Prevalence and factors associated with poor self-rated health among community dwelling older adults in Lomé (Togo) in 2019
Accepted: 17 February 2020
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
The number of older adults is increasing worldwide, including in sub-Saharan Africa (SSA). However, there is a paucity of data on the overall health status of older adults living in SSA. To assess the prevalence and factors associated with poor Self-Rated Health (SRH) among community-dwelling older adults in Lomé, Togo, we conducted a cross-sectional study from January to June 2019 in Lomé among community-dwelling older adults aged 50 years and older. A 30- minute questionnaire was used to collect socio-demographic characteristics, medical history, patterns of medication use and use of herbal products and dietary supplements during a face-to-face interview. SRH was assessed using a single item: Overall, you would say that your health is… (1) excellent, (2) very good, (3) good, (4) fair and (5) poor with response fair or poor defining poor SRH. A total of 344 respondents with median age 63 years, (IQR: 55-72) were enrolled in the study. Women represented 57.6% of the sample. Overall prevalence of poor SRH was 56.4% (95%CI: 51.0-61.9) and was the highest among females (62.6% vs 47.9%; P=0.007) and participants >60 years (61.5% vs 51.1%; P=0.021). Female sex, aged ≥60 years, osteoarthritis, hospitalization within the 12 months preceding the survey, polypharmacy, and the use of herbal products were factors associated with poor SRH (P<0.05). More than half of community- dwelling older adults had poor SRH in Lomé. Further studies are needed to guide policymakers in their efforts to design and implement meaningful policies to improve older adults health conditions.
World Health Organization. Active ageing: a policy framework. 2002. Available online: https://www.who.int/ageing/publications/active_ageing/en/. Accessed 11 Nov 2019.
World Health Organization. What is Healthy Ageing? Available online: https://www.who.int/ageing/healthy-ageing/en/. Accessed 11 Nov 2019.
Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013;13:320. DOI: https://doi.org/10.1186/1471-2458-13-320
Lundberg O, Manderbacka K. Assessing reliability of a measure of self-rated health. Scand J Soc Med. 1996;24:218–24. DOI: https://doi.org/10.1177/140349489602400314
Bruin A de, Picavet HSJ, Nossikov A, editors. Health interview surveys: towards international harmonization of methods and instruments. Copenhagen: World Health Organization, Regional Office for Europe; 1996.
Idler EL, Kasl SV. Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci. 1995;50:S344-353. DOI: https://doi.org/10.1093/geronb/50B.6.S344
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38:21–37. DOI: https://doi.org/10.2307/2955359
The World Bank. Life expectancy at birth, total (years) - Sub-Saharan Africa, Togo | Data. Available online: https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=ZG-TG. Accessed 11 Nov 2019.
Institut National de la Statistique et des Etudes Economiques et Démographiques Perspectives-demographiques-final-2016-05.pdf. Available online: http://www.stat-togo.org/contenu/pdf/Perspectives-demographiques-final-2016-05.pdf. Accessed 11 Nov 2019.
Rashrash M, Schommer JC, Brown LM. Prevalence and Predictors of Herbal Medicine Use Among Adults in the United States. J Patient Exp. 2017;4:108–13. DOI: https://doi.org/10.1177/2374373517706612
González-Stuart A. Herbal product use by older adults. Maturitas. 2011;68:52–5. DOI: https://doi.org/10.1016/j.maturitas.2010.09.006
Ozioma E-OJ, NwamakaChinwe OA. Herbal Medicines in African Traditional Medicine. Herb Med. 2019. doi:10.5772/intechopen.80348. DOI: https://doi.org/10.5772/intechopen.80348
Fonta CL, Nonvignon J, Aikins M, Nwosu E, Aryeetey GC. Predictors of self-reported health among the elderly in Ghana: a cross sectional study. BMC Geriatr. 2017;17. doi:10.1186/s12877-017-0560-y. DOI: https://doi.org/10.1186/s12877-017-0560-y
Abuladze L, Kunder N, Lang K, Vaask S. Associations between self-rated health and health behaviour among older adults in Estonia: a cross-sectional analysis. BMJ Open. 2017;7. doi:10.1136/bmjopen-2016-013257. DOI: https://doi.org/10.1136/bmjopen-2016-013257
Duboz P, Boëtsch G, Gueye L, Macia E. Self-rated health in Senegal: A comparison between urban and rural areas. PLOS ONE. 2017;12:e0184416. DOI: https://doi.org/10.1371/journal.pone.0184416
Bonner WIA, Weiler R, Orisatoki R, Lu X, Andkhoie M, Ramsay D, et al. Determinants of self-perceived health for Canadians aged 40 and older and policy implications. Int J Equity Health. 2017;16. doi:10.1186/s12939-017-0595-x. DOI: https://doi.org/10.1186/s12939-017-0595-x
Gbeasor-Komlanvi F, Zida-Compaore W, Dare I, Diallo A, Darre T, Potchoo Y, et al. Medication consumption patterns and polypharmacy among community dwelling elderly in Lomé (Togo) in 2017. Current Gerontology and Geriatrics Research. In press.
