Dataset Information

The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa.

ABSTRACT:

Background

Older adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children. How these changes affect the mental health of older adults is largely unknown.

Methods

We use data from the 2002-2003 World Health Surveys for 15 countries in sub-Saharan Africa to examine whether older adults who may be lacking adequate support through living alone or in skipped-generation households are at an increased risk of depressive symptoms compared to those living with at least one working-age adult. Using meta-regression, we also examine whether heterogeneity across countries in the prevalence of depressive symptoms or in the association between living arrangements and depressive symptoms is associated with HIV/AIDS prevalence and national economic status.

Results

The pooled prevalence of depressive symptoms among older adults was 9.2%. Older adults living alone had a 2.3% point higher predicted prevalence of depressive symptoms compared to individuals living with at least one working-age adult (95% confidence interval: 0.2%, 4.4%). None of the country characteristics examined explained heterogeneity across countries in the relationship between living arrangements and depressive symptoms. However, there was some evidence suggesting a positive association between depressive symptom prevalence and the severity of a country's HIV/AIDS epidemic.

Conclusion

As depressive symptoms are known to be predictive of poor quality of life and increased mortality, it is important to address how health and social policies can be put in place to mitigate the potentially detrimental effects of solitary living on the mental health of older persons in sub-Saharan Africa.

SUBMITTER: McKinnon B

PROVIDER: S-EPMC3737026 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa.

McKinnon Brittany B Harper Sam S Moore Spencer S

BMC public health 20130725

<h4>Background</h4>Older adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children. How these changes affect the mental health of older adults is largely unknown.<h4>Methods</h4>We use data from the 2002-2003 World Health Surveys for 15 countries in sub-Saharan Africa to examine whether older adults who may be lacking adequate support through living alone or in skipped-g ...[more]

PMID: 23886221

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Project description:ObjectiveIn this systematic review, we aimed to summarise the empirical evidence on common mental disorders (CMDs), cognitive impairment, frailty and health-related quality of life (HRQoL) among people living with HIV aged ≥50 years (PLWH50 +) residing in sub-Saharan Africa (SSA). Specifically, we document the prevalence and correlates of these outcomes.Design, data sources and eligibility criteriaThe following online databases were systematically searched: PubMed, CINAHL, PsycINFO, Embase and Scopus up to January 2021. English-language publications on depression, anxiety, cognitive function, frailty and quality of life among PLWH50+ residing in SSA were included.Data extraction and synthesisWe extracted information, including study characteristics and main findings. These were tabulated, and a narrative synthesis approach was adopted, given the substantial heterogeneity among included studies.ResultsA total of 50 studies from fifteen SSA countries met the inclusion criteria. About two-thirds of these studies emanated from Ethiopia, Uganda and South Africa. Studies regarding depression predominated (n=26), followed by cognitive impairment (n=13). Overall, PLWH50+ exhibited varying prevalence of depression (6%-59%), cognitive impairments (4%-61%) and frailty (3%-15%). The correlates of CMDs, cognitive impairment, frailty and HRQoL were rarely investigated, but those reported were sociodemographic variables, many of which were inconsistent.ConclusionsThis review documented an increasing number of published studies on HIV and ageing from SSA. However, the current evidence on the mental and well-being outcomes in PLWH50+ is inadequate to characterise the public health dimension of these impairments in SSA, because of heterogeneous findings, few well-designed studies and substantial methodological limitations in many of the available studies. Future work should have sufficiently large samples of PLWH50+, engage appropriate comparison groups, harmonise the measurement of these outcomes using a standardised methodology to generate more robust prevalence estimates and confirm predictors.Prospero registration numberCRD42020145791.

Project description:Sub-Saharan Africa represents 69% of the total number of individuals living with HIV infection worldwide and 72% of AIDS deaths globally. Pulmonary infection is a common and frequently fatal complication, though little is known regarding the lower airway microbiome composition of this population. Our objectives were to characterize the lower airway microbiome of Ugandan HIV-infected patients with pneumonia, to determine relationships with demographic, clinical, immunological, and microbiological variables and to compare the composition and predicted metagenome of these communities to a comparable cohort of patients in the US (San Francisco). Bronchoalveolar lavage samples from a cohort of 60 Ugandan HIV-infected patients with acute pneumonia were collected. Amplified 16S ribosomal RNA was profiled and aforementioned relationships examined. Ugandan airway microbiome composition and predicted metagenomic function were compared to US HIV-infected pneumonia patients. Among the most common bacterial pulmonary pathogens, Pseudomonas aeruginosa was most prevalent in the Ugandan cohort. Patients with a richer and more diverse airway microbiome exhibited lower bacterial burden, enrichment of members of the Lachnospiraceae and sulfur-reducing bacteria and reduced expression of TNF-alpha and matrix metalloproteinase-9. Compared to San Franciscan patients, Ugandan airway microbiome were significantly richer, and compositionally distinct with predicted metagenomes that encoded a multitude of distinct pathogenic pathways e.g secretion systems. Ugandan pneumonia-associated airway microbiome is compositionally and functionally distinct from those detected in comparable patients in developed countries, a feature which may contribute to adverse outcomes in this population. Please note that the data from the comparable cohort of patients in the USUS data was published as supplemental material of PMID: 22760045 but not submitted to GEO The 'patient_info.txt' contains 12 clinical, 7 immunological and 3 microbiological variables for each patient.

Project description:BackgroundDespite being sexually active and engaging in risky sexual behaviours similar to young adults, older adults (50 years or older) are less likely to receive HIV testing, and disaggregated data are still scarce about HIV prevention and treatment in this vulnerable population in sub-Saharan Africa (SSA). This systematic review is aimed at examining sex differences in HIV testing and counseling (HTC) among older adults in SSA.MethodsA systematic search of four databases, namely, MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Global Health, was conducted from 2000 to January 2020. The primary outcome of interest for this study was gender differences in HTC among older adults in SSA. Observational studies including cross-sectional, retrospective, and prospective cohort studies were included. Eligible studies must have reported sex differences in HIV testing uptake in a standard HTC service among older adults in SSA.ResultsFrom the database search, 4143 articles were identified. Five studies were ultimately included in the final review. Of the 1189 participants, 606 (51.1%) and 580 (48.9%) were female and male, respectively. The review findings suggested that both men and women preferred HTC providers that are the same sex as them with women additionally preferring a provider who is also of a similar age. Men and women differed in their pathways to getting tested for HIV. The review documented mixed results with regard to the associations between sex of older adults and uptake of HTC. Older adult HTC uptake data are limited in scope and coverage in sub-Saharan Africa.ConclusionThis review revealed shortage of evidence to evaluate optimum HTC utilization among older adults. Few studies examined sex differences in HIV testing among older adults in the region. There is a need for stakeholders working in the area of HIV prevention and treatment to focus on older adult health utilization evidence organization, disaggregated by age and sex. Hence, high-quality research designs are needed on the topic in order to generate good quality evidence for targeted interventions to improve HTC among older adults in sub-Saharan Africa.

Dataset Information

The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa.

Background

Methods

Results

Conclusion

Publications

The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa.

Similar Datasets

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