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. 2023 Mar 1;18(1):9.
doi: 10.5334/gh.1188. eCollection 2023.

Cardiometabolic Multimorbidity Associated with Moderate and Severe Disabilities: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana and South Africa

Peter Otieno  1   2   3 , Gershim Asiki  4   5 , Justice Moses K Aheto  6 , Calistus Wilunda  1 , Richard E Sanya  1 , Welcome Wami  3   7 , Daniel Mwanga  1 , Charles Agyemang  2
Affiliations

Cardiometabolic Multimorbidity Associated with Moderate and Severe Disabilities: Results from the Study on Global AGEing and Adult Health (SAGE) Wave 2 in Ghana and South Africa

Peter Otieno et al. Glob Heart. .

Abstract

Background: Integrated management of cardiometabolic diseases is crucial in improving the quality of life of older persons. The objective of the study was to identify clusters of cardiometabolic multimorbidity associated with moderate and severe disabilities in Ghana and South Africa.

Methods: Data were from the World Health Organization (WHO) study on global AGEing and adult health (SAGE) Wave-2 (2015) conducted in Ghana and South Africa. We analysed the clustering of cardiometabolic diseases including angina, stroke, diabetes, obesity, and hypertension with unrelated conditions such as asthma, chronic lung disease, arthritis, cataracts, and depression. The WHO Disability Assessment Instrument version 2.0 was used to assess functional disability. We used latent class analysis to calculate the multimorbidity classes and disability severity levels. Ordinal logistic regression was used to identify the clusters of multimorbidity associated with moderate and severe disabilities.

Results: Data from 4,190 adults aged over 50 years were analysed. The prevalence of moderate and severe disabilities was 27.0% and 8.9% respectively. Four latent classes of multimorbidity were identified. These included a relatively healthy group with minimal cardiometabolic multimorbidity (63.5%), general and abdominal obesity (20.5%), hypertension, abdominal obesity, diabetes, cataracts, and arthritis (10.0%), and angina, chronic lung disease, asthma, and depression (6.0%). Compared to the participants with minimal cardiometabolic multimorbidity, the odds of moderate and severe disabilities were higher among participants with multimorbidity comprising hypertension, abdominal obesity, diabetes, cataract and arthritis [aOR = 3.0; 95% CI 1.6 to 5.6], and those with angina, chronic lung disease, asthma and depression [aOR = 2.7; 95% CI 1.6 to 4.5].

Conclusions: Cardiometabolic diseases among older persons in Ghana and South Africa cluster in distinct multimorbidity patterns that are significant predictors of functional disabilities. This evidence may be useful for defining disability prevention strategies and long-term care for older persons living with or at risk of cardiometabolic multimorbidity in sub-Saharan Africa.

Keywords: Cardiometabolic diseases; disability; latent class analysis; multimorbidity.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Latent classes of concordant and discordant cardiometabolic multimorbidity
Figure 1
Latent classes of concordant and discordant cardiometabolic multimorbidity.
Latent classes of disability severity levels
Figure 2
Latent classes of disability severity levels.
Dendrogram of concordant and discordant cardiometabolic multimorbidity clusters
Figure 3
Dendrogram of concordant and discordant cardiometabolic multimorbidity clusters.
Ordinal regression of cardiometabolic multimorbidity classes associated with disability
Figure 4
Ordinal regression of cardiometabolic multimorbidity classes associated with disability.
See this image and copyright information in PMC

References

    1. Arokiasamy P, Uttamacharya U, Jain K, Biritwum RB, Yawson AE, Wu F, et al. The impact of multimorbidity on adult physical and mental health in low-and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC medicine. 2015; 13(1): 1–16. DOI: 10.1186/s12916-015-0402-8 - DOI - PMC - PubMed
    1. Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. The Annals of Family Medicine. 2009; 7(4): 357–63. DOI: 10.1370/afm.983 - DOI - PMC - PubMed
    1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020; 396(10258): 1204–22. DOI: 10.1016/S0140-6736(20)30925-9 - DOI - PMC - PubMed
    1. Frieden TR, Cobb LK, Leidig RC, Mehta S, Kass D. Reducing premature mortality from cardiovascular and other non-communicable diseases by one third: achieving Sustainable Development Goal indicator 3.4.1. Global Heart. 2020; 15(1). DOI: 10.5334/gh.531 - DOI - PMC - PubMed
    1. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017; 390(10100): 1151–210. DOI: 10.1016/S0140-6736(17)32152-9 - DOI - PMC - PubMed

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