Frailty Among the Older Adults in Bangladesh: A Comparative Analysis of Rural and Urban Populations

The increasing incidence of frailty among older adults in Bangladesh is a significant public health concern. This study aims to compare the level and determinants of frailty among older adults living in rural and urban areas of Bangladesh.

A cross-sectional survey of 944 older adults aged 55 years and above, conducted in the Sylhet District of Bangladesh between 2022 and 2023, selected through a two-stage random sampling method in urban areas and a multistage random approach in rural areas. The health status of participants was assessed using a 33-indicator Frailty Index (FI₃₃), which categorized individuals into four groups: good health (0 < = FI₃₃ < = 12), mild frailty (0.12 < FI₃₃ < = 0.24), moderate frailty (0.24 < FI₃₃ < = 0.36), and severe frailty (FI₃₃ > 0.36). Data analysis involved descriptive statistics, Pearson χ ² tests, and multinomial logistic regression.

The prevalence of moderate to severe frailty was higher in rural areas (57.6%) compared to urban areas (49%). This difference was statistically significant (χ² = 37.09, p < 0.001). Rural older adults also had a higher likelihood of severe frailty than urban older adults (AOR: 1.80, 95% CI: 0.92-3.52). Age was a significant predictor of frailty, with adults aged 65 years and above having a much higher risk (AOR: 9.06, 95% CI: 4.33-18.94). Women were also more likely to experience moderate frailty than men (AOR: 4.43, 95% CI: 2.27-8.62).

These findings highlight the need for targeted interventions in rural areas and among older women to address frailty in Bangladesh's aging population.