Study Of Global Ageing And Adults Health Research Articles

A prospective cohort study on the association between grip strength and cognitive function in adults aged 50 years and above

Objective: To evaluate the association between grip strength (GS) and cognitive function in a population-based longitudinal cohort of Chinese adults aged ≥50 years. Methods: The study population of 3 600 adults was from the baseline survey and two rounds of follow up of World Health Organization (WHO) study of global ageing and adult health (SAGE) in five districts of Shanghai (Hongkou, Huangpu, Minhang, Qingpu and Pudong) after excluding individuals with self-report stroke and depression. The effects of baseline GS on cognitive function and its changes were evaluated. Factor analysis was applied to generate an overall cognition score based on verbal recall trials, verbal fluency test, forward digit span test and backward digit span test. Linear mixed effects model was used to examine the predictive capability of baseline GS for changes in cognitive function. Results: A total of 3 600 participants aged (61.2±8.1) years at baseline survey were included in this study, including 1 668 (46.3%) men and 1 932 (53.7%) women. The average of baseline GS and total cognitive function score were (28.19±12.18) kg and (58.93±14.56) respectively. Cognitive function score declined significantly during the follow-up, however, the changes were different among different age groups, education level groups and household income groups. After adjusted for age, education level, marital status, household income, co-morbidity of chronic conditions, drinking status, smoking status, physical activity level, vegetable/fruit intakes and BMI, no relationships between the baseline GS and cognitive score at baseline survey and at 1st follow-up were observed, however, compared with lower GS quartile group, there was a significant relationship between higher baseline GS level and better cognitive function at 2nd follow-up. The participants with highest GS quartile had better cognitive performance over time (male: β=1.938,95%CI:0.644-3.231,P=0.003, female: β=2.192,95%CI:0.975-3.409,P<0.001 and those aged 50-64 years: β=1.652,95%CI:0.646-2.659,P=0.001) than those with the lowest quartile. Conclusions: Higher baseline GS was significantly related to better cognitive function with slow decline. Thus, it is an indicator of cognitive function in middle-aged and elderly Chinese.

Cross-sectional study of association between dietary pattern and cognitive performance in people aged 50 and above years in Shanghai

Objective: To investigate the association between dietary pattern and cognitive performance in local residents aged ≥50 years in Shanghai. Methods: Data were obtained from the second round of Study of Global Ageing and Adult Health (SAGE) survey in Shanghai. Dietary patterns were surveyed by factor analysis. Cognitive tests were conducted to assess subjects' cognitive performance, including verbal recall, verbal fluency and digit test. Multiple linear regression analysis was used to evaluate the relationship between dietary patterns and cognition performance. Results: A total of 4 132 subjects with complete dietary and cognitive performance test data were included. Factor analysis was used to obtain three dietary patterns: including plant-based pattern, high animal-food pattern, high salt-oil pattern. After controlling for gender, age, education level and other factors, it was found that plant-based pattern (β=0.26,95%CI: 0.17-0.36) and high animal-food pattern (β=0.18, 95%CI:0.06-0.29) were positively associated with total cognitive test score while high salt-oil pattern (β=-0.28, 95%CI:-0.85--0.07) was negatively associated with verbal fluency test score. Conclusion: A dietary pattern with high intake of plant food and appropriate intake of animal food might be associated with better cognitive function of residents aged ≥50 years.

Social Participation as a Predictor of Morbid Thoughts and Suicidal Ideation among the Elderly Population: A Cross-Sectional Study on Four Low-Middle-Income Countries

