Abstract:

Frailty and ageing are bound together, and frailty is linked with reduced capacity and low ability to survive adverse health outcomes. While ageing is glowing globally, in Burundi, a lot has been done to protect and improving the lives of old people, however, multiple challenges persist and limit them from benefiting from their human rights. We, therefore, thought to assess for factors influencing their quality of life, and then to discuss about measures to be taken to ensure ageing in good health. A descriptive cross-sectional study was done in three hospice care sites in Burundi and 57 participants were interviewed using a questionnaire between 16 February and 28th March 2022. Data were analyzed using the Computer Software Statistical Product and Service Solutions (SPSS 20.0). The relationship was considered significant when the P-value was less than the level of significance (<0.05) at 95% confidence interval. The research found that social status is linked with physical frail (p=0.029), and marital status was associated with the apparition of physical signs of frailty (p=0.005); In addition, 47.32 % with the underlining condition were without medication, 90% attended to a clinic 2 times and plus while 28.07% were admitted, 50.87% complained about the limited access to medicine and medical care and 61.40% complained about the variety and the quality of food. These factors can impact ageing in good health, and we recommend that comprehensive support for elderly people be in place and future research compare home-based support and support from hospice care.

References:

[1] Kenneth, R., 2005, What would make a definition of frailty successful: age and ageing. Oxford University Press on behalf of the British Geriatrics Society, 34: 432–434, https://academic.oup.com/ageing/article/34/5/432/40406?login=true.

[2] Emma, G., L., 2019, Frailty in Tanzania: a longitudinal mixed methods study. Newcastle University, Doctor of Philosophy, Institute of Health, and Society, https://theses.ncl.ac.uk/jspui/handle/10443/4917.

[3] David, R. L., Eilann, C. S., Joan, C. L., Miranda, L. R. W., Mary, P. & Nancy, P. G., 2018, Understanding functional and social risk characteristics of frail older adults: a cross-sectional survey study. NIH, National Library of Medicine, National Center for Biotechnology Information, 19(1):170, https://pubmed.ncbi.nlm.nih.gov/30340530/.

[4] Eva, T., 2008, Ageing, disability and frailty. NIH, National Library of Medicine, National Center for Biotechnology Information, 52 Suppl 1:6-11, https://pubmed.ncbi.nlm.nih.gov/18382070/.

[5] AgeUK, Understanding Frailty, last updated 21/07/2020, https://www.ageuk.org.uk/our-impact/policy-research/frailty-in-older-people/understanding-frailty/.

[6] UNDP, Ageing, Older Persons and the 2030 Agenda for Sustainable Development, 12/07/2017, https://www.undp.org/publications/ageing-older-persons-and-2030-agenda-sustainable-development.

[7] WHO, Ageing and Health, 01/10/2022., https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.

[8] Republique Du Burundi, Rapport des Projections Démographiques 2008-2030, ministère des Finances et de la Planification Economique, Institut de Statistiques et d’Etudes Economiques du Burundi (ISTEEBU) Bujumbura, 11/12/2021, https://www.isteebu.bi/wp-content/uploads/2020/04/Projection-de-la-population-bdi-2008-2030.pdf.

[9] REPUBLIQUE DU BURUNDI, Plan National de Développement du Burundi (PND BURUNDI) 2018-2027, 23/3/2022, https://www.presidence.gov.bi/strategies-nationales/plan-national-de-developpement-du-burundi-pnd-burundi-2018-2027/.

[10] Republique Du Burundi, Document de Politique Nationale de Protection Sociale au Burundi, 12/04/2022, https://www.refworld.org/pdfid/609ed3e74.pdf.

[11] Republique Du Burundi, Protection Sociale au Burundi, 21/5/2022, https://cnps.gov.bi/quest-ce-que-la-protection-sociale/.

[12] Republique Du Burundi, ministère de l’Intégration Nationale, des Affaires Sociales, des Droits de la Personne Humaine et du Genre, Secrétariat Exécutif Permanent de la Commission Nationale de Protection Sociale (SEP/CNPS), 2016, Etude de Base sur le Programme de Financement de l’Accès aux Soins de Santé pour les Personnes Agées au Burundi, Rapport définitif, Réalisé par I.C.G.C, page 23.

[13] Republique Du Burundi, Commission Nationale de protection Sociale/Secrétariat Exécutif Permanent (SEP/CNPS), 2019, Livret Synthèse de la restitution de l’Etude sur la Situation des Personnes Agées dans les Provinces de Gitega, Muramvya et Mwaro, rapport définitif.

[14] UN, HelpAge International, Ageing, Older Persons and the 2030 Agenda for Sustainable Development, 17/2/2022, https://www.un.org/development/desa/dspd/wp-content/uploads/sites/22/2017/08/Ageing-Older-Persons-and-2030-Agenda_Issues-Brief-low-resolution-.pdf.

[15] Republique Du Burundi, ministère de l’Intégration Nationale, des Affaires Sociales, des Droits de la Personne Humaine et du Genre, Stratégie de la Protection Sociale au Burundi, 03/02/2022, https://www.ilo.org/dyn/natlex/docs/ELECTRONIC/110614/137626/F444053803/BDI-110614.pdf.

