WELLNESS BUFFERS: Aerobic exercise and social engagement
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A viral infection. A fall. A minor surgery. Most people can recover from these in a few days. For senior citizens, however, each of these could be a major setback to health and lifestyle.
In 2011, the country had 104 million seniors, or 10 per cent of the population. By 2050, that number will jump to 340 million, or 20 per cent of the population. This would mean that many more elderly Indians will face heightened health vulnerabilities in the coming decades.
A recent paper from doctors at Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital in New Delhi analyses the prevalence of frailty among India’s older adults using data from sources that include national surveys, research articles and primary data collection. It reports that 36 per cent of Indian seniors are frail, and 48 per cent are in the pre-frailty stage. This suggests many seniors may be on the cusp of a decline in health and independence.
Frailty is not simply about getting older. In some ways, the body’s “reserve tank” is running low — even small health challenges can cause major problems when there is less reserve strength to fight back.
Measuring frailty
Signs of frailty include loss of muscle mass, walking more slowly, feeling exhausted easily and becoming less active. This happens when multiple body systems gradually decline over time, leaving a person more vulnerable to health setbacks.
The paper mentions that several methods can be used to measure frailty. The Fried Phenotype, for instance, looks for physical signs like unintended weight loss, slow walking and exhaustion. Studies using this approach found 31 per cent of Indian seniors are frail.
Alternatively, researchers and doctors use the Frailty Index, which looks at 40-70 variables such as activity level and mobility, vision, hearing and ability to complete daily activities and cognitive tasks. The finding here is that nearly 50 per cent of Indian senior citizens are frail.
The paper notes that several factors increase frailty risk. Women show higher rates (45 per cent) compared with men (34 per cent). Poor nutrition, low physical activity and low BMI are the other major contributors. Medical conditions like diabetes, hearing problems, cognitive decline and depression are contributing factors. Living alone correlates with higher frailty rates.
The study found that regions with poorer healthcare infrastructure show higher frailty prevalence, suggesting system-level factors play an important role.
For individuals in their 50s and 60s, regular physical activity, combining strength training and aerobic exercise, is essential. Maintaining proper nutrition, particularly adequate protein intake, builds resilience against frailty. Social engagement appears protective as well.
Response to frailty
For policymakers, addressing frailty requires both individual and systemic approaches. Early screening can identify those at risk, focusing on the 48 per cent who are pre-frail and can still recover. Healthcare worker training in frailty management and community-based prevention programmes are needed, especially in States with higher prevalence.
Research priorities include developing India-specific assessment tools and conducting longitudinal studies. Understanding frailty’s economic impact could help guide resource allocation as India’s population ages.
With proper intervention, many seniors can avoid the transition from pre-frailty to frailty, maintaining independence and quality of life for more years.
(S Yasaswini is a writer based in Guwahati)
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Published on April 6, 2025
