METHODS: Seven hundred seventy individuals aged 55 years (lower age limit) and above were interviewed as to whether they experienced pruritus during the preceding week and the locations involved if present. The association between generalised pruritus, sleep quality, and major systemic risk factors were explored.
RESULTS: 5.97% of respondents reported generalised pruritus. Generalised pruritus was associated with poorer sleep quality, with Pittsburgh Sleep Quality Index score above 6. Mean haemoglobin level was lower in subjects with generalised pruritus (13.14 g/dL) but there was no significant difference in the frequency of generalised pruritus and severe generalized pruritus between subjects with clinically defined anaemia. Also, there were no significant associations between other major systemic risk factors and generalised pruritus in this population-based study. There was no association between generalised pruritus with depression, anxiety or stress.
CONCLUSION: The negative effect of pruritus on sleep quality suggests a possible deleterious effect of pruritus on health and quality of life. Further prospective research on the longer-term effects of pruritus on health status is now warranted. (222 words).
DESIGN: Cross-sectional analysis was carried out using the first wave data from MELoR which is a longitudinal study.
SETTING: Urban community dwellers in a middle-income South East Asian country.
PARTICIPANTS: 1565 participants aged ≥55 years were selected by simple random sampling from the electoral rolls of three parliamentary constituencies.
OUTCOME MEASURES: Consenting participants from the MELoR study were asked the question 'Have you fallen down in the past 12 months?' during their computer-assisted home-based interviews. Logistic regression analyses were conducted to compare the prevalence of falls among various ethnic groups.
RESULTS: The overall estimated prevalence of falls for individuals aged 55 years and over adjusted to the population of Kuala Lumpur was 18.9%. The estimated prevalence of falls for the three ethnic populations of Malays, Chinese and Indian aged 55 years and over was 16.2%, 19.4% and 23.8%, respectively. Following adjustment for ethnic discrepancies in age, gender, marital status and education attainment, the Indian ethnicity remained an independent predictor of falls in our population (relative risk=1.45, 95% CI 1.08 to 1.85).
CONCLUSION: The prevalence of falls in this study is comparable to other previous Asian studies, but appears lower than Western studies. The predisposition of the Indian ethnic group to falls has not been previously reported. Further studies may be needed to elucidate the causes for the ethnic differences in fall prevalence.
METHODS: The choice of enteral tube access was determined by managing clinicians and patients/caregivers. Comparisons of tube feeding methods were made during a 4-month period, adjusting statistically for inherent confounders.
RESULTS: A total of 102 participants (NG: n = 52, gastrostomy: n = 50) were recruited over 2 years from 2013 to 2015. Subjects on long-term NG tube feeding were older (82.67 ± 7.15 years vs 76.88 ± 7.37 years; P < .001) but both groups had similar clinical indications (stroke: 63.5% NG vs 54% gastrostomy; P = .33). After adjustment for confounders, gastrostomy feeding was associated with fewer tube-related complications (adjusted odds ratio [aOR] = 0.19; 95% confidence interval [CI] = 0.06-0.60) and better complication-free survival rate (aOR = 0.32; 95% CI = 0.12-0.89) at 4-month follow-up. Anthropometric and biochemical nutrition parameters improved significantly in both groups at 4 months, but no significant differences were observed at the end of the study.
CONCLUSION: Gastrostomy feeding is associated with a greater 4-month complication-free survival and lower tube-related complications compared with long-term NG feeding in older Asians with dysphagia. However, no differences in nutrition outcomes were observed between NG and gastrostomy feeding at 4 months.
METHODS: Data from the Malaysian elders longitudinal research (MELoR) study were utilised. Baseline data were obtained from home-based computer-assisted interviews and hospital-based health-checks from 2013 to 2015. Protocol of MELoR study has been described in previous study (Lim in PLoS One 12(3):e0173466, 2017). Follow-up interviews were conducted in 2019 during which data on the adverse outcomes of falls, sarcopenia, hospitalization, and memory worsening were obtained. Sarcopenia at follow-up was determined using the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire.
RESULTS: Follow-up data was available for 776 participants, mean (SD) age 68.1 (7.1) years and 57.1% women. At baseline, 37.1% were robust, 12.8% had isolated cognitive impairment, 24.1% were prefrail, 1.0% were frail, 20.2% were prefrail with cognitive impairment, and 4.8% had CF. Differences in age, ethnicity, quality of life, psychological status, function and comorbidities were observed across groups. The association between CF with hospitalisation and falls compared to robust individuals was attenuated by ethnic differences. Pre-frail individuals were at increased risk of memory worsening compared robust individuals [aOR(95%CI) = 1.69 (1.09-2.60)]. Frail [7.70 (1.55-38.20)], prefrail with cognitive impairment [3.35 (1.76-6.39)] and CF [6.15 (2.35-16.11)] were significantly more likely to be sarcopenic at 5-year follow-up compared to the robust group.
