Home | Volume 14 | Article number 5


A rapid review of research conducted on diseases and conditions impacting older persons in South Africa

A rapid review of research conducted on diseases and conditions impacting older persons in South Africa

Chinwe Iwu-Jaja1,&, Anelisa Jaca1, Jane Simmonds2,3, Charles Parry4,5, Charles Shey Wiysonge1,6


1Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa, 2Office of the Vice President for Extra Mural Research and Internal Portfolio, South African Medical Research Council, Cape Town, South Africa, 3MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, 4Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa, 5Department of Psychiatry, Stellenbosch University, Cape Town, South Africa, 6World Health Organization Regional Office for Africa, Brazzaville, Congo



&Corresponding author
Chinwe Iwu-Jaja, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa




The population of older persons in South Africa is increasing. With the accompanying health conditions that come with ageing, it is critical to understand the burden, risk factors, and useful interventions that will promote healthy ageing and overall well-being of older persons in the country. The goal of this study was to map the research conducted on diseases and conditions affecting older persons in South Africa in order to guide future research and planning efforts. A comprehensive search of the literature was conducted on PubMed, Scopus, and Web of Science databases using a defined search strategy for studies conducted between 2010 and 2022. Study selection, data extraction and narrative syntheses were rapidly performed following a systematic methodology. A total of 1488 articles were found, of which 244 were found to be eligible for inclusion in this study. The majority of the studies on health conditions affecting older persons focused on infectious diseases (n=46), followed by non-communicable diseases (n=39), mental health (n-28), musculoskeletal conditions (n=28), cognitive health (n=24). Few studies among older populations, which were mostly less than five studies and these studies focused on alcohol and drug use, ageing and frailty, falls, blood disorders, cancer, violence against older persons, reproductive health and eye health. A high number of studies (n=73) focused on determinants of health among older persons such as lifestyle (nutrition and physical activity), mortality, quality of life, care and support, elder abuse, health policy and expenditure, and access to health care. Our study shows that the majority of studies identified were centred on both infectious and non-communicable diseases. Nevertheless, there remains a need for further research to deepen our understanding of the epidemiology of these conditions in older persons in South Africa with particular emphasis on topics that have received less attention such as alcohol and drug use, ageing and frailty, falls, blood disorders, cancer, reproductive health, and eye health.



Introduction    Down

Many countries are seeing an increase in the number and proportion of older persons. It is expected that by 2030, one in every six persons globally will be 60 or older, and by 2050, the world's population of persons aged 60 and up will have more than doubled (2.1 billion) [1]. According to projections, about 80% of the world's ageing population will reside in developing countries. The percentage of elderly Africans is projected to rise from 5.1% in 2000 to 10.4% in 2050 [2]. Sub-Saharan Africa, in particular, is experiencing an increase in the number of older persons due to a growing population, the rollout of antiretrovirals, and the effects of globalization [2].

The Older Persons Act 13 of 2006 defines an Older Person (OP) as a person who is 60 years old or older [3]. Population estimates in South Africa indicate that the proportion of OPs has grown from 7.6% in 2002 to 9.1% in 2020. This puts the current estimated population of OPs in the country at 5.43 million [4]. Over the last 20 years, South Africa has moved from a country where most deaths occurred as a result of communicable diseases such as tuberculosis and HIV/AIDS - which were often concentrated at younger ages - to a country where most causes of death are attributable to non-communicable diseases, manifesting at older ages, such as from strokes or heart disease [4,5]. COVID-19 has also impacted on deaths in this age group. Vulnerabilities evident in this age group range from the need for social assistance programs and easy access to cash transfers to food programs and access to health care [4].

The years 2021-2030 have been designated as the decade of healthy ageing by the UN General Assembly, with the World Health Organization tasked with overseeing its implementation. It is planned that governments, civic society, international organizations, experts, academics, the media, and the commercial sector will work together for ten years to reduce health inequities and promote longer, healthier lives of older persons, their families and communities [1]. Mapping the available evidence on research conducted in OPs in South Africa will serve as a first step towards shaping interventions and research priorities that would lead to improved health outcomes among this population in this country. This study aims to review the nature and extent of research on diseases and conditions affecting older persons in South Africa.



Methods Up    Down

A rapid review of published research was undertaken using systematic methods to identify South African research in this area. The Joanna Brigg's Institute (JBI) methodology for scoping reviews was adapted for this review [6,7].

Search strategy

We used PubMed, Scopus, Web of Science, Google Scholar, and the HAALS database to identify relevant studies. We scanned reference lists of included articles to ensure all relevant systematic reviews were identified. Grey literature was also considered including conference proceedings from the Public Health Association of South Africa and the Psychological Society of South Africa. The following keywords were used in the searches: "Elderly OR older persons OR older people OR…. AND "Health OR Disease OR Burden of Disease", AND "NCDs OR hypertension OR diabetes OR obesity OR COVID OR TB OR HIV OR Cancers OR Mental Health OR alcohol, tobacco or drug use OR substance use OR abuse of medications Or Hearing OR Vision OR oral health" and South Africa. Supplementary information contains the search strategies for PubMed, Scopus, and Web of Science databases and the corresponding search results.

Inclusion criteria

We considered all published articles and unpublished reports, research studies (including student theses and dissertations at postgraduate level) and scientific letters that have a specific focus on the health of OPs, eligible for inclusion. Older persons in this study referred to persons 60 years and older. The focus was on studies conducted in South Africa, including multi-site studies. This review focused on research published between 2010 and 2022. Systematic reviews and meta-analyses were also included.

Exclusion criteria

Studies that did not specifically acknowledge the unique health conditions and burden of disease in OPs were excluded as well as studies published before 2010 or studies not conducted in LMICs or which were not written in English.

Study selection and data extraction

One Investigator (CI) independently selected potentially eligible publications from the records yielded in the search, to confirm eligibility by looking at the titles and abstracts of articles, removing duplicates, and extracting data from the included publications. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) [8] flow diagram in Figure 1 shows the search results and the study inclusion procedure: identifying the number of articles retrieved from the individual searches, the number excluded for various reasons, the number of duplicates removed, and the final number of articles identified. A data extraction sheet was prepared by the investigators capturing authors' names, year of publication, study objectives, and locus of research topic, on the areas listed under data synthesis below. Other authors reviewed the data for completeness and confirmed the eligibility of papers for inclusion in this study (Figure 1).

Data synthesis

Data synthesis was carried out, with the primary focus on study objectives and information extracted from each study. The included studies were grouped into themes according to specific diseases and health conditions such as infectious diseases, non-communicable diseases, mental health, musculoskeletal conditions, cognitive health, cancer, falls, ageing and frailty, eye health, blood disorders, alcohol, tobacco, and other drug use. The findings were then narratively described in the results section.



ResultsUp    Down

A total of 244 studies were included in this review. There was a successive increase in the number of publications between 2010 and 2022. The lowest number was in 2010 (n=2), while the highest number of publications was in 2019 (n=47) (Figure 2). Almost all studies (n=243) were peer-reviewed articles with only one being a conference abstract.

Countries where studies were published

Of the 244 studies included in this review, 185 were conducted in South Africa alone. The remaining (n=59) were multi-country studies either consisting of South Africa and other sub-Saharan African countries, with other low and middle-income countries (LMICs) (e.g., China, Brazil, India) or with high-income countries (the USA and European countries).

Study designs and type of publications

Most of the studies were quantitative (n=197), including cross-sectional, cohort, longitudinal, and randomized controlled trials. Twenty-eight studies (n=28) were qualitative, while 19 were categorized as reviews, including systematic reviews, scoping reviews, literature reviews, and guidelines; eight studies were mixed or multi-method studies, including combinations of quantitative or qualitative or systematic reviews and qualitative or quantitative studies.

Locus of research

Our findings were divided into two primary categories: "health conditions in older people"; (Table 1) and "the determinants of health" (Table 2), with each category having subcategories as detailed below.

Research on health conditions among older persons

Infectious diseases (n=46)

Forty-six studies were focused on infectious diseases. Of these, 31 studies dealt with infectious diseases only, while the remaining were a combination of infectious diseases with health focus such as infectious diseases s and non-communicable diseases (n=10), including nutrition, well-being of persons living with HIV, cognitive health HIV and sleep parameters.

The majority of the studies in this category (n=28) focused on HIV. The studies that focused on HIV alone were further divided into various themes. Firstly, five studies focused on the prevalence and risk factors of HIV acquisition and sexual behaviors among older persons [9-13]. In addition, four qualitative studies explored the knowledge of older persons about HIV transmission and the vulnerability of older persons to HIV [13-16]. Further, four studies focused on food insecurity, economic factors that affect access to quality food, comorbidities requiring multiple medications, side effects of drugs, difficulties related to social factors and lifestyle, support and adherence to Antiretroviral Therapy (ART), experience with the health system and stigma, and how disclosure could affect adherence and retention in care [17-20]. Also, two studies focused on the wellbeing of HIV infected persons [21,22]: while three studies consisting of two cross-sectional studies and one multi-method study focused on the caregiving role of elderly taking care of sick relatives infected with HIV [23-25] with older women playing these roles mainly [26]. One cross-sectional study conducted in a rural setting which focused on assessing the wellbeing of older persons living with HIV [27].

Two studies focused on the disclosure of HIV status [28,29]. Two studies focused on access to HIV testing [22,30]. One study followed persons living with HIV to assess mortality risk [31]. One study reported on the first HIV treatment cascade among older persons infected with HIV [32]. Two studies focused on the experiences of persons living with HIV and the impact of stigma on their lives [33,34]. Only one study focused on TB: a cohort study focused on the burden of TB among older persons [35]. Also, only one study focused on COVID-19 [36] a protocol that focused on the management plan for COVID-19 in an urban older persons home, including prevention, treatments, and referrals [36].

On the other hand, 10 studies focused on a combination of infectious diseases and other health conditions. These topics included HIV and nutritional wellness [37]; HIV and wellbeing of persons living with HIV [29,38]; HIV and cognitive health such as dementia [39,40]; HIV and multimorbidity such as hypertension, diabetes mellitus [41-44] and HIV and sleep parameters [45].

Cardiometabolic diseases, kidney diseases and cancers (n=39)

The majority of studies in this category were cross-sectional studies (n=35), while the remaining were cohort studies (n=4). Studies focused on the burden of all non-communicable diseases and risk factors [46-52], with some focusing specifically on the burden of heart diseases and risk factors, including hypertension and stroke [53-63]. In addition, some of the studies focused on diabetes and hypertension [64,65] or diabetes alone [66] or its impact on quality of life [67] or care and support systems for persons living with diabetes [68,69]. Five cross-sectional studies focused on the burden of obesity and associated factors [70-73]; the burden of chronic respiratory diseases [74]; impact of well-being on general health, the association between social capital and non-communicable diseases including the occurrence of hypertension [75,76]. One study each focused on the occurrence of kidney disease [77] and dyslipidemia [78] as well as the occurrence of Noncommunicable Diseases (NCDs) alongside communicable diseases like HIV [79]. Four cross-sectional studies focused on cancers, including breast, cervical, vulvar, and prostate cancers [80-83]. These studies focused on the incidence of cancer and the factors associated with cancer.

