| Summary: | Thesis (M.Sc.(Med.) (Field Population Based Epidemiology))--University of the Witwatersrand, Faculty of Health Sciences, 2014. === Background: The world population is aging at an increasing rate. One product of this increase is the shift in mortality patterns and causes as a result of change in the age structure of the general population. An understanding of patterns and predictors of mortality in older populations is essential for policy and planning.However, very little is known due to limited research targeting this older population.
Objectives: To identify patterns and predictors of mortality in older people (50 years and above) in the Kassena-Nankana district of Northern Ghana from 2006-2010, and to investigate the association between self-rated health (SRH) and subsequent mortality of older adults.
Methods: Longitudinal follow-up of 4584 older people aged 50 and above who participated in a SAGE cross-sectional survey conducted in the Kassena-Nankana District of Ghana in 2007. Mortality rates were estimated using person time (in years) as the denominator, and Kaplan-Meier curves were employed to compare survival between different exposure groups. Cox proportional hazards modeling was used to identify predictors of mortality.
Results: Of the 4584 people followed up until the end of 2010, 601 (13.1%) died. Overall mortality rates were 37.5 (95% CI 34.5, 40.6) deaths per 1000 Persons Years (PY). Older males had consistently higher mortality rates than women and the pattern indicate that, the highest mortality rate of 43.3 (95% CI 37.3, 49.9) was observed in
2008. Being married, being female, and living in household with higher socio-economic status were associated with significant reduction of mortality. There was increased risk of mortality among participants who rated their health as bad (HR=2.36 (95%CI 1.57 , 3.54 ) as compared to those who rated their health as very good (P<0.05).
Conclusions: Despite overall low level of older adult mortality, there were significant difference in mortality magnitudes for different subgroups such as sex, education level, wealth and marital status. The findings also support previous studies that show the ability of SRH to significantly predict subsequent older mortality.
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