Cardiometabolic risk factors and multidomain functional, cognitive, and sensory impairments among tribal adults aged 45 years and above in India: evidence to inform healthy aging policy

BACKGROUND: Evidence on functional, cognitive, and sensory impairments among aging tribal populations in India is inadequate, limiting the effectiveness of ongoing public health policies and programmes aimed at healthy aging and equity. Although national initiatives address non-communicable diseases and primary health care, the integration of functional and cognitive health within these frameworks remains limited. This study aims to assess the burden and determinants of cognitive, functional, and sensory impairments among tribal older-adults and to identify modifiable risk factors that can inform the strengthening of public health policies and healthy aging strategies in tribal populations. MATERIALS AND METHODS: A community-based cross-sectional study prospectively collected data using complete enumeration across five tribal villages of Gorakhpur district, north India. Older-adults aged 45 years and above were considered as study participants to assessed the mobility limitation, activities of daily living (ADL) limitation, memory, visual, and hearing impairment. Cardiometabolic and anthropometric indicators were the primary explanatory variables. Descriptive statistics, bivariate analyses, and multivariable logistic regression models were applied. RESULTS: Among 788 tribal older-adults, the prevalence of mobility limitation was 18.2%, ADL limitation 28.8%, memory impairment 17.5%, visual impairment 20.6%, and hearing impairment 20.8%. Hypertension significantly increased the adjusted odds ratio (aOR) of ADL limitation (aOR 2.08) and memory impairment (aOR 2.31). Overweight status predicted mobility limitation (aOR 1.57), memory impairment (aOR 1.88), visual impairment (aOR 1.65), and hearing impairment (aOR 1.67). Adults aged 60-69 years had substantially higher odds of mobility limitation (aOR 6.02) and memory impairment (aOR 7.48) compared with those aged 45-59 years. CONCLUSION: Functional, cognitive, and sensory impairments were common among tribal older-adults and were strongly associated with hypertension, overweight, and advancing age. These findings highlight modifiable cardiometabolic pathways contributing to early functional and cognitive decline. Strengthening healthy aging strategies within existing primary care programmes by optimizing routine multidomain screening in tribal settings may improve early detection and reduce disability burden.