Conference Abstract | Volume 9 (ConfPro8): Abstract 40 | Published: 07 Oct 2026
Michael Boah1,2,&, Callixte Cyuzuzo1, Francios Uwinkindi3, Chester Kalinda1, Tsion Yohannes1, Carolyn Greig4, Justine Davies4, Lisa Ruth Hirschhorn5, Alemayehu Amberbir1
1University of Global Health Equity, Kigali, Rwanda, 2University for Development Studies, Tamale, Ghana, 3Rwandan Biomedical Center, Ministry of Health, Kigali, Rwanda, 4University of Birmingham, Birmingham, United Kingdom, 5Northwestern University, Chicago, United States
&Corresponding author: Michael Boah, University of Global Health Equity, Kigali, Rwanda, Email: mboah@ughe.org, ORCID: https://orcid.org/0000-0002-5660-2292
Received: 11 Mar 2026, Accepted: 30 Aug 2026, Published: 07 Oct 2026
Domain: Non-Communicable Disease Epidemiology
Keywords: Multimorbidity, mental health, frailty, noncommunicable diseases, Rwanda
©Michael Boah et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Michael Boah et al., Multimorbidity, mental health, and frailty among older adults in Rwanda: Epidemiological insights for integrated noncommunicable disease care. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfPro8):40. https://doi.org/10.37432/JIEPH-CONFPRO8-0040
Population ageing in sub-Saharan Africa is driving a growing burden of physical non-communicable diseases, alongside increasing mental health conditions and functional decline. However, integrated evidence examining these domains together remains limited in low-resource settings such as Rwanda.
We conducted a cross-sectional, population-based study among 4,369 adults aged ≥40 years across rural and urban Rwanda from March 2024 to June 2024. Multimorbidity (≥2 chronic conditions) and frailty (Fried phenotype) were assessed using validated tools. Mental health outcomes included anxiety (GAD-2), depression (PHQ-9), and cognitive impairment (CSI-D). Multivariable regression models examined associations of outcomes with demographic and socioeconomic factors.
Among 4,369 adults aged ≥40 years, overall multimorbidity prevalence was 55.2% (95% CI: 53.7, 56.6). Multimorbidity in physical chronic conditions affected 37.0% (95% CI: 35.6–38.4), with hypertension being the most common (40.1%; 95% CI: 38.6–41.5). Symptoms of anxiety and depression were reported by 31.9% (95% CI: 30.6–33.3) and 23.3% (95% CI: 22.1–24.6), respectively, and 11.4% (95% CI: 10.5–12.4) had cognitive impairment; 18.3% (95% CI: 17.1–19.4) had ≥2 mental health conditions. Overlap was substantial: 23.9% of those with multimorbidity in physical chronic conditions also had mental multimorbidity, and 48.4% of those with mental multimorbidity had physical conditions. Frailty prevalence was 14.5% (95% CI: 13.5–15.6). Older age, female sex, and lower socioeconomic status were consistently associated with worse physical and mental health outcomes. Urban residents had higher multimorbidity but lower frailty.
Older adults in Rwanda experience a high and overlapping burden of NCDs and mental health conditions. Integrated, person-centred care models that address both physical and mental health, alongside social determinants, are essential to support healthy ageing and strengthen NCD response systems in Africa.
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