The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter?

Waterhouse, Philippa; Wielen, Nele van der; Banda, Pamela C; Channon, Andrew Amos

doi:10.1186/s12939-017-0537-7

Cited by 15 publications

(21 citation statements)

References 27 publications

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“…Being wealthy had lower odds of "severe disability" (i.e. over 90 th percentile), among older adults in South Africa, where the measurement of wealth (types of floors and walls, access to water, ownership of bicycles, internet and refrigerators, etc) [35] and "economic hardship" in our study both measured households`financial circumstances by incorporating a range of economic aspects in day-to-day life.…”

Section: Discussionmentioning

confidence: 93%

Disability patterns over the first year after a diagnosis of epilepsy

Neuen

Glozier

et al. 2019

Clinical Neurology and Neurosurgery

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2019) Disability patterns over the first year after a diagnosis of epilespy. Clinical Neurology and Neurosurgery, 179,[60][61][62][63][64][65] Objective: To determine the patterns and predictors of disability over the first 12 months after a diagnosis of epilepsy. Patients and methods: The Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC) was a prospective, multicenter, community-based study of people with newly diagnosed epilepsy in Sydney, Australia. Disability was assessed using the World Health Organization's, Disability Assessment Schedule (WHODAS) 2.0 12-item version, at baseline (i.e. within 28 days of diagnosis) and 12 months post-diagnosis. Demographic, socioeconomic, clinical and epilepsy-related data, obtained through structured interviews, were entered into multivariable linear regression and shift analysis to determine predictors of greater disability. Results: Of 259 adults (≥18 years), 190 (73%) had complete WHODAS at baseline (mean ± SD scores 4 ± 6) and follow-up (4 ± 8). After adjustment for age, sex and co-morbidity, greater overall disability at 12 months was associated with lower education (P = 0.05), economic hardship (P = 0.004), multiple antiepileptic medications (P = 0.02) and greater disability (P < 0.001) at the time of diagnosis; these variables explained 38.3% of the variance. Among the 12 WHODAS items, "being emotionally affected by health problems" was the most frequent disability problem identified at both time points (all P < 0.0001). The proportion of participants without problems in that domain improved over 12 months (from 24% to 50%, P < 0.0001), whereas the other 11 items remained relatively stable. Independent baseline predictors of a worse emotional outcome at 12 months were severe/extreme emotional distress (odds ratio [OR] 4.52, 95% confidence intervals [CI] 1.67-12.24), economic hardship (OR 2.30, 95% CI 1.24-4.25) and perceived stigma (OR 2.02, 95% CI 1.03-3.93). Conclusion: Most people report problems with emotional health after a diagnosis of epilepsy but many recover over the next 12 months. Services addressing the social and psychological impact of diagnosis may be needed to improve outcome.

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Section: Discussionmentioning

confidence: 93%

Disability patterns over the first year after a diagnosis of epilepsy

Neuen

Glozier

et al. 2019

Clinical Neurology and Neurosurgery

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“…Estudos mostraram que o declínio funcional está relacionado às condições de saúde (Alves et al, 2010;Silva, 2013;Van den Brink et al, 2003;Berkman et al, 1989;Graciani et al, 2004;Alves et al, 2008;Huisman et al, 2003;Alves & Rodrigues, 2005). Pior auto percepção de saúde e presença de doenças crônicas também estão associados ao aumento da incapacidade funcional para ambos os sexos (Baron-Epel & Kaplan, 2001;Gomez-Olive et al, 2017;Pedro-Cuesta et al, 2011;Naidoo et al, 2017;Courtney-Long, 2015;Silva et al, 2013;Giacomin et al, 2018;Adib-Hajbaghery, 2011;Waterhouse et al, 2017;Argyriou et al, 2017;Ćwirlej-Sozańska et al, 2018;Sousa et al, 2009). Idosos com artrite, diabetes, bronquite, hipertensão, doença cardíaca, insuficiência renal crônica, depressão e tuberculose têm maior chance de apresentar incapacidade funcional (Silva, 2013;Alves & Rodrigues, 2005;Berkman et al, 1989;Barros et al, 2006;Crimmins & Seeman, 2001).…”

