Chronic diseases and health inequalities in older persons in Botswana (southern Africa): A national survey

Objectives: To evaluate the health status of older persons in Botswana, to report on the prevalence of common health conditions - typically chronic diseases, to assess the socio-demographic correlates of morbidity in this population, and to assess the associations between physical functioning and self-reported health and the common health problems presented. Design: National, cross-sectional survey (12 rural areas, 3 urban centres), inclusive of clinical examinations. Sample: 372 individuals (183 females, 189 males) aged 60 - 109 years. Results: 68% of respondents reported musculoskeletal pain in two or more locations; 42% were found to be hypertensive; 36% reported dental problems; 32% had dermatological problems; 11% were blind (as defined); 9% had cognitive impairment; 7% were depressed. Multinomial regression analyses showed poor self reported health to be significantly associated with musculoskeletal pain (OR = 15.5), depression (OR = 9.7), incontinence (OR = 3.9), dermatological problems (OR = 3.0) and dental problems (OR = 2.3); hypertension, blindness and cognitive impairment did not show significant associations. Conclusion: A large number of older persons in Botswana suffer from one or more age-associated chronic diseases that may impair function and quality of life. Several of the conditions may be diagnosed and treated to optimise the individuals' functioning. Poor self reported health was associated with "painful conditions" which are commonly poorly managed or untreated.