Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey.

Background: Nationally representative evidence on the burden and determinants of disability among older people in sub-Saharan Africa in general, and Uganda in particular, is limited.

Objective: The aim of this study was to estimate the prevalence and investigate the correlates of disability among older people in Uganda.

Design: We conducted secondary analysis of data from a sample of 2,382 older persons from the Uganda National Household Survey. Disability was operationalized as either: 1) having a lot of difficulty on any one question; 2) being unable to perform on any one question; or, 3) having some difficulty with two of the six domains. We used frequency distributions for description, chi-square tests for initial associations, and multivariable logistic regressions to assess the associations.

Results: A third of the older population was disabled. Among all older persons, disability was associated with advancement in age (OR=4.91, 95% CI: 3.38-7.13), rural residence (0.56, 0.37-0.85), living alone (1.56, 1.07-2.27), separated or divorced (1.96, 1.31-2.94) or widowed (1.86, 1.32-2.61) marital status, households' dependence on remittances (1.48, 1.10-1.98), ill health (2.48, 1.95-3.15), and non-communicable diseases (NCDs) (1.81, 0.80-2.33). Gender was not associated with disability among older persons.

Conclusions: Disability was associated with advancement in age, rural residence, living alone, divorced/separated/widowed marital status, dependence on remittances, ill health, and NCDs. Interventions to improve health and functioning of older people need to focus on addressing social inequalities and on the early preventive interventions and management of NCDs in old age in Uganda.