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      Self-reported prevalence of chronic non-communicable diseases and associated factors among older adults in South Africa

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          Abstract

          Introduction

          Little is known about the prevalence and predictors of chronic non-communicable diseases (NCDs) of older adults in South Africa. This study aims to investigate the self-reported prevalences of major chronic NCDs and their predictors among older South Africans.

          Methods

          We conducted a national population-based cross-sectional survey with a sample of 3,840 individuals aged 50 years or above in South Africa in 2008. The outcome variable was the self-reported presence of chronic NCDs suffered, namely, arthritis, stroke, angina, diabetes, chronic lung disease, asthma, depression, and hypertension. The exposure variables were sociodemographic characteristics: age, gender, education, wealth status, race, marital status, and residence. Multivariate logistic regression was used to determine sociodemographic factors predictive of the presence of chronic NCDs.

          Results

          The prevalence of chronic NCDs was 51.8%. The prevalence of multimorbidity (≥2 chronic conditions) was 22.5%. Multivariate logistic regression analysis showed that being female, being in age groups 60–79 and 70–79, being Coloured or Asian, having no schooling, having greater wealth, and residing in an urban area were associated with the presence of NCDs.

          Conclusion

          The rising burden of chronic NCDs affecting older people places a heavy burden on the healthcare system as a result of increased demand and access to healthcare services. Concerted effort is needed to develop strategies for the prevention and management of NCDs, especially among economically disadvantaged individuals who need these services the most.

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          Non-communicable diseases in low- and middle-income countries: context, determinants and health policy.

          Juan Casas, Abdul Ebrahim, J. Geelhoed … (2008)
          The rise of non-communicable diseases and their impact in low- and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today's low- and middle-income countries. This review appraises these differences in context to gain a better understanding of the epidemic of non-communicable diseases in low- and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the research needs for low- and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic.
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            Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study

            Inge Kirchberger, Christa Meisinger, Margit Heier … (2012)
            Multimorbidity is a common problem in aged populations with a wide range of individual and societal consequences. The objective of the study was to explore patterns of comorbidity and multimorbidity in an elderly population using different analytical approaches. Data were gathered from the population-based KORA-Age project, which included 4,127 persons aged 65–94 years living in the city of Augsburg and its two surrounding counties in Southern Germany. Information on the presence of 13 chronic conditions was collected in a standardized telephone interview and a self-administered questionnaire. Patterns of comorbidity and multimorbidity were analyzed using prevalence figures, logistic regression models and exploratory tetrachoric factor analysis. The prevalence of multimorbidity (≥2 diseases) was 58.6% in the total sample. Hypertension and diabetes (Odds Ratio [OR] 2.95, 99.58% confidence interval [CI] [2.19–3.96]), as well as hypertension and stroke (OR 2.00, 99.58% CI [1.26–3.16]) most often occurred in combination. This association was independent of age, sex and the presence of other conditions. Using factor analysis, we identified four patterns of multimorbidity: the first pattern includes cardiovascular and metabolic diseases, the second includes joint, liver, lung and eye diseases, the third covers mental and neurologic diseases and the fourth pattern includes gastrointestinal diseases and cancer. 44% of the persons were assigned to at least one of the four multimorbidity patterns; 14% could be assigned to both the cardiovascular/metabolic and the joint/liver/lung/eye pattern. Further common pairs were the mental/neurologic pattern combined with the cardiovascular/metabolic pattern (7.2%) or the joint/liver/lung/eye pattern (5.3%), respectively. Our results confirmed the existence of co-occurrence of certain diseases in elderly persons, which is not caused by chance. Some of the identified patterns of multimorbidity and their overlap may indicate common underlying pathological mechanisms.
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              Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh: A Cross-sectional Study

              Masuma Akter Khanam, Peter Kim Streatfield, Zarina Kabir … (2011)
              Data on multimorbidity among the elderly people in Bangladesh are lacking. This paper reports the prevalence and distribution patterns of multimorbidity among the elderly people in rural Bangladesh. This cross-sectional study was conducted among persons aged ≥60 years in Matlab, Bangladesh. Information on their demographics and literacy was collected through interview in the home. Information about their assets was obtained from a surveillance database. Physicians conducted clinical examinations at a local health centre. Two physicians diagnosed medical conditions, and two senior geriatricians then evaluated the same separately. Multimorbidity was defined as suffering from two or more of nine chronic medical conditions, such as arthritis, stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary symptoms, symptoms of heart failure, impaired vision, hearing impairment, and high blood pressure. The overall prevalence of multimorbidity among the study population was 53.8%, and it was significantly higher among women, illiterates, persons who were single, and persons in the non-poorest quintile. In multivariable logistic regression analyses, female sex and belonging to the non-poorest quintile were independently associated with an increased odds ratio of multimorbidity. The results suggest that the prevalence of multimorbidity is high among the elderly people in rural Bangladesh. Women and the non-poorest group of the elderly people are more likely than men and the poorest people to be affected by multimorbidity. The study sheds new light on the need of primary care for the elderly people with multimorbidity in rural Bangladesh.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Glob Health Action
                Journal ID (iso-abbrev): Glob Health Action
                Journal ID (publisher-id): GHA
                Title: Global Health Action
                Publisher: Co-Action Publishing
                ISSN (Print): 1654-9716
                ISSN (Electronic): 1654-9880
                Publication date (Electronic): 19 September 2013
                Publication date Collection: 2013
                Volume: 6
                Electronic Location Identifier: 10.3402/gha.v6i0.20936
                Affiliations
                [1 ]HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council, Pretoria, South Africa
                [2 ]Office of the Deputy Vice Chancellor: Research and Engagement, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
                [3 ]Department of Psychology, University of Limpopo, Turfloop Campus, Sovenga, South Africa
                [4 ]Faculty of Health Sciences, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
                Author notes
                [* ]Correspondence to: Nancy Phaswana-Mafuya, Human Sciences Research Council, 44 Pickering Street, PO Box 35115, Newton Park, Port Elizabeth, 6055, South Africa, Tel: +27-41-3998700, Fax: +27-41-3998711, Email: nphaswanamafuya@ 123456hsrc.ac.za
                Article
                Publisher ID: 20936
                DOI: 10.3402/gha.v6i0.20936
                PMC ID: 3779355
                PubMed ID: 24054088
                SO-VID: f0346018-76aa-4d7f-a288-46cffc9a3e07
                Copyright © © 2013 Nancy Phaswana-Mafuya et al.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 24 March 2013
                Date revision received : 25 August 2013
                Date accepted : 27 August 2013
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Health & Social care
                Keywords: self-reported,chronic non-communicable diseases,ageing,south africa
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: self-reported, chronic non-communicable diseases, ageing, south africa

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