Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda
Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda
复制标题
DOI：
10.3402/gha.v9.31098
复制
发表时间：
2016-01-01
影响因子：
2.6
通讯作者：
Seeley, Janet
中科院分区：
文献类型：
--
作者：
Mugisha, Joseph O.;Schatz, Enid J.;Seeley, Janet
背景资料：在撒哈拉以南非洲，关于感染和未感染艾滋病毒的老年人慢性病患病率、风险因素及其与残疾的关联的数据很少。目标：在撒哈拉以南非洲，感染和未感染艾滋病毒的老年人中：1）描述慢性病患病率及其风险因素; 2）提请注意慢性病与残疾之间的关联。来自乌干达三个研究地点的50岁及以上艾滋病毒感染者和非感染者的横断面个人水平调查数据进行了分析。慢性病的诊断是通过自我报告进行的，残疾是使用世界卫生组织残疾评估表（WHODAS）确定的。我们使用有序逻辑回归并计算预测概率，以显示不同HIV状态、年龄组和地区的多种慢性病患病率的差异。我们使用线性回归，以确定慢性疾病和WHODAS.Results之间的关联：在总数，471参与者进行了调查，约一半的受访者是艾滋病毒感染者。慢性阻塞性肺疾病和眼部问题的患病率（60-69岁的人除外）在HIV阳性参与者中较高，并随年龄增加而增加。糖尿病和心绞痛的患病率在HIV阴性的参与者中更高。与无慢性疾病相比，女性（OR 1.6，95% CI 1.1-2.3）和70岁及以上人群（OR 2.1，95% CI 1.2-3.6）中有一种或多种慢性疾病的几率更高。睡眠问题（系数14.2，95%CI 7.3-21.0）和抑郁症（系数9.4，95%CI 1.2-17.0）与较高的残疾scores.Conclusion：慢性疾病是常见的老年人，影响他们的功能。乌干达的保健服务目前没有处理其中许多情况。有必要修订乌干达的保健政策和做法，以考虑老年人的保健需求，特别是因为携带艾滋病毒和其他慢性病进入老年的人数正在增加。
Background: Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa.Objectives: In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability.Methods: Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS.Results: In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60-69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1-2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2-3.6). Sleep problems (coefficient 14.2, 95% CI 7.3-21.0) and depression (coefficient 9.4, 95% CI 1.2-17.0) were strongly associated with higher disability scores.Conclusion: Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.