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Do depression and educational attainment mediate the association between ethnicity and dementia?

Momtaz YA, Hamid TA, Yusoff S, Ibrahim R

Gerontology, 2013;59(3):206-12.
PMID: 23147388 DOI: 10.1159/000342254

Research shows marked differences in the prevalence of dementia among different ethnic groups. However, there is a relative dearth of studies focusing on how ethnicity may influence dementia. The main aim of the current study is to test potential mediating effects of depression and level of education on the association between ethnicity and dementia.
Loneliness as a risk factor for hypertension in later life

Momtaz YA, Hamid TA, Yusoff S, Ibrahim R, Chai ST, Yahaya N, et al.

J Aging Health, 2012 Jun;24(4):696-710.
PMID: 22422758 DOI: 10.1177/0898264311431305

The present study aims to determine the impact of loneliness on hypertension in later life.
Fulltext The growth trend of never-married elderly population in Iran in the third millennium

Hamedanchi A, Momtaz YA, Khankeh HR, Zanjari N

J Family Med Prim Care, 2020 Jun;9(6):2837-2842.
PMID: 32984135 DOI: 10.4103/jfmpc.jfmpc_264_20

BACKGROUND: Statistics show that the age of the Iranian population is advancing, and the marriage age is increasing as well. Clearly, an increase in the number of never-married older adults is expected. The aim of this descriptive, analytical study was to determine the growth trend of never-married older population and its association with education level in Iran.
METHODS: Based on the raw data collected from the Statistical Center of Iran, we studied the population of never-married older adults in the past 25 years and evaluated the growth pattern in different parts of Iran, using ArcGIS software. We also examined the association of singlehood in late life with education in men and women residing in rural and urban areas, using the Chi-square test in SPSS version 22.
RESULTS: A sharp increase was observed in the population of never-married older adults, particularly women, in the past 10 years. Women with formal education from urban and rural areas were more likely to be never married in late life (χ2 = 10455.35, P < 0.001 and χ2 = 271.31, P < 0.001, respectively). Older men with formal education from urban areas were more likely to be never married (χ2 = 35.44, P < 0.001), while men with formal education from rural areas were less likely to be never married (χ2 = 179.13, P < 0.001).
CONCLUSION: The rate of increase in the population of never-married older women was much higher than the overall growth of older population. Women with formal education, particularly those with university and pre-university degrees, were more likely to be single in late life. It is strongly suggested to determine the causes and process of singlehood in old age in future research, including qualitative studies.
Fulltext Prevalence and associated factors of potentially inappropriate medications among Iranian older adults

Saboor M, Kamrani AA, Momtaz YA, Sahaf R

Med Glas (Zenica), 2019 Feb 01;16(1):121-127.
PMID: 30680986 DOI: 10.17392/989-19

Aim Potentially inappropriate medications (PIMs) in older people are associated with the increased use of health care services. The aim of this study was to investigate the prevalence of PIMs among the elderly being referred to pharmacies in Tehran using the Beers criteria of 2012, and identify factors related to PIMs. Methods This cross-sectional study was conducted on elderly patients (60 years and above) referred to pharmacies in Tehran, in 2017. The Beers' criteria 2012 were used to evaluate PIMs. The logistic regression analysis was used to find sociodemographic predictors of PIMs. Results The mean age of 1591 patients was 70.51 years. The overall prevalence of PIMs was 26.0%. The most frequent PIMs, in order of frequency, included diclofenac (13.5%), alprazolam (9.3%), and chlordiazepoxide (9.1%) and clonazepam (8.4%). The pain medications were found to be most common PIMs (37.6%). Polypharmacy (OR=3.64, CI 95%: .81-4.70; p<0.001), number of chronic disease (OR=2.371, CI 95%:1.71-3.28; p<0.001) insomnia (OR=1.45, CI 95%: 1.13-1.87; p<0.01) and type of specialists were found as PIMs risk factors. Internal medicine specialists prescribed PIMs significantly fewer times than other specialists(OR=0.59, CI 95%: 0.40-0.88; p<0.01, and the orthopedic specialists prescribed PIMs significantly more times than other physicians (OR=3.23, CI 95%: 5.76-1.81; p<0.001). Conclusion High prevalence of PIMs among Iranian elderly patients implies a need for the development and operationalization of scientific guidelines for the use of medicines. It is also necessary to hold training courses for physicians to be educated in such cases.
Fulltext Prescription pattern among Iranian community dwelling older adults

Saboor M, Momtaz YA, Kamrani AA, Sahaf R

Med Glas (Zenica), 2019 Feb 01;16(1):115-120.
PMID: 30680985 DOI: 10.17392/986-19