Phaswana-Mafuya N, Peltzer K, Chirinda W, Kose Z, Hoosain E, Ramlagan S, et al. Self-rated health and associated factors among older South Africans: evidence from the study on global ageing and adult health. Glob Health Action. 2013;6. doi:10.3402/gha.v6i0.19880. DOI: https://doi.org/10.3402/gha.v6i0.19880
Cau BM, Falcão J, Arnaldo C. Determinants of poor self-rated health among adults in urban Mozambique. BMC Public Health. 2016;16:856. DOI: https://doi.org/10.1186/s12889-016-3552-5
Bazargan M, Smith J, Saqib M, Helmi H, Assari S. Associations between Polypharmacy, Self-Rated Health, and Depression in African American Older Adults; Mediators and Moderators. Int J Environ Res Public Health. 2019;16. doi:10.3390/ijerph16091574. DOI: https://doi.org/10.3390/ijerph16091574
Zhao G, Okoro CA, Hsia J, Town M. Self-Perceived Poor/Fair Health, Frequent Mental Distress, and Health Insurance Status Among Working-Aged US Adults. Prev Chronic Dis. 2018;15. doi:10.5888/pcd15.170523. DOI: https://doi.org/10.5888/pcd15.170523
Saka S, Oosthuizen F, Nlooto M. National Policies and Older People’s Healthcare in Sub-Saharan Africa: A Scoping Review. Ann Glob Health. 85. doi:10.5334/aogh.2401. DOI: https://doi.org/10.5334/aogh.2401
Liu F, Zhang C, Liang Y, Deng Q, Hang D, Pan Y, et al. Epidemiology of self-rated health in rural China: a population-based cross-sectional study. Sci Rep. 2017;7:1–8. DOI: https://doi.org/10.1038/s41598-017-04381-6
Hoeymans N, Feskens EJM, Kromhout D, van den Bos GAM. The Contribution of Chronic Conditions and Disabilities to Poor Self-Rated Health in Elderly Men. J Gerontol Ser A. 1999;54:M501–6. DOI: https://doi.org/10.1093/gerona/54.10.M501
Mäntyselkä PT, Turunen JHO, Ahonen RS, Kumpusalo EA. Chronic Pain and Poor Self-rated Health. JAMA. 2003;290:2435–42. DOI: https://doi.org/10.1001/jama.290.18.2435
Huang KTL, Owino C, Gramelspacher GP, Monahan PO, Tabbey R, Hagembe M, et al. Prevalence and Correlates of Pain and Pain Treatment in a Western Kenya Referral Hospital. J Palliat Med. 2013;16:1260–7. DOI: https://doi.org/10.1089/jpm.2013.0080
International Narcotics Control Board. Report of the International Narcotics Control Board for 2010. New York: United Nations; 2011. Available on: http://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=387587. Accessed 13 Nov 2019.
Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough-Gorr KM. Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ. 2010;340:c1718. DOI: https://doi.org/10.1136/bmj.c1718
Marelli E, Procino G, Cottino M, Previderè G, Giorgi S, Dell’Acqua D, et al. Modification in self-rated health in patients discharged by a geriatric rehabilitation ward. Health (N Y). 2013;5:720–6. DOI: https://doi.org/10.4236/health.2013.56A2014
Arcury TA, Grzywacz JG, Bell RA, Neiberg RH, Lang W, Quandt SA. Herbal remedy use as health self-management among older adults. J Gerontol Ser B. 2007;62:S142–9. DOI: https://doi.org/10.1093/geronb/62.2.S142