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Impairment in Activities of Daily Living and Unmet Need for Care Among Older Adults: A Population-Based Study From Burkina Faso

Lookup NU author(s): Professor Miles WithamORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America.OBJECTIVES: The importance of impairment in performing activities of daily living (ADL) is likely to increase in sub-Saharan Africa because few care options for affected people exist. This study investigated the prevalence of ADL impairment, the extent to which care need was met, and described characteristics of people with ADL impairment and unmet need in Burkina Faso. METHODS: This study used data from the Centre de Recherche en Santé de Nouna Heidelberg Aging Study, a population-based study among 3,026 adults aged older than 40 years conducted in rural Burkina Faso. Information on 6 basic ADL items was sought, with a follow-up question asking whether care need was not met, partially met, or met. Bivariable correlations and multivariable logistic regression were used to determine sociodemographic and health characteristics associated with ADL impairment and unmet need. RESULTS: ADL impairment of any kind was reported by 1,202 (39.7%) respondents and was associated with older age (adjusted odds ratio: 1.05 [95% CI: 1.04-1.06]), being a woman (1.33 [1.06-1.60]), and reporting depressive symptoms (1.90 [1.65-2.18]). Among those with ADL impairment, 67.8% had at least one unmet need. Severe ADL impairment was found in 202 (6.7%) respondents, who reported a lower prevalence of unmet need (43.1%). Severe ADL impairment was associated with depressive symptoms (2.55 [2.11-3.07]) to a stronger degree than any ADL impairment. DISCUSSION: Prevalence of ADL impairment and unmet need was high in this setting. Variation in impairment across the population highlighted key groups for future interventions. Unmet need for care was highest in middle-aged adults, indicating a gap in care provision.

Publication metadata

Author(s): Brinkmann B, Davies JI, Witham MD, Harling G, Barnighausen T, Bountogo M, Siedner MJ, Ouermi L, Junghanns J, Coulibaly B, Sie A, Payne CF, Kohler IV

Publication type: Article

Publication status: Published

Journal: Journals of Gerontology B: Psychological Sciences and Social Sciences

Year: 2021

Volume: 76

Issue: 9

Pages: 1880-1892

Print publication date: 01/11/2021

Online publication date: 14/03/2021

Acceptance date: 24/02/2021

Date deposited: 25/02/2021

ISSN (print): 0016-9013

ISSN (electronic): 1758-5341

Publisher: Oxford University Press


DOI: 10.1093/geronb/gbab041

PubMed id: 33715008


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Funder referenceFunder name
M. D. Witham acknowledges support from the National Institute for Health Research Newcastle Biomedical Research Centre.