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  1. Choo WY, Hairi NN, Sooryanarayana R, Yunus RM, Hairi FM, Ismail N, et al.
    BMJ Open, 2016 05 25;6(5):e011057.
    PMID: 27225651 DOI: 10.1136/bmjopen-2016-011057
    INTRODUCTION: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences.

    METHODS AND ANALYSIS: This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression.

    ETHICS AND DISSEMINATION: The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.

  2. Yunus RM, Hairi NN, Choo WY, Tan MP, Hairi F, Sooryanarayana R, et al.
    J Am Geriatr Soc, 2018 07;66(6):1165-1171.
    PMID: 29601084 DOI: 10.1111/jgs.15370
    OBJECTIVES: To examine the cross-sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians.

    DESIGN: Two-year prospective cohort study.

    SETTING: Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur.

    PARTICIPANTS: Community-dwelling older adults aged 60 and older. Using a multistage cluster sampling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re-assessed 2 years later.

    MEASURES: EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self-report using validated questions.

    RESULTS: The prevalence of chronic pain was 20.4%. Cross-sectional results revealed 8 variables significantly associated with chronic pain-age, education, income, comorbidities, self-rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03-2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81-1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data.

    CONCLUSION: Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross-sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, individuals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.

  3. Yunus RM, Hairi NN, Yuen C, Sooryanarayana R, Hairi F, Ismail N, et al.
    Int J Geriatr Psychiatry, 2019 01;34(1):60-66.
    PMID: 30230023 DOI: 10.1002/gps.4986
    BACKGROUND: Elder abuse and neglect (EAN) is a growing public health problem, and numerous adverse health effects of abuse in late life have been documented. Little is known, however, about the impact of elder abuse on sleep quality. This study examines the longitudinal relationship between EAN and sleep quality.

    METHODS: This was a 2-year prospective cohort study involving 1927 older adults in a rural Malaysian district, Kuala Pilah. A multi-stage cluster sampling strategy was employed. After 2 years, 1189 respondents were re-assessed. EAN was determined using the modified Conflict Tactic Scale, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).

    RESULTS: The prevalence of elder abuse was 8.1% (95% CI:6.9,9.3). Longitudinal analysis using generalized estimating equations showed that elder abuse contributed to higher PSQI scores (B:0.49, 95% CI:0.17,0.58). Sub-analyses demonstrated that psychological abuse and neglect had significant longitudinal relationships with increase of PSQI scores, while other subtypes did not.

    CONCLUSION: Abuse in late life, particularly psychological abuse and neglect, result in greater PSQI scores. Even though this may imply decline in sleep quality, our findings were not considered clinically significant as they did not exceed the clinical cut-off score of five. Nevertheless, sleep quality is an important determinant of health and a predictor of mortality among older adults; thus, understanding its relationship with abuse is useful to health care providers and policy-makers in improving health services and upgrading preventive measures.
  4. Chan YY, Lim KK, Omar MA, Mohd Yusoff MF, Sooryanarayana R, Ahmad NA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:49-56.
    PMID: 33370865 DOI: 10.1111/ggi.13977
    AIM: Physical inactivity in older adults is linked to increased risk of chronic diseases, disability and various poor health outcomes. As the aging population rises, the prevalence of diseases associated with aging also increases. Regular physical activity in older adults is important to improve overall health and promote healthy aging. This study aimed to determine the prevalence and factors associated with physical inactivity among older adults in Malaysia.

    METHODS: This study was based on 3969 Malaysian older adults aged ≥60 years who completed the physical activity module in the National Health and Morbidity Survey 2018, a population-based cross-sectional survey. Physical activity was measured using the Global Physical Activity Questionnaire through a face-to-face interview. Participants were classified as physically active or inactive. Associations between physical inactivity, sociodemographic characteristics and a range of selected independent variables were examined using multivariable logistic regression.