Social wellbeing constitutes a critical aspect of one’s health, quality of life, and overall psychosocial wellbeing. Social isolation and perceived loneliness are growing public health concerns as they are considered to be important risk factor for poor physical and mental health outcomes. Not much is known about how the level of one’s social participation is associated with morbid thought and suicidal ideation. In the present study, we aimed to investigate whether social participation shows any significant correlation with morbid thought and suicidal ideation among the elderly population. Methods: Cross-sectional data were collected from Wave 1 of the Study of Global AGEing and Adult Health (SAGE). The sample population consisted 2018 men and women aged 65 years and above from the following countries: China (n = 787), Ghana (n = 278), India (n = 560), and Russia (n = 396). Outcome variables of self-reported occurrence of morbid thoughts and suicide ideation during the past 12 months were reported. Results: A great majority of the participants reported not participating in activities such as public meetings (84.6%), club meeting (49.6%), neighborhood activities (46%), and religious activities (57.2%). Those who reported attending public meetings several times a year had a higher likelihood of reporting having morbid thoughts (predicted probability = 1.24, 95% CI = 1.02, 1.52). However, the association was no longer significant after stratifying by sex. Attending clubs (marginal effect = 0.61, 95% CI = 0.49, 0.76) and neighborhood activities (predicted probability = 0.71, 95% CI = 0.58, 0.88) several times a year showed protective effects against morbid thoughts. Being visited by friends several times a month (predicted probability = 0.52, 95% CI = 0.40, 0.67) and visiting friends (predicted probability = 0.61, 95% CI = 0.50, 0.75) several times a year also showed lower likelihood of morbid thoughts. Similar effects were observed for attending social gatherings with colleagues and social events as well. Conclusions: The present findings suggest that there exist significantly positive associations between participation in social activities and morbid thoughts and suicidal ideation among the elderly population in the sample countries. More in-depth studies are necessary to investigate the barriers to participation in social activities as well as the role of the quality of social relationships with experiencing suicidal thoughts.

Intersectional Effects of Gender, Education, and Geographic Region on Functional Health Disparities Among Older Adults in India.

Objective: Research on social determinants of health in India has focused largely on the independent influence of education, gender, and region. Using an intersectionality framework in this study, we examine the combined effects of these three key social locators on the critical, yet underexamined outcome of later life functional health. Method: We use data from Wave 1 (2007-2010) of the Study of Global Ageing and Adult Health (SAGE) (N = 7,150) to examine whether the effects of education on functional limitations differ by gender in six highly heterogenous regions of India. Results: The effects of education on functional limitations were significantly greater (β = .026, p < .001) for men than women. Consistent with established regional differences in economic development, cultural practices, and political context, this relationship varied across locales. Discussion: Our findings highlight the need to move beyond independent sources of heterogeneity in examining later life functional health in the global South.

Neighborhood social environment and disability among Mexican older adults: a cohort-based analysis.

Considering that the world population is rapidly aging and disability is a very frequent event in older adults, there is an increasing interest in studying their determinants, such as the neighborhood characteristics. Thus, this study aimed to explore the association between the social environment of the neighborhood and disability in older adults. A cohort study was assembled using waves 1 and 2 from the Study of Global Ageing and Adults Health (SAGE) in Mexico, which included adults with 55+ years old. Neighborhood characteristics - such as social participation, trust and safety - and individual covariates were measured only in wave 1 (baseline), while disability was measured in both waves to adjust for the score of wave 1. Multilevel negative binomial models with random intercepts at the municipality level were constructed for the disability score in wave 2, using each of the social environment variables as the main exposure and adjusting for the sociodemographic and health-related variables. Finally, interaction terms with sex, age, and socioeconomic quintiles were tested. Results showed that neighborhoods with a medium (IRR: 0.68; 95%CI: 0.53-0.87) or high (IRR: 0.67; 95%CI: 0.52-0.86) safety level were associated with a significant reduction in the disability score of adults older than 75 years, although there was no association between other characteristics of the social environment and disability in the general sample. Consequently, actions to improve safety in the neighborhoods should be carried out to help reduce the disability score in vulnerable older adults, especially in a context where safety is a critical issue, as in Mexico.

Assessment of the factors of mental health of the elderly population of Russia on the basis of individual data

Mental health is determined as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO 2014, 2017). By taking the example of the elderly population of Russia the article reveals the existence and nature of ties between individual socio-economic characteristics of the older age people and the level of their mental health. The article presents the author’s method of assessment of mental health of the elderly population, which is based on a brief scale of the Center for Epidemiologic Studies Depression Scale (CES-D). Individual data from the WHO International Study of Global Ageing and Adult Health (SAGE) conducted in the regions of Russia in 2002-2004 (wave 0) and in 2007-2010 (wave 1) are used as the empirical basis of the study.

