title: Sociodemographic and socioeconomic patterns of chronic non-communicable disease among the older adult population in Ghana.
abstract: BACKGROUND
  In Ghana, the older adult population is projected to increase from 5.3% of the total population in 2015 to 8.9% by 2050. National and local governments will need information about non-communicable diseases (NCDs) in this population in order to allocate health system resources and respond to the health needs of older adults.
  
  
  METHODS
  The 2007/08 Study on global AGEing and adult health (SAGE) Wave 1 in Ghana used face-to-face interviews in a nationally representative sample of persons aged 50-plus years. Individual respondents were asked about their overall health, diagnosis of 10 chronic non-communicable conditions, and common health risk factors. A number of anthropometric and health measurements were also taken in all respondents, including height, weight, waist and hip circumferences, and blood pressure (BP).
  
  
  RESULTS
  This paper includes 4,724 adults aged 50-plus years. The highest prevalence of self-reported chronic conditions was for hypertension [14.2% (95% CI 12.8-15.6)] and osteoarthritis [13.8%, (95% CI 11.7-15.9)]. The figure for hypertension reached 51.1% (95% CI 48.9-53.4) when based on BP measurement. The prevalence of current smokers was 8.1% (95% CI 7.0-9.2), while 2.0 (95% CI 1.5-2.5) were infrequent/frequent heavy drinkers, 67.9% (95% CI 65.2-70.5) consume insufficient fruits and vegetables, and 25.7% (95% CI 23.1-28.3) had a low level of physical activity. Almost 10% (95% CI 8.3-11.1) of adults were obese and 77.6% (95% CI 76.0-79.2) had a high-risk waist-to-hip ratio (WHR). Risks from tobacco and alcohol consumption continued into older age, while insufficient fruit and vegetable intake, low physical activity and obesity increased with increasing age. The patterns of risk factors varied by income quintile, with higher prevalence of obesity and low physical activity in wealthier respondents, and higher prevalence of insufficient fruit and vegetable intake and smoking in lower-income respondents. The multivariate analysis showed that only urban/rural residence and body mass index (BMI) were common determinates of both self-reported and measured hypertension, while all other determinants have differing patterns.
  
  
  CONCLUSIONS
  The findings show a high burden of chronic diseases in the older Ghanaian population, as well as high rates of modifiable health risk factors. The government could consider targeting these health behaviors in conjunction with work to improve enrolment rates in the National Health Insurance Scheme.
authors.affiliation: National Research Council, Neuroscience Institute, Padova, Italy; Department of Community Health, University of Ghana, Accra, Ghana; nadia.minicuci@unipd.it.
authors.forename: Nadia
authors.initials: N
authors.lastname: Minicuci
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Biritwum
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: George
authors.initials: G
authors.lastname: Mensah
authors.affiliation: Department of Community Health, University of Ghana, Accra, Ghana.
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Yawson
authors.affiliation: Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Naidoo
authors.affiliation: Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.affiliation: Multi-Country Studies Unit, World Health Organization, Geneva, Switzerland; Research Centre for Gender, Health and Ageing, University of Newcastle, Newcastle, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Kowal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Ghana; SAGE; aging; health behavior; non-communicable disease
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