    RESULTS: Overall, three out of 10 (29.8%) Malaysian older adults were physically inactive. Results of multivariable analysis showed that older age group (≥80 years), of Bumiputera Sarawak ethnicity, unemployed/retirees/homemakers, functional limitation, diabetes mellitus and dementia were significantly associated with a higher risk of physical inactivity. Women, with secondary education level and good social support were less likely to be physically inactive.

    CONCLUSIONS: The present study reported the status of physical inactivity among older adults in Malaysia. There is the need to design effective public health programs and interventions to promote active living and healthy aging among Malaysian older adults, particularly in those at-risk older population subgroups. Geriatr Gerontol Int 2020; 20: 49-56.
  5. Yunus RM, Wazid SW, Hairi NN, Choo WY, Hairi FM, Sooryanarayana R, et al.
    PLoS One, 2017;12(7):e0180222.
    PMID: 28686603 DOI: 10.1371/journal.pone.0180222
    OBJECTIVES: To examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI).
    DESIGN: This study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome.
    SETTING: Kuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia.
    PARTICIPANTS: 1648 community-dwelling older Malaysians.
    RESULTS: The Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach's Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for "no abuse", "1 type of abuse" and "2 types or more". Generalized linear models revealed six variables as significant determinants of sleep quality-abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep.
    CONCLUSION: The Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.
  6. Sooryanarayana R, Choo WY, Hairi NN, Chinna K, Hairi F, Ali ZM, et al.
    BMJ Open, 2017 Sep 01;7(8):e017025.
    PMID: 28864485 DOI: 10.1136/bmjopen-2017-017025
    BACKGROUND: As Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia.

    DESIGN: Cross-sectional study, analysing baseline findings of a cohort of older adults.

    SETTING: Kuala Pilah district, Negeri Sembilan state, Malaysia.

    OBJECTIVES: To determine the prevalence of elder abuse among community dwelling older adults and its associated factors.

    PARTICIPANTS: A total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census.

    PRIMARY AND SECONDARY OUTCOME MEASURES: Elder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined.

    RESULTS: The prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse.

    CONCLUSION: Elder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.

  7. Chan YY, Sooryanarayana R, Mohamad Kasim N, Lim KK, Cheong SM, Kee CC, et al.
    Arch Gerontol Geriatr, 2018 11 26;81:74-83.
    PMID: 30521992 DOI: 10.1016/j.archger.2018.11.012
    Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged ≥60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged ≥60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (≥7 h/day), those with diabetes, anaemia, and functional limitations (p 
  8. Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):73S-79S.
    PMID: 31353928 DOI: 10.1177/1010539519862161
    Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
    Study name: National Health and Morbidity Survey (NHMS-2017)
  9. Ho BK, Omar MA, Sooryanarayana R, Ghazali SS, Zainal Abidin SBI, Krishnapillai A, et al.
    PLoS One, 2020;15(9):e0238780.
    PMID: 32911521 DOI: 10.1371/journal.pone.0238780
    BACKGROUND: Hypertension is one of the most important risk factors for cardiovascular diseases. Thus, it is an important public health challenge worldwide. In Malaysia, only a few studies have focused on the trends of hypertension specifically for the aging population. In view of the rapid growth of the elderly population in Malaysia, there is an urgent need to explore the condition of hypertension in this aging population. Hence, the objectives of this study were to determine the trends of population mean systolic and diastolic blood pressure (BP) levels, the prevalence, awareness, treatment and control of hypertension, and its' associated factors among older persons in two cross-sectional national surveys that were conducted in 2006 and 2015 in Malaysia.

    METHODS: This was a subanalysis of secondary data collected from the two cross-sectional national population-based surveys conducted in Malaysia in 2006 and 2015. Adults aged 60 and older who had participated in these two surveys were included in the study.

