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Subjective health and quality of life among elderly people living with chronic multimorbidity and difficulty in activities of daily living in rural South Africa

Authors Wang C, Pu R, Li Z, Ji L, Li X, Ghose B, Huang R, Tang S

Received 17 February 2019

Accepted for publication 3 June 2019

Published 17 July 2019 Volume 2019:14 Pages 1285—1296

DOI https://doi.org/10.2147/CIA.S205734

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Bik-Wai Bilvick Tai

Peer reviewer comments 2

Editor who approved publication: Dr Zhi-Ying Wu


Chao Wang,1,2 Run Pu,3 Zhifei Li,3 Lu Ji,4,5 Xiaosong Li,6 Bishwajit Ghose,7 Rui Huang,8 Shangfeng Tang4,5

1School of Public Policy and Management, China University of Mining and Technology, Xuzhou, People’s Republic of China; 2School of Safety Engineering, China University of Mining and Technology, Xuzhou, People’s Republic of China; 3Department of Industrial Development, China National Center for Biotechnology Development, Beijing, People’s Republic of China; 4School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 5Research Center for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, People’s Republic of China; 6Clinical Molecular Medicine Testing Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 7Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada; 8School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China

Background: South Africa has been experiencing a growing proportion of elderly population with rapid increases in the burden of non-communicable diseases (NCDs) characteristic of population aging. Rural areas in South Africa represent a far smaller fraction of the population, however, share a relatively higher burden of NCDs. In the current literature, there is limited evidence on rural studies in the context of chronic diseases and activities of daily living (ADLs) among the elderly population (60 years and above) in South Africa.
Purpose: In this regard, we undertook the present study with the objective of examining the demographic, behavioral, and socioeconomic predictors of subjective health, depression, and quality of life among elderly men and women living in the rural areas (n=2,627).
Methods: Data for this study were collected from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI). Main explanatory variables were self-reported NCDs and difficulties in ADLs. The predictors of subjective health, depression, and quality of life were assessed using multivariable regression methods.
Results: We found that the proportion of participants who reported good health, not having depression, and good quality of life was respectively 44.7%, 81.3%, and 63%. Women in the oldest age group (80+ years) were significantly less likely to report good health (OR=0.577, 95% CI=0.420, 0.793) and quality of life (OR=0.709, 95% CI=0.539, 0.933) compared with those in the youngest group. Having more than one chronic condition and ADL difficulties significantly lowered the odds of good health, having no depression, and quality of life among men and women.
Conclusion: The present findings suggest the involvement of sociodemographic factors in health and quality of life outcomes among elderly South Africans, and call for enhanced efforts to address these health limiting conditions such as ADLs and chronic multimorbidity.

Keywords: activities of daily, elderly population, non-communicable diseases, rural health, South Africa

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