Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.

<h4>Background</h4>Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique c...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Collin F Payne, James Mkandawire, Hans-Peter Kohler
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/4db35e7c1c1146438715981cbb916db1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4db35e7c1c1146438715981cbb916db1
record_format	dspace
spelling	oai:doaj.org-article:4db35e7c1c1146438715981cbb916db12021-11-18T05:42:37ZDisability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.1549-12771549-167610.1371/journal.pmed.1001435https://doaj.org/article/4db35e7c1c1146438715981cbb916db12013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23667343/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited.<h4>Methods and findings</h4>Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge) microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64%) of their remaining 28 y of life (95% CI, 25.7-33.5) with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46%) of their remaining 25.4 y (95% CI, 23.3-28.8) with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well-being.<h4>Conclusions</h4>Individuals in this population experience a lengthy struggle with disabling conditions in adulthood, with high probabilities of remitting and relapsing between states of functional limitation. Given the strong association of disabilities with work efforts and subjective well-being, this research suggests that current national health policies and international donor-funded health programs in SSA inadequately target the physical health of mature and older adults.Collin F PayneJames MkandawireHans-Peter KohlerPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 10, Iss 5, p e1001435 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Collin F Payne James Mkandawire Hans-Peter Kohler Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
description	<h4>Background</h4>Falling fertility and increasing life expectancy contribute to a growing elderly population in sub-Saharan Africa (SSA); by 2060, persons aged 45 y and older are projected to be 25% of SSA's population, up from 10% in 2010. Aging in SSA is associated with unique challenges because of poverty and inadequate social supports. However, despite its importance for understanding the consequences of population aging, the evidence about the prevalence of disabilities and functional limitations due to poor physical health among older adults in SSA continues to be very limited.<h4>Methods and findings</h4>Participants came from 2006, 2008, and 2010 waves of the Malawi Longitudinal Survey of Families and Health, a study of the rural population in Malawi. We investigate how poor physical health results in functional limitations that limit the day-to-day activities of individuals in domains relevant to this subsistence-agriculture context. These disabilities were parameterized based on questions from the SF-12 questionnaire about limitations in daily living activities. We estimated age-specific patterns of functional limitations and the transitions over time between different disability states using a discrete-time hazard model. The estimated transition rates were then used to calculate the first (to our knowledge) microdata-based health expectancies calculated for SSA. The risks of experiencing functional limitations due to poor physical health are high in this population, and the onset of disabilities happens early in life. Our analyses show that 45-y-old women can expect to spend 58% (95% CI, 55%-64%) of their remaining 28 y of life (95% CI, 25.7-33.5) with functional limitations; 45-y-old men can expect to live 41% (95% CI, 35%-46%) of their remaining 25.4 y (95% CI, 23.3-28.8) with such limitations. Disabilities related to functional limitations are shown to have a substantial negative effect on individuals' labor activities, and are negatively related to subjective well-being.<h4>Conclusions</h4>Individuals in this population experience a lengthy struggle with disabling conditions in adulthood, with high probabilities of remitting and relapsing between states of functional limitation. Given the strong association of disabilities with work efforts and subjective well-being, this research suggests that current national health policies and international donor-funded health programs in SSA inadequately target the physical health of mature and older adults.
format	article
author	Collin F Payne James Mkandawire Hans-Peter Kohler
author_facet	Collin F Payne James Mkandawire Hans-Peter Kohler
author_sort	Collin F Payne
title	Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
title_short	Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
title_full	Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
title_fullStr	Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
title_full_unstemmed	Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.
title_sort	disability transitions and health expectancies among adults 45 years and older in malawi: a cohort-based model.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/4db35e7c1c1146438715981cbb916db1
work_keys_str_mv	AT collinfpayne disabilitytransitionsandhealthexpectanciesamongadults45yearsandolderinmalawiacohortbasedmodel AT jamesmkandawire disabilitytransitionsandhealthexpectanciesamongadults45yearsandolderinmalawiacohortbasedmodel AT hanspeterkohler disabilitytransitionsandhealthexpectanciesamongadults45yearsandolderinmalawiacohortbasedmodel
_version_	1718424783484354560

Disability transitions and health expectancies among adults 45 years and older in Malawi: a cohort-based model.

Ejemplares similares