Oral problems and associated risk indicators in adults in the Russian Federation, India, and China

BackgroundOral problems, known as a neglected epidemic, have become prevalent in Brazil, the Russian Federation, India, China, and South Africa (BRICS) countries in last decade. The objective of the study is to examine the prevalence and associated risk indicators of oral problems in adults in the Russian Federation, India, and China in BRICS countries.MethodsWe used data from the first round of the Study of Global AGEing and Adult Health (SAGE), conducted by WHO in 2007–10 in selected BRICS countries. Oral problems are defined as if an adult had any mouth and/or teeth related problems including swallowing problems in last 1 year of the survey. We estimated the mean age of adults who had oral problems and used a t-test for comparing it by sex of adults. We determined the prevalence of oral problems in adults. We designed a hierarchical conceptual model to identify associated risk indicators with oral problems. Finally, we applied a multivariable binary logistic regression model based on a conceptual model to examine associated socioeconomic and demographic, behavioral and nutritional risk indicators and systemic diseases – diabetes, hypertension, and angina pectoris/angina with oral problems in adults.ResultsThe mean age of adults who had oral problems is lowest in India (57 years; SD: 15) and highest in China (65 years; SD: 11). However, it does not vary by sex of adults except India. The prevalence of oral problems is highest in the Russian Federation (35%) and lowest in China (9%). Adults with body mass index (BMI) less than 25 kg/m2, age 45 years or more, diabetes, hypertension, and angina pectoris/angina have a higher risk of oral problems. Females and adults using alcohol are also more likely to have oral problems in selected countries.ConclusionsThe study concludes that females, adults using alcohol and those having any systemic disease are at higher risk of oral problems in the Russian Federation, India, and China. A one-third of adults had oral problems in particularly, in the Russian Federation; thus there is an urgent need to formulate oral policy and program, which the country currently lacks in.

Engagement in physical activity, suicidal thoughts and suicide attempts among older people in five developing countries.

BackgroundSuicide causes rising economic costs and public health risks for communities in the worldwide. Physical activity (PA) is considered a potentially feasible approach to reduce risk of suicide with low cost and high accessibility, and therefore attracting increasing attention. However, current literature on the association between PA and suicidal behavior amongst elderly people in low- and middle-income countries (LMICs) are scarce. Therefore, in this study we aimed to examine the relationship between suicidal thoughts (ST) and suicidal attempts (SA) with PA among elderly people in five LMICs.MethodsCross-sectional data were collected from WHO’s Study of Global Ageing and Adult Health (SAGE) with 2,861 participants aged 50 years or above. Variables included: self-reported occurrence of ST and SA during past 12 months and four types of PA (vigorous physical activity (VPA), moderate physical activity (MPA), walking/bike riding, moderate leisure time physical activity (MLPA)).ResultsThe overall prevalence of taking >75 min of VPA/week, >150 min/week, MLPA and walking/bike riding were, respectively, 85.4% (95% CI [81.3–88.7]), 61.6% (95% CI [52.9–69.6]), 9.6% (95% CI [7.2–12.6]) and 75.1% (95% CI [68.7–80.6]). Respectively, 31.0% (95% CI [24.3–38.7]) and 5.5% (95% CI [3.9–7.5]) of the respondents reported having morbid thoughts and SA during last 12 months. In adjusted multivariable regression analysis, not engaging in PA revealed positive association with higher odds of having morbid thoughts and SA, however, with varying degrees for different types of PA among men and women and across countries. The adjusted odds ratio among elderly who encountered ST increased significantly with PA levels (1.265 in male and 1.509 in female with VPA, 1.292 in male and 1.449 in female with MPA, 1.669 in female with LMPA and 3.039 in women with walk/bike); similarly, with SA (1.526, 1.532, 1.474 and 1.392 in women with VPA, MPA, LMPA and Walk/bike, respectively). The degree of adjusted odds ratio varied between genders and among countries.ConclusionAlthough the data were cross-sectional, and no linear dose-response relationship was observed between PA and morbid thought and suicide ideation, the findings provide important indications of potential harmful effects of no/inadequate PA on psychological morbidities among older individuals. Promoting adequate PA among older individuals through community-based suicide prevention programs can potentially contribute to reduction in the burden of PA in LMICs.

