title: Physical Function in an Aging Population in Rural South Africa: Findings From HAALSI and Cross-National Comparisons With HRS Sister Studies.
abstract: OBJECTIVE
  We use recently-collected data from the Health and Aging in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort from Agincourt, South Africa, to describe physical functioning in this aging population, and place the overall level and age-trajectories of physical health in the context of other Health and Retirement Study (HRS) sister studies in low- and middle-income countries (LMICs).
  
  
  METHODS
  We conduct multiple regression to estimate associations of physical functioning assessed from both self-report (activities of daily living [ADL] limitation, self-reported health) and performance (grip strength, gait speed) with socio-demographic and health characteristics in HAALSI, and use fully-interacted regression models to compare age-patterns of physical functioning outcomes cross-nationally.
  
  
  RESULTS
  Gender differences in self-reported health are minimal, and men had 30% higher odds of being ADL limited controlling for socio-demographic and health characteristics. Measured physical performance is closely tied with socioeconomic conditions, but self-reported measures have a much smaller or weaker socioeconomic gradient. In international age-adjusted comparisons, the HAALSI sample had lower physical performance outcomes than most comparison populations.
  
  
  CONCLUSIONS
  As the first HRS sister study undertaken in Africa, HAALSI adds vital information on population aging and health in the region. Continuing waves of HAALSI data will be a key resource for understanding differences in the complex processes of disability across LMIC contexts.
authors.affiliation: Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts.
authors.forename: Collin F
authors.initials: CF
authors.lastname: Payne
authors.affiliation: Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts.|MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Francesc Xavier
authors.initials: FX
authors.lastname: Gómez-Olivé
authors.affiliation: MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Centre for Global Health Research, Epidemiology and Global Health, Umeå University, Sweden.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kahn
authors.affiliation: Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts.
authors.forename: Lisa
authors.initials: L
authors.lastname: Berkman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D012424:Rural Population; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology
keywords: Africa; Cross-national comparisons; Disability; Low- and middle-income countries; Physical functioning