Mental health (n=28)

Twenty-eight studies (n=28) in this category either focused on mental health alone or in combination with other conditions. The majority were cross-sectional studies (n=27), with only one being a randomized controlled trial. Fifteen studies focused on the prevalence and predictors of mental illnesses and depression, including symptoms [84-98]. Seven studies focused on mental health and social capital, support, and well-being [99-106]. One study focused on the impact of mental health illness on caregivers [107], mental health and multimorbidities [108] and life decision-making for persons with mental illness [109]. Also, an Randomized Controlled Trial (RCT) was found to assess a drug, bupropion, for treating depression in older persons [110].

Cognitive Health (n=24)

Twenty-four studies were found in this category; 21 were quantitative studies including cross-sectional (n=13), cohort (n=9) and a Randomized Controlled Trial (RCT) (n=1) and only one study (n=1) was a qualitative study. The majority of the studies (n=17) looking at cognitive health focused on the prevalence of cognitive impairment and correlates of cognitive health [111-123] including studies with a specific focus on dementia [124-126]. One study was an RCT that sought to evaluate the effectiveness of a therapy known as low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which "targeted maladaptive cognitions in older people experiencing loneliness" [127]. Four other studies focused on sleep disorders and their predictors among older persons [113,128-130]. Two studies focused on the screening tools for cognitive impairment (n=2) [131-133].

Musculoskeletal conditions (n=8)

Eight cross-sectional studies focused on musculoskeletal conditions, such as the impact of musculoskeletal disorders on the quality of life [134]; the prevalence of osteoporosis and arthritis, sarcopenia, hip fractures, and back pain [135-141].

Ageing and frailty (n=6)

Two studies focused on ageing [142], including ageing with HIV [143], experience with ageing [144]. Three cross-sectional studies focused on developing frailty index [145]; prevalence and risk factors of frailty and disability [146,147].

Medicine use (n=5)

Five cross-sectional studies were included in this category. The first assessed the prevalence of potentially serious Drug-Drug Interactions (DDIs) and their predictor [148]. The second study evaluated the ability of a checklist, known as the American Geriatrics-Beers (AGS- Beers) criteria, to predict adverse drug reactions [149]. The third study assessed the knowledge and perceptions of Nigerian and South African health care professionals on appropriate prescribing among the elderly [150]. The fourth described the prevalence and pattern of potentially inappropriate prescriptions [151], while the last assessed adherence to chronic medications in the elderly [152].

Falls (n=4): studies in this category (n=4) focused on the prevalence of falls in older persons [153]; risk factors associated with falls [154]; preventive measures [155]; and methodological challenges of a study on falls [156]. Three studies were cross-sectional, while one was a mixed-methods study.

Dental/oral health (n=4): four studies which were all cross-sectional studies, focused on dental health. The prevalence of dental diseases, including periodontal disease and edentulism, were described in these studies [157-160].

Eye health (n=3): three cross-sectional studies in this category focused on the prevalence of cataracts [161] and causes of visual impairments [162], and factors associated with visual impairment [162].

Hearing impairment (n=2): these two cross-sectional studies focused on hearing impairment and its impact on quality of life [163,164].

Reproductive health (n=1): only one study focused on the relationship between sexual activity and self-rated health status [165].

Blood disorders (n=1): only one study focused on anaemia [166].

Alcohol use (n=1) (only one study was focused on this area): a study which assessed the relationship between alcohol consumption and high-risk sexual behaviour among elderly [167].

Research on the determinants of health among older persons (n=72)

Lifestyle factors nutrition and physical activity (n=22): studies focusing on nutrition comprised seven cross-sectional studies, six reviews, and one RCT. These studies focused on vitamins deficiency and supplementation [168,169]; consumption habits of sugars and beverages [170]; malnutrition [171,172]; body mass index [173,174]; dietary guidelines [175-179] ; nutritional pattern [180] and malnutrition [172]. An RCT assessed the effects of a fish diet on cognitive health [181]. Seven cross-sectional studies focused on physical activity and its correlates among older persons [96,182-187].

Quality of life (and wellbeing) n=19: nineteen cross-sectional studies in this category focused on quality of life, including issues around socio-economic factors that affect the health and well-being of older persons, such as living arrangements and others [188-202]. Other studies focused on diseases that impact the quality of life [48] and how inequality affects the quality of life [203,204].

Disability status -Quality of life, handgrip strength (n=9): seven cross-sectional studies focused on quality of life as it relates to disability among older persons, including factors associated with disability [205-211]. While two cross-sectional studies focused on handgrip strength and associated factors [212,213].

Care and support offered to older persons (n=8): eight studies focused on the care and support mechanisms for older persons. There were three cross-sectional studies, one qualitative, two reviews, and two mixed-methods studies. These studies focused on various kinds of support offered to older persons suffering from various health conditions, such as social support [214-219], self-care [220] and access to such support systems [218].

Access to health care (n=6)

Six studies focused on access to health care by older persons. These were qualitative studies (n=3) and quantitative/cross-sectional studies (n=2). Most studies (n=4) focused on the experiences of older persons regarding healthcare delivery [221-224], while the remaining focused on predictors of health care use [225] and health insurance [226].

Violence and 'eldercides' (homicides) among the elderly (n=3): three cross-sectional studies assessed the proportion of homicides [227] and the violence faced by older persons, particularly intimate partner violence [228], and their predictors [229].

Mortality (n=3): three cross-sectional studies focused on mortality and causes [41,230,231].

Health policy affecting older persons (n=1): only one study described how health policies could impact the health of older persons [232].

Health expenditure on older persons (n=1): two studies in this category described the health expenditure for persons living with HIV [187,233].



DiscussionUp    Down

Our scoping review of research on diseases affecting older persons in South Africa showed that most studies focused on infectious diseases, particularly HIV. Many studies were also conducted on non-communicable diseases, such as hypertension, diabetes, and obesity. Additionally, our study found that a large number of studies each focused on mental health and musculoskeletal disorders. The least studies were conducted on ageing and frailty, alcohol and tobacco use, cancer and eye health. These findings are consistent with previous research on the disease burden among older people in South Africa and other Low- and Middle-Income Countries (LMICs), as communicable and non-communicable diseases are major contributors to morbidity and mortality among the elderly [1,4,234].

The finding that many studies focused on HIV may be because the population of older persons living with HIV is growing due to access to Antiretrovirals (ARTs) and high survival rates. Secondly, the incidence of the infection appears to be growing among older persons [235,236]. More studies are required to understand the factors associated with this rising incidence and factors affecting access to HIV services among older persons. Only one study was found looking at COVID-19 and older persons. We may attribute this to the fact that we conducted our literature search in 2022. It's possible that some relevant papers, crucial for our synthesis, may not have been published. As a result, more research into other infectious diseases like COVID-19, particularly long-term effects of COVID-19 ('long COVID'), and how it impacts older people may be necessary.

Among the non-communicable diseases, more studies on cardiometabolic diseases were reported than cancers, reflecting a greater research focus on these conditions in South Africa. Considering that cancers could contribute to morbidity and mortality among older persons [237], more research may also be needed to understand the burden of cancer, risk factors, and effective interventions to address these conditions among older persons. Also, the few cancer studies identified in this review were focused on the prevalence and risk factors of cervical and prostate cancer. It is important to note that older persons in South Africa are also at risk of other types of cancers and likewise further research is needed to understand the burden of other kinds of cancers among older men and women in the country.

We found a significant number of studies focused on determinants of health, such as lifestyle, mortality, quality of life, care and support, violence against older persons, health policy and expenditure, and access to healthcare in South Africa. Physical and social environments can affect health directly or indirectly. Maintaining healthy behaviors throughout life, such as eating a balanced diet, engaging in regular physical activity and refraining from tobacco use, all contribute to reducing the risk of non-communicable diseases, improving physical and mental capacity, and delaying care dependency [1]. The fact that several studies are looking at nutrition among older persons in South Africa is encouraging as understanding nutrition knowledge gaps can guide educational interventions to reduce nutritional deficiencies and promote healthy ageing, as nutrition knowledge affects eating behaviour and nutritional status [238].

Sexual and reproductive health issues in older people have received little attention from health professionals, researchers, and policymakers [239]. We found only one study that focused on the reproductive health of older people which supports the statement. Male and female hormone declines in men and women are linked to physical and psychological symptoms such as decreased libido, pre- and menopausal symptoms in women, and erectile dysfunction, among others [239]. Furthermore, studies show that more than 80% of men and 65% of women continue to be sexually active in old age, which may affect their sexual behaviors and potentially increase their risk of contracting HIV and other Sexually Transmitted Infections (STIs) [239]. The prevalence of STIs among the elderly appears to be increasing [240]. As a result, more research is needed to better understand the reproductive health issues of this age group in South Africa.

Population ageing has been recognized as one of the world's most important public health problems. With the increase in life expectancy globally, there is an urgent need to promote research on ageing and ageing-related diseases to increase healthy and productive longevity for the elderly population [241,242]. Also, several reports have shown that frameworks that promote healthy ageing are lacking in developing countries [243]. Therefore, as the population of older persons in South Africa continues to grow, studies focused on understanding the ageing process are essential, especially in areas where there has been little recent research. Furthermore, frailty, falls, and sarcopenia are conditions among older persons that require attention considering the exponential growth of the ageing population [244]. As osteoporosis and sarcopenia may go underdiagnosed and undertreated [245]. Although we found studies on falls and osteoporosis, much more are needed to understand the burden and risk factors in our setting. Studies on the assessment of frailty indicators are also required to aid early interventions.

The use of alcohol and tobacco is associated with a range of adverse health outcomes, including cancer, cardiovascular disease, and respiratory disease. Alcohol use is also associated with functional and psychiatric issues for older adults, sleep disorders, falls, other injuries and accidents [242]. Several studies focused on alcohol and tobacco use among the elderly have been published elsewhere, some of which include the use of alcohol among older persons during the pandemic [246], patterns of alcohol use and alcohol disorders [247], the association between smoking in older persons and developing frailty [248]. While much can be learnt from research conducted elsewhere, there is still a need for local research to understand the patterns of alcohol and tobacco use and risk factors among older persons in South Africa, as well as effective interventions to reduce their use among this population.

Eye health is, an essential aspect of overall health and well-being, but our review shows a lack of research on eye health among older persons in South Africa. This finding is consistent with the disproportionate distribution of eye health research, with more seen in high-income countries than in low- and middle-income countries [249]. In the same vein, the demand for eye health services is expected to rise further as the world's population ages, especially given the widespread inequality in access and the constraints due to limited resources [250]. Studies on access to eyecare services among the older population will be relevant. Vision impairment is one of the most common eye-related conditions in older persons. The most causes include cataracts, refractive error, age-related macular degeneration, glaucoma, and diabetic retinopathy [250]. We need more research to understand the burden of these conditions in South Africa. An association between vision impairment and cognitive decline and dementia has been studied extensively in high-income countries with few ongoing studies from LMICs [249]. As more work remains to be done to achieve universal eye health [251], we need to consider similar studies in our setting.

Chronic respiratory diseases will continue to be a significant cause of morbidity and mortality worldwide as populations age and urbanization increases [251]. Globally, there may be a lack of true estimates of the burden on Chronic Obstructive Pulmonary Disease (COPD) in the older population, which could limit the implementation of required evidence-based interventions [251]. More studies are also needed to understand the burden of COPD among older persons in South Africa, as well as effective interventions to prevent, diagnose and manage COPD in this population.

