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Annual transition probabilities of overweight and obesity in older adults: evidence from World Health Organization Study on global AGEing and adult health

Lartey, ST ORCID: 0000-0001-9519-7886, Si, L ORCID: 0000-0002-3044-170X, Otahal, P ORCID: 0000-0003-4042-1769, de Graaff, B ORCID: 0000-0003-0743-9561, Boateng, GO, Biritwum, RB, Minicuci, N, Kowal, P, Magnussen, CG ORCID: 0000-0002-6238-5730 and Palmer, AJ ORCID: 0000-0002-9703-7891 2020 , 'Annual transition probabilities of overweight and obesity in older adults: evidence from World Health Organization Study on global AGEing and adult health' , Social Science and Medicine, vol. 247 , pp. 1-9 , doi: 10.1016/j.socscimed.2020.112821.

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Overweight/obesity is becoming increasingly prevalent in sub-Saharan Africa including Ghana. However,transition probabilities, an essential component to develop cost-effective measures for weight management islacking in this population. We estimated annual transition probabilities between three body mass index (BMI)categories: normal weight (BMI ≥18.5 and 2), overweight (BMI ≥25.0 and 2), andobesity (BMI ≥30.0 kg/m2), among older adults aged ≥50 years in Ghana. Data were used from a nationallyrepresentative, multistage sample of 1496 (44.3% females) older adults in both Waves 1 (2007/8) and 2 (2014/15) of the Ghana WHO SAGE. A multistage Markov model was used to estimate annual transition probabilities.We further examined the impact of specific socio-economic factors on the transition probabilities. At baseline,22.8% were overweight and 11.1% were obese. The annual transition probability was 4.0% (95% CI: 3.4%,4.8%) from normal weight to overweight, 11.1% (95% CI: 9.5%, 13.0%) from overweight to normal weight and4.9% (95% CI: 3.8%, 6.2%) from overweight to obesity. For obese individuals, the probability of remainingobese, transitioning to overweight and completely reverting to normal weight was 90.2% (95% CI: 87.7%,92.3%), 9.2% (95% CI: 7.2%, 11.6%) and 0.6% (95% CI: 0.4%, 0.8%) respectively. Being female, aged 50–65years, urban residence, having high education and high wealth were associated with increased probability oftransitioning into the overweight or obese categories. Our findings highlight the difficulty in transitioning awayfrom obesity, especially among females. The estimated transition probabilities will be essential in health economicsimulation models to determine sustainable weight management interventions.

Item Type: Article
Authors/Creators:Lartey, ST and Si, L and Otahal, P and de Graaff, B and Boateng, GO and Biritwum, RB and Minicuci, N and Kowal, P and Magnussen, CG and Palmer, AJ
Keywords: multistage markov model, obesity, transition probabilities, sub-Saharan Africa, Ghana WHO SAGE
Journal or Publication Title: Social Science and Medicine
Publisher: Pergamon-Elsevier Science Ltd
ISSN: 0277-9536
DOI / ID Number: 10.1016/j.socscimed.2020.112821
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© 2020 Elsevier Ltd. All rights reserved.

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