title: A cohort study of elderly people in Bloemfontein, South Africa, to determine health-related quality of life and functional abilities.
abstract: BACKGROUND
  An ageing population has become an issue of global importance. According to statistics, the number of people aged ≥60 years will outnumber children &lt;5 years by 2020.
  
  
  OBJECTIVE
  To identify chronic and comorbid diseases that contribute to reduced quality of life (QoL) and functional ability in elderly people living in nursing homes in Bloemfontein, Free State, South Africa (SA).
  
  
  METHODS
  This study used utility- and capability-based questionnaires EQ-6D and a modified ICECAP-O to identify chronic and comorbid diseases that contribute to reduced QoL and functioning in the elderly. An information leaflet was supplied to respondents, along with an informed consent form that each signed and dated. The respondents participated voluntarily and anonymously. Structured interviews were conducted. No algorithm for the EQ-6D or ICECAP-O is available for the SA population. Statistical Package for the Social Sciences version 16 was used to perform the sum score calculations. Data were presented using standard descriptive statistics (frequencies, medians, means, standard deviations and standard errors).
  
  
  RESULTS
  The total sample comprised 104 elderly respondents, 72.1% females and 27.9% males (mean age 77 years). Most suffered from at least two of the following diseases: hypertension (68.8%), joint disease (46.2%), heart disease (22.1%), cancer (19.2%) and psychological disorders (18.3%). The EQ-6D indicated that 'pain' (48.3%) and 'mobility' (36.2%) were the domains chiefly affected. Elderly subjects with extreme problems reported all domains to be equally affected, with the exception of 'cognition' (29.1%).
  
  
  CONCLUSIONS
  Our results confirm that diseases result in pain and affect mobility and cognition in old age. Access to healthcare and services for older people involves recognition of the importance of health promotion and activities that will help prevent disease, and there should be a focus on maintaining independence, prevention and delay of disease, and disability treatment. This includes improving QoL in elderly people with existing disabilities. Reform of medical care services is essential to improve healthcare for the elderly and thus improve their QoL.
authors.affiliation: Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa. gerberam@ufs.ac.za.
authors.forename: Anthonie Marthinus
authors.initials: AM
authors.lastname: Gerber
authors.forename: Riaan
authors.initials: R
authors.lastname: Botes
authors.forename: Arnelle
authors.initials: A
authors.lastname: Mostert
authors.forename: Annelize
authors.initials: A
authors.lastname: Vorster
authors.forename: Erik
authors.initials: E
authors.lastname: Buskens