Abstract
ObjectivesThe importance of impairment in performing activities of daily living (ADL) is likely to increase in sub-Saharan Africa because few care options for affected people exist. This study investigated the prevalence of ADL impairment, the extent to which care need was met, and described characteristics of people with ADL impairment and unmet need in Burkina Faso.MethodsThis study used data from the Centre de Recherche en Santé de Nouna Heidelberg Aging Study, a population-based study among 3,026 adults aged older than 40 years conducted in rural Burkina Faso. Information on 6 basic ADL items was sought, with a follow-up question asking whether care need was not met, partially met, or met. Bivariable correlations and multivariable logistic regression were used to determine sociodemographic and health characteristics associated with ADL impairment and unmet need.ResultsADL impairment of any kind was reported by 1,202 (39.7%) respondents and was associated with older age (adjusted odds ratio: 1.05 [95% CI: 1.04–1.06]), being a woman (1.33 [1.06–1.60]), and reporting depressive symptoms (1.90 [1.65–2.18]). Among those with ADL impairment, 67.8% had at least one unmet need. Severe ADL impairment was found in 202 (6.7%) respondents, who reported a lower prevalence of unmet need (43.1%). Severe ADL impairment was associated with depressive symptoms (2.55 [2.11–3.07]) to a stronger degree than any ADL impairment.DiscussionPrevalence of ADL impairment and unmet need was high in this setting. Variation in impairment across the population highlighted key groups for future interventions. Unmet need for care was highest in middle-aged adults, indicating a gap in care provision.
Highlights
As is the case worldwide, populations in sub-Saharan Africa (SSA) and Burkina Faso are rapidly aging
Understanding the care needs of older people in Burkina Faso is challenging, as there is very little evidence about physical function and health in later life (Berthe et al, 2012; Berthe et al, 2014) and no information t regarding unmet need for care among functionally impaired people. The resources in this ip region are limited for older people and caregivers alike and the focus of care and research has r traditionally been on earlier stages of the life course and on infectious diseases (Nachega et c al., 2012). us The amount of research about functional health of older people from other SSA countries like n South Africa (Payne, Gómez-Olivé, et al, 2017; Payne, Wade, et al, 2017), Tanzania (Lewis a et al, 2018), Nigeria (Ojagbemi et al, 2017) and Uganda (Yaya et al, 2020) is slowly M increasing, but the majority of evidence still comes from high income countries, where d population aging is an established field of research
We categorized some difficulty walking across a room with mild to moderate us impairment group and inability to walk across a room with severe to extreme impairment. n Respondents answering with ‘do not want to do’ to the Activities of Daily Living (ADL) questions were put in the severe a to extreme impairment group, as the ADLs are essential activities to maintain an independent M life and by reporting their unwillingness to engage in these pivotal activities, we considered them severely disabled
Summary
As is the case worldwide, populations in sub-Saharan Africa (SSA) and Burkina Faso are rapidly aging. Understanding the care needs of older people in Burkina Faso is challenging, as there is very little evidence about physical function and health in later life (Berthe et al, 2012; Berthe et al, 2014) and no information t regarding unmet need for care among functionally impaired people. The resources in this ip region are limited for older people and caregivers alike and the focus of care and research has r traditionally been on earlier stages of the life course and on infectious diseases (Nachega et c al., 2012). The Centre de Recherche en c Santé de Nouna (CRSN) Heidelberg Aging Study (CHAS) was designed to Ac extend the current literature regarding functional health impairment and unmet need for care in Burkina Faso and SSA
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