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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 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, 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, 247 Article 112821. ISSN 0277-9536 (2020) [Refereed Article]

Copyright Statement

2020 Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.socscimed.2020.112821


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 is lacking in this population. We estimated annual transition probabilities between three body mass index (BMI) categories: normal weight (BMI ≥18.5 and <25.0 kg/m2), overweight (BMI ≥25.0 and <30.0 kg/m2), and obesity (BMI ≥30.0 kg/m2), among older adults aged ≥50 years in Ghana. Data were used from a nationally representative, 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 and 4.9% (95% CI: 3.8%, 6.2%) from overweight to obesity. For obese individuals, the probability of remaining obese, 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 5065 years, urban residence, having high education and high wealth were associated with increased probability of transitioning into the overweight or obese categories. Our findings highlight the difficulty in transitioning away from obesity, especially among females. The estimated transition probabilities will be essential in health economic simulation models to determine sustainable weight management interventions.

Item Details

Item Type:Refereed Article
Keywords:multistage markov model, obesity, transition probabilities, sub-Saharan Africa, Ghana WHO SAGE
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Public health (excl. specific population health) not elsewhere classified
UTAS Author:Lartey, ST (Mrs Stella Lartey)
UTAS Author:Si, L (Mr Lei Si)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:de Graaff, B (Dr Barbara de Graaff)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:137148
Year Published:2020
Web of Science® Times Cited:12
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-02-03
Last Modified:2020-04-30

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