Epidemiology of frailty, multimorbidity, and disability: a cross-sectional study of mid-aged and older adults in The Gambia, Zimbabwe and South Africa
A third of mid-aged to older adults in this study had multimorbidity, and nearly a quarter were disabled, highlighting the need for patient-centered interventions.
Where it sits
this study against the rest of the ss-31 corpusSummary and findings
This study quantified the overlap between multimorbidity, frailty, and disability in adults aged ≥ 40 years across five settings in Africa. The study found that 36.3% of participants were multimorbid, 14.1% were frail, and 22.9% were disabled. The overall mean HRQoL utility score was 0.829 ± 0.107.
Abstract
<title>Abstract</title> <p>Background Multimorbidity, frailty and disability risk are increasing with longevity across Africa. We aimed to quantify the overlap between multimorbidity, frailty, and disability; assess associations with health-related quality of life (HRQoL); and between individual long-term conditions (LTCs) and frailty and disability. Methods This population-based cross-sectional study recruited adults aged ≥ 40 years in five settings: rural(n = 1052) and urban Gambia(n = 1218), rural(n = 948) and urban South Africa (SA) (n = 968), and urban Zimbabwe(n = 1110). Researcher-administered questionnaires and assessments determined LTCs by self-reported diagnosis, medication use, blood pressure, glucose and HIV testing. Multimorbidity was defined as ≥ 2 LTCs, disability by Washington Group questionnaire, frailty using five Fried criteria (≥ 3 frail, 1–2 pre-frail, 0 robust), and HRQoL using EuroQol-5 Dimension 5-Level. A minimally important difference [MID] was considered half a standard deviation[SD]. Results Of 5,296 adults (mean age 61.0 [SD:12.9] years, 53.3% (n = 2823) female), 1924 (36.3%) were multimorbid, 741 (14.1%) frail, 3199 (60.7%) prefrail, and 1211 (22.9%) disabled. Overall, 202(3.8%) had the triad of multimorbidity, frailty, and disability (range: 10.6% urban SA, to 5.5% rural Gambia). Mood disorders (odds ratio [OR] 7.16 [95%CI: 4.16;12.33]), severe mental illness (4.66 [2.71;8.00]), and chronic kidney disease (4.25 [1.62;11.10]) were associated with frailty, whilst mood disorders (3.19 [2.48;4.09]), arthritis (2.78 [1.54;4.94]), and cardiac disease (2.50 [1.66;3.56]) were associated with disability. Age-adjustment strengthened associations, and revealed disability associations with epilepsy, HIV, and prior tuberculosis. The overall mean ± SD HRQoL utility score was 0.829 ± 0.107 (MID = 0.054). In younger adults (40–54 years), a HRQoL MID was observed in females with multimorbidity, pre-frailty and disability, and in men with frailty and disability (+/- multimorbidity). In older ages (≥ 55 years), a HRQoL MID was reached in females and males with pre-frailty or frailty and disability (+/- multimorbidity). Conclusions A third of mid-age to older adults were living with multimorbidity, three-quarters with frailty or pre-frailty and a quarter with disability. Patient-centred interventions, rather than disease-based approaches, should be evaluated and may improve functional and health outcomes and quality of life in people living with multimorbidity, frailty, and disability.</p>
Background
The study likely addresses the prevalence and characteristics of frailty, multimorbidity, and disability among mid-aged and older adults in The Gambia, Zimbabwe, and South Africa. Understanding these factors is crucial for public health planning and resource allocation in these regions.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Limitations
- Not reported in abstract.