The research, led by Tiro Theodore Monamo together with Mpho Keetile and Gobopamang Letamo of the Department of Statistics, Demography and Population Studies at the University of Botswana, used in-depth, semi-structured interviews with 18 older adults aged 65 and above who live with various forms of disability. Participants were recruited through health service networks in the Serowe/Palapye District, a setting that combines urban infrastructure with deeply rural and underserved communities. The team analysed the transcripts thematically with ATLAS.ti software, anchoring the analysis in Smith’s Interpretative Phenomenological Analysis, a method designed to capture the depth of individual lived experience while still identifying patterns shared across narratives.

Two broader theoretical lenses shaped the interpretation. The social model of disability reframes disability not simply as a bodily limitation but as the product of barriers erected by society, from inaccessible buildings to discriminatory attitudes. A life-course perspective, meanwhile, allowed the researchers to trace how personal, social and structural factors accumulate and interact over decades, shaping how a person arrives at old age and how they experience disability within it. Together, these frameworks pushed the study beyond a catalogue of impairments toward an account of how disability is made, endured and negotiated across a lifetime.

What emerged from the interviews is a picture of compounding disadvantage. Participants described declining health and memory loss, but they placed equal or greater weight on social exclusion, inadequate access to healthcare and economic marginalisation. For many, the loss of income-earning capacity in old age collided with the costs of transport, medication and daily necessities, while distance to clinics and the quality of services added further friction. Social isolation compounded these pressures: reduced mobility and shifting family structures left some older adults cut off from the community networks that had once sustained them. The findings suggest that disability in later life cannot be understood as a purely medical phenomenon; it is woven into systems of care, economy and belonging.

Yet the study refuses a narrative of pure deprivation. Alongside the hardships, participants reported genuinely positive dimensions of ageing, including emotional growth, spiritual acceptance and pride in the contributions they had made across their lives. Many framed their later years through faith and a sense of completion rather than solely through loss. This duality, the authors argue, is essential for anyone hoping to design policy for this population: interventions that treat older adults with disabilities only as recipients of need miss the agency, purpose and meaning that participants themselves identified as central to their lives.

That agency took concrete, culturally grounded forms. Coping strategies reported by participants included engaging in light physical activity, making traditional dietary adjustments, and turning to prayer as a source of strength and structure. Equally important were efforts to remain socially and culturally relevant, finding alternative roles and ways of contributing when physical limitations closed off previous ones. Participants drew on indigenous knowledge to self-manage health conditions, and many articulated a deep sense of purpose that persisted despite disability. These are not trivial details; they represent resources, familial, cultural and personal, that any serious policy framework would need to strengthen rather than bypass.

The study’s conclusions point squarely at structural reform. The authors argue that addressing the needs of older adults with disabilities in Botswana requires policy changes that strengthen community-based care, improve physical and service accessibility, and integrate both ageing and disability into national development plans. At present, they note, existing policies often overlook the complex realities faced by this population, particularly in rural and underserved communities where the intersection of age and disability is most acute. The researchers call for rights-based, contextually grounded approaches to healthy ageing, an orientation that treats older adults with disabilities as rights-holders with agency rather than as passive beneficiaries of charity.

The significance of the work extends beyond Botswana’s borders. Sub-Saharan Africa is ageing faster than many public health systems are prepared for, and research on the intersection of ageing and disability in the region remains thin. By documenting lived experience with methodological rigour, the study contributes to a growing body of literature that can inform regional policy, from the design of community care programmes to the inclusion of disability considerations in healthy-ageing strategies. It also demonstrates the value of phenomenological methods in demographic and population health research, where large surveys often flatten the textures of experience that determine whether policies actually work on the ground.

The research was conducted with extensive ethical safeguards. It received clearance from the University of Botswana Institutional Review Board and regulatory approval from the Ministry of Local Government and Traditional Affairs, with additional approval from the Serowe District Health Management Team and Palapye Primary Hospital management. Written informed consent was obtained from all participants, who were informed of their right to withdraw at any stage, and all quotations were anonymised to protect identities. The study received no external funding, and the authors declare no competing interests. The article is published open access under a Creative Commons licence, making the full findings available to researchers, policymakers and communities across the region.

For Botswana, the message of the study is ultimately one of both warning and opportunity. The warning is that systemic, cultural and economic barriers, not just functional decline, shape disability in later life, and that ignoring them will deepen inequality as the population ages. The opportunity lies in the resilience the researchers documented: older adults are already managing their health, sustaining their communities and finding meaning despite constrained circumstances. Policy that builds on those existing strengths, while dismantling the barriers that exhaust them, could transform what it means to grow old with a disability in Botswana, and offer a model for the wider region.

Subject of Research: Lived experiences of ageing and disability among older adults in Botswana

Article Title: Lived experiences of ageing and disability among older adults in Botswana

Article References: Monamo, T. T., Keetile, M., & Letamo, G. (2026). Lived experiences of ageing and disability among older adults in Botswana. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00478-4

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00478-4

Keywords: ageing, disability, Botswana, older adults, lived experiences, qualitative research, interpretative phenomenological analysis, social model of disability, life-course perspective, sub-Saharan Africa, healthy ageing, community-based care

Cognitive disability, often characterized by deficits in memory, attention, and problem-solving abilities, poses significant challenges for individuals, families, and communities. In Botswana, where the population of older adults is rapidly increasing, the implications of cognitive disabilities are profound. This study sheds light on the prevalence of such conditions and how various demographic factors correlate with cognitive health in later life. As the world becomes more aware of mental health, particularly in older adults, this research contributes valuable data to inform policymakers and healthcare providers.