PSY20 - Health State Utilities and High Body Mass Index: Evidence from who Study of Global Ageing and Adult Health (SAGE)

To provide age- and sex-specific health state utilities (HSUs) and examine their associations with overweight/ obesity in the Ghanaian population. Data from the World Health Organization’s 2008 Study of Global Ageing and Adult Health (SAGE) was used. HSUs were derived, first by mapping EQ-5D-3L profiles to responses from the health state descriptions in SAGE. The UK population norms were applied in the baseline scenario to calculate HSUs. Multilevel linear regressions that utilize the identity link were used to evaluate associations between HSUs and overweight/ obesity. Responses from 3,946 adults aged 18-79 years were analysed. The mean (95 % confidence interval) HSU was 0.661 (95% CI: 0.652, 0.670) for the analytical sample, 0.690 (95% CI: 0.679, 0.702) for men and 0.626 (95% CI: 0.612, 0.640) for women. Mean HSU was significantly higher for overweight respondents compared to those with normal BMI. There was statistically significant negative association between HSUs and being a woman (-0.048; 95% CI: -0.066, -0.029) compared to being a man, women with class I obesity (-0.047; 95% CI: -0.091, -0.002) compared to women with normal BMI, ages 50-79 years compared to 18-29 years and all obesity-related medical conditions. The study provides HSUs by sex and age in the Ghanaian population. Mean HSU was significantly higher in overweight respondents in the population; and class I obesity (BMI= 30.00 to ≤ 35.00kg/m2) was negatively associated with HSUs in women.

Prevalence of Loneliness and Associated Factors among Older Adults in South Africa

OBJECTIVE: Loneliness can be detrimental to health. The aim of this study is to estimate the prevalence of loneliness as well as its risk factors in older adults in South Africa.MATERIALS &amp; METHODS: This cross-sectional population based study investigated factors associated with loneliness in a nationally representative sample (n=3624) of older South Africans who took part in the “Study of Global Ageing and Adults Health (SAGE)” wave 1 in 2008. The outcome variable was self-reported prevalence of loneliness and the exposure variables were socio-demographic characteristics and health variables.RESULTS: The overall prevalence of self-reported loneliness was 9.9%. Prevalence of loneliness was 10.2% for females and 9.5% for males, lowest among those married (7.5%), and highest among the 70+ years olds (12.5%). Individuals with highest level of education had the lowest prevalence of loneliness (5.9%). Indians or Asians were significantly more likely to experience loneliness than other population groups (Adjusted Odds Ratio=AOR: 3.20; 95% Confidence Interval=CI: 1.31, 7.80). Married or cohabiting individuals were significantly less likely to experience loneliness than unmarried or non-cohabiting ones, respectively (AOR: 0.55; 95% CI: 0.37, 0.81). In multivariable logistic regression, individuals with good subjective health were less likely to experience loneliness than those with poor health (AOR: 0.40, 95% CI: 0.22, 0.73). Similarly, individuals with good cognitive functioning were significantly less likely to experience loneliness than those with poor cognitive functioning (AOR: 0.55, 95% CI: 0.32, 0.97).CONCLUSION: The study found that the prevalence of loneliness among older adults in South Africa is significant. Preventative interventions that address the identified factors, including poor health status and low cognitive functioning, associated with loneliness need to be developed.

Association between Visual Impairment and Low Vision and Sleep Duration and Quality among Older Adults in South Africa

This study aims to estimate the association between visual impairment and low vision and sleep duration and poor sleep quality in a national sample of older adults in South Africa. A national population-based cross-sectional Study of Global Ageing and Adults Health (SAGE) wave 1 was conducted in 2008 with a sample of 3840 individuals aged 50 years or older in South Africa. The interviewer-administered questionnaire assessed socio-demographic characteristics, health variables, sleep duration, quality, visual impairment, and vision. Results indicate that 10.0% of the sample reported short sleep duration (≤5 h), 46.6% long sleep (≥9 h), 9.3% poor sleep quality, 8.4% self-reported and visual impairment (near and/or far vision); and 43.2% measured low vision (near and/or far vision) (0.01–0.25 decimal) and 7.5% low vision (0.01–0.125 decimal). In fully adjusted logistic regression models, self-reported visual impairment was associated with short sleep duration and poor sleep quality, separately and together. Low vision was only associated with long sleep duration and poor sleep quality in unadjusted models. Self-reported visual impairment was related to both short sleep duration and poor sleep quality. Population data on sleep patterns may want to include visual impairment measures.

Differences in Sleep Duration among Four Different Population Groups of Older Adults in South Africa.

