Assessment of vitality and locomotor capacity among older adults in rural Bangladesh: A cross-sectional study

Abstract

Background: Population ageing is accelerating in Bangladesh, with 9.5% of people now aged 60 years or above, and this proportion is expected to rise to 22% by 2050. The WHO Integrated Care for Older People (ICOPE) framework identifies vitality and locomotor capacity as two foundational domains of intrinsic capacity (IC) in older adults. Impairment in these domains leads to loss of independence, increased disability, and a heavier burden on health systems. Community-level evidence on these domains from rural Bangladesh is almost completely absent.

Objectives: To assess the status of vitality and locomotor capacity among community-dwelling older adults aged ≥ 60 years in rural Bangladesh and identify associated factors with impairments.

Methods: A community-based cross-sectional study was conducted from January to May 2026 among 402 older adults in Sujalpur Union, Birganj, Dinajpur, Bangladesh. Simple random sampling was employed. Vitality was assessed using the Mini Nutritional Assessment Short Form (MNA-SF); a score of ≤11 indicated impairment. Locomotor capacity was assessed using the Short Physical Performance Battery (SPPB) chair stand test; a time of ≥12 s (AWGS 2019 cut-off) indicated impairment. Data on sociodemographic, behavioral, dietary, clinical, and functional characteristics were also collected. Chi-square tests were used for bivariate analysis and binary logistic regression was used to identify associated factors.

Results: The mean age of the surveyed older adults was 68.3 (±6.0) years, and 54% were male. The prevalence of impaired vitality was 75.1% (n=302), and that of impaired locomotor capacity was 35.3% (n=142). In the multivariable analysis, older age (aOR: 1.07, 95% confidence interval [CI], 1.02–1.12) and female sex (aOR, 2.60; 95% CI, 1.44–4.68) were associated with higher odds of impaired vitality, whereas food security (aOR, 0.27; 95% CI, 0.14–0.51) and highest wealth tertile (aOR, 0.50; 95% CI, 0.27–0.91) were protective. For locomotor capacity, older age (aOR: 1.08, 95% CI: 1.04–1.13), female sex (aOR: 2.40, 95% CI: 1.31–4.42), and cognitive decline (aOR: 1.89, 95% CI: 1.17–3.04) increased the odds of impairment, whereas adequate physical activity (aOR: 0.43, 95% CI: 0.26–0.73) was protective.

Conclusions: Three in four rural older adults had impaired vitality, and more than one in three had impaired locomotor capacity, with older women at the greatest risk. Food insecurity, poverty, physical inactivity, and cognitive decline were the most important modifiable factors. Integrating ICOPE-based screening into primary healthcare in Bangladesh can enable early detection and targeted interventions to preserve the functional independence of older adults.