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Browsing School of Public Health (ETDs) by Author "Georges, Some"

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    Predictors of frailty and multimorbidity in adults aged 40 to 65 years in a rural population cohort in Burkina Faso
    (University of the Witwatersrand, Johannesburg, 2024) Georges, Some; Kandala, Ngianga-Bakwin
    Background: Frailty and multimorbidity are vulnerable geriatric syndromes that pose a disability problem among the elderly in Sub-Saharan Africa (SSA). Assessment of factors associated with frailty and multimorbidity in middle-aged adults has remained limited despite the prevalence established in previous studies. We determined factors associated with frailty and multimorbidity among middle-aged adults in rural areas from 2015 to 2022 in Burkina Faso. Methods: This study utilized data from the Africa Wits-INDEPTH Partnership for Genomic Research (AWI-Gen) sub-study, a retrospective cohort study of 1500 participants aged 40-65 residing in Nanoro and Yako in Burkina Faso between 2015-2022. Each participant was asked to complete a standardized and structured questionnaire on socio-demographic, lifestyle, and clinical information. In addition, measures of Fried's phenotypic frailty components, and twelve chronic diseases were assessed for derivation into frailty and multimorbidity score variants respectively. To determine the risk factors associated with frailty and multimorbidity, we performed an ordinal and multinomial logistic regression analysis respectively with a significance level of 5%. Results: The prevalence of pre-frailty and frailty was 59.3% and 8.5% respectively while that of multimorbidity was 38.3%, where the multimorbidity prevalence rate stratified by existing chronic diseases was 13.0%. Half of the participants who had multimorbidity were frail (47.2%) while 10.4% of frail participants had multimorbidity. Weight loss (23.9%) and self-reported exhaustion (23.1%) were the most frequent phenotypic components. Dyslipidemia (63.9%), hypertension (26.4%) and rheumatic arthritis (15.0%) were the most frequent chronic diseases. On the one hand, age (≥50 years, aOR 1.4[1.0-1.9]), being widowed (aOR 1.5[1.1-2.1]), being unemployed (aOR 2.5[1.1-5.8]), smokeless tobacco use (aOR 2.5[1.1-5.7]), being underweight (aOR 26.2[17.1-40.2]) and multimorbidity (aOR 1.4[1.0-2.1]) were independently associated with increased odds of frailty. However, fruits (aOR 0.9[0.8-1.0]) and vegetables consumption (aOR 0.9[0.8-1.0]), and being highly active in weekly activities (aOR 0.1[0.0-0.2]) significantly reduced the odds of frailty. On the other hand, age (≥60 years, RRR 1.8[1.1-2.8]), being a woman (RRR 2.6[1.7-3.9]), being widowed (RRR 1.6[1.0-2.7]), being unemployed (RRR 4.5[1.1-18.0]), overweight (RRR 5.0[2.8- 9.1]), obesity (RRR 3.4[1.1-11.0]), pre-frailty (RRR 1.8[1.2-2.6]) and frailty (RRR 2.1[1.0-4.2]) were strongly associated with an increased risk of multimorbidity. Nevertheless, the consumption of alcohol (RRR 0.4[0.3-0.6]) and fruit (RRR 0.9[0.8-1.0]) significantly reduced the risk of multimorbidity. There was no significant association with determinants such as gender, level of education, smoking status. Conclusion: These findings provide additional evidence on the determinants of frailty and multimorbidity in Burkina Faso. Community awareness initiatives should be strengthened to influence lifestyle on tobacco consumption, alcoholism, physical activity, and vitamin supplementation associated with the consumption of fruits and vegetables