The study aims to investigate sleep duration in four different population groups in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) Wave 1. A national population-based cross-sectional study with a sample of 3284 aged 50 years or older in South Africa was conducted in 2008. The questionnaire included socio-demographic characteristics, health variables, and self-reported sleep duration. Results indicate that White Africans compared to other population groups had the lowest mean sleep duration (7.88 h among men and 7.46 h among women). The prevalence of short sleep was the highest among both men and women among the White African (18.8% in men and 16.9% in women) and Indian or Asian African population groups (14.5% in men and 17.1% in women), and lowest among both men and women in the Black African (7.0% in men and 6.5% in women) and multi-ancestry population groups (15.6% in men and 12.7% in women). The prevalence of long sleep was among both men and women the highest in the Black African population group (56.2% in men and 58.5% in women), and the lowest in the White African population group (36.4% in men and 24.3% in women). In a Poisson regression model, adjusted for sociodemographics and chronic disease status, coming from the male and female White African population group was associated with short sleep. In addition, coming from the Indian or Asian African population group was associated with short sleep. No population group differences were found regarding long sleep prevalence. White Africans reported more short sleep duration than the other population groups, while there were no racial or ethnic differences in long sleep. White Africans are more likely to have sleep durations that are associated with negative health outcomes. An explanation of the high short sleep prevalence among White Africans may be related to their racial or ethnic minority status in South Africa.

Attitude Towards Ageing and Perceived Health Status among the Elderly in Malaysia

There is an increasing number of older people globally, thus it is essential to build knowledge of how older people view their own ageing, considering their health related circumstances. However, limited attention has been given to attitude towards ageing, particularly in Malaysia. The purpose of this study is to examine the relationship between self- perception of ageing and perceived health status in adults aged 60 years and above. This study is primarily conducted via survey among the elderly patients who are 60 years old and above, who are using the services at public hospitals in Peninsular Malaysia. The ‘Attitudes towards ageing’ questionnaire was used to measure participants’ perception of ageing, while perceived health status was measured using questions from the Study of Global Ageing and Adult Health (SAGE) developed by World Health Organization(WHO). All items in both questionnaires were measured on a 5-point Likert-scale. The findings reveal that positive attitudes to ageing were associated with health status in older adults. The research contributes to greater understanding of the attitudes among the elderly towards ageing and their perceived health status. Understanding these associations may help healthcare providers and policy makers consider strategies to enhance the quality of life of the elderly.

Measuring Active Aging for Cross-Country Comparisons and Policy Planning

An aging population and the low involvement of elderlies in social activities makes the measurement of active aging an important research question, since it gives an insight into the potential of the elderly. Policy agendas in many countries stress the need for active aging in terms of improved health and a greater degree of autonomy. This paper aims to investigate the potential and limits of international comparison for setting policy goals concerning older adults. We use World Health Organization (WHO) micro data from the Study of Global Ageing and Adult Health (SAGE) to measure active aging in five countries demonstrating similar macroeconomic outcomes, namely Russia, India, China, South Africa and Mexico. Following the WHO concept of active aging, we select indicators for three components of active aging (health, participation in social activities, and security) and aggregate them into three sub-indices, which become the outcome index of active aging. Our findings show significant variation in the proportion of actively aging individuals in selected countries (from 89% in China to 44% in South Africa) and in the sub-indices of health, participation and security. We compare our results with macro-level data and conclude that the active aging index could be a useful tool for measuring the proportion of actively aging individuals and understanding the challenges for policy makers in each country. However, one should understand the limits of micro-level data analysis and interpret the results carefully. We also argue that for international comparisons, active aging indexes should be studied with respect to the activity of non-elderlies in each country.

Are estimates of socioeconomic inequalities in chronic disease artefactually narrowed by self-reported measures of prevalence in low-income and middle-income countries? Findings from the WHO-SAGE survey

BackgroundThe use of self-reported measures of chronic disease may substantially underestimate prevalence in low-income and middle-income country settings, especially in groups with lower socioeconomic status (SES). We sought to determine...

Breast and cervical cancer screening and associated factors among older adult women in South Africa.

Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic conditions were associated with breast cancer screening. Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.