Aim To assess prescription pattern among Iranian communitydwelling older adults. Methods This cross-sectional study employed a cluster random sampling to obtain a sample of 1591 patients aged 60 years and over referred to pharmacies in Tehran, 2017. Data were collected using a questionnaire: socio-demographic characteristics, type of pharmacy visited, the municipal district, the university covering the pharmacy, the number and names of prescribed drugs, drug category, type of insurances and physician's socio-demographic profile (age, gender, type of specialization, and work experience). Results The mean age of the patients was 70.51±7.84. A total of 5838 drugs were prescribed, giving an average of 3.73±2.24 drugs per patient (ranging of 1-15). Polypharmacy was noticed in 32.4% patients. Cardiovascular drugs accounted for 20.8% of the prescriptions, antidiabetics 8.8%, nutritional agents and vitamins 7.6%, and analgesics, anti-inflammatory drugs and antipyretics accounted for 7.5%. Conclusion Developing educational programs on geriatric pharmacology general practitioners and more supervision among community-dwelling older adults might have effects on prescription pattern. There is a need for prescriber training and retraining with emphasis on the geriatric population.
Mediating effects of social and personal religiosity on the psychological well being of widowed elderly people

Momtaz YA, Ibrahim R, Hamid TA, Yahaya N

Omega (Westport), 2010;61(2):145-62.
PMID: 20712141

Spousal death is one the most stressful life events that seriously affects the psychological well being of widowed. This study examined the mediating effects of social and personal religiosity on the psychological well being of widowed elderly people. The sample for this study was comprised of 1367 widowed and married elderly Muslims from Malaysia. Psychological well being, religiosity, and physical health were measured using WHO-5 Well being Index, Intrinsic Extrinsic religiosity scale, and a checklist of 16 physical health problems, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (version-13). As expected, bivariate correlation analysis revealed that widowhood is statistically and negatively associated with psychological well being. Results of multiple hierarchical regression analyses and Sobel test showed that only the indirect effect of widowhood through personal religiosity was statistically significant (Sobel = -2.79, p < .01). Sobel test for social religiosity was not significant (Sobel = -1.54, p > .05). The results of this study confirmed earlier studies, which found that widowhood negatively affects psychological well being of elderly people. Overall, the findings show that the potential solace provided by religiosity can decrease the negative effects of widowhood on the psychological well being of widowed elderly people.
The effect of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia

Mohammadi F, Momtaz YA, Motalebi SA, Boosepasi S

Rev Recent Clin Trials, 2017;12(3):182-186.
PMID: 28530532 DOI: 10.2174/1574887112666170522142315

BACKGROUND: There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia.

METHODS: The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data.

RESULTS: The mean age of 60 elderly patients participated in the study was 65.25 ± 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group.

CONCLUSION: The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.
Fulltext Urinary incontinence and sleep complaints in community dwelling older adults

Nazaripanah NS, Momtaz YA, Mokhtari F, Sahaf R

Sleep Sci, 2018 8 8;11(2):106-111.
PMID: 30083298 DOI: 10.5935/1984-0063.20180020

Sleep disorder is associated with poor quality of life in old age. Therefore, it is imperative to identify contributing factors leading to sleep disorder. The current study aimed to examine the impact of urinary incontinence on sleep complaint after controlling for potential sociodemographic and health covariates. Materials and Methods: A cross-sectional study was conducted on a sample of 184 community dwelling older adults 60 years and older in Yazd, Iran, 2016. In order to obtain the sample a multistage proportional random sampling technique was employed. Sociodemographic characteristics, sleep complaint, and urinary incontinence were collected from medical records. Statistical analyses were performed using SPSS version 24. A multiple logistic regression analysis was used to examine the impact of urinary incontinence on sleep complaint after controlling for potential covariates. Findings: A total of 184 respondents with a mean age of 68.48±6.65 years (age range, 60-87 years) were included in the study. About 70% of the respondents were women, 72.8% were married, 68.5% were not formally educated, and 21.7% were living alone. The prevalence of sleep complaint and urinary incontinence were 27.2% (95% CI: 21-34) and 22.3% (95% CI: 17-29), respectively. The results of the multiple logistic regression analysis revealed respondents with urinary incontinence were four times more likely to suffer from sleep complaint than those without urinary incontinence after adjusting for potential covariates (AOR=4.04, 95% CI: 1.74-9.35, p<0.001). Conclusion: Based on the results of this present study, which showed that urinary incontinence independently contributed to sleep complaint among older adults, it is necessary to employ effective interventions for controlling urinary incontinence to reduce sleep complaints.
Unmet needs among disabled elderly Malaysians

Momtaz YA, Hamid TA, Ibrahim R

Soc Sci Med, 2012 Sep;75(5):859-63.
PMID: 22632847 DOI: 10.1016/j.socscimed.2012.03.047