CONCLUSIONS: Cognitive frailty was an independently predictor of sarcopenia at 5-year follow-up. The relationship between CF with falls and hospitalization, however, appeared to be accounted for by ethnic disparities. Future studies should seek to unravel the potential genetic and lifestyle variations between ethnic groups to identify potential interventions to reduce the adverse outcomes associated with CF.
METHODS: The MELoR study recruited community-dwelling adults aged 55 years and over, selected through stratified random sampling from three parliamentary constituencies. The baseline data collected during the first wave was obtained through face-to-face interviews in participants' homes using computer-assisted questionnaires. During their baseline assessments, participants were asked whether they had ever experienced a blackout in their lifetime and if they had experienced a blackout in the preceding 12 months.
RESULTS: Information on blackouts and ethnicity were available for 1530 participants. The weight-adjusted lifetime cumulative incidence of syncope for the overall population aged 55 years and above was 27.7%. The estimated lifetime cumulative incidence according to ethnic groups was 34.6% for Malays, 27.8% for Indians and 23.7% for Chinese. The estimated 12-month incidence of syncope was 6.1% overall, equating to 11.7% for Malays, 8.7 % for Indians and 2.3% for Chinese. Both Malay [odds ratio (OR) 1.46; 95% confidence interval (CI) 1.10-1.95 and OR 3.62, 95% CI 1.96-6.68] and Indian (OR 1.34; 95% CI 1.01-1.80 and OR 3.31, 1.78-6.15) ethnicities were independently associated with lifetime and 12-month cumulative incidence of syncope, respectively, together with falls, dizziness and myocardial infarction.
CONCLUSION: Ethnic differences exist for lifetime cumulative incidence of syncope in community-dwelling individuals aged 55 years and over in an urban area in Southeast Asia. Future studies should now seek to determine potential genetic, cultural and lifestyle differences which may predispose to syncope.
METHODS: A cross-sectional survey was conducted among caregivers and patients attending geriatric outpatient services in Kuala Lumpur, Malaysia. The survey measured the availability of equipment for virtual consultations, prior knowledge and experience of telemedicine, and willingness to consult geriatricians through virtual technology, using the Unified Theory of Acceptance and Use of Technology (UTAUT) scale.
RESULTS: A total of 197 caregivers and 42 older patients with a mean age of 54.28 (±13.22) and 75.62 (±7.32) years, respectively, completed the survey. One hundred and fifty-six (79.2%) of the caregivers were adult children accompanying patients. The mean UTAUT score was 65.97 (±13.71) out of 90, with 66.64 (±13.25) for caregivers and 62.79 (±15.44) for older adults, suggesting a high acceptance of adopting virtual consultations in lieu of face-to-face care. The independent predictors of acceptance of virtual consultation were : possession of an electronic device capable of video-communication, living with someone, living in a care home, weekly online banking usage, and perceived familiarity with virtual platforms.
CONCLUSION: Caregivers and patients indicated a high level of acceptance of virtual medical consultations, which is likely facilitated by caregivers such as adult children or spouses at home or staff in care homes. To minimize the transmission of COVID-19 in a highly vulnerable group, virtual consultations are an acceptable alternative to face-to-face consultations for older people and their caregivers in our setting.
METHODS: Individuals aged ≥ 55 years were recruited through the Malaysian Elders Longitudinal Research (MELoR) study and continuous non-invasive BP was monitored over 5 min of supine rest and 3 min of standing. Physical performance was measured using the timed-up-and-go test, functional reach, handgrip and Lawton's functional ability scale. Cognition was measured with the Montreal Cognitive Assessment. Participants were categorized according to BP responses into four categories according to changes in SBP/DBP reductions from supine to standing:
PURPOSE: With the rising number of older people in Malaysia, it is envisaged that the number of fragility hip fractures would also increase. The objective of this study was to determine patient characteristics and long-term outcomes of hip fracture in older individuals at a teaching hospital in Malaysia.
METHODS: This was a prospective observational study which included consecutive patients aged ≥ 65 years old admitted to the orthopedic ward with acute hip fractures between March 2016 and August 2018. Patient socio-demographic details, comorbidities, pre-fracture mobility status, fracture type, operation and anesthesia procedure, and length of stay were recorded. Post-fracture mobility status was identified at 6 months. Cox proportional hazard analysis was used to assess the risk of death in all patients.
RESULTS: 310 patients (70% women) with the mean age of 79.89 years (SD 7.24) were recruited during the study period. Of these, 284 patients (91.6%) underwent surgical intervention with a median time to surgery of 5 days (IQR 3-8) days. 60.4% of patients who underwent hip fracture surgery did not recover to their pre-fracture mobility status. One year mortality rate was 20.1% post hip fracture surgery. The independent predictor of mortality included advanced age (hazard ratio, HR = 1.05, 95% CI = 1.01-1.08; p = 0.01), dependency on activities of daily living (HR = 2.08, 95% CI = 1.26-3.45; p = 0.01), and longer length of hospitalization (HR = 1.02, 95% CI = 1.01-1.04; p