Measuring Active Aging for Government Policy Planning: A Case of Russia

Rising life expectancy and an aging population highlight the need for appropriate government policies to transform of the role of the elderly from a dependent part of the population to an economically active one. This paper aims to measure active aging of the elderly in Russia. We review definitions of active aging and base our research on the concept of the World Health Organization. Active aging is characterized by three components: health, participation, and security. We select indicators for these components and aggregate them into three sub-indexes which become the outcome index of active aging. As a result, the sample is divided into two groups of elderly people in Russia, “actively aging” and “inactively aging”. The empirical research is based on the Study of Global Ageing and Adult Health (SAGE). Our findings show that 70% of the elderly population are at the intersection of “health” and “participation in social activities”; 61.2% between “health” and “security”; 73.5% between “security” and “participation in social activities”. Overall, 58.5% of Russian senior citizens meet all three criteria of active aging, thus creating a great challenge for policy response.

Problem drinking and associated factors in older adults in South Africa

Alcohol abuse poses special risks for increased morbidity and mortality among older adults. Little attention has focused on assessing alcohol use and associated factors among older adults in transitional societies such as South Africa. This study aimed to determine the prevalence of alcohol use and associated factors in older South Africans who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. We conducted a national population-based cross-sectional study with a sample of 3840 aged 50 years or older in South Africa in 2008. In this study we analysed data from all 2144 participants who were over 60 years old. The questionnaire included socio-demographic characteristics, alcohol intake as well as comorbidity. Risky drinking was defined in two ways: heavy drinkers (>7 drinks/week) and binge drinkers (>3 drinks/one occasion/week). Four percent of participants reported heavy drinking and 3.7% binge drinking. Male gender (Odds Ratio (OR) =3.79, Confidence Interval (CI) =1.38-10.37) and white population group (OR=3.01, CI=1.31-6.89) were associated with risky drinking in multivariate analysis; as well as tobacco use (OR=5.25, CI=2.20-12.52) and not being obese (OR=0.14, CI=0.05-0.35). Hypertension, diabetes and depression were not associated. This study reveals moderate rates of risky drinking among older adults (60 years and more) in South Africa that puts them at risk of morbidity. Alcohol problems among older adults are commonly under-recognized, indicating a need for health care worker intervention.

Cognitive functioning and associated factors in older adults in South Africa

Objective. To investigate cognitive functioning and associated factors in a national probability sample of older South Africans who participated in the Study of Global AGEing and Adult Health (SAGE) in 2008. Methods. In 2008 we conducted a national population-based cross-sectional study with a sample of 3 840 adults aged ≥50 years in South Africa. We administered a questionnaire surveying socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. Multivariate regression analyses were used to assess the association of socio-demographic factors and health variables with cognitive functioning. Results. Mean variables in the sample were: 5.9 recalled words, a verbal fluency of 9.9 words in a specified category (animals), a forward and backward digit span of 5.2 and 3.2, respectively, and an overall mean cognition score of 48.5. Higher overall cognitive functioning (a combination of memory and executive functioning) was positively associated with: younger age; white, Indian/Asian or coloured ethnicity; being married; a higher level of education; greater wealth; a higher level of physical activity; a greater quality of life; and a better subjective health status. Conclusions. Our findings can be used to refine future projections of cognitive function and healthcare needs in ageing middle-income societies such as those in South Africa.

Sociodemographic and health correlates of sleep problems and duration in older adults in South Africa

Objective. To investigate sleeping problems, sleep duration and associated factors in a national probability sample of older South Africans who participated in the Study of Global Ageing and Adult Health (SAGE) in 2008. Methods. In 2008 I conducted a national population-based cross-sectional study with a sample of 3 840 South African individuals aged ≥50 years. A questionnaire was used to survey sociodemographic characteristics and health variables, and anthropometric and blood pressure measurements were recorded. Results. Of the participants, 9.1% reported having a sleeping problem at the time of the study. The average number of self-reported hours of sleep was 8.6 (SD ±2.1), with 11.6%, 45.1%, 20.0%, and 23.5% reporting ≤6, 7 - 8, 9, and ≥10 h, respectively. In multivariable analysis, depression, cognitive impairment, lack of social cohesion, and moderate or severe activity limitations were associated with having a current sleeping problem. In terms of sociodemographic and health variables, a short sleep duration was associated with: white, Indian/Asian or coloured ethnicity; daily tobacco use; and moderate and severe activity limitations. In participants aged 60 - 79 years, lower wealth, hypertension, risky drinking and lower health-related quality of life were associated with a long sleeping duration. Conclusion. This study robustly characterised the prevalence of sleeping problems and specific associated risk factors in a large sample in South Africa. This can help to direct future healthcare efforts.