Physical Function in an Aging Population in Rural South Africa: Findings From HAALSI and Cross-National Comparisons With HRS Sister Studies

Abstract

Objectives: We use recently-collected data from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort from Agincourt, South Africa, to describe physical functioning in this aging population, and place the overall level and age-trajectories of physical health in the context of other Health and Retirement Study (HRS) sister studies in low- and middle-income countries (LMICs).

Method: We conduct multiple regression to estimate associations of physical functioning assessed from both self-report (activities of daily living [ADL] limitation, self-reported health) and performance (grip strength, gait speed) with socio-demographic and health characteristics in HAALSI, and use fully-interacted regression models to compare age-patterns of physical functioning outcomes cross-nationally.

Results: Gender differences in self-reported health are minimal, and men had 30% higher odds of being ADL limited controlling for socio-demographic and health characteristics. Measured physical performance is closely tied with socioeconomic conditions, but self-reported measures have a much smaller or weaker socioeconomic gradient. In international age-adjusted comparisons, the HAALSI sample had lower physical performance outcomes than most comparison populations.

Discussion: As the first HRS sister study undertaken in Africa, HAALSI adds vital information on population aging and health in the region. Continuing waves of HAALSI data will be a key resource for understanding differences in the complex processes of disability across LMIC contexts.

Keywords: Africa; Cross-national comparisons; Disability; Low- and middle-income countries; Physical functioning.

Figure 1.

Age patterns of activities of daily living (ADL) limitation, self-rated health, gait speed, and grip strength for men and women in the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) sample. Notes: Marginal means (with 95% confidence intervals) for men and women obtained by regressing the respective physical health indicator on 5-year age groups and gender.

Figure 2.

Age patterns of activities of daily living (ADL) limitation (A), self-rated health (B), gait speed (C), and grip strength (D) for men and women in the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), Health and Retirement Study (HRS), Mexican Health and Aging Study (MHAS), and China Health and Retirement Longitudinal Survey (CHARLS) samples. Notes: Marginal means (with 95% confidence intervals) obtained by regressing the respective physical health indicator on 5-year age groups and gender, fully interacted with sample country dummies.