Functional difficulties and toileting among older adults in Ghana: evidence from the World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 1

Abstract

Ghana's older population is projected to increase in coming decades and as a result will see increasing care needs. Understanding the functional difficulties older adults experience, and the associated factors, will help identify relevant intervention to assist older adults in meeting their care needs. This study aimed to analyse the prevalence of functional difficulties among older adults in Ghana, and examine how the World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) conceptual framework can relate to toileting difficulty to understand the factors that increase older adults’ care needs. Data were for 5,096 adults aged ⩾50 years from the WHO Study on global AGEing and adult health (SAGE) Ghana Wave 1. Difficulties were assessed using self-reported difficulty on 22 functional items, including toileting. Multivariate logistic regression tested associations between toileting and other factors as related to the WHO-ICF conceptual framework. Older adults reported climbing one flight of stairs without resting as a common functional difficulty. Difficulty eating was the item least identified. Toileting difficulty was ranked second among five total activities of daily living difficulties. Age, marital status, self-reported health, memory, bodily pain, short- and far-distance vision, obesity, stroke, chronic lung disease, trust at individual and neighbourhood level, toilet facility type, socialising with co-workers, and public and religious meeting attendance were statistically significantly associated with toileting difficulty in the final parsimonious model. Post-hoc analysis testing interaction revealed that interaction existed between female sex and never married marital status (p = 0.04), and obesity and widowed marital status (p = 0.01), with toileting as the outcome. A significant level of functional difficulty existed among Ghanaian older adults in this sample. Toileting difficulty was associated with factors across different components in the WHO-ICF, emphasising functional, social and environmental factors related to this fundamental human activity.

Older Adults’ Vigorous Occupational Physical Activity Levels in Six Countries Are Explained by Country and ‘Having Multiple Jobs’

“…As such, our evidence does not describe current phenomena and may not be applicable in situations where evidence from current data is needed. Yet, this study is one of several recently published studies [ 15 , 23 , 24 , 25 ] utilizing data of a similar age. Moreover, it has provided evidence and methods that can encourage or inform future research.…”

Understanding older adults' functioning and health‐seeking behaviour during the COVID‐19 pandemic in Ghana: A descriptive qualitative study

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Housing conditions and long-term care needs of older adults in Ghana: Evidence from the WHO SAGE Ghana Wave 1

“…This finding implies that health factors better moderate the relationship between housing and long-term care needs. Health-related factors determining the significant association between housing and long-term care needs, as revealed in this study, are not surprising because older adults living with multiple chronic conditions will have more functional disabilities [14,33]. that may increase their needs for long-term care.…”

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