Mammography examination among women aged 40 years or older in Ghana: evidence from wave 2 of the World Health Organization's study on global AGEing and adult health multicountry longitudinal study.

OBJECTIVE: To determine the uptake of mammography among Ghanaian women aged 40 years or older and to examine critical risk factors that influence the uptake. STUDY DESIGN: A cross-sectional survey. METHODS: A nationally representative sample of 2787 women and 1948 men aged ≥18 years were surveyed in the Wave 2 (2014-2015) of the World Health Organization's multicountry study on AGEing and adult health in Ghana. Of the 2787 women aged ≥18 years, data on a total of 2301 women aged ≥40 years were included in this study. Univariable and multivariable logistic regression models were applied to examine critical risk factors for mammogram examination. RESULTS: Of the 2301 women sampled, only 83 (3.61%) ever had mammogram. The odds of mammogram examination were lower for women aged ≥70 years (odds ratio [OR] 0.42, 95% confidence interval [CI]: 0.19, 0.93), being self-employed (OR = 0.21, 95% CI: 0.11, 0.42) and being informal sector employee (OR = 0.26, 95% CI: 0.12, 0.57) in the multivariable analyses. Belonging to the Ewe ethnic group (OR=3.41, 95% CI:1.88, 6.16) compared to the Akan group was associated with increased odds of mammogram examination in the multivariable analysis. Women aged ≥70 years, being self-employed, being an informal employee and belonging to the Ewe ethnic group were independently associated with mammography examination. CONCLUSION: The prevalence of screening for breast cancer using mammography among Ghanaian women aged 40 years and older was 3.6%. Age, type of employer and ethnicity were associated with an older adult woman's likelihood to access mammography screening. Overall, our study provided critical data to encourage and promote good health-seeking behaviour in terms of breast cancer screening among older adult women. Further qualitative studies are warranted to explore why some of these factors influence mammography.

The Effect of Cognitive Impairment on the Health-Related Quality of Life Among Stroke Survivors at a Major Referral Hospital in Ghana.

BACKGROUND: The sequelae of stroke include both physical and cognitive impairment. However, the physical impairment usually takes center-stage during rehabilitation, while cognitive impairment is largely ignored. Cognitive deficit is very common following stroke and its assessment and identification is crucial as it impacts on the outcome and rehabilitation of stroke survivors. Very few studies have explored any relationship between cognitive impairment and quality of life after stroke and these studies have been inconclusive. This study set out to explore any relationship that might exist between post-stroke cognitive impairment and quality of life of the survivors. METHODS: A descriptive cross-sectional study was conducted at the Stroke unit of the Korle Bu teaching hospital during which 110 stroke survivors were recruited. A structured questionnaire was used to obtain the demographic, clinical characteristics and risk factor profile of the study participants. The HRQOLISP-26 questionnaire which is a stroke specific quality of life scale was used to assess the QoL in this study while the Montreal Cognitive Assessment Scale (MoCA) was used to assess cognitive deficit. RESULTS: Mean age of the 110 study participants was 61±17 years. Presence of cognitive impairment after 3 months was associated with lower quality of life (p=0.003) while increasing age and level of education were associated with lower scores on MoCA scale (p=0.019, p=0.048 respectively). CONCLUSION: Cognitive impairment is strongly associated with poor quality of life following stroke, therefore, cognitive rehabilitation (and not just physiotherapy) should be considered as an integral component in the management of stroke survivors.

Predictors of Subjective Well-Being among Older Ghanaians

Background: Later years of life are accompanied by many physical; emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults; but most; if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. Methods: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective wellbeing. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. Results: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4 were males. Following multivariate logistic regression analysis; age; sex; educational level; income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39 - 2.03). For those 50 years and above; being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027); Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. Conclusion: Among older Ghanaians; factors that positively influence SWB are younger age; male sex; high educational level and high income

Predictors of subjective well-being among older Ghanaians.

BACKGROUND: Later years of life are accompanied by many physical, emotional and environmental changes which may impact on the well-being of the individual. Many factors are known to influence the subjective well-being of older adults, but most, if not all of this information was the result of studies in the Western world. This study aimed at obtaining and documenting the predictors of subjective well-being (SWB) among older Ghanaians. METHODS: Data for the study was obtained from the WHO SAGE study. The single item measure of life satisfaction was used to determine subjective well-being. Descriptive statistics as well as logistic regression analysis were carried out to determine the predictors of SWB. RESULTS: A total of 4724 individuals aged 50 years and above responded to the questionnaires. Of these 50.4% were males. Following multivariate logistic regression analysis, age, sex, educational level, income and ethnic background were found to significantly affect the SWB of older Ghanaians. Being male was associated with higher level of SWB (OR=1.68; CI: 1.39 - 2.03). For those 50 years and above, being younger (50-59 years) was also associated with a high level of SWB (OR=17.72; CI: 10.13-30.98). Earning a low income and having low educational level were both associated with low levels of SWB (OR=0.304; CI: 0.22-0.42; and OR=0.47; CI: 0.37-0.60 respectively). Ewes (p=0.027), Grumas (p=0.002) and Mole-Dagbons (p=0.04) had significantly higher SWB compared to the other ethnic groups. CONCLUSION: Among older Ghanaians, factors that positively influence SWB are younger age, male sex, high educational level and high income.