Dependency and associated factors among elderly in central Kerala


  • Prithiba B. Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
  • Anitha Baskar Department of Community Medicine, Government Medical College, Thrissur, Kerala, India
  • Anupa Lucas Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
  • Rani Suhra S. Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
  • Sobha A. Department of Community Medicine, Government Medical College, Ernakulam, Kerala, India
  • Geetha Devi Department of Community Medicine, Government Medical College, Kottayam, Kerala, India
  • Sairu Philip Department of Community Medicine, Government Medical College, Kottayam, Kerala, India



Central Kerala, Comorbidity, Dependency, Elderly, Katz scale, Kottayam


Background: Globally the proportion of elderly has been increasing and physical dependency is one of major problem faced by elderly. Physical dependency will affect the quality of life. Despite this, very limited number of studies were done to assess the dependency among elderly. Aim was to estimate the prevalence of dependency and to determine the association between selected factors and dependency among elderly >60 years.

Methods: A cross-sectional study was conducted among 352 elderly in Athirampuzha Panchayat using simple random sampling. A semi-structured interview schedule using basic activities of daily living scale-BADL (Katz scale) was  used. Data was coded and entered in Microsoft Excel and analysed using IBM SPSS software version 22.

Results: The mean age of participants was 71.68 years with a standard deviation of 8.457 years and the prevalence of dependency was found to be 30.7%. Univariate analysis results revealed that  age (>85 years), occupation, living arrangement, presence of aphasia, hearing impairment, visual disturbances, locomotor disability, presence of comorbidity, onset of comorbidity and comorbid conditions like  diabetes mellitus, coronary artery disease and chronic arthritis were found to have significant association with dependency. Binary logistic regression results  revealed that  factors like age group (>85 years), presence of hearing impairment, loco motor disability, onset of comorbidity, presence of diabetes mellitus and coronary artery disease were found to be independent predictors of dependency.

Conclusions: Since dependency increases with age physical dependency is to be assessed periodically to achieve healthy ageing.


u X, Yao Y, Jin Y. Digital exclusion and functional dependence in older people: findings from five longitudinal cohort studies. E Clinical Medicine. 2022; 54:101708.

Keshari P, Shankar H. Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India. J Family Community Med. 2017;24(2):86-90.

Kerala Government. Economic review 2017 State Planning Board, Thiruvananthapuram, Kerala, India. Available at: Accessed 10 November 2022.

Bhaskar A, D M, Joseph J. Study on morbidities and functional disabilities of elderly in rural area of Kottayam. J Evolut Med Dent Sci. 2014;3:9601–9.

Maroof M, Ahmad A, Khalique N, Ansari MA. Locomotor problems among rural elderly population in a district of Aligarh, North India. J Fam Medi Prim Care. 2017;6(3):522.

Medhi GK, Hazarika NC, Borah PK, Mahanta J. Health problems and disability of elderly individuals in two population groups from same geographical location. J Assoc Physicians India. 2006;54:539-44.

Kumar S, Chauhan S, Patel R, Simon DJ. A Study of Prevalence and Factors Associated with Geriatric Impairment: Evidence from a Cross-Sectional Study in India. Res Square. 2021:1-18.

Sarasakumari.pdf. Socio-economic conditions, morbidity Pattern and social support among the Elderly women in a rural area. Available at: Accessed 28 December 2022.

Bürkle A, Caselli G, Franceschi C, Mariani E, Sansoni P, Santoni A, et al. Pathophysiology of ageing, longevity and age related diseases. Immu Age. 2007;4(1):4.

Wikipedia. Demographics of Kottayam district, 2022. Available at: Accessed 28 December 2022.

Irudaya Rajan S, Sunitha S, Arya UR. Elder care and living arrangement in Kerala. Elderly Care in India: Societal and State Responses. 2017:95-116.

Gayathri S. Prevalence of Functional Dependence among Elderly People in Tiruvallur District of Tamilnadu (Doctoral dissertation, Kilpauk Medical College, Chennai). 2020.

Gomathy R, Karunagari DK. Assessment of functional status of elderly residing at old age homes of Puducherry. Int J Sci Res. 2020 Dec 1;12–4.

Davis JW, Chung R, Juarez DT. Prevalence of comorbid conditions with aging among patients with diabetes and cardiovascular disease. Hawaii Med J. 2011;70(10):209-13.

Peter RM, Logaraj M, Ramraj B. Association of comorbidities with Activity of Daily Living (ADL) in a community-based sample of older adults in Tamil Nadu, India. Clin Epidemiol Glob Heal. 2022;15:101068.

Jędrzejczyk M, Foryś W, Czapla M, Uchmanowicz I. Relationship between multimorbidity and disability in elderly patients with coexisting frailty syndrome. Int J Environ Res Public Health. 2022;19(6):3461.

Vu T, Finch CF, Day L. Patterns of comorbidity in community-dwelling older people hospitalised for fall-related injury: A cluster analysis. BMC Geriatrics. 2011;11(1):45.

Hong X, Chen X, Chu J, Shen S, Chai Q, Lou G, et al. Multiple diabetic complications, as well as impaired physical and mental function, are associated with declining balance function in older persons with diabetes mellitus. Clin Interv Aging. 2017;12:189-95.

Dunlay SM, Manemann SM, Chamberlain AM, Cheville AL, Jiang R, Weston SA, et al. Activities of daily living and outcomes in heart failure. Circ Heart Fail. 2015;8(2):261-7.

Gilmour H, Park J. Dependency, chronic conditions and pain in seniors. Health Rep. 2006;16(Suppl):21–31.




How to Cite

B., P., Baskar, A., Lucas, A., S., R. S., A., S., Devi, G., & Philip, S. (2023). Dependency and associated factors among elderly in central Kerala. International Journal Of Community Medicine And Public Health, 10(10), 3625–3630.



Original Research Articles