    RESULTS: A total of 4954 (2295 males and 2659 females) and 3790 (1771 males and 2019 females) respondents completed the hypertension module surveys in 2006 and 2015, respectively. The mean age of the respondents was 68.5±6.9 years in 2006 and 68.6±7.1 years in 2015 and the difference was not significant. The prevalence of hypertension significantly reduced from 73.8% in 2006 to 69.2% in 2015 (p<0.001). Among the respondents with hypertension, the awareness, treatment and control of hypertension significantly increased from 49.7% to 60.2%, 86.7% to 91.5% and 23.3% to 44.8%, respectively, from 2006 to 2015. Logistic regression analysis showed that female sex and unemployed/retiree were significantly associated with higher hypertension prevalence in both 2006 and 2015. Being unemployed/ retiree was significantly associated with higher awareness of hypertension in both 2006 and 2015. In both 2006 and 2015, Chinese ethnicity were significantly associated with higher awareness and control of hypertension.

    CONCLUSIONS: The mean population BP levels and hypertension prevalence among the elderly population in Malaysia have reduced significantly over the past decade. Although the awareness, treatment and control of hypertension among older adults have improved significantly, the awareness and control rates remain suboptimal. As population aging is inevitable, appropriate public health programs and optimal treatment strategies targeting this vulnerable group are urgently needed to improve the overall awareness and control of hypertension and to prevent hypertension-related complications.

  10. Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:16-20.
    PMID: 33370858 DOI: 10.1111/ggi.14031
    AIM: Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD.

    METHODS: A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.

    RESULTS: The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P 

  11. Sooryanarayana R, Wong NI, Ahmad NA, Razak MAA, Yusoff MFM, Chan YY, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:7-15.
    PMID: 33370855 DOI: 10.1111/ggi.14094
    AIM: This article describes the methodology of the 2018 Malaysian National Health and Morbidity Survey, and provides an overview of the sociodemographic details of the respondents and key findings on the health of older adults.

    METHODS: The survey included 3977 community-dwelling respondents, aged ≥60 years across Malaysia. Two-stage stratified random sampling with selection of enumeration blocks from both urban and rural areas ensured the findings were representative of the Malaysian older population.

    RESULTS: Complex sampling analyses ensured that findings on various geriatric syndromes, non-communicable diseases, nutritional status, functional status, social well-being and quality of life are representative of the Malaysian older population. Among the limitations are that the composition of older persons varied slightly from the general older population.

    CONCLUSIONS: This article presents the methodology of the survey, and a baseline of the major health issues for older persons in Malaysia to provide clear guidance to researchers, program managers and policymakers to fully utilize the data from the Malaysian National Health and Morbidity Survey toward achieving healthy aging. The findings might stimulate more research on the health problems faced by older people to provide inputs for policymaking and program implementation. Geriatr Gerontol Int 2020; 20: 7-15.

  12. Abdul Mutalip MH, Abdul Rahim FA, Mohamed Haris H, Yoep N, Mahmud AF, Salleh R, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:92-97.
    PMID: 33370851 DOI: 10.1111/ggi.13961
    AIM: Quality of life (QoL) among the older persons provides valuable insights into the potential modifiable risk factors that affect well-being in later life. This study aimed to describe the QoL and psychosocial factors of QoL of older persons in Malaysia.

    METHODS: We used the 19-item Control, Autonomy, Self-realization and Pleasure scale, a validated instrument that measures psychological well-being related to QoL in older persons. Scores range from 0 to 57, and higher scores indicate better QoL. We included several factors as covariates. Analysis of complex samples was carried out using Stata 15. Descriptive analysis was carried out to determine QoL by sociodemographic characteristics and other factors. Linear regression analysis was used to identify psychosocial factors that influence QoL.