Section: Incapacidade Funcional E Saúdeunclassified

“…Alguns estudos compararam a prevalência de incapacidade funcional entre países e atribuíram suas diferenças às características populacionais (Sousa et al, 2009;Gomez-Olive et al, 2017). Dentro os idosos, a prevalência de incapacidade funcional foi geralmente maior entre as mulheres, as faixas etárias mais velhas, indivíduos com menor nível de escolaridade, com mais comorbidades e residentes em países de renda média e baixa, como demonstrado por estudos realizados em países da Europa, Ásia, África, Américas e Oriente Médio (Rodrigues et al, 2009;Sousa et al, 2009;Adib-Hajbaghery, 2011;Pedro-Cuesta et al, 2011;Hosseinpoor et al, 2012;Silva et al 2013, Almazán-Isla et al, 2014Courtney-Long, 2015;Biritwun et al, 2016;Almazán-Isla et al, 2017;Argyriou et al, 2017;Gomez-Olive et al, 2017;Jasser et al, 2017;Katta et al, 2017;Naidoo et al, 2017;Waterhouse et al, 2017;Ćwirlej-Sozańska et al, 2018;Giacomin et al, 2018 (Barros et al, 2006).…”

Section: A Estratégia Saúde Da Família No Brasilunclassified

“…No presente estudo, os domínios do WHODAS 2.0 nos quais os indivíduos em ambas as cidades relataram mais comprometimento foram a mobilidade e a participação social, assim como relatado em estudos realizados na Espanha, Polônia, Irã e aldeias rurais na Índia (Shahbazi et al, 2007;Adib-Hajbaghery, 2011;Virués-Ortega et al, 2011;Almazán-Isla et al, 2014;Katta et al, 2017;Ćwirlej-Sozańska et al, 2018 -Isla et al, 2014;Biritwum et al, 2016;Katta et al, 2017;Gomez-Olive et al, 2017;Naidoo et al, 2017;Waterhouse et al, 2017;Ćwirlej-Sozańska et al, 2018).…”

Section: Avaliaçõesunclassified

“…Resultados do presente estudo mostraram que incapacidade funcional global e incapacidade funcional grave estavam significativamente associadas a múltiplas comorbidades e à autopercepção ruim de saúde, em conformidade com estudos anteriores (Kim et al, 2005;Sousa et al, 2009;Alves et al, 2010;Adib-Hajbaghery, 2011;Pedro-Cuesta et al, 2011;Gomez-Olive et al, 2017;Waterhouse et al, 2017). Apesar disso, consultar-se na UBS com um médico da família nos três meses anteriores ao estudo não esteve associado à incapacidade funcional global ou grave.…”

Section: Avaliaçõesunclassified

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Incapacidade funcional em idosos cadastrados na Estratégia Saúde da Família nos municípios de São Paulo e Manaus: prevalência e fatores associados

Watfe¹

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The prevalence and social determinants of multimorbidity in South Africa

Brady

Castelli

Walker

et al. 2022

World Med & Health Policy

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Multimorbidity is an increasing global public health challenge, however, most existing research focuses on high‐income countries, with limited evidence from low‐ and middle‐income countries. This paper aims to estimate the prevalence of multimorbidity in South Africa and analyse the associations between multimorbidity and social determinants of health in the adult population. Multimorbidity will be defined as the coexistence of two or more chronic diseases in an individual throughout this paper. Data from the South African National Income Dynamics Survey of 2017 was used with a total sample of 20,833. A binary logistic regression was performed to analyse the associations between multimorbidity and several social determinants of health indicators based on the Commission on Social Determinants of Health Framework. Multimorbidity was prevalent in 5.4% of the South African adult population surveyed, with 71.35% of those with multimorbidity being female. Hypertension was the most common NCD and the highest contributor to multimorbidity. Multimorbidity was found to have statistically significant associations with age, obesity, being female, being of Colored or Asian/Indian ethnicity, being in employment, and having no schooling. This study highlights the importance of analysing the associations between multimorbidity and the social determinants of health. Further research on multimorbidity is required in low‐ and middle‐income countries to understand the specific challenges not identifiable in the existing research predominately based in high‐income nations.

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The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter?

Cited by 15 publications

References 27 publications

Disability patterns over the first year after a diagnosis of epilepsy

Disability patterns over the first year after a diagnosis of epilepsy

Incapacidade funcional em idosos cadastrados na Estratégia Saúde da Família nos municípios de São Paulo e Manaus: prevalência e fatores associados

The prevalence and social determinants of multimorbidity in South Africa

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