Impairment in activities of daily living, care receipt, and unmet needs in a middle-aged and older rural South African population: Findings from the HAALSI study

Objectives: The objective of this study is to analyze the degree to which
care needs are met in an aging rural African population. Method: Using
data from the Health and Aging in Africa: Longitudinal Study of an INDEPTH
Community (HAALSI) baseline survey, which interviewed 5,059 adults
aged older than 40 years in rural South Africa, we assessed the levels of
limitations in activities of daily living (ADLs) and in unmet care for these
ADLs, and evaluated their association with sociodemographic and health
characteristics. Results: ADL impairment was reported by 12.2% of
respondents, with the proportion increasing with age. Among those with
ADL impairment, 23.9% reported an unmet need and 51.4% more a partially
met need. Relatives provided help most often; formal care provision was
rare. Unmet needs were more frequent among younger people and women,
and were associated with physical and cognitive deficits, but not income or
household size. Discussion: Unmet care needs in rural South Africa are
often found among individuals less expected to require care.
Keywords
disability, gender, comorbidities, socioeconomic status