Alcohol use and multimorbidity among adults aged 40 years and above in rural South Africa: a cross-sectional study

Abstract

Abstract Background: We assessed the prevalence of reported alcohol use and its association with multimorbidity among adults aged 40 years and above in a rural, transitioning South African setting. Findings could potentially inform alcohol interventions integration in the prevention and treatment of chronic conditions. Methods: We analysed data from the first wave of The Health and Ageing in Africa – a longitudinal Study in an INDEPTH community (HAALSI) nested within the Agincourt Health and Demographic Surveillance Systems (HDSS), conducted between November 2014 and November 2015 (n=5059). We computed descriptive statistics and performed univariate analysis to determine factors independently associated with multimorbidity. Age, Body Mass Index, education, sex, and household wealth status and variables with a p-value <0.20 in univariate analysis were included in multivariable Modified Poisson regression models. Any factors with a p-value of <0.05 in the final models were considered statistically significant. Results: The first wave of HAALSI was completed by 5059 participants aged 40 years and above and included 2714 (53.6%) females. The prevalence of reported ever alcohol use was 44.6% (n=2253) and of these 51.9% (n=1171) reported alcohol use in the last 30 days. The prevalence of multimorbidity that includes HIV was 59.6% (3014/5059) and for multimorbidity without HIV 52.5% (2657/5059). Alcohol use was associated with multimorbidity that includes HIV among all participants (RR: 1.05, 95% CI: 1.02-1.08), and separately for males (RR: 1.05, 95% CI: 1.00-1.10) and females (RR: 1.06, 95%CI: 1.02-1.11). Similarly, alcohol use was associated with multimorbidity without HIV among all participants (RR: 1.05, 95% CI: 1.02-1.09), and separately for males (RR: 1.06, 95% CI: 1.00-1.12) and females (RR: 1.06, 95% CI: 1.01-1.11). Conclusion: Reported alcohol use was common and associated with multimorbidity that includes HIV and multimorbidity without HIV among older adults in rural northeast South Africa. There is a need to integrate screening, brief interventions, and referral for alcohol treatment (SBIRT) in the existing prevention and treatment of multimorbidity in South Africa.