Cohort profile: the mature adults cohort of the Malawi longitudinal study of families and health (MLSFH-MAC). Issue 10 (16th October 2020)

• Record Type: Journal Article
• Authors: Kohler, Iliana V; Bandawe, Chiwoza; Ciancio, Alberto; Kämpfen, Fabrice; Payne, Collin F; Mwera, James; Mkandawire, James; Kohler, Hans-Peter
• Is Part Of: BMJ open. Volume 10:Issue 10(2020)
• Publication Date: 2020-10-16
• Subjects: hypertension -- epidemiology -- health policy -- HIV & AIDS -- public health -- mental health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-038232
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Purpose: The Mature Adults Cohort of the Malawi Longitudinal Study of Families and Health (MLSFH-MAC) contributes to global ageing studies by providing a rare opportunity to study the processes of individual and population ageing, the public health and social challenges associated with ageing and the coincident shifts in disease burdens, in a low-income, high HIV prevalence, sub-Saharan African (SSA) context. Participants: The MLSFH-MAC is an open population-based cohort study of mature adults aged 45+ years living in rural communities in three districts in Malawi. Enrolment at baseline is 1266 individuals in 2012. Follow-ups were in 2013, 2017 and 2018 when the cohort size reached 1626 participants in 2018. Findings to date: Survey instruments cover ageing-related topics such as cognitive and mental health, non-communicable diseases (NCDs) and related health literacy, subjective survival expectations, measured biomarkers including HIV, grip strength, hypertension, fasting glucose, body mass index (BMI), broad individual-level and household-level social and economic information, a 2018 qualitative survey of mature adults and community officials, 2019 surveys of village heads, healthcare facilities and healthcare providers in the MLSFH-MAC study areas. Across many domains, MLSFH-MAC allows for comparative research with global ageing studies through harmonised measures and instruments. Key findings to date include a high prevalence of depression and anxiety among older adults, evidence for rapid declines in cognitive health with age, a low incidence of HIV among mature adults, rising prevalence of HIV due to increased survival of HIV-positive individuals and poor physical health with high NCD prevalence. Future plans: An additional wave of MLSFH-MAC is forthcoming in 2021, and future expansions of the cohort are planned. MLSFH-MAC data will also be publicly released and will provide a wealth of information unprecedented for ageing studies in a low-income SSA context that broadly represents the socioeconomic environment of millions of individuals in south-eastern Africa.