Disability, Pain, and Everyday Functioning: Profiles of Life-limiting Conditions Among Older Adults in Rural India

Chronic pain and mobility limitations are common in later life and frequently contribute to functional disability. However, disability assessment often focuses primarily on biomedical impairments, potentially overlooking broader dimensions of functional burden experienced by older adults. The study aimed to describe the prevalence of functional disability and physical burden, identify subgroups of older adults with shared patterns of functional limitation, and examine demographic factors associated with these profiles in rural Tamil Nadu, India. A cross-sectional survey was conducted among 521 adults aged ≥ 55 years across five rural villages in Tamil Nadu, India. Functional disability was measured using the Washington Group-Short Set (WG-SS), and physical burden was assessed using the EQ-5D-5L domains of mobility, self-care, and pain/discomfort. Latent class analysis (LCA) was used to identify patterns of functional limitation, followed by multinomial logistic regression to examine demographic predictors of class membership. Functional difficulty was highly prevalent, with 94.4% of participants reporting difficulty in at least one domain. Disability severity showed a graded association with physical burden. LCA identified three functional profiles: Low Severe Burden (55.3%), Pain–Mobility Dominant (40.7%), and Multidomain Severe Impairment (4%). Older age, marital or union status, and income were associated with class membership, whereas sex was not associated after adjustment. Disability in later life appears to occur in distinct patterns of functional limitation rather than as a uniform condition. Pain and mobility limitations represent key components of functional burden among older adults in rural India. Early screening on function-based difficulties along with non-communicable diseases (NCD)s screening and early community support for mobility and pain-related limitations may help address unmet needs as populations age.