Normative data for three physical frailty parameters in an aging, rural Indian population

Physical frailty is associated with multiple adverse health outcomes. Since physical characteristics markedly vary with different populations, population-specific norms for physical frailty parameters are necessary. Such norms are lacking for the Indian population, especially for older, rural Indians. We aimed to develop normative values for three quantitative, frailty parameters-handgrip strength, "Timed Up-and-Go" (TUG) test time, and physical activity in an aging, rural Indian population.

The study sample is from an ongoing, prospective, cohort (Srinivaspura NeuoSenescence and COGnition, SANSCOG) comprised of rural, community-dwelling, cognitively healthy, aging Indians. Subjects are recruited through area sampling strategy, from villages of Srinivaspura, Kolar district, Karnataka state, India. Three physical frailty parameters of Fried's phenotype-handgrip strength (n = 1787), TUG time (n = 1863), and physical activity (n = 1640) were assessed using digital hand dynamometry, TUG test, and General Physical Activity Questionnaire (GPAQ), respectively.

The 10th, 25th, 50th, 75th, 90th percentiles for the three frailty parameters were: right-hand grip strength (kg): males-13.9, 18.6, 23.8, 28.7, 33.7 and females-7.8, 10.6, 14.2, 17.9, 21.3; left-hand grip strength (kg): males-13.3, 18.3, 23.6, 28.9, 32.9 and females-7.9, 10.5, 14.3, 17.8, 21.2; TUG time (s): males-9.1, 10.1, 11.4, 13.4, 15.5 and females-9.5, 10.7, 12.4, 14.5, 16.6; physical activity (MET-minutes/week): males-1680; 4320; 8880; 15,840; 23,352 and females-1680; 4320; 9240; 15,120; 20,160.

Our findings show that from 45 years onwards, overall grip strength decreases and TUG time increases, with women performing significantly poorer than men across all age groups, except >75 years, where no differences were seen. Physical activity did not show any consistent trend according to age or gender. Reference values for this aging, rural Indian population were substantially lower for grip strength and higher for TUG time than aging populations in several Western and other Asian countries.