Unmet need as a significant factor affecting quality of life in later life has recently received considerable attention in gerontological research. The main aim of this study was to identify the prevalence, predicting factors, and negative consequence of unmet need among older Malaysians. The findings may be useful to reduce unmet need and the burden of its adverse consequence. The sample for this study consists of 400 functionally disabled elderly people aged 60 and over was obtained from a large national survey. Unmet need was operationally defined based on Manton's (1989) criteria. The findings from the present study showed about 18.0% of functionally disabled older Malaysians suffer from unmet need. Logistic regression revealed that gender (being male) and chronic health conditions are statistically associated with increased odds of unmet need after adjusting for other possible risk factors. Further results indicated that unmet need statistically increases odds of fall as a negative consequence of unmet need. The high prevalence rates of unmet need among disabled elderly men and chronically ill older persons suggest that policy makers should pay more attention to this vulnerable group to achieve good quality of life. The implications and limitations of the present study are discussed.
Fulltext Emergency contraception: knowledge, attitudes and practices among married Malay women staff at a public university in Malaysia

Najafi F, Abdul Rahman H, Hanafiah M, Momtaz YA, Ahmad Z

Southeast Asian J. Trop. Med. Public Health, 2012 Nov;43(6):1512-20.
PMID: 23413716

There is a high rate of unintended pregnancies in Malaysia due to low contraceptive use. Only 30% of married women use modern contraceptive methods. Emergency contraception (EC) is used within a few days of unprotected sex to prevent pregnancy. The purpose of this study was to investigate the knowledge, attitudes, and practices regarding EC pill use among Malay women. A cross sectional study was conducted among married female staff using stratified random sampling from 15 faculties in the Universiti Putra Malaysia (UPM). Data about sociodemographic factors, reproductive health, knowledge, attitudes and practices regarding EC use were gathered using validated self-administered questionnaire. The response rate was 87%. Half the 294 subjects who participated had a low knowledge, 33.0% a moderate knowledge and 17.0% a good knowledge about the EC pill. Eighty-eight percent of respondents had a positive attitude and 12.0% a negative attitude toward EC. Eleven percent of respondents had previously used EC. Unplanned and unwanted pregnancies were reported by 35.0% and 14.0% of respondents, respectively. Most respondents lacked knowledge about the indications for using EC, its mechanism of action, when it can be used and its side effects. Our findings show a need to educate women about EC.
Study site: 15 faculties in Universiti Putra Malaysia, Serdang. Selangor, Malaysia
Fulltext The Barriers, Challenges, and Strategies of COVID-19 (SARS-CoV-2) Vaccine Acceptance: A Concurrent Mixed-Method Study in Tehran City, Iran

Khankeh HR, Farrokhi M, Khanjani MS, Momtaz YA, Forouzan AS, Norouzi M, et al.

Vaccines (Basel), 2021 Oct 28;9(11).
PMID: 34835179 DOI: 10.3390/vaccines9111248

Acceptance and willingness to receive the vaccine are among the main factors in the success or failure of a health system in implementing the vaccination program. The present study was conducted in Tehran, the political and economic capital of Iran, to determine the acceptance of the COVID-19 vaccine and identify its associated factors, and explain the most important barriers and acceptance strategies for vaccination. This research was a concurrent quantitative and qualitative mixed-method study. In the quantitative part, 1200 individuals aged more than 18 years were selected from the households in 22 districts of Tehran City, with a multistage stratified cluster sampling method. Two questionnaires were used to evaluate the acceptance of the COVID-19 vaccine and vaccine acceptance determinants. The qualitative content analysis method addressed the influencing factors, as well as challenges and strategies related to the acceptance of the COVID-19 vaccine in four groups of Tehran inhabitants: the elderly, people with underlying diseases, healthcare workers, and the general population. The related data were simultaneously collected by applying in-depth semi-structural interviews and a data analysis process. Furthermore, we used the Graneheim and Lundman method for data analysis. We analyzed the data of 1200 people with a mean (SD) age of 46.4 (11.1) years, and approximately 58% of them were men. The vaccine acceptance was 83.6% (95% CI: 81.3-85.9). Among those who welcomed vaccination, 58% preferred the imported vaccines, 25% the Iranian ones, and 17% both. There was a significant association between the variables of age (adjusted odds ratio [AOR] = 1.72, 95% CI: 1.01-2.93), being single (AOR = 0.54, 95% CI: 0.41-0.91), moderate pharmacotherapy adherence (AOR = 0.58, 95% CI: 0.4-0.85), and the willingness to receive COVID-19 vaccine. Qualitative study after interviewing 45 people from four study groups showed an insufficient social trust in healthcare system officials, pharmaceutical and vaccine production companies; distrust in the effectiveness of the vaccines, concerns about the vaccine adverse effects, being tracked by microchips after vaccination, traditional anti-vaccination movements, the feeling the inessentiality of vaccination, and uncertainty about the fair distribution of the vaccine. These concerns were the main challenges addressed by the study groups. A good proportion of Tehran residents reported their willingness to receive the COVID-19 vaccine. Additionally, they expressed their critical concerns, such as insufficient trust in the healthcare system, vaccine safeties, and adverse effects that were the significant barriers to vaccine acceptance. It seems that conflicts raised by the shortage of vaccines and their import due to the sanctions have led to intense desire and demand in the general population, and especially the elderly, for vaccination. Besides, vaccination phobia in some individuals requires further investigations.

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