Association of Composite and Domain-Specific Intrinsic Capacity and Frailty Among Older Adults in India: Evidence from the Longitudinal Ageing Study in India (LASI)

Frailty and intrinsic capacity (IC), central constructs in the WHO healthy ageing framework, reflect vulnerability and resilience, respectively. Although both are linked to adverse outcomes, population-level evidence from India examining their relationship remains limited. This study explored the association between IC and frailty among older Indian adults.

Data from 26,943 community-dwelling adults aged ≥60 years from the Longitudinal Ageing Study in India (LASI Wave 1) were analysed. Frailty was assessed using Fried's phenotype. IC was measured across cognition, locomotion, sensory, vitality, and mood domains, generating a composite score (0-10). Associations between IC and frailty status were examined using chi-square tests and multinomial logistic regression adjusted for sociodemographic factors and comorbidities.

Median age was 67 (63-72) years, and 48.4% were male. Frail individuals had lower median IC scores [6 (5-7)] than pre-frail and robust participants [7 (6-8); p<0.001]. Higher IC scores were inversely associated with pre-frailty (RRR: 0.79, 95% CI: 0.75-0.84) and frailty (RRR: 0.67, 95%CI: - 0.64-0.71). Poor cognition, locomotion, vitality, and mood were significantly associated with frailty, whereas sensory impairment was not.

Lower IC is strongly associated with frailty among older Indian adults, supporting IC-based geriatric assessment for early identification of frailty progression.