Abstract
BackgroundOlder adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children. How these changes affect the mental health of older adults is largely unknown.MethodsWe use data from the 2002–2003 World Health Surveys for 15 countries in sub-Saharan Africa to examine whether older adults who may be lacking adequate support through living alone or in skipped-generation households are at an increased risk of depressive symptoms compared to those living with at least one working-age adult. Using meta-regression, we also examine whether heterogeneity across countries in the prevalence of depressive symptoms or in the association between living arrangements and depressive symptoms is associated with HIV/AIDS prevalence and national economic status.ResultsThe pooled prevalence of depressive symptoms among older adults was 9.2%. Older adults living alone had a 2.3% point higher predicted prevalence of depressive symptoms compared to individuals living with at least one working-age adult (95% confidence interval: 0.2%, 4.4%). None of the country characteristics examined explained heterogeneity across countries in the relationship between living arrangements and depressive symptoms. However, there was some evidence suggesting a positive association between depressive symptom prevalence and the severity of a country’s HIV/AIDS epidemic.ConclusionAs depressive symptoms are known to be predictive of poor quality of life and increased mortality, it is important to address how health and social policies can be put in place to mitigate the potentially detrimental effects of solitary living on the mental health of older persons in sub-Saharan Africa.
Highlights
Older adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children
Using data from 15 sub-Saharan African countries, we examined whether older Africans who may be lacking adequate support as a consequence of living alone or in skipped-generation households report more depressive symptoms compared to those living in households with at least one working-age adult
In South Africa, Kenya and Malawi, 20% or more of older adults lived in single generation households, whereas in Mali and Senegal it was less than 2%
Summary
Older adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children. How these changes affect the mental health of older adults is largely unknown. In sub-Saharan Africa, families have traditionally been the primary source of care and support for older people, with the majority of older adults residing with adult children and their families [1]. Depressed older people had impaired quality of life and greater difficulty functioning at home and in social roles
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