Health conditions of older adults in complex humanitarian settings in low- and middle-income countries: a retrospective analysis of 2019-2025 data from Médecins Sans Frontières-supported inpatient departments

Abstract

BACKGROUND: Inpatient admissions of older adults in humanitarian settings in low-income and middle-income countries remain poorly documented, likely leading to gaps in the delivery of age-appropriate health services. This analysis aims to contribute to age-adapted and gender-adapted healthcare strategies in humanitarian settings. METHODS: This multicountry study includes adults who were admitted at Médecins Sans Frontières-supported inpatient departments in humanitarian settings across four regions between July 2019 and April 2025. Diagnoses of diseases and syndromes were compared between younger adults (20-49 years old) and older adults (50 years or older), stratified by sex, using regression analyses. RESULTS: Data of 149 483 adults were included. Most adults were admitted to inpatient departments for non-communicable diseases (NCDs) (40.7%), followed by communicable diseases (23.3%) and trauma or injury (20.4%). Compared with younger adults, older adults had higher odds of admission being for chronic non-infectious respiratory diseases (OR=2.32; 95% CI 2.27 to 2.38), acute cerebrovascular events (OR=2.17; 95% CI 2.09 to 2.26), acute cardiogenic events (OR=1.93; 95% CI 1.90 to 1.97), lower respiratory tract infections (LRTIs) (OR=1.42; 95% CI 1.41 to 1.44) and acute watery diarrhoea (AWD) (OR=1.20; 95% CI 1.17 to 1.22). Across age groups, women had higher odds of admission being for malaria, AWD, LRTIs, chronic non-infectious respiratory diseases and acute hypertensive crises than men. Older women had higher odds of admission being for complications of diabetes than older men. LRTIs were the leading cause of hospitalisation for older adults in three out of four regions. CONCLUSIONS: Older adults in humanitarian settings face intersecting vulnerabilities related to age, gender and geography, with a dual burden of infectious and NCDs. Gender disparities were evident, as older women were more frequently admitted. Including older adults in preventive interventions, while addressing care gaps such as trauma, multimorbidity and palliative needs, is essential to deliver more equitable, inclusive and effective health responses.