Multimorbidity and Functional Status of the Elderly in a Primary Care Setting of Northern Nigeria: A Cross-Sectional Study

BACKGROUND: Globally, multimorbidity has attracted considerable attention in recent years. In resource-poor settings, the elderly bears the highest burden of chronic illnesses. Poor outcomes associated with multimorbidity in the elderly are well reported. However, the relationship between multimorbidity and functional status in elderly patients in developing countries is poorly understood. OBJECTIVE: To examine the burden of multimorbidity and functional disability as well as the factors associated with multimorbidity among the elderly in a primary care setting in Kano. METHODS: This was a cross-sectional study of 279 elderly patients randomly selected among the General Outpatient Clinic attendees of a Nigerian tertiary hospital. Data on participants' socio-demographics and diagnoses were collected. The Katz activity of daily living index was used to assess functional status. Data were analysed using SPSS and odds ratios were calculated. RESULTS: Participants were predominantly females (66.7%). The prevalence of multimorbidity and functional disability were 72.0% and 16.9%, respectively. Functional disability was found to have a positive interplay with multimorbidity (OR=20.819, 95%CI=1.752-247.4 and p=0.016). Other predictors of multimorbidity were lack of formal education (OR=0.362, 95%CI=0.141-0.931, p=0.035), unemployment (OR=0.386, 95%CI=0.165-0.903, p=0.028), and increased Body Mass Index (OR=218.8, 95%CI=12.090-3961.8 p<0.001). CONCLUSION: The burden of multimorbidity and functional disability is high. The predictors in this study could be valuable in identifying the elderly with greater risk of becoming multimorbid in similar primary care settings.