    RESULTS: A total of 3444 individuals aged ≥60 years completed all 19-item Control, Autonomy, Self-realization and Pleasure items. The estimated mean QoL score was 47.01 (95% CI 46.30-47.72). Adjusted for confounders, QoL was lower among individuals with no formal education (-2.554, 95% CI -3.684, -1.424), probable depression (-1.042, 95% CI -1.212, -0.871) and food insecurity (-0.815, 95% CI -1.083, -0.548). QoL continued to improve with improved ADL score (0.302, 95% CI 0.052, 0.552), IADL score (0.646, 95% CI 0.382, 0.909) and better social support (0.308, 95% CI 0.187, 0.429).

    CONCLUSIONS: Lower education, depression, food insecurity, presence of limited functional status and poor social support negatively influenced QoL in older Malaysians. This study identified potentially modifiable factors that could be targeted for interventions to enhance QoL of older persons in Malaysia. Geriatr Gerontol Int 2020; 20: 92-97.

  13. Yunus RM, Hairi NN, Choo WY, Hairi FM, Sooryanarayana R, Ahmad SN, et al.
    J Elder Abuse Negl, 2017;29(1):59-71.
    PMID: 27841737 DOI: 10.1080/08946566.2016.1260083
    Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.
  14. Awaluddin SM, Ahmad FH, Jeevananthan C, Ganapathy SS, Sooryanarayana R, Mohamad Anuar MF, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):65S-72S.
    PMID: 31522523 DOI: 10.1177/1010539519872662
    Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents' health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.
  15. Saminathan TA, Ganapathy SS, Sooryanarayana R, Hasim MHB, Mohd Anuar MF, Ahmad FH, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):88S-96S.
    PMID: 31680535 DOI: 10.1177/1010539519883139
    We assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures.
  16. Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, et al.
    BMJ Open, 2021 10 20;11(10):e052126.
    PMID: 34670764 DOI: 10.1136/bmjopen-2021-052126
    OBJECTIVES: To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia.

    DESIGN: A population-based cross-sectional study.

    SETTING: 13 states and 3 Federal Territories in Malaysia.

    PARTICIPANTS: A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set.

    PRIMARY OUTCOME MEASURES: Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer.

    RESULTS: The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009).

    CONCLUSION: This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.

  17. Krishnapillai A, Kee CC, Ariaratnam S, Jaffar A, Omar MA, Sanaudi RB, et al.
    Healthcare (Basel), 2023 Aug 10;11(16).
    PMID: 37628448 DOI: 10.3390/healthcare11162249
    BACKGROUND: Globally, the average age of the world's population of older people continues to rise and having a good social support network becomes increasingly relevant with the aging populace. Overall, in Malaysia, social support prevalence was low among older persons. This study was conducted to determine the association between social support and smoking status among the older Malaysian population.

    METHODS: Data were obtained from the National Health and Morbidity (NHMS) 2018 survey on the health of older Malaysian adults and analyzed. This cross-sectional population-based study used a two-stage stratified random sampling design. Sociodemographic characteristics, smoking status, and social support data were collected from respondents aged 60 years and more. A validated Malay language interviewer-administered questionnaire of 11-items, the Duke Social Support Index, was utilized to assess the social support status. A multivariable logistic regression analysis was used to assess the association of social support and smoking status among the respondents.

    RESULTS: The prevalence of good social support was significantly higher among the 60-69 years old (73.1%) compared to the ≥80 years old respondents (50%). Multivariate logistic regression analysis showed that respondents aged ≥80 years old were 1.7 times more likely to have poor social support compared to those aged 60-69 years. Respondents with no formal education were 1.93 times more likely to have poor social support compared to respondents who had tertiary education. Respondents with an income of MYR 3000. Former smokers had good social support compared to current smokers (73.6% vs. 78.7%). For current smokers, they had poor social support, which is almost 1.42 times higher than that for non-smokers.

    CONCLUSION: There was poor social support among older people who were current smokers, had an increased age, had no formal education and had a low income. The findings obtained from this study could assist policymakers to develop relevant strategies at the national level to enhance the social support status among older smokers and aid in their smoking cessation efforts.