The cross-sectional data analyzed in the study were collected from diverse regions across Botswana, providing a holistic view of the cognitive landscape in the country. Through rigorous statistical methods, the researchers were able to determine not only the prevalence rates but also the demographic trends that appeared to influence cognitive disabilities. This systemic approach allows for a more accurate representation of the challenges faced by the aging population, paving the way for targeted interventions and prevention strategies. Understanding how different regions and communities are affected by cognitive disabilities can help tailor public health initiatives effectively.

Furthermore, the research delves into sociodemographic determinants that are associated with cognitive disabilities. Factors such as education level, income, residential location, and social engagement can significantly impact cognitive health. The study’s findings highlight that lower educational attainment and lack of social networks correlate with higher instances of cognitive decline. In a society where educational access and socioeconomic opportunities are still evolving, these insights are vital for addressing the potential future burden of cognitive disabilities.

One of the most striking aspects of the research is its depiction of trends over time in the prevalence of cognitive disabilities in Botswana. Historical data have shown a gradual increase, a phenomenon that can be attributed to numerous factors, including lifestyle changes and increased life expectancy. The traditional family structures that once supported older adults are shifting, leading to isolation and decreased cognitive engagement. As such, the researchers call for an urgent reevaluation of social support systems aimed at older adults to enhance their quality of life and cognitive functioning.

Interestingly, the study does not shy away from discussing the implications of cultural factors in Botswana that affect cognitive health. Traditional beliefs and stigma surrounding mental health often create barriers to seeking assistance for cognitive disabilities. Understanding how cultural perceptions intersect with healthcare access can inform strategies to promote mental wellness among older adults. Initiatives that are culturally sensitive and community-based are essential to breaking down these barriers and improving cognitive health.

Moreover, as the healthcare infrastructure continues to develop in Botswana, integrating mental health services into geriatric care will be crucial. The findings indicate that older adults are often screened for physical health conditions, while cognitive assessments are overlooked. This study makes a strong argument for the inclusion of cognitive evaluations in routine health checks for older adults, thereby facilitating early detection and timely intervention.

Stakeholders in the healthcare sector must take heed of the implications that the findings present. As more individuals are diagnosed with cognitive disabilities, the demand for specialized care will likely rise. The study advocates for training healthcare professionals in providing comprehensive geriatric assessments that address both physical and cognitive health. This holistic approach can improve outcomes and ensure that older adults receive the multi-faceted care they require.

Additionally, the research underscores the importance of community involvement in supporting older adults with cognitive disabilities. Community programs that encourage social interactions, cognitive engagement, and physical activities can play a pivotal role in staving off cognitive decline. By fostering environments that promote mental stimulation and social connectedness, communities can significantly impact the cognitive health of their older populations.

As we navigate the implications of these findings, it is vital to consider the role of technology in enhancing cognitive health among older adults. Innovations such as telehealth services, mobile health applications, and cognitive training programs offer promising avenues for improving access to mental health support. These technological tools can bridge the gap for older adults who may have difficulty accessing traditional healthcare infrastructure, thereby supporting their cognitive well-being.

While the study highlights alarming trends in cognitive disabilities, it also offers a hopeful perspective. With greater awareness and improved resources, Botswana has the potential to address the challenges posed by cognitive decline. By investing in education, healthcare access, and community initiatives, the society can cultivate an environment that champions the cognitive health of its older citizens.

As the research by Monamo, Keetile, and Letamo indicates, understanding the prevalence, trends, and sociodemographic determinants of cognitive disability is essential for creating effective interventions and policies in Botswana. The time for action is now, as the implications of inaction will be felt not just by individuals, but by society as a whole. Engaging in discussions about cognitive health for older adults can lead to transformative changes that will benefit future generations.

In conclusion, the study serves as a clarion call for researchers, healthcare providers, and policymakers alike. The findings compel us to confront the realities of cognitive disabilities head-on and seek solutions that are grounded in data and the lived experiences of older adults. By prioritizing research and action in this critical area, we can foster a future where cognitive health is valued, supported, and preserved for all older adults in Botswana.

Subject of Research: Cognitive Disability among Older Adults in Botswana

Article Title: Cognitive disability among older adults in Botswana: prevalence, trends, and sociodemographic determinants from cross-sectional data.

Article References:

Monamo, T.T., Keetile, M. & Letamo, G. Cognitive disability among older adults in Botswana: prevalence, trends, and sociodemographic determinants from cross-sectional data.
BMC Geriatr 25, 670 (2025). https://doi.org/10.1186/s12877-025-06383-w

Image Credits: AI Generated

DOI: 10.1186/s12877-025-06383-w

Keywords: Cognitive disability, older adults, Botswana, prevalence, sociodemographic determinants, healthcare policy