[16] Lieve, J., Hoeyberghs, J. M. G. A., Schols, D. V., Nico, D. W. et al, 2019, Psychological frailty and quality of life of community dwelling older people: a qualitative study. Applied Research in Quality of Life, 15, 1395–1412 (2020), https://link.springer.com/article/10.1007/s11482-019-09735-y.

[17] Magdalena, S., Jerzy, S. & Katarzyna, W. T., 2020, Determinants of multidimensional and physical frailty and their individual components: interactions between frailty deficits, observational study. NIH, National Library of Medicine, National Center for Biotechnology Information, 21, 17(22):8656, https://pubmed.ncbi.nlm.nih.gov/33233408/.

[18] Bruno, B., Oscar, R., & Tiago, C., 2018, Assessing the social dimension of frailty in old age: A systematic review, Archives of Gerontology and Geriatrics, 78, 101-113, https://doi.org/10.1016/j.archger.2018.06.005.

[19] Fried, L. P., et al, 2001, Frailty in older adults: evidence for a phenotype. NIH, National Library of Medicine, National Center for Biotechnology Information, 56(3):M146-56, https://pubmed.ncbi.nlm.nih.gov/11253156/.

[20] Gobbens, R. J. J.& van, A. M. A. L. M., 2014, The prediction of quality of life by physical, psychological, and social components of frailty in community-dwelling older people. Quality of Life Research, 23, 2289–2300, https://doi.org/10.1007/s11136-014-0672-1.

[21] UNHCR, RefWorld, Burundi: At what age are people considered elderly, treatment of the elderly by society and the authorities, including those who are political militants, 26/02/2018, https://www.refworld.org/cgi-bin/texis/vtx/rwmain?docid=5acf85d74.

[22] WORLD HEALTH RANKINGS, Live Longer Live Better, Burundi, 16/03/2022, https://www.worldlifeexpectancy.com/burundi-life-expectancy.

[23] Buchman, A. S., Wilson, R. S., Bienias, J. L. & Bennett, D. A, 2009, Change in frailty and risk of death in older persons. Experimental Ageing Research, pages 61–82, https://doi.org/10.1080/03610730802545051.

[24] Fereshteh, M. & François, B., 2021, Frailty as a Moderator of the relationship between social isolation and health outcomes in community-dwelling older adults. Environmental Research and Public Health, 18(4): 1675; https://doi.org/10.3390/ijerph18041675.

[25] Caterina, T. et al, 2016, Marital status and frailty in older people: gender differences in the Progetto Veneto Anziani, longitudinal study. Journal of Women’s Health, 25, 6, https://doi.org/10.1089/jwh.2015.5592.

[26] Mina, K., Phyo, K. M., Christopher, M. N. & Alison, D. M. A., 2017, Review of frailty syndrome and its physical, cognitive, and emotional domains in the elderly. Geriatrics, 2(4), 36; https://doi.org/10.3390/geriatrics2040036.

[27] Kota, T. et al, 2018, Ageing-related anorexia and its association with disability and frailty. NIH, National Library of Medicine, National Center for Biotechnology Information, (5):834-843, https://pubmed.ncbi.nlm.nih.gov/30109778/.

[28] Tino, P. Alexander, W., Hannah, M. Z., Sigrid, F. & Hubertus, A., 2021, Impact of common dizziness associated symptoms on dizziness handicap in older adults. Frontiers in Neurology, 12, 801-499, https://doi.org/10.3389/fneur.2021.801499.

[29] Löhler, J. & al, 2019, Hearing impairment in old age: detection, treatment, and associated Risks. Dtsch Arztebl International, 116(17), 301–310, https://doi.org/10.3238/arztebl.2019.0301.

[30] Van, D. B. et al, 2015, Palliative care for older people: A public health perspective. Oxford Academy accessed 11 Nov. 2022, https://doi.org/10.1093/acprof:oso/9780198717614.001.0001.

[31] Michelle, C. O., Pamela, R. B. & Carmen, A. P., 2017, Blood pressure in older adults: The Importance of Frailty. Springer Link, (7): 55, https://doi.org/10.1007/s11906-015-0564-y.

[32] Mit, P., Gorik, O., Sally, H. & Andrew, D., 2004, Burundi: a population deprived of basic health care. British Journal of General Practice, 54(505): 634–635, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324857/.

[33] Aoife, L. et al., 2021, The impact of frailty screening of older adults with multidisciplinary assessment of those at-Risk during emergency hospital attendance on the quality, safety and cost-effectiveness of care (SOLAR): a randomized controlled trial. Trials, 22: 581 (2021), https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05525-w.

[34] WHO, Clinical Consortium on Healthy Ageing (frailty and intrinsic capacity), 23/04/2022, https://apps.who.int/iris/bitstream/handle/10665/272437/WHO-FWC-ALC-17.2-eng.pdf.

[35] UN General Assembly, Department of Economic and Social Affairs Ageing. International Year of Older Persons 1999, (Principles for older persons), 24/04/2022, https://www.un.org/development/desa/ageing/resources/international-year-of-older-persons-1999/principles.html.