  18. Mustaffa M, Hairi NN, Majid HA, Choo WY, Hairi FM, Peramalah D, et al.
    PMID: 38482611 DOI: 10.1177/10105395241238092
    Frailty and malnutrition commonly co-occur but remains undetected and untreated in community settings. This study aimed to determine the prevalence of co-occurring frailty and malnutrition, and its associated factors among community-dwelling older adults in a rural setting in Malaysia. A cross-sectional study was conducted among adults aged ≥ 60 residing in Kuala Pilah district, Negeri Sembilan, Malaysia. Physical frailty and nutritional status were assessed using the Fried phenotype and the Mini Nutritional Assessment (MNA), respectively. Among 1855 participants, 6.4% had co-occurring frailty and at-risk/malnutrition and 11.3% had co-occurring prefrailty and at-risk/malnutrition. Older age, fair-to-poor self-rated health, long-term disease, polypharmacy, activities of daily living (ADLs) and instrumental ADLs' disabilities, cognitive impairment, and poor social support were associated with higher odds of co-occurring frailty and malnutrition. Therefore, beside early identification, targeted intervention is crucial to prevent or delay the progression of frailty and malnutrition in this population.
  19. Sazlina SG, Sooryanarayana R, Ho BK, Omar MA, Krishnapillai AD, Mohd Tohit N, et al.
    PLoS One, 2020;15(10):e0240826.
    PMID: 33085718 DOI: 10.1371/journal.pone.0240826
    Study on cardiovascular disease (CVD) risk factors and their prevalence among the older people in Malaysia is limited. We aimed to determine the prevalence and factors associated with CVD risk factors using the non-laboratory Framingham Generalized 10-Year CVD risk score among older people in Malaysia. This was a population-based cross-sectional study using data of 3,375 participants aged ≥60 years from the National Health and Morbidity Survey 2015. Sociodemographic, health factors and clinical assessments (anthropometry and blood pressure) were included. Complex survey analysis was used to obtain prevalence with 95% confidence intervals (CI). We applied ordinal regression to determine the factors associated with CVD risk. The prevalence for the high 10-year CVD risk was 72.1%. Body mass index was higher among those aged 60-69 years in men (25.4kg/m2, 95%CI 25.1-25.8) and women (26.7kg/m2, 95%CI 26.3-27.1) than the other age groups. The factors associated with moderate and high 10-year CVD risk were Malay ethnicity (Odds Ratio(OR) 0.76, 95%CI 0.63-0.92, p = 0.004), unmarried status (OR 1.55, 95%CI 1.22-1.97, p<0.001) and physically inactive (OR 0.72, 95%CI 0.55-0.95, p = 0.020). There is a need for future study to evaluate preventive strategies to improve the health of older people in order to promote healthy ageing.
  20. Tan L, Ganapathy SS, Sooryanarayana R, Hasim MH, Saminathan TA, Mohamad Anuar MF, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):18S-29S.
    PMID: 31470742 DOI: 10.1177/1010539519870665
    This study aimed to assess the prevalence and factors associated with bullying victimization from a nationwide school-based survey among 27 458 students aged 13 to 17 years. The overall prevalence of having been bullied in the past 30 days was 16.2%; this decreased with age. Multivariate logistic regression analysis revealed that factors most strongly associated with bullying victimization were exposure to physical attacks (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 2.17-2.79), illicit drug use (aOR = 2.44, 95% CI = 1.78-3.34), involvement in physical fights (aOR = 1.97, 95% CI = 1.74-2.23), being younger than 14 years (aOR =1.95, 95% CI = 1.59-2.38), and having ever attempted suicide (aOR = 1.83, 95% CI = 1.51-2.21). Other significantly associated factors include loneliness, truancy, making suicidal plans, and symptoms of depression, anxiety, and stress. Exposure to bullying victimization can result in negative lifelong sequelae and important associated factors should be considered in planning effective school-based anti-bullying interventions.
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