Mental health and cognitive health are important in older population. Mental health conditions such as depression and anxiety contribute to years lived with disability among older persons [252]. Also, older people with substance abuse issues could be misdiagnosed. Stigma surrounding mental health problems also pose a problem, more research is thus needed in these areas. Also, 'elder abuse' including physical, verbal, psychological, financial, sexual, abandonment, neglect, can cause physical injuries and long-term psychological issues like depression and anxiety [252]. We found few studies on elder abuse, therefore, more studies are required.

In May 2017, the World Health Assembly approved the Global Action Plan on dementia public health response 2017-2025, which aims to "raise dementia awareness and establish dementia-friendly initiatives, reduce dementia risk, diagnose, treat, and care, conduct research and innovation, and support dementia carers". Our review identified only five studies that looked at the prevalence and risk factors for dementia, suggesting that this could also be a fruitful area for increased research locally [252].

Our review is not without limitations. Firstly, study selection was done by one reviewer. However, extraction of information from the included studies were verified by a second reviewer. Furthermore, our research was limited to studies conducted in English. Finally, no risk of bias assessment was performed to determine the quality of included studies.



Conclusion Up    Down

In conclusion, this scoping review of research conducted on diseases affecting older persons in South Africa has highlighted that the majority of studies focused on communicable and non- communicable diseases, mental health and musculoskeletal disorders and determinants of health.

What is known about this topic

  • Numerous countries in sub-Saharan Africa, including South Africa are witnessing an increase in the number of older persons;
  • Interventions are required to help older people live longer, healthier lives in South Africa;
  • Researching the health conditions affecting this population is a crucial step towards formulating these interventions.

What this study adds

  • The majority of the studies on health conditions affecting older persons focused on infectious diseases, non-communicable diseases, mental health, musculoskeletal conditions, and cognitive health;
  • The epidemiology of these conditions needs to be more described;
  • Fewer topics related to alcohol and drug use, ageing and frailty, falls, blood disorders, cancer, reproductive health, and eye health were reported requiring further research.



Competing interests Up    Down

The authors declare no competing interests.



Funding Up    Down

This work is supported by funding from the South African Medical Research Council (through Cochrane South Africa's baseline funding: Project Code 43500). The funder has no role in the design of the study, data collection, analysis, interpretation of data, and writing of this manuscript.



Authors' contributions Up    Down

This study was conceived by Jane Simmonds, Charles Parry and Charles Shey Wiysonge. The search strategy and search were conducted by Chinwe Iwu-Jaja, with the help of a librarian. The selection of eligible studies and data extraction were done by Chinwe Iwu-Jaja and validated by Anelisa Jaca. Charles Shey Wiysonge supervised the entire study. CI wrote the first draft of the manuscript. All authors made contributions to subsequent drafts. The final version was read and approved by all authors.



Acknowledgement Up    Down

The authors would like to acknowledge Ms. Alvina Matthee, a librarian from the Faculty of Medicine and Health Sciences at Stellenbosch University South Africa, for her assistance with the search strategy used in this review.



Tables and figures Up    Down

Table 1: summary of key themes from research on health conditions among older persons in South Africa between 2010 and 2022

Table 2: summary of key themes from research on determinants of health among older persons in South Africa between 2010-2022

Figure 1: PRISMA flow diagram of the process for study selection

Figure 2: number of studies published between 2010-2022 (literature search was conducted up till 8 February 2022)



References Up    Down

  1. World Health Organization. Ageing and Health. 2022. Accessed 18th September 2023.

  2. Audain K, Carr M, Dikmen D, Zotor F, Ellahi B. Exploring the health status of older persons in Sub-Saharan Africa. Proc Nutr Soc. 2017 Nov;76(4):574-579. PubMed | Google Scholar

  3. The Government of South Africa. Department of Social Development (National). Older Persons Act 13 of 2006. No. 13 of 2006. Legislated: 2 November 2006.

  4. Republic of South Africa. Protecting South Africa's elderly. Department of statistics South Africa. 2020. Accessed 18th September 2023.

  5. Achoki T, Sartorius B, Watkins D, Glenn SD, Kengne AP, Oni T et al. Health trends, inequalities and opportunities in South Africa's provinces, 1990-2019: findings from the Global Burden of Disease 2019 Study. J Epidemiol Community Health. 2022 Jan 19;76(5):471-81. PubMed | Google Scholar

  6. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119-212. PubMed | Google Scholar

  7. Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015 Sep;13(3):141-6. PubMed | Google Scholar

  8. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. PubMed | Google Scholar

  9. van Empel E, de Vlieg RA, Montana L, Gómez-Olivé FX, Kahn K, Tollman S et al. Older Adults Vastly Overestimate Both HIV Acquisition Risk and HIV Prevalence in Rural South Africa. Arch Sex Behav. 2021 Oct;50(7):3257-3276. PubMed | Google Scholar

  10. Houle B, Yu ST, Angotti N, Schatz E, Kabudula CW, Gómez-Olivé FX et al. Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older. Arch Sex Behav. 2020 Aug;49(6):2057-2068. PubMed | Google Scholar

  11. Rosenberg MS, Gómez-Olivé FX, Rohr JK, Houle BC, Kabudula CW, Wagner RG et al. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa. J Acquir Immune Defic Syndr. 2017 Jan 1;74(1):e9-e17. PubMed | Google Scholar

  12. Gómez-Olivé FX, Houle B, Rosenberg M, Kabudula C, Mojola S, Rohr JK et al. Brief Report: HIV Incidence Among Older Adults in a Rural South African Setting: 2010-2015. J Acquir Immune Defic Syndr. 2020 Sep 1;85(1):18-22. PubMed | Google Scholar

  13. Mojola SA, Williams J, Angotti N, Gómez-Olivé FX. HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults. Soc Sci Med. 2015 Oct;143:204-12. PubMed | Google Scholar

  14. Lekalakala-Mokgele E. Understanding of the risk of HIV infection among the elderly in Ga-Rankuwa, South Africa. Sahara J. 2014;11(1):67-75.. PubMed | Google Scholar

  15. Schatz E, Knight L, Belli RF, Mojola SA. Assessing the feasibility of a life history calendar to measure HIV risk and health in older South Africans. PLoS One. 2020 Jan 15;15(1):e0226024. PubMed | Google Scholar

  16. Lekalakala-Mokgele E. Understanding of the risk of HIV infection among the elderly in Ga-Rankuwa, South Africa. SAHARA J. 2014;11(1):67-75. PubMed | Google Scholar

  17. Knight L, Schatz E, Lewis KR, Mukumbang FC. 'When you take pills you must eat': Food (in)security and ART adherence among older people living with HIV. Glob Public Health. 2020 Jan;15(1):97-110. PubMed | Google Scholar

  18. Lekalakala-Mokgele E. Adherence to Antiretroviral Therapy among Older HIV-infected Persons Receiving Treatment in a Public Hospital in Gauteng Province. Afr J Nurs Midwifery. 2021;22:2. Google Scholar

  19. Watson MJ, Klopper HC, Kruger A. Community-based collaboration in support of older persons. J Psychol Africa. 2013;23(3):515-518. Google Scholar

  20. Edwards A, Siedner MJ, Nash S, Neuman M, Danaviah S, Smit T et al. HIV serostatus, inflammatory biomarkers and the frailty phenotype among older people in rural KwaZulu-Natal, South Africa. African J AIDS Res. 2020;19(3):177-185. PubMed | Google Scholar

  21. Nyirenda M, Chatterji S, Falkingham J, Mutevedzi P, Hosegood V, Evandrou M et al. An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa. BMC Public Health. 2012 Apr 2;12:259. PubMed | Google Scholar

  22. Schatz E, Houle B, Mojola SA, Angotti N, Williams J. How to "Live a Good Life": Aging and HIV Testing in Rural South Africa. J Aging Health. 2019 Apr;31(4):709-732. PubMed | Google Scholar

  23. Madiba S, Ntuli M. Delayed Disclosure of HIV Status and Lack of Resources Affect Older Persons during Care of Adult Family Members with AIDS-Related Illness in Rural Mpumalanga, South Africa. Curr Gerontol Geriatr Res. 2020 Jun 24;2020:3430847. PubMed | Google Scholar

  24. Ntuli M, Madiba S. The Burden of Caring: An Exploratory Study of the Older Persons Caring for Adult Children with AIDS-Related Illnesses in Rural Communities in South Africa. Int J Environ Res Public Health. 2019 Aug 30;16(17):3162. PubMed | Google Scholar

  25. Angotti N, Mojola SA, Schatz E, Williams JR, Gómez-Olivé FX. 'Taking care' in the age of AIDS: older rural South Africans' strategies for surviving the HIV epidemic. Cult Health Sex. 2018 Mar;20(3):262-275. PubMed | Google Scholar

  26. Ogunmefun C, Gilbert L, Schatz E. Older female caregivers and HIV/AIDS-related secondary stigma in rural South Africa. J Cross Cult Gerontol. 2011 Mar;26(1):85-102. PubMed | Google Scholar

  27. Nyirenda M, Evandrou M, Mutevedzi P, Hosegood V, Falkingham J, Newell ML. Who cares? Implications of care-giving and -receiving by HIV-infected or -affected older people on functional disability and emotional wellbeing. Ageing Soc. 2015 Jan;35(1):169-202. PubMed | Google Scholar

  28. Rohr JK, Xavier Gómez-Olivé F, Rosenberg M, Manne-Goehler J, Geldsetzer P, Wagner RG et al. Performance of self-reported HIV status in determining true HIV status among older adults in rural South Africa: a validation study. J Int AIDS Soc. 2017 Jul 18;20(1):21691. PubMed | Google Scholar

  29. Madhavan S, Schatz E, Gómes-Olivé FX, Collinson M. Social Positioning of Older Persons in Rural South Africa: Change or Stability? J South Afr Stud. 2017;43(6):1293-1307. PubMed | Google Scholar

  30. Schatz E, Knight L. "I was referred from the other side": Gender and HIV testing among older South Africans living with HIV. PLoS One. 2018 Apr 23;13(4):e0196158. PubMed | Google Scholar

  31. Cornell M, Johnson LF, Schomaker M, Tanser F, Maskew M, Wood R et al. Age in antiretroviral therapy programmes in South Africa: a retrospective, multicentre, observational cohort study. Lancet HIV. 2015 Sep;2(9):e368-75. PubMed | Google Scholar

  32. Rohr JK, Manne-Goehler J, Gómez-Olivé FX, Wagner RG, Rosenberg M, Geldsetzer P et al. HIV treatment cascade for older adults in rural South Africa. Sex Transm Infect. 2020 Jun;96(4):271-276. PubMed | Google Scholar

  33. Hlongwane N, Madiba S. Navigating Life with HIV as an Older Adult in South African Communities: A Phenomenological Study. Int J Environ Res Public Health. 2020 Aug 11;17(16):5797. PubMed | Google Scholar

  34. Singo VJ, Lebese RT, Maluleke TX, Nemathaga LH. The views of the elderly on the impact that HIV and AIDS has on their lives in the Thulamela Municipality, Vhembe District, Limpopo province. Curationis. 2015 Jun 9;38(1):1166. PubMed | Google Scholar

  35. Karstaedt AS, Bolhaar M. Tuberculosis in older adults in Soweto, South Africa. Int J Tuberc Lung Dis. 2014 Oct;18(10):1220-2. PubMed | Google Scholar

