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INDEPTH AGM, October 2009 Pune, India

STATUS REPORT: INDEPTH Adult Health & Aging - with WHO SAGE – Site scientists, editorial team, mentors engaged funder R Suzman / NIA. INDEPTH AGM, October 2009 Pune, India. Goals: INDEPTH Adult Health & Aging.

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INDEPTH AGM, October 2009 Pune, India

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  1. STATUS REPORT: INDEPTH Adult Health & Aging- with WHO SAGE – Site scientists, editorial team, mentorsengaged funder R Suzman / NIA INDEPTH AGM, October 2009 Pune, India

  2. Goals: INDEPTH Adult Health & Aging -> To establish INDEPTH’s capability to contribute critical insights into the adult health, aging and disease transitions evolving in Africa and Asia; -> To use this understanding to evaluate interventions of potentially high impact

  3. Background October 2003, Johannesburg • develop’t of INDEPTH Adult Health & Aging platform • 17 African and Asian sites April 2005, Johannesburg • collaboration with Evidence, Info & Res for Policy, WHO • development of INDEPTH/WHO short module 2006 – 2007: 8 INDEPTH sites • Fieldwork: short module (8 sites); full SAGE (3 sites) May 2008, Epidemiol & Global Health, Umeå U, Sweden • Data harmonization and analysis workshop Paper drafting, internal review

  4. INDEPTH-WHO collaboration Aims to: • conduct a summaryphysical & cognitive function module that is integrated into routine surveillance rounds • [implement the full version of SAGE in a few DSS sites] Summary function module should: • be repeated regularly to allow measurement of health transition in older populations • relate health transition to demographic events such as fatal health outcomes (mortality) • Large samples will be needed to examine associations with cause-specific mortality.

  5. 2008, Umeå workshop

  6. INDEPTH-WHO physical & cognitive function in older adults 2006/7

  7. SAGE Instruments (Summary Modules) • Health state descriptions • Self reported health status • Difficulty with work/household activities • 8 health domains: mobility, self-care, pain and discomfort, cognition, interpersonal activities, affect, vision, sleep and energy. • Set of vignettes for the 8 health domains: 5 scenarios for each domain • Subjective wellbeing and quality of life All questions are in categorical ordered response

  8. Analyzing the SAGE data • Creating composite index • WHO-DAS (Disability Assessment Schedule) • WHO-QOL (Quality of Life) • WHO-Health Score • Enriching the data with DSS variables Age at time of interview, sex, education completed, marital status, HH size, number of HH member 50+ in the same household, SES quintile

  9. The composite scores • Health Score: difficulties in conducting activities in eight health domains: affect, cognition, interpersonal activities, mobility, pain, self-care, sleep and energy, and vision. • Quality of Life index: respondent’s thoughts about their life and life situation, satisfaction with themselves, health, ability to perform daily living activities, personal relationships, living conditions, and overall life. • Disability assessment: difficulties in functional assessment and activities in the last 30 days • All questions were posed as five-response scale • Results transformed to a continuous cardinal scale from 0 to 100

  10. Study subjects Sample of 50+ (*) vs. All of 50+

  11. Health score was used as outcome variables, and the regression analyses were adjusted to sex, age, education level, socio-economic quintiles, and marital status in each site.

  12. Health score was used as outcome variables, and the regression analyses were adjusted to sex, age, education level, socio-economic quintiles, and marital status in each site.

  13. Cross-site highlights • Predictors of poor health are being women, older age, lived in Matlab, Agincourt and Navrongo, low SES, and reported disability and poor functioning. • A larger difference of health score in men and women than expected. • Post-regression decomposition: 87% of the health score difference was attributable to differences of age, education, socio-economic levels, marital status, living arrangement, disability and functioning, quality of life between men and women.

  14. Journal progress update: Global Health Action Journal launch 2010 with release Public access dataset

  15. Planning ahead… • Further analyses and writing with enriched dataset (contextual variables, longitudinal data) • Data validity: cross-site comparison INDEPTH-Harvard workshop 04/2010 • Repeat module - 2010 • Bring together… • NCD risk factor module • Work on demogr / epidem transitions • Work on health systems R&D • Program of intervention / health systems R&D

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