Comparative Analysis of Functional Ability among Older Women Living in Two Old Age Homes of Northeast India: A Cross-Sectional Study

Abstract

Objective: The functional ability of older women residing in two old age homes in Northeast India was compared through measurements of physical functioning, cognitive status, and mental well-being using standardized performance-based assessments. Design: A cross-sectional comparative observational study was conducted. Methods: Seventy-eight older women residents from two institutions were assessed: 46 from Apnaghar Old Age Home, Agartala (Tripura) and 32 from Ima Leimarel Women Welfare Association, Imphal (Manipur). Functional capacity was measured using the Short Physical Performance Battery (SPPB), grip strength was assessed with Camry EH101 Dynamometer, cognition was evaluated through Mini-Cog™, and psychological well-being was determined using the WHO-5 Well-being Index. Data normality was determined through Shapiro-Wilk tests and appropriate parametric (independent t-tests) or non-parametric (Mann-Whitney U) statistical analyses. Demographic characteristics, social support patterns, and institutional activity participation were examined. Results: Despite improved sociodemographic status being observed in Imphal residents, including higher literacy rates (15.21% vs 9.52%), greater voluntary admissions (76.08% vs 64.29%), and increased family visitation (56.51% vs 42.86%), superior functional outcomes were demonstrated by Agartala residents across all measures. Significantly better performance was exhibited by Agartala participants compared to Imphal counterparts in physical function (SPPB: 8.217±0.917 vs. 7.625±1.032, p=0.006, Cohen’s d=0.611), cognitive function (Mini-Cog™: 3.239±0.874 vs. 2.875±0.937, p=0.037, Cohen’s d=0.400), psychological well-being (WHO-5: 67.91±10.98 vs. 61.43±11.76, p=0.013, Cohen’s d=0.567), and handgrip strength (13.998±1.891 vs. 12.765±1.947 kg, p=0.004, Cohen’s d=0.640). Significant positive correlations were identified between structured activity participation and functional outcomes (r=0.412-0.526, p<0.01). Conclusion: The findings demonstrated that highly structured and challenging activities predicted better maintenance of functional capacities than passive social support, emphasizing the critical importance of comprehensive physical, mental, and psychological stimulation programs in institutional care settings for preserving independence and overall well-being among older women.