  36. Eleftheriades C. A recommended management plan for coronavirus disease 2019-positive geriatric patients based in South African old age homes. S Afr Fam Pract (2004). 2021 Feb 8;63(1):e1-e5. PubMed | Google Scholar

  37. Oduro JK, Kissah-Korsah K. Aged Persons Living with HIV and Nutritional Wellness: Analysis of 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2. J Aging Res. 2021 Jun 23;2021:6635814. PubMed | Google Scholar

  38. Klemz BR, Boshoff C, Mazibuko NE, Asquith JA. The effect of altruism on the spending behavior of elderly caregivers of family members with HIV/AIDS in South African townships. Health Mark Q. 2015;32(1):81-95. PubMed | Google Scholar

  39. Joska JA, Dreyer AJ, Nightingale S, Combrinck MI, De Jager CA. Prevalence of HIV-1 Infection in an elderly rural population and associations with neurocognitive impairment. AIDS. 2019 Sep 1;33(11):1765-1771. PubMed | Google Scholar

  40. Asiimwe SB, Farrell M, Kobayashi LC, Manne-Goehler J, Kahn K, Tollman SM et al. Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa. Sci Rep. 2020 Oct 6;10(1):16625. PubMed | Google Scholar

  41. Wade AN, Payne CF, Berkman L, Chang A, Gómez-Olivé FX, Kabudula C et al. Multimorbidity and mortality in an older, rural black South African population cohort with high prevalence of HIV findings from the HAALSI Study. BMJ Open. 2021 Sep 15;11(9):e047777. PubMed

  42. Manne-Goehler J, Montana L, Gómez-Olivé FX, Rohr J, Harling G, Wagner RG et al. The ART Advantage: Health Care Utilization for Diabetes and Hypertension in Rural South Africa. J Acquir Immune Defic Syndr. 2017 Aug 15;75(5):561-567. PubMed | Google Scholar

  43. Chang AY, Gómez-Olivé FX, Manne-Goehler J, Wade AN, Tollman SM, Gaziano TA et al. Multimorbidity and care for hypertension, diabetes and HIV among older adults in rural South Africa. Bull World Health Organ. 2019 Jan 1;97(1):10-23. PubMed | Google Scholar

  44. Manne-Goehler J, Montana L, Gomez-Olive X, Rohr J, Wagner R, Kabudula C et al. Human Immunodeficiency Virus (HIV) Infection, Antiretroviral Therapy (ART) Use and Access to Care for Diabetes and Hypertension in Agincourt, South Africa. Open Forum Infect Dis. December 2016;3(suppl_1):851. Google Scholar

  45. Gómez-Olivé FX, Rohr JK, Roden LC, Rae DE, von Schantz M. Associations between sleep parameters, non-communicable diseases, HIV status and medications in older, rural South Africans. Sci Rep. 2018 Nov 23;8(1):17321. PubMed | Google Scholar

  46. Phaswana-Mafuya N, Peltzer K. Racial or Ethnic Health Disparities among Older Adults in Four Population Groups in South Africa. Ann Glob Health. 2018 Apr 30;84(1):7-13. PubMed | Google Scholar

  47. Phaswana-Mafuya N, Peltzer K, Chirinda W, Musekiwa A, Kose Z. Sociodemographic predictors of multiple non-communicable disease risk factors among older adults in South Africa. Glob Health Action. 2013 Sep 16;6:20680. PubMed | Google Scholar

  48. Gerber AM, Botes R, Mostert A, Vorster A, Buskens E. A cohort study of elderly people in Bloemfontein, South Africa, to determine health-related quality of life and functional abilities. S Afr Med J. 2016 Feb 4;106(3):298-301. PubMed | Google Scholar

  49. Chidumwa G, Maposa I, Corso B, Minicuci N, Kowal P, Micklesfield LK et al. Identifying co-occurrence and clustering of chronic diseases using latent class analysis: Cross-sectional findings from SAGE South Africa Wave 2. BMJ Open. 2021;11(1):1-8. PubMed | Google Scholar

  50. Kobayashi LC, Frank S, Riumallo-Herl C, Canning D, Berkman L. Socioeconomic gradients in chronic disease risk behaviors in a population-based study of older adults in rural South Africa. Int J Public Health. 2019 Jan;64(1):135-145. PubMed | Google Scholar

  51. Wu F, Guo Y, Chatterji S, Zheng Y, Naidoo N, Jiang Y et al. Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1. BMC Public Health. 2015 Feb 6;15:88. PubMed | Google Scholar

  52. Koyanagi A, Garin N, Olaya B, Ayuso-Mateos JL, Chatterji S, Leonardi M et al. Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PLoS One. 2014 Dec 5;9(12):e114742. PubMed | Google Scholar

  53. Ferro EG, Abrahams-Gessel S, Jardim TV, Wagner R, Gomez-Olive FX, Wade AN et al. Electrocardiographic Abnormalities Among Elderly Adults With Cardiovascular Disease in Rural South Africa. Circ Cardiovasc Qual Outcomes. 2021 Nov;14(11):e007847. PubMed | Google Scholar

  54. Lloyd-Sherlock P, Gómez-Olivé FX, Ngobeni S, Wagner RG, Tollman S. Pensions and Low Sodium Salt: A Qualitative Evaluation of a New Strategy for Managing Hypertension in Rural South Africa. Curr Aging Sci. 2018;11(2):140-146. PubMed | Google Scholar

  55. Lloyd-Sherlock P, Beard J, Minicuci N, Ebrahim S, Chatterji S. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control. Int J Epidemiol. 2014 Feb;43(1):116-28. PubMed | Google Scholar

  56. Lloyd-Sherlock P, Minicuci N, Corso B, Beard J, Chatterji S, Ebrahim S. Diseases of the Rich? the Social Patterning of Hypertension in Six Low- and Middle-Income Countries. Eur J Dev Res. 2017;29(4):827-842. Google Scholar

  57. Houle B, Gaziano T, Farrell M, Gómez-Olivé FX, Kobayashi LC, Crowther NJ et al. Cognitive function and cardiometabolic disease risk factors in rural South Africa: baseline evidence from the HAALSI study. BMC Public Health. 2019 Nov 27;19(1):1579. PubMed | Google Scholar

  58. Houle B, Gaziano TA, Angotti N, Mojola SA, Kabudula CW, Tollman SM et al. Hypertension incidence among middle-aged and older adults: findings from a 5-year prospective study in rural South Africa, 2010-2015. BMJ Open. 2021 Dec 7;11(12):e049621. PubMed | Google Scholar

  59. Jardim TV, Witham MD, Abrahams-Gessel S, Gómez-Olivé FX, Tollman S, Berkman L et al. Cardiovascular Disease Profile of the Oldest Adults in Rural South Africa: Data from the HAALSI Study (Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities). J Am Geriatr Soc. 2018 Nov;66(11):2151-2157. PubMed | Google Scholar

  60. Ruan Y, Guo Y, Zheng Y, Huang Z, Sun S, Kowal P et al. Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC Public Health. 2018 Jun 20;18(1):778. PubMed | Google Scholar

  61. Ntuli ST, Maimela E, Alberts M, Choma S, Dikotope S. Prevalence and associated risk factors of hypertension amongst adults in a rural community of Limpopo Province, South Africa. Afr J Prim Health Care Fam Med. 2015 Oct 22;7(1):847. PubMed | Google Scholar

  62. Waterhouse P, van der Wielen N, Banda PC, Channon AA. The impact of multi-morbidity on disability among older adults in South Africa: do hypertension and socio-demographic characteristics matter? Int J Equity Health. 2017 Apr 8;16(1):62. PubMed | Google Scholar

  63. Gómez-Olivé FX, Montana L, Wagner RG, Kabudula CW, Rohr JK, Kahn K et al. Cohort Profile: Health and Ageing in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI). Int J Epidemiol. 2018 Jun 1;47(3):689-690j. PubMed | Google Scholar

  64. Manne-Goehler J, Siedner MJ, Montana L, Harling G, Geldsetzer P, Rohr J et al. Hypertension and diabetes control along the HIV care cascade in rural South Africa. J Int AIDS Soc. 2019 Mar;22(3):e25213. PubMed | Google Scholar

  65. Laverty AA, Palladino R, Lee JT, Millett C. Associations between active travel and weight, blood pressure and diabetes in six middle income countries: a cross-sectional study in older adults. Int J Behav Nutr Phys Act. 2015 May 20;12:65. PubMed | Google Scholar

  66. Roux M le, Walsh C, Reid M, Raubenheimer J. Diabetes-related knowledge, attitude and practices (KAP) of adult patients with type 2 diabetes mellitus in the Free State province, South Africa. South African J Clin Nutr. 2019;32:4.

  67. Werfalli M, Kassanjee R, Kalula S, Kowal P, Phaswana-Mafuya N, Levitt NS. Diabetes in South African older adults: prevalence and impact on quality of life and functional disability - as assessed using SAGE Wave 1 data. Glob Health Action. 2018;11(1):1449924. PubMed | Google Scholar

  68. Werfalli MM, Kalula SZ, Manning K, Levitt NS. Does social support effect knowledge and diabetes self-management practices in older persons with Type 2 diabetes attending primary care clinics in Cape Town, South Africa? PLoS One. 2020 Mar 13;15(3):e0230173. PubMed | Google Scholar

  69. Werfalli M, Murphy K, Kalula S, Levitt N. Current policies and practices for the provision of diabetes care and self-management support programmes for older South Africans. Afr J Prim Health Care Fam Med. 2019 Aug 29;11(1):e1-e12. PubMed | Google Scholar

  70. Romano E, Ma R, Vancampfort D, Firth J, Felez-Nobrega M, Haro JM et al. Multimorbidity and obesity in older adults from six low- and middle-income countries. Prev Med. 2021 Dec;153:106816. PubMed | Google Scholar

  71. Jamshidi-Naeini Y, Bavil AK, Egal A, Oldewage-Theron W. Hemoglobin and ferritin concentrations are positively associated with blood pressure and hypertension risk in older adults: a retrospective cross-sectional study, Sharpeville, South Africa. Asia Pac J Clin Nutr. 2019;28(3):533-543. PubMed | Google Scholar

  72. Chikobvu D, Matizirofa L. Quantile Regression Analysis of Modifiable and Non-Modifiable Predictors of Stroke among Adults in South Africa. Open Public Health J. 2021;14(1):409-416. Google Scholar

  73. Otitoola OC, Oldewage-Theron WN, Egal AA. Trends in the development of obesity in elderly day care attendees in Sharpeville, South Africa, from 2007-2011. South African J Clin Nutr. 2015;28(1):12-17. Google Scholar

  74. Nkosi V, Wichmann J, Voyi K. Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps? Environ Health. 2015 Apr 3;14:33. PubMed | Google Scholar

  75. Lloyd-Sherlock P, Agrawal S. Pensions and the health of older people in South Africa: is there an effect? J Dev Stud. 2014 Nov 2;50(11):1570-1586. PubMed | Google Scholar

  76. Christian AK, Sanuade OA, Okyere MA, Adjaye-Gbewonyo K. Social capital is associated with improved subjective well-being of older adults with chronic non-communicable disease in six low- and middle-income countries. Global Health. 2020 Jan 2;16(1):2. PubMed | Google Scholar

