Association of disability and 12-year all-cause and cause-specific mortality: analyses from the Wellbeing of Older People cohort study in Uganda

INTRODUCTION: Disability is linked to poor health outcomes and increased mortality, yet evidence on this relationship in sub-Saharan Africa is limited. This study investigated the association between disability and all-cause and cause-specific mortality among older adults in Uganda. METHODS: The analysis was based on longitudinal data from the Wellbeing of Older People Study, an open cohort of individuals aged at least 50 years and followed over five data collection waves from 2009 to 2022. Disability was assessed using the WHO Disability Assessment Schedule 2.0. Mortality data were collected, supplemented by verbal autopsies. Gompertz regression models examined the association between disability severity and mortality, adjusting for sociodemographic, socioeconomic, health access and health risk factors. RESULTS: Among 938 participants followed up for a median of 8.0 years (interquartile range (IQR): 3.2-11.5), 153 deaths were recorded (mortality rate: 2.4 per 100 person-years). The age-sex-adjusted analyses showed that the hazard ratio (HR) was 3.88-fold higher (95% confidence interval (CI) 2.50 to 6.02; p value