摘要：Mahmoud Werfalli a http://orcid.org/0000-0002-5418-4138 , Reshma Kassanjee b , Sebastiana Kalula c , Paul Kowal de http://orcid.org/0000-0002-6314-8753 , Nancy Phaswana-Mafuya fg & Naomi S. Levitt *aa Chronic Disease Initiative in Africa, Division of Diabetic Medicine and Endocrinology Department of Medicine , University of Cape Town , Cape Town , South Africa b Department of Statistical Sciences , University of Cape Town , Cape Town , South Africa c Albertina & Walter Sisulu Institute of Ageing in Africa, Division of Geriatric Medicine, Department of Medicine , University of Cape Town , Cape Town , South Africa d WHO Study on global AGEing and adult health (SAGE) , Geneva , Switzerland e Research Centre for Generational Health and Ageing, University of Newcastle , Newcastle , NSW , Australia f Office of the Deputy Vice Chancellor , Research and Innovation, North West University , Potchefstroom , South Africa g HIV/AIDS/STI/TB Research Programme , Human Sciences Research Council , Pretoria , South Africa All authors collaborated in this study. NSL, SK and MW conceived the study and MW collated the data. RK analysed the data, and all authors provided crictical inputs to the analysis and interpetation of the data and results. MW wrote the initial manuscript for this study. All authors read and approved the final manuscript. CONTACT Naomi S. Levitt naomi.levitt@uct.ac.za Chronic Disease Initiative in Africa, Division of Diabetic Medicine and Endocrinology Department of Medicine , University of Cape Town , Cape Town , South Africa Background : Diabetes is a chronic disease with severe late complications. It is known to impact the quality of life and cause disability, which may affect an individual’s capacity to manage and maintain longer-term health and well-being. Objectives : To examine the prevalence of self-report diabetes, and association between diabetes and each of health-related quality of life and disability amongst South Africa’s older adults. To study both the direct relationship between diabetes and these two measures, as well as moderation effects, i.e. whether associations between other factors and these measures of well-being differed between individuals with diabetes and those without. Methods : Secondary analyses of data on participants aged 50 years and older from the Study on global AGEing and adult health (SAGE) in South Africa Wave 1 (2007–2008) were conducted. Prevalence of self-reported diabetes was assessed. Multivariable regressions describe the relationships between each of quality of life (WHOQoL) and disability (WHODAS), and diabetes, while controlling for selected socio-demographic characteristics, health risk behaviours and co-morbid conditions. In the regression models, we also investigated whether diabetes moderates the relationships between these additional factors and WHOQoL/WHODAS. Results : Self-reported diabetes prevalence was 9.2% (95% CI: 7.8,10.9) and increased with age. Having diabetes was associated with poorer WHOQoL scores (additive effect: −4.2; 95% CI: −9.2,0.9; p-value <0.001) and greater disability (multiplicative effect: 2.1; 95% CI: 1.5,2.9; p-value <0.001). Lower quality of life and greater disability were both related to not being in a relationship, lower education, less wealth, lower physical activity and a larger number of chronic conditions. Conclusions : Diabetes is associated with lower quality of life and greater disability amongst older South Africans. Attention needs to be given to enhancing the capacity of health systems to meet the changing needs of ageing populations with diabetes in SA as well as facilitating social support networks in communities.
