Ageing and adult health status in eight lower-income countries: the INDEPTH WHO-SAGE collaboration

Abstract

BackgroundGlobally, ageing impacts all countries, with a majority of older persons residing in lower- and middle-income countries now and into the future. An understanding of the health and well-being of these ageing populations is important for policy and planning; however, research on ageing and adult health that informs policy predominantly comes from higher-income countries. A collaboration between the WHO Study on global AGEing and adult health (SAGE) and International Network for the Demographic Evaluation of Populations and Their Health in developing countries (INDEPTH), with support from the US National Institute on Aging (NIA) and the Swedish Council for Working Life and Social Research (FAS), has resulted in valuable health, disability and well-being information through a first wave of data collection in 2006–2007 from field sites in South Africa, Tanzania, Kenya, Ghana, Viet Nam, Bangladesh, Indonesia and India.ObjectiveTo provide an overview of the demographic and health characteristics of participating countries, describe the research collaboration and introduce the first dataset and outputs.MethodsData from two SAGE survey modules implemented in eight Health and Demographic Surveillance Systems (HDSS) were merged with core HDSS data to produce a summary dataset for the site-specific and cross-site analyses described in this supplement. Each participating HDSS site used standardised training materials and survey instruments. Face-to-face interviews were conducted. Ethical clearance was obtained from WHO and the local ethical authority for each participating HDSS site.ResultsPeople aged 50 years and over in the eight participating countries represent over 15% of the current global older population, and is projected to reach 23% by 2030. The Asian HDSS sites have a larger proportion of burden of disease from non-communicable diseases and injuries relative to their African counterparts. A pooled sample of over 46,000 persons aged 50 and over from these eight HDSS sites was produced. The SAGE modules resulted in self-reported health, health status, functioning (from the WHO Disability Assessment Scale (WHODAS-II)) and well-being (from the WHO Quality of Life instrument (WHOQoL) variables). The HDSS databases contributed age, sex, marital status, education, socio-economic status and household size variables.ConclusionThe INDEPTH WHO–SAGE collaboration demonstrates the value and future possibilities for this type of research in informing policy and planning for a number of countries. This INDEPTH WHO–SAGE dataset will be placed in the public domain together with this open-access supplement and will be available through the GHA website (www.globalhealthaction.net) and other repositories. An improved dataset is being developed containing supplementary HDSS variables and vignette-adjusted health variables. This living collaboration is now preparing for a next wave of data collection.

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

“…Face-to-face interviews using a standardised questionnaire were used to collect information on socio-demographic characteristics, disability, subjective well-being, and other health measures and behavioural risk factors. Post-stratified weights were used to ensure that estimates were nationally representative [14]. …”

“…The following measures were used to assess quality of life and level of disability: Subjective well-being, or quality of life, was measured using the eight-item WHO Quality of Life Instrument (WHOQoL) [14]. Outcomes from the eight questions were summed to obtain an overall WHOQoL score which was transformed to a 0–100 scale, where a score of 0 represents the worst quality of life, and a maximum score of 100 represents the highest quality of life.…”

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

“…20,21 Typically, countries propose (to varying degrees of detail) one or both of two kinds of responses: (i) steps to develop preventive and/or curative primary healthcare services for major CNCD and, in some cases (e.g., Kenya) other degenerative diseases, 22 5,20,21 What underlies the uncertainties are wide gaps in understanding of both (i) the scope, determinants and impacts of unmet old age-related health needs in SSA societies and (ii) the nature and causes of major deficiencies in service provision for them. To be sure, a fair body of research on the health of older persons in SSA has accumulated over the last decade, including, notably, the World Health Organization (WHO) Study on Adult Health and AGEing (SAGE) 25 and the Ibadan Study of Ageing.…”

Social Epidemiology of Hypertension in Middle-Income Countries

“…20 A major advantage of the study was that, as opposed to singlecountry surveys, the SAGE questionnaires and methods were validated and applied simultaneously to multiple countries, investigating what factors may be common and generalizable between nations rather than specific to certain cultures (eg, because of local nutrition), unobserved genetic differences, or healthcare system differences. 21 …”