This article, authored by Şenol Demirci and Sıdıka Kaya, published in Research on Ageing and Social Policy in July 2025, investigates the profound impact of noncommunicable diseases (NCDs) on the health and daily functioning of middle-aged and older adults in Türkiye. Recognizing NCDs as a significant public health concern, particularly for developing countries like Türkiye, and given that the risk of NCDs increases with age, this study specifically focuses on older adults who are especially vulnerable.
The research is a cross-sectional study that utilized data from the Türkiye Health Survey (THS) conducted in 2019, involving a substantial sample of 7,889 community-dwelling individuals aged 45 and above. The primary objective was to evaluate the association between a selection of NCDs and key health status variables, which included perceived health status, activities of daily living (ADLs), and instrumental activities of daily living (IADLs). The NCDs specifically examined in this study encompassed stroke, myocardial infarction, kidney problems, depression, chronic obstructive pulmonary disease (COPD), coronary heart disease, asthma, diabetes, neck disorder, low back disorder, and multimorbidity (defined as having two or more selected NCDs). The study highlights that assessing the impact of NCDs at a national level is crucial for effective problem clarification and the development of practical solutions, especially given the limited national-scale studies on NCDs’ functional health impact in Türkiye.
Key findings of the study reveal a consistent negative association between NCDs and the functional health of middle-aged and older adults:
- Self-Perceived Health: All NCDs evaluated in the study were significantly associated with a higher likelihood of experiencing very poor/poor or fair self-perceived health status across all analytical models. The NCDs with the highest effect on very poor/poor self-perceived health were stroke, myocardial infarction, coronary heart disease, and multimorbidity.
- Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs):
- Stroke, kidney problems, depression, coronary heart disease, low back disorder, and multimorbidity were consistently found to be associated with limitations in ADLs. Stroke had the most significant impact on ADL limitations across all models.
- For IADLs, a broader range of NCDs showed significant associations with limitations. These included stroke, multimorbidity, COPD, coronary heart disease, low back disorder, and depression, which consistently demonstrated strong associations with IADL limitations. The study notes that NCDs tend to limit IADLs earlier due to their more complex nature, before impacting basic physical needs related to ADLs.
- Overall Strongest Associations: When considering all health outcomes together, stroke, cardiovascular diseases (like coronary heart disease), and multimorbidity demonstrated the strongest overall associations with adverse health status.
In conclusion, the study emphasizes the critical need for implementing measures that support the vital activities of middle-aged and older adults and enhance their overall health status in Türkiye. It recommends developing and implementing policies to mitigate existing NCD risk factors, enhancing social support for patients, and improving the quality and quantity of home treatment and care services. For future research, the authors suggest validating NCD and risk factor status through biochemical measurements and physician diagnoses, and employing longitudinal data to better understand the causality between NCDs and health status variables.
Reference: Demirci, Ş., & Kaya, S. (2025). The Impact of Noncommunicable Diseases on Health and Daily Functioning Among Middle-Aged and Older Adults in Türkiye. Research on Ageing and Social Policy, 13(2), 147–169. http://dx.doi.org/10.17583/rasp.17592