  77. Okpechi IG, Ayodele OE, Rayner BL, Swanepoel CR. Kidney disease in elderly South Africans. Clin Nephrol. 2013 Apr;79(4):269-76. PubMed | Google Scholar

  78. Reiger S, Jardim TV, Abrahams-Gessel S, Crowther NJ, Wade A, Gomez-Olive FX et al. Awareness, treatment, and control of dyslipidemia in rural South Africa: The HAALSI (Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa) study. PLoS One. 2017 Oct 27;12(10):e0187347. PubMed | Google Scholar

  79. Knight L, Schatz E, Mukumbang FC. "I attend at Vanguard and I attend here as well": barriers to accessing healthcare services among older South Africans with HIV and non-communicable diseases. Int J Equity Health. 2018 Sep 18;17(1):147. PubMed | Google Scholar

  80. Butt JL, Botha MH. Vulvar cancer is not a disease of the elderly: Treatment and outcome at a tertiary referral centre in South Africa. S Afr Med J. 2017 Oct 31;107(11):1000-1004. PubMed | Google Scholar

  81. Jalloh M, Friebel TM, Sira Thiam F, Niang L, Sy C, Siby T et al. Evaluation of 4, 672 routine prostate biopsies performed in six African countries. Journal Africain du Cancer. 2013;5(3):144-154. Google Scholar

  82. Parag Y, Buccimazza I. How long are elderly patients followed up with mammography after the diagnosis of breast cancer? A single-centre experience in a developing country. S Afr Med J. 2016 Jun 17;106(7):721-3. PubMed | Google Scholar

  83. Peltzer K, Phaswana-Mafuya N. Breast and cervical cancer screening and associated factors among older adult women in South Africa. Asian Pac J Cancer Prev. 2014;15(6):2473-6. PubMed | Google Scholar

  84. Hao G, Bishwajit G, Tang S, Nie C, Ji L, Huang R. Social participation and perceived depression among elderly population in South Africa. Clin Interv Aging. 2017 Jun 23;12:971-976. PubMed | Google Scholar

  85. Narainsamy J, Chipps J, Cassim B. Depressive symptoms in community-dwelling persons aged ?60 years in Inanda, Ntuzuma and KwaMashu in eThekwini, KwaZulu-Natal. South African Journal of Psychiatry. 2015;21(1):13-18. Google Scholar

  86. Padayachey U, Ramlall S, Chipps J. Depression in older adults: Prevalence and risk factors in a primary health care sample. South African Fam Pract. 2017;59(2):61-66. Google Scholar

  87. Brandão DJ, Fontenelle LF, da Silva SA, Menezes PR, Pastor-Valero M. Depression and excess mortality in the elderly living in low- and middle-income countries: Systematic review and meta-analysis. Int J Geriatr Psychiatry. 2019 Jan;34(1):22-30. PubMed | Google Scholar

  88. Owusu JT, Doty SB, Adjaye-Gbewonyo D, Bass JK, Wilcox HC, Gallo JJ et al. Association of sleep characteristics with suicidal ideation and suicide attempt among adults aged 50 and older with depressive symptoms in low- and middle-income countries. Sleep Health. 2020 Feb;6(1):92-99. PubMed | Google Scholar

  89. Adjaye-Gbewonyo D, Rebok GW, Gallo JJ, Gross AL, Underwood CR. Urbanicity of residence and depression among adults 50 years and older in Ghana and South Africa: an analysis of the WHO Study on Global AGEing and Adult Health (SAGE). Aging Ment Health. 2019 Jun;23(6):660-669. PubMed | Google Scholar

  90. Lotfaliany M, Hoare E, Jacka FN, Kowal P, Berk M, Mohebbi M. Variation in the prevalence of depression and patterns of association, sociodemographic and lifestyle factors in community-dwelling older adults in six low- and middle-income countries. J Affect Disord. 2019 May 15;251:218-226. PubMed | Google Scholar

  91. Fernández-Ninõ JA, Bojorquez I, Becerra-Arias C, Astudillo-Garcia CI. Religious affiliation and major depressive episode in older adults: a cross-sectional study in six low- and middle- income countries. BMC Public Health. 2019 Apr 30;19(1):460. PubMed | Google Scholar

  92. Gehlich KH, Beller J, Lange-Asschenfeldt B, Köcher W, Meinke MC, Lademann J. Fruit and vegetable consumption is associated with improved mental and cognitive health in older adults from non-Western developing countries. Public Health Nutr. 2019 Mar;22(4):689-696. PubMed | Google Scholar

  93. Ghose B, Wang R, Tang S, Yaya S. Engagement in physical activity, suicidal thoughts and suicide attempts among older people in five developing countries. PeerJ. 2019 Jun 12;7:e7108. PubMed | Google Scholar

  94. Pengpid S, Peltzer K. Mental morbidity and its associations with socio-behavioural factors and chronic conditions in rural middle- and older-aged adults in South Africa. J Psychol Afr. 2020;30(3):257-263. PubMed | Google Scholar

  95. Payne CF, Mall S, Kobayashi L, Kahn K, Berkman L. Life-Course Trauma and Later Life Mental, Physical, and Cognitive Health in a Postapartheid South African Population: Findings From the HAALSI study. J Aging Health. 2020 Oct;32(9):1244-1257. PubMed | Google Scholar

  96. Vancampfort D, Stubbs B, Hallgren M, Veronese N, Mugisha J, Probst M et al. Correlates of physical activity among community-dwelling individuals aged 65 years or older with anxiety in six low- and middle-income countries. Int Psychogeriatr. 2018 May;30(5):705-714. PubMed | Google Scholar

  97. Peltzer K, Phaswana-Mafuya N. Depression and associated factors in older adults in South Africa. Glob Health Action. 2013 Jan 18;6:1-9. PubMed | Google Scholar

  98. Geldsetzer P, Vaikath M, Wagner R, Rohr JK, Montana L, Gómez-Olivé FX et al. Depressive Symptoms and Their Relation to Age and Chronic Diseases Among Middle-Aged and Older Adults in Rural South Africa. J Gerontol A Biol Sci Med Sci. 2019 May 16;74(6):957-963. PubMed | Google Scholar

  99. Chipps J, Jarvis MA. Social capital and mental well-being of older people residing in a residential care facility in Durban, South Africa. Aging Ment Health. 2016 Dec;20(12):1264-1270. PubMed | Google Scholar

  100. Schatz E, Gilbert L. 'My heart is very painful': Physical, mental and social wellbeing of older women at the times of HIV/AIDS in rural South Africa. J Aging Stud. 2012;26(1):16-25. Google Scholar

  101. Aartsma DP, Groenewald E, Koen L, Potocnik F, Niehaus DJ. A clinical profile of inpatient admissions to the psychogeriatric unit at Stikland Hospital. S Afr J Psychiatr. 2019 Aug 26;25:1344. PubMed | Google Scholar

  102. Adjaye-Gbewonyo D, Rebok GW, Gross AL, Gallo JJ, Underwood CR. Assessing urban-rural differences in the relationship between social capital and depression among Ghanaian and South African older adults. PLoS One. 2019 Jun 19;14(6):e0218620. PubMed | Google Scholar

  103. Jennings EA, Ralston M, Schatz E. Support in times of need: How depressive symptoms can impact receipt of social support among aging adults in rural South Africa. SSM Popul Health. 2020 Sep 10;12:100666. PubMed | Google Scholar

  104. Ramlagan S, Peltzer K, Phaswana-Mafuya N. Social capital and health among older adults in South Africa. BMC Geriatr. 2013 Sep 28;13:100. PubMed | Google Scholar

  105. Geffen LN, Kelly G, Morris JN, Howard EP. Peer-to-peer support model to improve quality of life among highly vulnerable, low-income older adults in Cape Town, South Africa. BMC Geriatr. 2019 Oct 22;19(1):279. PubMed | Google Scholar

  106. Wang C, Pu R, Li Z, Ji L, Li X, Ghose B, Huang R, Tang S. Subjective health and quality of life among elderly people living with chronic multimorbidity and difficulty in activities of daily living in rural South Africa. Clin Interv Aging. 2019 Jul 17;14:1285-1296. PubMed | Google Scholar

  107. Dunham CC, Flores-Yeffal NY. The effect of stress proliferation on depression in South African grandparent caregivers. Int Soc Work. 2021;64(3):371-385. Google Scholar

  108. Stubbs B, Vancampfort D, Veronese N, Schofield P, Lin PY, Tseng PT, et al. Multimorbidity and perceived stress: a population-based cross-sectional study among older adults across six low- and middle-income countries. Maturitas. 2018;107(October 2017):84-91.. PubMed | Google Scholar

  109. Kotzé C, Roos JL, Ehlers R. End-of-Life Decision-Making Capacity in Older People With Serious Mental Illness. Front Psychiatry. 2021 Sep 22;12:752897. PubMed | Google Scholar

  110. Hewett K, Chrzanowski W, Jokinen R, Felgentreff R, Shrivastava RK, Gee MD et al. Double-blind, placebo-controlled evaluation of extended-release bupropion in elderly patients with major depressive disorder. J Psychopharmacol. 2010 Apr;24(4):521-9. PubMed | Google Scholar

  111. Kobayashi LC, Mateen FJ, Montana L, Wagner RG, Kahn K, Tollman SM et al. Cognitive Function and Impairment in Older, Rural South African Adults: Evidence from "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in Rural South Africa". Neuroepidemiology. 2019;52(1-2):32-40. PubMed | Google Scholar

  112. Kobayashi LC, Glymour MM, Kahn K, Payne CF, Wagner RG, Montana L et al. Childhood deprivation and later-life cognitive function in a population-based study of older rural South Africans. Soc Sci Med. 2017 Oct;190:20-28. PubMed | Google Scholar

  113. Gildner TE, Liebert MA, Kowal P, Chatterji S, Snodgrass JJ. Associations between sleep duration, sleep quality, and cognitive test performance among older adults from six middle income countries: results from the Study on Global Ageing and Adult Health (SAGE). J Clin Sleep Med. 2014 Jun 15;10(6):613-21. PubMed | Google Scholar

  114. Ghose B, Abdoul Razak MY. Memory and Learning Complaints in Relation to Depression among Elderly People with Multimorbidity. Geriatrics (Basel). 2017 May 9;2(2):15. PubMed | Google Scholar

  115. Kobayashi LC, Farrell MT, Langa KM, Mahlalela N, Wagner RG, Berkman LF. Incidence of Cognitive Impairment during Aging in Rural South Africa: Evidence from HAALSI, 2014 to 2019. Neuroepidemiology. 2021;55(2):100-108. PubMed | Google Scholar

  116. Bassil DT, Farrell MT, Wagner RG, Brickman AM, Glymour MM, Langa KM et al. Cohort Profile Update: Cognition and dementia in the Health and Aging in Africa Longitudinal Study of an INDEPTH community in South Africa (HAALSI dementia). Int J Epidemiol. 2022 Aug 10;51(4):e217-e226. PubMed | Google Scholar

  117. Jiang N, Wu B, Lu N, Dong T. Neighborhood-based social capital and cognitive function among older adults in five low- and middle-income countries: Evidence from the World Health Organization Study on global AGEing and adult health. Int J Geriatr Psychiatry. 2020 Apr;35(4):365-375. PubMed | Google Scholar

