Cognitive disability among older adults in Botswana: prevalence, trends, and sociodemographic determinants from cross-sectional data.

BACKGROUND

Cognitive impairment is a critical issue among older adults, especially as populations age and demands on healthcare systems increase. In Botswana, the growing older adult population and the rising chronic diseases prevalence highlight the need for focused research on cognitive disability trends and their socio-demographic influences. By analysing demographic data and examining socio-demographic and health-related factors associated with cognitive disability, this research seeks to provide an in-depth understanding of the trajectory of cognitive disability within the ageing demographic in Botswana.

METHODS

This study analysed self-reported cognitive disability trends among older adults aged 65 + in Botswana using data from the 2017 Botswana Demographic Survey (BDS) and the 2022 Population and Housing Census (PHC). Disability prevalence was measured using the Washington Group Short Set (WGSS) questions. Bivariate analyses assessed prevalence and trends across demographic groups, and logistic regression models examined socio-demographic and health factors associated with cognitive disability.

RESULTS

The prevalence of self-reported cognitive disability in Botswana increased substantially over a five-year period, rising from 6.4% in 2017 to 22.2% in 2022-an increase of 15.8%. This upward trend was consistent across all sociodemographic indicators examined. The most rapid rise was observed among adults aged 80 years and older. In the 2022 data, several factors were significantly associated with higher odds of cognitive disability, including advancing age, female gender, residence in rural areas, unemployment, and the presence of physical health conditions (p < 0.05 for all associations).

CONCLUSION

This study demonstrates a substantial and consistent increase in the prevalence of self-reported cognitive disability among older adults in Botswana between 2017 and 2022. This sharp rise likely reflects a combination of measurement differences, changing cultural attitudes, real epidemiological shifts associated with an ageing population and rising non-communicable diseases, and possibly the broader impacts of the COVID-19 pandemic. These findings underscore the urgent need for enhanced cognitive health interventions, improved data quality, and continued monitoring to address the growing burden of cognitive disability in Botswana's ageing society.