Uwakwe Richard, Ibeh Christian C, Modebe Anne Ifeoma, Bo Emeka, Ezeama Nkiru, Njelita Ifeoma, Ferri Cleusa P, Prince Martin J
Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
J Am Geriatr Soc. 2009 Sep;57(9):1620-7. doi: 10.1111/j.1532-5415.2009.02397.x. Epub 2009 Aug 13.
To describe the prevalence and determinants of dependence in older Nigerians and associations with informal care and health service utilization.
A single-phase cross-sectional catchment area survey.
Dunukofia, a rural community in southeastern Nigeria.
One thousand two hundred thirty-eight adults aged 65 and older, for whom full data were available on 914.
The full 10/66 Dementia Research Group survey protocol was applied, including ascertainment of depression, cognitive impairment, physical impairments, and self-reported diagnoses. The interviewer rated dependence as not needing care, needing some care, or needing much care. The prevalence of dependence and the independent contribution of underlying health conditions were estimated. Sources of income, care arrangements, caregiver strain, and health service use are described according to level of dependence.
The prevalence of dependence was 24.3% (95% confidence interval=22.1-26.5%), with a concentration in participants aged 80 and older. Only 1% of participants received a pension, and fewer than 7% had paid work. Those who were dependent were less likely than others to receive income from their family. Cognitive impairment, physical impairments, stroke, and depression were each independently associated with dependence. Depression made the largest contribution. Dependence was strongly associated with health service use (particularly private doctor and traditional healer services) and with high levels of out-of-pocket expenditure.
In Nigeria, dependence is an important outcome given rapid demographic aging and increases in chronic disease prevalence in all developing regions. Enhancing the social protection of dependent older adults should be a policy priority. Cognitive and mental disorders are important contributors to disability and dependence; more attention should be given to their prevention, detection, and treatment.
描述尼日利亚老年人依赖的患病率、决定因素以及与非正式照护和卫生服务利用的关联。
单相横断面集水区调查。
尼日利亚东南部的一个农村社区杜努科菲亚。
1238名65岁及以上的成年人，其中914人有完整数据。
采用了完整的10/66痴呆症研究组调查方案，包括确定抑郁、认知障碍、身体损伤和自我报告的诊断。访谈者将依赖程度评定为不需要照护、需要一些照护或需要大量照护。估计了依赖的患病率以及潜在健康状况的独立影响。根据依赖程度描述了收入来源、照护安排、照护者压力和卫生服务使用情况。
依赖的患病率为24.3%（95%置信区间=22.1-26.5%），集中在80岁及以上的参与者中。只有1%的参与者领取养老金，不到7%的人有带薪工作。依赖者比其他人从家庭获得收入的可能性更小。认知障碍、身体损伤、中风和抑郁各自都与依赖独立相关。抑郁的影响最大。依赖与卫生服务使用（特别是私人医生和传统治疗师服务）以及高额自付费用密切相关。
在尼日利亚，鉴于所有发展中地区人口迅速老龄化和慢性病患病率上升，依赖是一个重要问题。加强对依赖老年人的社会保护应成为政策重点。认知和精神障碍是残疾和依赖的重要促成因素；应更加关注其预防、检测和治疗。
