Assessing health and well-being among older people in rural South Africa

Background: The population in developing countries is ageing, which is likely to increase the burden of noncommunicable diseases and disability. Objective: To describe factors associated with self-reported health, disability and quality of life (QoL) of older people in the rural northeast of South Africa. Design: Cross-sectional survey of 6,206 individuals aged 50 and over. We used multivariate analysis to examine relationships between demographic variables and measures of self-reported health (Health Status), functional ability (WHODASi) and quality of life (WHOQoL). Results: About 4,085 of 6,206 people eligible (65.8%) completed the interview. Women (Odds Ratio (OR) 1.30, 95% CI 1.09, 1.55), older age (OR2.59, 95% CI 1.97, 3.40), lower education (OR1.62, 95% CI 1.31,2.00), single status (OR1.18, 95% CI 1.01, 1.37) and not working at present (OR1.29, 95% CI 1.06, 1.59) were associated with a low health status. Women were also more likely to report a higher level of disability (OR1.38, 95% CI 1.14, 1.66), as were older people (OR2.92, 95% CI 2.25, 3.78), those with no education (OR1.57, 95% CI 1.26, 1.97), with single status (OR1.25, 95% CI 1.06, 1.46) and not working at present (OR1.33, 95% CI 1.06, 1.66). Older age (OR1.35, 95% CI 1.06, 1.74), no education (OR1.39, 95% CI 1.11, 1.73), single status (OR1.28, 95% CI 1.10, 1.49), a low household asset score (OR1.52, 95% CI 1.19, 1.94) and not working at present (OR1.32; 95% CI 1.07, 1.64) were all associated with lower quality of life. Conclusions: This study presents the first population-based data from South Africa on health status, functional ability and quality of life among older people. Health and social services will need to be restructured to provide effective care for older people living in rural South Africa with impaired functionality and other health problems

A novel 3-bp deletion in the PANK2 gene of Dutch patients with pantothenate kinase-associated neurodegeneration: evidence for a founder effect

Mutation analysis was performed in four apparently unrelated Dutch families with pantothenate kinase-associated neurodegeneration, formerly known as Hallervorden-Spatz syndrome. A novel 3-bp deletion encompassing the nucleotides GAG at positions 1,142 to 1,144 of exon 5 of the PANK2 gene was found in all patients. One patient was compound heterozygous; she also carried a novel nonsense mutation (Ser68Stop). The other patients were homozygous for the 1142_1144delGAG mutation. The 1142_1144delGAG mutation was also found in a German patient of unknown descent. We used polymorphic microsatellite markers flanking the PANK2 gene (spanning a region of approximately 8 cM) for haplotype analyses in all these families. A conserved haplotype of 1.5 cM was found for the 1142_1144delGAG mutation carriers. All the Dutch families originated from the same geographical region within the Netherlands. The results indicate a founder effect and suggest that the 1142_1144delGAG mutation probably originated from one common ancestor. It was estimated that this mutation arose at the beginning of the ninth century, approximately 38 generations ago

Methods for determination of the age of Pleistocene tephra, derived from eruption of Toba, in central India

Tephra, emplaced as a result of Pleistocene eruption of the Indonesian ‘supervolcano’ Toba, occurs at many localities in India. However, the ages of these deposits have hitherto been contentious; some workers have argued that these deposits mark the most recent eruption (eruption A, ca 75 ka), although at some sites they are stratigraphically associated with Acheulian (Lower Palaeolithic) artefacts. Careful examination of the geochemical composition of the tephras, which are composed predominantly of shards of rhyolitic glass, indicates that discrimination between the products of eruption A and eruption D (ca 790 ka) of Toba is difficult. Nonetheless, this comparison favours eruption D as the source of the tephra deposits at some sites in India, supporting the long-held view that the Lower Palaeolithic of India spans the late Early Pleistocene. In principle, these tephra deposits should be dateable using the K–Ar system; however, previous experience indicates contamination by a small proportion of ancient material, resulting in apparent ages that exceed the true ages of the tephras. We have established the optimum size-fraction in which the material from Toba is concentrated, 53–61 μm, and have considered possible origins for the observed contamination. We also demonstrate that Ar–Ar analysis of four out of five of our samples has yielded material with an apparent age similar to that expected for eruption D. These numerical ages, of 809 ± 51, 714 ± 62, 797 ± 45 and 827 ± 39 ka for the tephras at Morgaon, Bori, Gandhigram and Simbhora, provide a weighted mean age for this eruption of 799 ± 24 ka (plus-or-minus two standard deviations). However, these numerical ages are each derived from no more than 10–20% of the argon release in each sample, which is not ideal. Nonetheless, our results demonstrate that it is feasible, in principle, to date this difficult material using the Ar–Ar technique; future follow-up studies will therefore be able to refine our preparation and analysis procedures to better optimize the dating