  118. Rosenberg M, Gómez-Olivé FX, Wagner RG, Rohr J, Payne CF, Berkman L et al. The relationships between cognitive function, literacy and HIV status knowledge among older adults in rural South Africa. J Int AIDS Soc. 2020 Mar;23(3):e25457. PubMed | Google Scholar

  119. Jennings EA, Farrell MT, Kobayashi LC. Grandchild Caregiving and Cognitive Health Among Grandparents in Rural South Africa. J Aging Health. 2021 Oct;33(9):661-673. PubMed | Google Scholar

  120. Soo CC, Farrell MT, Tollman S, Berkman L, Nebel A, Ramsay M. Apolipoprotein E Genetic Variation and Its Association With Cognitive Function in Rural-Dwelling Older South Africans. Front Genet. 2021 Oct 14;12:689756. PubMed | Google Scholar

  121. Kobayashi LC, Berkman LF, Wagner RG, Kahn K, Tollman S, Subramanian SV. Education modifies the relationship between height and cognitive function in a cross-sectional population-based study of older adults in Rural South Africa. Eur J Epidemiol. 2019 Feb;34(2):131-139. PubMed | Google Scholar

  122. Kobayashi LC, Farrell MT, Payne CF, Mall S, Montana L, Wagner RG et al. Adverse childhood experiences and domain-specific cognitive function in a population-based study of older adults in rural South Africa. Psychol Aging. 2020 Sep;35(6):818-830. PubMed | Google Scholar

  123. Farrell MT, Kobayashi LC, Montana L, Wagner RG, Demeyere N, Berkman L. Disparity in Educational Attainment Partially Explains Cognitive Gender Differences in Older Rural South Africans. J Gerontol B Psychol Sci Soc Sci. 2020 Aug 13;75(7):e161-e173. PubMed | Google Scholar

  124. Ramlall S, Chipps J, Pillay BJ, Bhigjee AL. Mild cognitive impairment and dementia in a heterogeneous elderly population: prevalence and risk profile. Afr J Psychiatry (Johannesbg). 2013 Nov 19;16(6). PubMed | Google Scholar

  125. de Jager CA, Msemburi W, Pepper K, Combrinck MI. Dementia Prevalence in a Rural Region of South Africa: A Cross-Sectional Community Study. J Alzheimers Dis. 2017;60(3):1087-1096. PubMed | Google Scholar

  126. Adedeji IA, Ogunniyi A, Henderson DC, Sam-Agudu NA. Experiences and practices of caregiving for older persons living with dementia in African countries: A qualitative scoping review. Dementia. 2022;21(3):995-1011. PubMed | Google Scholar

  127. Jarvis MA, Padmanabhanunni A, Chipps J. An Evaluation of a Low-Intensity Cognitive Behavioral Therapy mHealth-Supported Intervention to Reduce Loneliness in Older People. Int J Environ Res Public Health. 2019 Apr 11;16(7):1305. PubMed | Google Scholar

  128. Pengpid S, Peltzer K. Sedentary Behaviour and 12 Sleep Problem Indicators among Middle-Aged and Elderly Adults in South Africa. Int J Environ Res Public Health. 2019 Apr 20;16(8):1422. PubMed | Google Scholar

  129. Wang C, Liu J, Li Z, Ji L, Wang R, Song H et al. Predictor of sleep difficulty among community dwelling older populations in 2 African settings. Medicine (Baltimore). 2019 Nov;98(47):e17971. PubMed | Google Scholar

  130. Peltzer K, Pengpid S. Sedentary behaviour and sleep problems among young, middle-aged, and older persons in South Africa: A brief report. J Psychol Africa. 2019;29(4):401-404. Google Scholar

  131. Ramlall S, Chipps J, Bhigjee AL, Pillay BJ. Screening a heterogeneous elderly South African population for cognitive impairment: the utility and performance of the Mini- Mental State Examination, Six Item Screener, Subjective Memory Rating Scale and Deterioration Cognitive Observee. Afr J Psychiatry (Johannesbg). 2013 Nov 19;16(6). PubMed | Google Scholar

  132. Humphreys GW, Duta MD, Montana L, Demeyere N, McCrory C, Rohr J et al. Cognitive Function in Low-Income and Low-Literacy Settings: Validation of the Tablet-Based Oxford Cognitive Screen in the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI). J Gerontol B Psychol Sci Soc Sci. 2017 Jan;72(1):38-50. PubMed | Google Scholar

  133. Harling G, Kobayashi LC, Farrell MT, Wagner RG, Tollman S, Berkman L. Social contact, social support, and cognitive health in a population-based study of middle-aged and older men and women in rural South Africa. Soc Sci Med. 2020 Sep;260:113167. PubMed | Google Scholar

  134. Wang C, Pu R, Ghose B, Tang S. Chronic Musculoskeletal Pain, Self-Reported Health and Quality of Life among Older Populations in South Africa and Uganda. Int J Environ Res Public Health. 2018 Dec 10;15(12):2806. PubMed | Google Scholar

  135. Gregson CL, Madanhire T, Rehman A, Ferrand RA, Cappola AR, Tollman S et al. Osteoporosis, Rather Than Sarcopenia, Is the Predominant Musculoskeletal Disease in a Rural South African Community Where Human Immunodeficiency Virus Prevalence Is High: A Cross-Sectional Study. J Bone Miner Res. 2022 Feb;37(2):244-255. PubMed | Google Scholar

  136. Peltzer K, Phaswana-Mafuya N. Arthritis and associated factors in older adults in South Africa. Turkish Journal of Geriatrics. 2013;16(4):389-394. Google Scholar

  137. Tyrovolas S, Koyanagi A, Olaya B, Ayuso-Mateos JL, Miret M, Chatterji S et al. Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi-continent study. J Cachexia Sarcopenia Muscle. 2016 Jun;7(3):312-21. PubMed | Google Scholar

  138. Pina I, Mendham AE, Tomaz SA, Goedecke JH, Micklesfield LK, Brooks NE et al. Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities. Int J Environ Res Public Health. 2021 Apr 19;18(8):4310. PubMed | Google Scholar

  139. Paruk F, Matthews G, Cassim B. Osteoporotic hip fractures in Black South Africans: a regional study. Arch Osteoporos. 2017 Dec 5;12(1):107. PubMed | Google Scholar

  140. Brennan-Olsen SL, Bowe SJ, Kowal P, Naidoo N, Quashie NT et al. Functional Measures of Sarcopenia: Prevalence, and Associations with Functional Disability in 10,892 Adults Aged 65 Years and Over from Six Lower- and Middle-Income Countries. Calcif Tissue Int. 2019 Dec;105(6):609-618. PubMed | Google Scholar

  141. Stewart Williams J, Ng N, Peltzer K, Yawson A, Biritwum R, Maximova T et al. Risk Factors and Disability Associated with Low Back Pain in Older Adults in Low- and Middle-Income Countries. Results from the WHO Study on Global AGEing and Adult Health (SAGE). PLoS One. 2015 Jun 4;10(6):e0127880. PubMed | Google Scholar

  142. Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Lopez Ridaura R et al. Data resource profile: the World Health Organization Study on global AGEing and adult health (SAGE). Int J Epidemiol. 2012 Dec;41(6):1639-49. PubMed | Google Scholar

  143. Hontelez JA, Lurie MN, Newell ML, Bakker R, Tanser F, Bärnighausen T et al. Ageing with HIV in South Africa. AIDS. 2011 Aug 24;25(13):1665-7. PubMed | Google Scholar

  144. Booker SQ. Lessons learned about ageing and gerontological nursing in South Africa. Curationis. 2015 Jul 30;38(1):1216. PubMed | Google Scholar

  145. Barker FJ, Davies JI, Gomez-Olive FX, Kahn K, Matthews FE, Payne CF et al. Developing and evaluating a frailty index for older South Africans-findings from the HAALSI study. Age Ageing. 2021 Nov 10;50(6):2167-2173. PubMed | Google Scholar

  146. Biritwum RB, Minicuci N, Yawson AE, Theou O, Mensah GP, Naidoo N et al. Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas. 2016 Sep;91:8-18. PubMed | Google Scholar

  147. Payne CF, Wade A, Kabudula CW, Davies JI, Chang AY, Gomez-Olive FX et al. Prevalence and correlates of frailty in an older rural African population: findings from the HAALSI cohort study. BMC Geriatr. 2017 Dec 28;17(1):293. PubMed | Google Scholar

  148. van Heerden JA, Burger JR, Gerber JJ, Vlahovic-Palcevski V. Prevalence of potentially serious drug-drug interactions among South African elderly private health sector patients using the Mimica Matanovic/Vlahovic-Palcevski protocol. Int J Pharm Pract. 2018 Apr;26(2):156-164. PubMed | Google Scholar

  149. Saka SA, Nlooto M, Oosthuizen F. American Geriatrics Society-Beers Criteria and adverse drug reactions: a comparative cross-sectional study of Nigerian and South African older inpatients. Clin Interv Aging. 2018 Nov 19;13:2375-2387. PubMed | Google Scholar

  150. Saka SA, Oosthuizen F, Nlooto M, Odusan O. The knowledge, awareness, and perception of healthcare professionals about appropriate prescribing in the elderly: Findings from Nigeria and South Africa. J Eval Clin Pract. 2020 Oct;26(5):1512-1521. PubMed | Google Scholar

  151. Saka SA, Oosthuizen F, Nlooto M. Potential inappropriate prescribing and associated factors among older persons in Nigeria and South Africa. Int J Clin Pharm. 2019 Feb;41(1):207-214. PubMed | Google Scholar

  152. Coleman A. Medication adherence of elderly citizens in retirement homes through a mobile phone adherence monitoring framework (Mpamf) for developing countries: A case study in South Africa. Indian J Pharm Educ Res. 2014;48(3):6-11. Google Scholar

  153. Zimba Kalula S, Ferreira M, Swingler G, Badri M, Aihie Sayer A. Prevalence of Falls in an Urban Community-Dwelling Older Population of Cape Town, South Africa. J Nutr Health Aging. 2015 Dec;19(10):1024-31. PubMed | Google Scholar

  154. Stewart Williams J, Kowal P, Hestekin H, O'Driscoll T, Peltzer K, Yawson A et al. Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE). BMC Med. 2015 Jun 23;13:147. PubMed | Google Scholar

  155. Kalula SZ, Scott V, Dowd A, Brodrick K. Falls and fall prevention programmes in developing countries: environmental scan for the adaptation of the Canadian Falls prevention curriculum for developing countries. J Safety Res. 2011 Dec;42(6):461-72. PubMed | Google Scholar

  156. Kalula SZ, Ferreira M, Swingler GH, Badri M, Sayer AA. Methodological challenges in a study on falls in an older population of Cape Town, South Africa. Afr Health Sci. 2017 Sep;17(3):912-922. PubMed | Google Scholar

  157. Chan AKY, Tamrakar M, Jiang CM, Lo ECM, Leung KCM, Chu CH. A Systematic Review on Caries Status of Older Adults. Int J Environ Res Public Health. 2021 Oct 12;18(20):10662. PubMed | Google Scholar

  158. Chikte U, Pontes CC, Karangwa I, Kimmie-Dhansay F, Erasmus RT, Kengne AP et al. Periodontal Disease Status among Adults from South Africa-Prevalence and Effect of Smoking. Int J Environ Res Public Health. 2019 Sep 29;16(19):3662. PubMed | Google Scholar

