Functional Disability in Elderly Nigerians: Results from the Ibadan Study of Aging

TLDR

Functional disability is a common cause of loss of independence and informal care needs among the elderly, yet data on its prevalence and unmet care needs in sub‑Saharan Africa remain scarce. The study used a multistage clustered household survey of 2,152 Yoruba‑speaking Nigerians aged 65 and older to assess ADL/IADL disability, self‑reported health, depression, and informal care availability. Disability prevalence was 9.2%, with higher risk in women, older adults, urban residents, those with chronic pain, poor health, or undernutrition; disabled individuals had lower quality of life, higher depression rates, and 19.8% lacked informal care, indicating a substantial unmet care need linked to urbanization and poverty.

Abstract

Functional disability is a common reason for loss of independence and need for informal care by elderly persons. There is little information on the profile of disability and the level of unmet need for care in elderly persons living in sub‐Saharan Africa. Using a multistage clustered sampling of households conducted in the Yoruba‐speaking area of Nigeria (representing 22% of the national population), persons aged 65 and older (N=2,152) were assessed for disability in activities of daily living and instrumental activities of daily living. Respondents were assessed for self‐reports of physical health, for major depressive disorder, and for availability of informal care. The prevalence of any functional disability (defined as inability to independently perform any function) was 9.2% (standard error 0.6). In logistic regression analysis, high risks of disability were associated with female sex, older age, and urban dwelling. Risks were also high for persons with chronic pain, those with poor self‐reported overall health, and those with evidence of undernutrition. Disabled persons had poorer quality of life and were more likely to suffer from major depressive disorder; 19.8% of disabled elderly persons lacked any informal care, and this unmet need for care increased the likelihood of having depression. The findings suggest a high burden of unmet need for care in a large section of disabled elderly persons in this African community undergoing demographic and social changes. Social factors relating to urbanization and poverty may be associated with the occurrence of disability and inability to access informal care.