physical activity and healthy ageing in uganda: opportunities and threats. sandra kasoma phd, msc,...
TRANSCRIPT
Physical Activity and Healthy Ageing in Uganda: Opportunities and threats.
Sandra Kasoma PhD, MSc, BEd
Makerere University Dept. Of Biochemistry & Sports Science
Physical Activity and Sport for Health and Development in Africa
25th – 29th Maputo, Mozambique
Overview
There is evidence that the no. of older people age 60+ worldwide is increasing due to:
Provision of health facilities & nutrition This no. OA is expected to rise to 1.2 billion by
2025, with a bigger % of them living in developing countries (WHO,2000).
Africa alone having 204 – 210 million by 2050 Most aged people in most parts of the world live
sedentary lives (WHO 1998.1). Sedentary living leads to loss of muscle function
and physical impairment
Overview cont’d
UBOS (2010) indicates Uganda population is 32 million. A large proportion of this population is age 15 and below.
Many OA have lost family members to HIV/AIDS; 12% of the children are orphans (UDHS, 2011). hence;
OA left with grand children after death of parents Traditional family support system crumble Lack of awareness among Ugandans of the
needs, rights and problems of OA
Overview cont’d
According to UN figures, more than 80% of men aged 65+ are still working for a living in parts of Africa, including Uganda while that of women is 75%. Over 90% of these, work in informal sector. This means few people are entitled to state pension.
Low or no income at all Increased vulnerability to diseases and poor
conditions Neglect and rejection
Trends in the OA nutritional status
Carbohydrate rich diet Diet lacking fruits and vegetables Plant protein rich diet Inadequate fluid intakes Irregular meal patterns – meal skipping Existing programmes for improving nutritional
status exclude OA Numerous socio-economic and cultural
factors influence patterns of feeding.
Trends in the OA PA status
Weak due to a no. of factors: Deterioration in the physiological capacity and function
Inactive do not meet the 150min/wk PA requirement
Physical planning & architecture (buildings, pavements, walkways, public toilets..) does not favor OA – affects mobility & independence of OA
ADL
Trends in the OA Health status
Hypertensive Diabetic Disabled Untreated conditions Illnesses and degenerative conditions Impairment including physical, vision
and auditory
Welfare of the elderly Poverty – few OA entitled to pension 64%
survive on less than US $1 a day (Uganda reach the Aged, Global Activity on Aging, 2010)
Promised reasonable provision for the welfare and maintenance of the aged
Facing hard conditions such as queuing for services, pension and elections. (Global Activity on Aging, 2010)
Abuse (mental & physical) and neglect
To determine the: Physical activity patterns among the OA in
homes. Functional independence and health fitness
levels of the OA in homes Nutritional patterns of the elderly in Uganda. Effect of the 8-week PAP intervention on the
functional independence and health of the OA in homes.
Objectives of the Study
Intervention
Evaluate impact of an 8-week regular Physical Activity Programme (PAP) on the physical activity patterns, the nutritional patterns, functional independence of the OA
Limitations
Number of homes for the elderly Availability of elderly people in the home Health conditions & disability facilities and resources.
BalanceSleep wellHealthMobility levelsPhysiological capacityFlexibility levelsAgilityFunctional Independence
Phy. inactivity
Active living
Adult life 60+ years
Conceptual framework
Relationship between active & inactive lifestyle Baechle and Earle (2000), …
Method/s
Both men and women age 60+ in the home participated in a quasi experimental PAP intervention that lasted 8 weeks.
Pre tests at baseline & post tests at halftime and at end of the programme.
The Community Health Intervention Programme (CHIPS) as used by Kolbe et al (2004) was adapted for use in this study.
Analysis
use both the Statistical Programme for Social Scientist (SPSS-15.0) and STATA 9.
Kruskal-Wallis analysis of ranks was used
to determine differences between independent groups and
The Fisher’s Exact Test
Table 4.1: Elderly at home and those who took part in the study
Gender Total No. in Home
< 60 Years
Uncontrolled BP / require specialized attention
Eligible for PAP
Did not successfully complete the PAP
Completed the PAP
Male 25 5 8 12 02 10
Female 15 2 3 10 03 07
Total 40 7 11 22 05 17
Physical activity patterns This study was limited to only establishing
the routine activities. The total related energy expenditure was
not calculated; the elderly persons and the caregivers could not specify amounts of time spent on most activities.
Descriptive statistics
Mean value (SE), (N=17) KRUSKAL-WALLIS
Variable Baseline 4 Weeks 8 Weeks X2 P
Systolic 133.4 (6.8) 132.1(6.3) 116.1(3.4) 5.33 0.070
Diastolic 78.7 (3.4) 67.7(3.7) 70.3(1.7) 8.32 0.016
Heart Rate 79.4 (6.7) 63.1(3.6) 65.6(3.5) 4.49 0.010
Gait 72.3(10.6) 49.8(7.6) 45.2(9.3) 3.74 0.013
Sit-to-stand 3.2 (0.4) 5.2(0.4) 5.6(0.6) 14.16 0.001
Cardio end. 160.6 (19.4) 221.6(24.1) 220.1(23.6) 4.00 0.135
D. balance 26.9 (5.6) 26.7(5.7) 23.1(5.1) 5.82 0.054
S. balance 26.9 (1.2) 29.4(0.6) 29.3(0.5) 4.21 0.122
Frequency of attacks by timing
Frequency of attacks Timing
BaselineN=17
HalftimeN=17
FulltimeN=17
None 5.9 5.9 41.2
Rarely 11.8 52.9 29.3
Frequently 47.1 23.5 17.7
Always 35.2 17.7 11.8
Fisher's exact Sig. = 0.012
Self perceived healthTiming N Rating %
Poor Good Improved
Baseline 17 76.5 23.5 .
Halftime 17 11.8 0.00 88.2
Fulltime 17 11.7 0.00 88.3
Fisher's exact Sig. = 0.000
Distribution of constipation problem by timing
Timing N Constipation problem %
No Yes
Baseline 17 52.9 47.1
Halftime 17 76.5 23.5
Fulltime 17 94.1 5.9
Fisher's exact Sig. = 0.025
Results show a significant association inactivity and prevalence of constipation problem among the OA by timing
Conclusion
Intervention effective Changes not significant
Gait quality & lower body strength Dynamic & static balance
Heart rate & diastolic blood pressure Systolic & cardio endurance
Eliminating constipation
Dealing with nearly all the sleep problems
Reducing the frequency of chronic illness attacks
.
Insufficient nutritional requirements in the diet of the elderly at the home..
Opportunities
Existence of Gov’t. Policy Govt’s promise to support OA Many of the OA esp. now, are still
functionally independent Availability of supporting partners
though few e.g. HelpAge
Threats Crumbling of the traditional social support system /
structure OA do not have regular support from their families Poor management of health related conditions due to a no.
of factors Poor management of Gov’t programs for the OA Insufficient nutritional intakes (feeding practices) Segregation in terms of prioritization of care and support
opportunities as compared to other groups of population Loss of functional dependence
General Conclusions
Research and publication on OA required Evidence based advocacy to improve conditions of OA Sensitizing stake holders on the needs, rights and
contributions of OA Need for development partners especially in order to
- Strengthen the health of OA to remain active, productive.
- Promote wellbeing among OA
Thank you for listening to me!