Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study

Uday Narayan Yadav; Saruna Ghimire; Sabuj Kanti Mistry; Selvanaayagam Shanmuganathan; Lal B Rawal; Mark Harris

doi:10.1136/bmjopen-2020-041728

Prevalence of non-communicable chronic conditions, multimorbidity and its correlates among older adults in rural Nepal: a cross-sectional study

BMJ Open. 2021 Feb 25;11(2):e041728. doi: 10.1136/bmjopen-2020-041728.

Authors

Uday Narayan Yadav^{1

2

3}, Saruna Ghimire⁴, Sabuj Kanti Mistry⁵, Selvanaayagam Shanmuganathan^{3

6}, Lal B Rawal⁷, Mark Harris⁵

Affiliations

¹ Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia unyadav1@gmail.com.
² Center for Research Policy and Implementation, Biratnagar, Nepal.
³ Torrens University, Sydney, New South Wales, Australia.
⁴ Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, Ohio, USA.
⁵ Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia.
⁶ Menzies Centre for Health Policy, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.
⁷ School of Health Medical and Allied Sciences, Central Queensland University-Sydney Campus, Sydney, New South Wales, Australia.

Abstract

Objectives: This study's objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors.

Design: This was a community-based cross-sectional study conducted between January and April 2018.

Setting: Rural municipalities of Sunsari and Morang districts in eastern Nepal.

Participants: 794 older Nepalese adults, 60 years and older, were recruited using a multistage cluster sampling approach.

Primary outcome measures: Prevalence of four major non-communicable chronic conditions (osteoarthritis, cardiovascular disease, diabetes and chronic obstructive pulmonary disease (COPD) and multimorbidity.

Results: Almost half (48.9%: men 45.3%; women 52.4%) of the participants had at least one of four non-communicable chronic conditions, and 14.6% (men 12.5%; women 16.8%) had two or more conditions. The prevalence of individual conditions included: osteoarthritis-41.7% (men 37.5%; women 45.9%), cardiovascular disease-2.4% (men 2.8%; women 2.0%), diabetes-5.3% (men 6.0%; women 4.6%) and COPD-15.4% (men 13.3%; women 17.5%). In the adjusted model, older adults aged 70-79 years (adjusted OR (AOR): 1.62; 95% CI: 1.04 to 2.54), those from Madhesi and other ethnic groups (AOR: 1.08; 95% CI: 1.02 to 1.72), without a history of alcohol drinking (AOR: 1.53; 95% CI: 1.18 to 2.01) and those physically inactive (AOR: 5.02; 95% CI: 1.47 to 17.17) had significantly higher odds of multimorbidity.

Conclusions: This study found one in seven study participants had multimorbidity. The prevalence of multimorbidity and associated socioeconomic and behavioural correlates need to be addressed by integrating social programmes with health prevention and management at multiple levels. Moreover, a longitudinal study is suggested to understand the temporal relationship between lifestyle predictors and multimorbidity among older Nepalese adults.

Keywords: epidemiology; geriatric medicine; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Female
Humans
Longitudinal Studies
Male
Multimorbidity*
Nepal / epidemiology
Prevalence