title: Chronic disease, risk factors and disability in adults aged 50 and above living with and without HIV: findings from the Wellbeing of Older People Study in Uganda.
abstract: BACKGROUND
  Data on the prevalence of chronic conditions, their risk factors, and their associations with disability in older people living with and without HIV are scarce in sub-Saharan Africa.
  
  
  OBJECTIVE
  In older people living with and without HIV in sub-Saharan Africa: 1) to describe the prevalence of chronic conditions and their risk factors and 2) to draw attention to associations between chronic conditions and disability.
  
  
  METHODS
  Cross-sectional individual-level survey data from people aged 50 years and over living with and without HIV were analyzed from three study sites in Uganda. Diagnoses of chronic conditions were made through self-report, and disability was determined using the WHO Disability Assessment Schedule (WHODAS). We used ordered logistic regression and calculated predicted probabilities to show differences in the prevalence of multiple chronic conditions across HIV status, age groups, and locality. We used linear regression to determine associations between chronic conditions and the WHODAS.
  
  
  RESULTS
  In total, 471 participants were surveyed; about half the respondents were living with HIV. The prevalence of chronic obstructive pulmonary disease and eye problems (except for those aged 60-69 years) was higher in the HIV-positive participants and increased with age. The prevalence of diabetes and angina was higher in HIV-negative participants. The odds of having one or more compared with no chronic conditions were higher in women (OR 1.6, 95% CI 1.1-2.3) and in those aged 70 years and above (OR 2.1, 95% CI 1.2-3.6). Sleep problems (coefficient 14.2, 95% CI 7.3-21.0) and depression (coefficient 9.4, 95% CI 1.2-17.0) were strongly associated with higher disability scores.
  
  
  CONCLUSIONS
  Chronic conditions are common in older adults and affect their functioning. Many of these conditions are not currently addressed by health services in Uganda. There is a need to revise health care policy and practice in Uganda to consider the health needs of older people, particularly as the numbers of people living into older age with HIV and other chronic conditions are increasing.
authors.affiliation: MRC/UVRI, Uganda Research Unit on AIDS, Uganda.|Department of Health Sciences, University of Missouri Columbia, Missouri, USA; joseph.mugisha@mrcuganda.org.
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Mugisha
authors.affiliation: Department of Health Sciences, University of Missouri Columbia, Missouri, USA.
authors.forename: Enid J
authors.initials: EJ
authors.lastname: Schatz
authors.affiliation: School of Public Health, University of Sydney, Australia.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Randell
authors.affiliation: MRC/UVRI, Uganda Research Unit on AIDS, Uganda.
authors.forename: Monica
authors.initials: M
authors.lastname: Kuteesa
authors.affiliation: World Health Organization, Study on global AGEing and adult health, Geneva, Switzerland.|Research Centre for Gender, Health and Ageing, University of Newcastle, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Kowal
authors.affiliation: School of Public Health, University of Sydney, Australia.
authors.forename: Joel
authors.initials: J
authors.lastname: Negin
authors.affiliation: MRC/UVRI, Uganda Research Unit on AIDS, Uganda.|London School of Hygiene and Tropical Medicine, London UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014454:Uganda / Q000453:epidemiology
keywords: Africa; HIV/AIDS; Uganda; aging; aging disability; non-communicable diseases; older adults