  159. Peltzer K, Hewlett S, Yawson AE, Moynihan P, Preet R, Wu F et al. Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. Int J Environ Res Public Health. 2014 Oct 30;11(11):11308-24. PubMed | Google Scholar

  160. Kailembo A, Preet R, Stewart Williams J. Common risk factors and edentulism in adults, aged 50 years and over, in China, Ghana, India and South Africa: results from the WHO Study on global AGEing and adult health (SAGE). BMC Oral Health. 2016 Jul 27;17(1):29. PubMed | Google Scholar

  161. Phaswana-Mafuya N, Peltzer K, Crampin A, Ahame E, Sokhela Z. Prevalence of Self-Reported Diagnosed Cataract and Associated Risk Factors among Elderly South Africans. Int J Environ Res Public Health. 2017 Dec 6;14(12):1523. PubMed | Google Scholar

  162. Mashige KP, Ramklass SS. Prevalence and causes of visual impairment among older persons living in low-income old age homes in Durban, South Africa. Afr J Prim Health Care Fam Med. 2020 Jun 10;12(1):e1-e7. PubMed | Google Scholar

  163. Govender SM, De Jongh M. Identifying hearing impairment and the associated impact on the quality of life among the elderly residing in retirement homes in Pretoria, South Africa. S Afr J Commun Disord. 2021 Mar 1;68(1):e1-e9. PubMed | Google Scholar

  164. Convery E, Keidser G, Caposecco A, Swanepoel de W, Wong LL, Shen E. Hearing-aid assembly management among adults from culturally and linguistically diverse backgrounds: toward the feasibility of self-fitting hearing aids. Int J Audiol. 2013 Jun;52(6):385-93. PubMed | Google Scholar

  165. Chirinda W, Zungu N. Health status and years of sexually active life among older men and women in South Africa. Reprod Health Matters. 2016 Nov;24(48):14-24. PubMed | Google Scholar

  166. Payne CF, Davies JI, Gomez-Olive FX, Hands KJ, Kahn K, Kobayashi LC et al. Cross-sectional relationship between haemoglobin concentration and measures of physical and cognitive function in an older rural South African population. J Epidemiol Community Health. 2018 Sep;72(9):796-802. PubMed | Google Scholar

  167. de Vlieg RA, van Empel E, Montana L, Xavier Gómez-Olivé F, Kahn K, Tollman S et al. Alcohol Consumption and Sexual Risk Behavior in an Aging Population in Rural South Africa. AIDS Behav. 2021 Jul;25(7):2023-2032. PubMed | Google Scholar

  168. Oldewage-Theron WH, Samuel FO, Djoulde RD. Serum concentration and dietary intake of vitamins A and E in low-income South African elderly. Clin Nutr. 2010 Feb;29(1):119-23. PubMed | Google Scholar

  169. Grobler CJ, Oldewage-Theron WH, Chalwe JM. The effect of vitamins B12, B6 and folate supplementation on homocysteine metabolism in a low-income, urbanised, black elderly community in South Africa. South African Journal of Clinical Nutrition. 2022;35(4):162-7. Google Scholar

  170. Pengpid S, Peltzer K. Prevalence and socio-behavioral factors associated with sugar-sweetened beverages consumption among 15 years and older persons in South Africa. Diabetes Metab Syndr Obes. 2019 Jun 21;12:937-945. PubMed | Google Scholar

  171. Robb L, Walsh CM, Nel M, Nel A, Odendaal H, van Aardt R. Malnutrition in the elderly residing in long-term care facilities: a cross sectional survey using the Mini Nutritional Assessment (MNA®) screening tool. South African Journal of Clinical Nutrition. 2017 Jun 23;30:2. Google Scholar

  172. Naidoo I, Charlton KE, Esterhuizen TM, Cassim B. High risk of malnutrition associated with depressive symptoms in older South Africans living in KwaZulu-Natal, South Africa: a cross-sectional survey. J Health Popul Nutr. 2015 Oct 19;33:19. PubMed | Google Scholar

  173. Ng CD. Stratification of BMI categories among older adults within and across countries. Public Health Nutr. 2020 Feb;23(2):254-263. PubMed | Google Scholar

  174. Lloyd-Sherlock P, Agrawal S, Gómez-Olivé FX. Pensions, consumption and health: evidence from rural South Africa. BMC Public Health. 2020 Oct 20;20(1):1577. PubMed | Google Scholar

  175. Jamshidi-Naeini Y, Moyo G, Napier C, Oldewage-Theron W. Food and beverages undermining elderly health: three food-based dietary guidelines to avoid or delay chronic diseases of lifestyle among the elderly in South Africa. South African J Clin Nutr. 2021;34(S1):S27-S40. Google Scholar

  176. Miller M, Oldewage-Theron W, Napier C. Eat clean and safe food: a food-based dietary guideline for the elderly in South Africa. South African J Clin Nutr. 2021;34(S1):S41-S50. Google Scholar

  177. Napier C, Grobbelaar H, Oldewage-Theron W. An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa. South African J Clin Nutr. 2021;34(S1):S1-S8. Google Scholar

  178. Saha S, Mukherjee U, Miller M, Peng LL, Napier C, Grobbelaar H et al. Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans. South African J Clin Nutr. 2021;34(S1):S51-S63. Google Scholar

  179. Mukherjee U, Napier C, Oldewage-Theron W. 'Drink clean, safe water and/or other fluids through-out the day even if you do not feel thirsty': a food-based dietary guideline for the elderly in South Africa. South African J Clin Nutr. 2021;34(S1):S9-S14. Google Scholar

  180. Kyomuhendo C, Adeola R. Green and grey: Nutritional lifestyle and healthful ageing in rural and urban areas of three sub-Saharan African countries. Bus Strateg Dev. 2021;4(1):22-33. Google Scholar

  181. Kühn L, MacIntyre UE, Kotzé C, Becker PJ, Wenhold FAM. Twelve Weeks of Additional Fish Intake Improves the Cognition of Cognitively Intact, Resource-Limited Elderly People: A Randomized Control Trial. J Nutr Health Aging. 2022;26(2):119-126. PubMed | Google Scholar

  182. Tomaz SA, Davies JI, Micklesfield LK, Wade AN, Kahn K, Tollman SM et al. Self-Reported Physical Activity in Middle-Aged and Older Adults in Rural South Africa: Levels and Correlates. Int J Environ Res Public Health. 2020 Aug 31;17(17):6325. PubMed | Google Scholar

  183. Payne CF, Gómez-Olivé FX, Kahn K, Berkman L. Physical Function in an Aging Population in Rural South Africa: Findings From HAALSI and Cross-National Comparisons With HRS Sister Studies. J Gerontol B Psychol Sci Soc Sci. 2017 Jul 1;72(4):665-679. PubMed | Google Scholar

  184. Chetty L, Ramklass SS, McKune AJ. The effects of a structured group exercise programme on functional fitness of older persons living in old-age homes. Ageing Soc. 2019;39(9):1857-1872. Google Scholar

  185. Ramocha LM, Louw QA, Tshabalala MD. Quality of life and physical activity among older adults living in institutions compared to the community. S Afr J Physiother. 2017 Jul 28;73(1):342. PubMed | Google Scholar

  186. Vancampfort D, Lara E, Smith L, Rosenbaum S, Firth J, Stubbs B et al. Physical activity and loneliness among adults aged 50 years or older in six low- and middle-income countries. Int J Geriatr Psychiatry. 2019 Dec;34(12):1855-1864. PubMed | Google Scholar

  187. Koyanagi A, Stubbs B, Smith L, Gardner B, Vancampfort D. Correlates of physical activity among community-dwelling adults aged 50 or over in six low- and middle-income countries. PLoS One. 2017 Oct 27;12(10):e0186992. PubMed | Google Scholar

  188. Ralston M. The Role of Older Persons' Environment in Aging Well: Quality of Life, Illness, and Community Context in South Africa. Gerontologist. 2018 Jan 18;58(1):111-120. PubMed | Google Scholar

  189. Yaya S, Idriss-Wheeler D, Sanogo NA, Vezina M, Bishwajit G. Self-reported activities of daily living, health and quality of life among older adults in South Africa and Uganda: a cross sectional study. BMC Geriatr. 2020 Oct 14;20(1):402. PubMed | Google Scholar

  190. Van Biljon L, Nel P, Roos V. A partial validation of the WHOQOL-OLD in a sample of older people in South Africa. Glob Health Action. 2015 Oct 6;8:28209. PubMed | Google Scholar

  191. Lloyd-Sherlock P, Corso B, Minicuci N. Widowhood, Socio-Economic Status, Health and Wellbeing in Low and Middle-Income Countries. J Dev Stud. 2015;51(10):1374-1388. PubMed | Google Scholar

  192. Ralston M, Schatz E, Madhavan S, Gómez-Olivé FX, Collinson MA. Perceived quality of life and living arrangements among older rural South Africans: Do all households fare the same. Ageing Soc. 2019;39(12):2735-2755. Google Scholar

  193. Amosun SL PT, PhD, PGDip, Harris F PT, BSc. "What next now that you are sixty?" - Preliminary exploration of the self-reported aspirations of community-dwelling older persons in the Western Cape Province, South Africa within the active aging framework. Physiother Theory Pract. 2020 Jul;36(7):791-798. PubMed | Google Scholar

  194. Luo M, Ding D, Bauman A, Negin J, Phongsavan P. Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data. BMC Public Health. 2020 Jan 23;20(1):99. PubMed | Google Scholar

  195. Jarvis MA, Ramlall S, Chipps J. A profile of social isolation and the influence of demographics in older persons living in residential care, Durban, South Africa. Int J Africa Nurs Sci. 2021;14:100271. Google Scholar

  196. Abdullahi AA, Ntozini A, Oguntayo R. Socio-contextual factors as determinants of psychological wellbeing of selected aged in South Africa: A moderating approach. Pertanika J Soc Sci Humanit. 2021;29(1):349-366. Google Scholar

  197. Xavier Gómez-Olivé F, Thorogood M, Clark BD, Kahn K, Tollman SM. Assessing health and well-being among older people in rural South Africa. Glob Health Action. 2010 Sep 27;3. PubMed | Google Scholar

  198. Govender T, Barnes JM. The health status and unmet health needs of old-age pensioners living in selected urban poor communities in Cape Town, South Africa. J Community Health. 2014 Dec;39(6):1063-70. PubMed | Google Scholar

  199. Phaswana-Mafuya N, Peltzer K, Chirinda W, Kose Z, Hoosain E, Ramlagan S et al. Self-rated health and associated factors among older South Africans: evidence from the study on global ageing and adult health. Glob Health Action. 2013 Jan;6(1):19880. PubMed | Google Scholar

  200. Schatz E, Gilbert L. "My legs affect me a lot. … I can no longer walk to the forest to fetch firewood": challenges related to health and the performance of daily tasks for older women in a high HIV context. Health Care Women Int. 2014;35(7-9):771-88. PubMed | Google Scholar

  201. Schatz E, Madhavan S, Collinson M, Gómez-Olivé FX, Ralston M. Dependent or Productive? A New Approach to Understanding the Social Positioning of Older South Africans Through Living Arrangements. Res Aging. 2015 Aug;37(6):581-605. PubMed | Google Scholar

  202. Chirinda W, Phaswana-Mafuya N. Happy life expectancy and correlates of happiness among older adults in South Africa. Aging Ment Health. 2019 Aug;23(8):1000-1007. PubMed | Google Scholar

