Assessing health and well-being among older people in rural South Africa

Abstract

BackgroundThe population in developing countries is ageing, which is likely to increase the burden of non-communicable diseases and disability.ObjectiveTo describe factors associated with self-reported health, disability and quality of life (QoL) of older people in the rural northeast of South Africa.DesignCross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demographic variables and measures of self-reported health (Health Status), functional ability (WHODASi) and quality of life (WHOQoL).ResultsAbout 4,085 of 6,206 people eligible (65.8%) completed the interview. Women (Odds Ratio (OR) = 1.30, 95% CI 1.09, 1.55), older age (OR = 2.59, 95% CI 1.97, 3.40), lower education (OR = 1.62, 95% CI 1.31, 2.00), single status (OR = 1.18, 95% CI 1.01, 1.37) and not working at present (OR = 1.29, 95% CI 1.06, 1.59) were associated with a low health status. Women were also more likely to report a higher level of disability (OR = 1.38, 95% CI 1.14, 1.66), as were older people (OR = 2.92, 95% CI 2.25, 3.78), those with no education (OR = 1.57, 95% CI 1.26, 1.97), with single status (OR = 1.25, 95% CI 1.06, 1.46) and not working at present (OR = 1.33, 95% CI 1.06, 1.66). Older age (OR = 1.35, 95% CI 1.06, 1.74), no education (OR = 1.39, 95% CI 1.11, 1.73), single status (OR = 1.28, 95% CI 1.10, 1.49), a low household asset score (OR = 1.52, 95% CI 1.19, 1.94) and not working at present (OR = 1.32; 95% CI 1.07, 1.64) were all associated with lower quality of life.ConclusionsThis study presents the first population-based data from South Africa on health status, functional ability and quality of life among older people. Health and social services will need to be restructured to provide effective care for older people living in rural South Africa with impaired functionality and other health problems.

Diabetes in South African older adults: prevalence and impact on quality of life and functional disability – as assessed using SAGE Wave 1 data

“…In addition, diabetes status per se was associated with poor quality of life and disability, as were socio-economic status (low education), being in a low wealth quintile, having a poor employment history, marital status (not being in a partnership), lifestyle habits (low physical activity, history of alcohol use) and co-morbid conditions. In accordance with previous studies, we found that having  diabetes [20–22], having lower formal education levels [23–25], being in a low socioeconomic group [26,27], not being in a marital relationship [28,29] and not having worked [30,31] were significantly associated with poor quality of life and a high level of disability, but unlike findings in other studies [32–35], being older and being female were not associated with a high level of disability 20–2223–25 26,27 28,29]30,31 32–35 The differences in findings in this study compared to others may relate to the use of different instruments to assess the quality of life and disability, as well as the use of diabetes-specific and generic measures across studies.…”

Family caregivers' perceptions and experiences regarding caring for older adults with chronic diseases

“…According to Townsend and Wilcock 5 , occupational imbalance is experienced by people who are un-occupied, under-occupied or over-occupied. Regarding the literature that deals with the challenges faced by family caregivers, it could be argued that they experience challenges in balancing their occupational demands related to their caregiver role, family, and career 15 . Previous studies reported that family caregivers seemed to experience caregiver burden, as they spent most of their time providing (or helping with) the self-care activi-ties of the older adults 5,16 .…”

Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs

“…[34][35][36][37][38][39][40] (ii) Health and functional impairments may significantly impact on older persons' quality of life. 41,42 (iii) Within the older population, levels of ill-health and impaired function clearly vary between sociodemographic (e.g., gender, rural/urban, socioeconomic) groups.…”

“…41,42 (iii) Within the older population, levels of ill-health and impaired function clearly vary between sociodemographic (e.g., gender, rural/urban, socioeconomic) groups. 28,29,34,[37][38][39][40] Evidence suggests a consistently higher risk of disability, depression, dementia as well as self-reported poor health and function among older women compared to men. Findings on relationships of rural/urban and socioeconomic status to health outcomes, however, are less clear.…”