Social and health determinants of gender differences in disability amongst older adults in South Africa

There has been an unprecedented increase in population ageing resulting in the increase in prevalence of various health conditions, including disability and associated risk factors. This study aimed to investigate the prevalence and predictors of functional status and disability amongst older South Africans. Little is known about disability amongst older South Africans because most previous health research has focused on younger individuals and infectious diseases. We conducted a national population-based cross-sectional study with a sample of 3840 subjects aged 50 years or older in South Africa. Multivariable regression analysis was performed in order to assess the association of social factors, health variables and functional disability. Overall, 37.2% of the respondents had moderate or severe and/or very severe functional disability, this being higher amongst women. The highest disability was found for the mobility, cognition and participation domains. In all domains, except for the self-care domain, women had a higher disability prevalence. Multivariable analysis amongst men revealed that older age, having some or primary education, being from Indian or Asian race, having chronic conditions, physical inactivity and a lower quality of life were associated with functional disability. Amongst women, older age, as well as having chronic conditions and a lower quality of life, were associated with functional disability. This study has implications for health-sector strategic plans aimed at preventing disabilities, ensuring access to curative and rehabilitative care. This study forms an evidence base upon which future policies and health care management systems can be based.