical pain (AOR: 1.42, 95% CI: 1.22–1.65), poor distant vision (AOR: 1.37, 95% CI: 1.17–1.62), hearing or ear problem (AOR: 1.39, 95% CI: 1.10–1.74), falls (AOR: 1.34, 95% CI: 1.15–1.55), and poor word recall (AOR: 1.60, 95% CI: 1.30–1.97) were positively associated with 2 or more ADL/IADL. In addition, male sex (AOR: 0.37, 95% CI: 0.31–0.45), and urban residence (AOR: 0.70, 95% CI: 0.58-0.84) were negatively associated with 2 or more ADL/IADL. Conclusion: Almost two in five middle-aged adults in India had 2 or more ADL/IADL and several associated factors were identified.