Factors associated with Multimorbidity among older persons in Uganda

Abstract

There is a dearth of literature on ageing multimorbidity in developing countries. For the case of Uganda, no definitive statistics on its prevalence are available and the associated risk factors remain less studied. This study examined the factors associated with multimorbidity occurrence among older persons (aged 50 years and more) in Uganda. Secondary analysis was conducted for cross-sectional survey data obtained from a sample of 471 older persons. These were participants from the 2013 (Wave II) Study on global ageing and adult health (SAGE) - Wellbeing of Older People (WOPS). Frequency distributions for descriptive statistics were conducted, chi-square tests and logistic regressions to examine associations of demographic, socio-economic and lifestyle variables with multimorbidity occurrence in older persons. Approximately, one in four older persons (24%) reported multimorbidity (experienced at least more than one chronic illness). The most prevalent chronic condition was hypertension (35%) and the least was stroke (2%) and angina (2%). Physical inactivity was established as a strong predictor for multimorbidity in older persons with multimorbidity occurring twice more in the physically inactive (40%) than the physically active (22%). Multimorbidity in older persons was statistically associated with being of age 70-79 years (p=0.026), having higher education (p=0.007), being obese (p=0.003) and being physically inactive (p=0.001). The odds of multimorbidity increased among older persons with higher education attainment (OR = 4.91, 95% CI: 1.55 – 15.57), obesity (OR = 4.32, 95%, CI: 1.64 – 11.38), of age 70-79 years (OR = 2.23, 95% CI: 1.11 - 4.50) and significantly lowered among the physically active (OR = 0.24, 95% CI: 0.106 – 0.541) in comparison to those with no formal education, underweight, of age 50-59 years, and physically active respectively. In response, policy attention should be focused on strengthening health systems to enhance the provision of age-friendly primary healthcare both at national and sub-national levels targeting the oldest old. There is also a need to increase the public health awareness of the importance of physical activity, having a balanced diet and weight management targeting caregivers responsible for older persons and older persons.