  203. Riumallo-Herl C, Canning D, Kabudula C. Health Inequalities in the South African elderly: The Importance of the Measure of Social-Economic Status. J Econ Ageing. 2019;14:100191. PubMed | Google Scholar

  204. Lee KH, Xu H, Wu B. Gender differences in quality of life among community-dwelling older adults in low- and middle-income countries: results from the Study on global AGEing and adult health (SAGE). BMC Public Health. 2020 Jan 28;20(1):114. PubMed | Google Scholar

  205. Salinas-Rodríguez A, Rivera-Almaraz A, Scott A, Manrique-Espinoza B. Severity Levels of Disability Among Older Adults in Low- and Middle-Income Countries: Results From the Study on Global Ageing and Adult Health (SAGE). Front Med (Lausanne). 2020 Oct 15;7:562963. PubMed | Google Scholar

  206. Fong JH. Rasch analysis highlighted relative importance of walking and transferring disabilities among elderly in developing countries. J Clin Epidemiol. 2021 Nov;139:121-129. PubMed | Google Scholar

  207. Rahman MH, Singh A. Disability and social cohesion among older adults: A multi-country study. International Journal of Social Economics. 2018 Sep 21;46(4):485-502. Google Scholar

  208. Lestari SK, Ng N, Kowal P, Santosa A. Diversity in the Factors Associated with ADL-Related Disability among Older People in Six Middle-Income Countries: A Cross-Country Comparison. Int J Environ Res Public Health. 2019 Apr 14;16(8):1341. PubMed | Google Scholar

  209. Rahman MHU, Singh A, Madhavan H. Disability-based disparity in outpatient health system responsiveness among the older adults in low- to upper-middle-income countries. Health Policy Plan. 2019 Mar 1;34(2):141-150. PubMed | Google Scholar

  210. Santosa A, Schröders J, Vaezghasemi M, Ng N. Inequality in disability-free life expectancies among older men and women in six countries with developing economies. J Epidemiol Community Health. 2016 Sep;70(9):855-61. PubMed | Google Scholar

  211. Schatz E, Ralston M, Madhavan S, Collinson MA, Gómez-Olivé FX. Living Arrangements, Disability and Gender of Older Adults Among Rural South Africa. J Gerontol B Psychol Sci Soc Sci. 2018 Aug 14;73(6):1112-1122. PubMed | Google Scholar

  212. Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep. 2021 Sep 30;11(1):19494. PubMed | Google Scholar

  213. Ramlagan S, Peltzer K, Phaswana-Mafuya N. Hand grip strength and associated factors in non-institutionalised men and women 50 years and older in South Africa. BMC Res Notes. 2014 Jan 7;7:8. PubMed | Google Scholar

  214. Ralston M, Jennings E, Schatz E. Who is at Risk? Social Support, Relationship Dissolution, and Illness in a Rural Context. Sociol Inq. 2022 Aug;92(3):1053-1082. PubMed | Google Scholar

  215. Harling G, Morris KA, Manderson L, Perkins JM, Berkman LF. Age and Gender Differences in Social Network Composition and Social Support Among Older Rural South Africans: Findings From the HAALSI Study. J Gerontol B Psychol Sci Soc Sci. 2020 Jan 1;75(1):148-159. PubMed | Google Scholar

  216. Bohman DM, van Wyk NC, Ekman SL. South Africans' experiences of being old and of care and caring in a transitional period. Int J Older People Nurs. 2011 Sep;6(3):187-95. PubMed | Google Scholar

  217. Petros SG. Use of a Mixed Methods Approach to Investigate the Support Needs of Older Caregivers to Family Members Affected by HIV and AIDS in South Africa. J Mix Methods Res. 2012;6:4. Google Scholar

  218. Harling G, Payne CF, Davies JI, Gomez-Olive FX, Kahn K, Manderson L et al. Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study. J Aging Health. 2020 Jun/Jul;32(5-6):296-307. PubMed | Google Scholar

  219. Small J, Aldwin C, Kowal P, Chatterji S. Aging and HIV-Related Caregiving in Sub-Saharan Africa: A Social Ecological Approach. Gerontologist. 2019 May 17;59(3):e223-e240. PubMed | Google Scholar

  220. Rabie T, Klopper HC. Guidelines to facilitate self-care among older persons in South Africa. Heal SA Gesondheid. 2015;20:1. Google Scholar

  221. Motsohi T, Namane M, Anele AC, Abbas M, Kalula SZ. Older persons' experience with health care at two primary level clinics in Cape Town, South Africa: a qualitative assessment. BJGP Open. 2020 Aug 25;4(3):bjgpopen20X101048. PubMed | Google Scholar

  222. Naidoo K, Van Wyk J. What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med. 2019 Oct 10;11(1):e1-e6. PubMed | Google Scholar

  223. Kelly G, Mrengqwa L, Geffen L. "They don't care about us": older people's experiences of primary healthcare in Cape Town, South Africa. BMC Geriatr. 2019 Apr 4;19(1):98. PubMed | Google Scholar

  224. Benedict MOA, Adefuye AO. Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa. Pan Afr Med J. 2020 Aug 5;36:245. PubMed | Google Scholar

  225. Ameh S, Gómez-Olivé FX, Kahn K, Tollman SM, Klipstein-Grobusch K. Predictors of health care use by adults 50 years and over in a rural South African setting. Glob Health Action. 2014 Aug 1;7:24771. PubMed | Google Scholar

  226. Golomski C. Elder Care and Private Health Insurance in South Africa: The Pathos of Race-Class. Med Anthropol. 2018 May-Jun;37(4):311-326. PubMed | Google Scholar

  227. Swart L, Buthelezi S, Seedat M. The incidence and characteristics of homicides in elderly compared with non-elderly age groups in Johannesburg, South Africa. S Afr Med J. 2019 May 31;109(6):437-442. PubMed | Google Scholar

  228. Metheny N, Essack Z. Intimate partner violence in older South African women: An analysis of the 2016 Demographic and Health Survey. S Afr Med J. 2020 Sep 30;110(10):1020-1025. PubMed | Google Scholar

  229. Bigala P, Ayiga N. Prevalence and predictors of elder abuse in mafikeng local municipality in South Africa. Etude la Popul Africaine. 2014;28:1. Google Scholar

  230. Gómez-Olivé FX, Thorogood M, Bocquier P, Mee P, Kahn K, Berkman L et al. Social conditions and disability related to the mortality of older people in rural South Africa. Int J Epidemiol. 2014 Oct;43(5):1531-41. PubMed | Google Scholar

  231. Pillay-van Wyk V, Msemburi W, Laubscher R, Dorrington RE, Groenewald P, Glass T et al. Mortality trends and differentials in South Africa from 1997 to 2012: second National Burden of Disease Study. Lancet Glob Health. 2016 Sep;4(9):e642-53. PubMed | Google Scholar

  232. Lloyd-Sherlock P, Amoakoh-Coleman M. A critical review of intervention and policy effects on the health of older people in sub-Saharan Africa. Soc Sci Med. 2020 Feb 27;250:112887. PubMed | Google Scholar

  233. Negin J, Randell M, Raban MZ, Nyirenda M, Kalula S, Madurai L et al. Health expenditure and catastrophic spending among older adults living with HIV. Glob Public Health. 2017 Oct;12(10):1282-1296. PubMed | Google Scholar

  234. Mattiuzzi C, Lippi G. Worldwide disease epidemiology in the older persons. Eur Geriatr Med. 2020 Feb;11(1):147-153. PubMed | Google Scholar

  235. Hsieh E, Polo R, Qian HZ, Fuster-RuizdeApodaca MJ, Del Amo J. Intersectionality of stigmas and health-related quality of life in people ageing with HIV in China, Europe, and Latin America. Lancet Healthy Longev. 2022 Mar;3(3):e206-e215. PubMed | Google Scholar

  236. The Lancet Healthy Longevity. Ageing with HIV. Lancet Healthy Longev. 2022 Mar;3(3):e119. PubMed | Google Scholar

  237. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. PubMed | Google Scholar

  238. Chin S, Wong R, Hirani V, O'Leary F. Nutrition knowledge assessment tools for older adults and their carers: a scoping review. Nutr Res Rev. 2023 Dec;36(2):216-231. PubMed | Google Scholar

  239. Banke-Thomas A, Olorunsaiye CZ, Yaya S. "Leaving no one behind" also includes taking the elderly along concerning their sexual and reproductive health and rights: a new focus for Reproductive Health. Reprod Health. 2020 Jun 29;17(1):101. PubMed | Google Scholar

  240. Steckenrider J. Sexual activity of older adults: let's talk about it. Lancet Healthy Longev. 2023 Mar;4(3):e96-e97. PubMed | Google Scholar

  241. Cosco TD, Howse K, Brayne C. Healthy ageing, resilience and wellbeing. Epidemiol Psychiatr Sci. 2017 Dec;26(6):579-583. PubMed | Google Scholar

  242. Jin K, Simpkins JW, Ji X, Leis M, Stambler I. The Critical Need to Promote Research of Aging and Aging-related Diseases to Improve Health and Longevity of the Elderly Population. Aging Dis. 2014 Dec 15;6(1):1-5. PubMed | Google Scholar

  243. Rudnicka E, Napierala P, Podfigurna A, Meczekalski B, Smolarczyk R, Grymowicz M. The World Health Organization (WHO) approach to healthy ageing. Maturitas. 2020 Sep;139:6-11. PubMed | Google Scholar

  244. Gustavson AM, Falvey JR, Jankowski CM, Stevens-Lapsley JE. Public Health Impact of Frailty: Role of Physical Therapists. J Frailty Aging. 2017;6(1):2-5. PubMed | Google Scholar

  245. Zanker J, Duque G. Osteoporosis in Older Persons: Old and New Players. J Am Geriatr Soc. 2019 Apr;67(4):831-840. PubMed | Google Scholar

  246. Satre DD, Hirschtritt ME, Silverberg MJ, Sterling SA. Addressing Problems With Alcohol and Other Substances Among Older Adults During the COVID-19 Pandemic. Am J Geriatr Psychiatry. 2020 Jul;28(7):780-783. PubMed | Google Scholar

  247. Han BH, Moore AA, Sherman S, Keyes KM, Palamar JJ. Demographic trends of binge alcohol use and alcohol use disorders among older adults in the United States, 2005-2014. Drug Alcohol Depend. 2017 Jan 1;170:198-207. PubMed | Google Scholar

  248. Kojima G, Iliffe S, Jivraj S, Liljas A, Walters K. Does current smoking predict future frailty? The English longitudinal study of ageing. Age Ageing. 2018 Jan 1;47(1):126-131. PubMed | Google Scholar

  249. Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021 Apr;9(4):e489-e551. PubMed

  250. Ramke J, Evans JR, Habtamu E, Mwangi N, Silva JC, Swenor BK et al. Grand Challenges in global eye health: a global prioritisation process using Delphi method. Lancet Healthy Longev. 2022 Jan;3(1):e31-e41. PubMed | Google Scholar

  251. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I; NIHR RESPIRE Global Respiratory Health Unit. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022 May;10(5):447-458. PubMed | Google Scholar

  252. Reed PG. Mental health of older adults. West J Nurs Res. 1989 Apr;11(2):143-57; discussion 158-63. PubMed