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  1. Fulltext Association between nutrient adequacy and psychosocial factors with overall rate of weight loss after bariatric surgery
    Vanoh D, Shahar S, Mahmood NR
    Asia Pac J Clin Nutr, 2015;24(4):610-9.
    PMID: 26693745 DOI: 10.6133/apjcn.2015.24.4.11
    This was a cross-sectional study that investigated the relationship between nutrient intake and psychosocial factors with the overall rate of weight loss after bariatric surgery among patients who had undergone sleeve gastrectomy in University Kebangsaan Malaysia Medical Centre (UKMMC). Forty-three subjects (15 men and 28 women) were recruited for this study. Subjects completed assessment questionnaires including the Binge Eating Scale (BES), Beck Depression Inventory (BECK), Family Support Questionnaires, and the Index of Peer Relation (IPR). Results showed that the median overall rate of weight loss was 4.3±5.5 kg/month, which was lower when compared to the rate of weight loss at three months which was 5.0±5.6 kg/month. Pre-operative weight was the predictor of overall rate of weight loss (p<0.05, R²=0.52). Binge eating disorder (BED) and depression were also closely associated with each other after bariatric surgery (p<0.001, R²=0.46). Subjects with good compliance to dietary advice had lower scores on the binge eating scale. The mean caloric and protein intake was very low, only 562±310 kcal/day and 29.6±16.1 g/day. The intake of vitamin A, B-1, B-2, B-3, B-12, C, folate, and iron met the Malaysian Recommended Nutrient Intake (RNI). However, the RNI for calcium, zinc, selenium, vitamin D, and vitamin E was not met. In conclusion, although bariatric surgery had many health benefits, several factors hindered weight loss after bariatric surgery. Health care professionals should closely monitor patients after bariatric surgery.
  2. Fulltext Parathyroid Carcinoma: Analysis of Patient Characteristics and Outcomes in a Retrospective Review of Eight Cases seen in a Single Center
    Shahar S, Lim KP, Mohamad M
    J ASEAN Fed Endocr Soc, 2019;34(2):229-232.
    PMID: 33442162 DOI: 10.15605/jafes.034.02.17
    Eight cases of parathyroid carcinoma were identified (8 females; median age 45 years, range 28-72). Half of whom were diagnosed preoperatively. Hypercalcemic symptoms were seen in 87.5% of the patients and the main complication was nephrolithiasis. At presentation, the median calcium was 3.675 mmol/L, median phosphate of 0.68 mmol/L, median intact parathyroid hormone (iPTH) was 211 pmol/L. Five patients had regional nodes metastasis and 1 had distant metastasis to the lungs. Parathyroid gland invasion to adjacent structures was seen in 62.5% of cases while another 62.5% showed capsular or vascular infiltration on histology with median tumour size of 3.2 cm. Recurrent hypercalcemia occurred in 50% of the patients with median time of recurrence of 21 months. In this case series, we found that patients with severe hypercalcemia and high iPTH also exhibited a high index suspicion of PC.
  3. Fulltext Dietary Polyphenol Intake Associated with Adiposity Indices among Adults from Low to Medium Socioeconomic Status in a Suburban Area of Kuala Lumpur: A Preliminary Findings
    Rosli H, Kee Y, Shahar S
    Malays J Med Sci, 2019 Nov;26(6):67-76.
    PMID: 31908588 MyJurnal DOI: 10.21315/mjms2019.26.6.7
    Background: Researches on polyphenols have been the interest of few parties due to its possible roles in the prevention of obesity. However, studies regarding this topic are still limited. Therefore, this study was conducted to examine the relationship between the intake of polyphenols with adiposity indices among middle-aged adults.

    Methods: This cross-sectional study involved 227 adults aged 40 to 59 years at low-cost housing flats in suburban area of Cheras, Kuala Lumpur. Data collection involved food frequency questionnaire (FFQ) for polyphenols and international physical activity questionnaire (IPAQ). Subjects were measured for anthropometric parameters including height, weight, waist and neck circumferences (NC), and body fat percentage. The polyphenol intake from the diet was estimated using local polyphenol database built according to PHENOL-EXPLORER.

    Results: The average intake of polyphenol of subjects was 1815 (672) mg/day. The main food sources of polyphenol were coffee with milk, followed by chocolate milk and red beans. A higher polyphenol intake according to quartile was significantly associated with a lower neck circumference (χ2 = 8.30, P = 0.040), waist circumference (χ2 = 8.45, P = 0.038) and body fat percentage (χ2 = 8.06, P = 0.045). Binomial logistic regression analysis showed that the association remained significant for the neck circumference (P = 0.032), after controlling for age, household income, energy intake and physical activity level. More subjects with normal NC had higher intake of polyphenols (50th percentile and above). In contrast, subjects with high NC showed lower percentiles of polyphenols intake (50th percentile and below).

    Conclusion: The result showed that polyphenol intake was associated with neck circumference and thus it can be suggested that polyphenol intake is associated with obesity.

  4. Nutritional Management in Enterocutaneous Fistula. What is the evidence?
    Badrasawi M, Shahar S, Sagap I
    Malays J Med Sci, 2015 12 31;22(4):6-16.
    PMID: 26715903 MyJurnal
    The management of Enterocutaneous fistula (ECF) is challenging. It remains associated with morbidity and mortality, despite advancements in medical and surgical therapies. Early nutritional support using parenteral, enteral or fystuloclysis routs is essential to reverse catabolism and replace nutrients, fluid and electrolyte losses. This study aims to review the current literature on the management of ECF. Fistulae classifications have an impact on the calories and protein requirements. Early nutritional support with parenteral, enteral nutrition or fistuloclysis played a significant role in the management outcome. Published literature on the nutritional management of ECF is mostly retrospective and lacks experimental design. Prospective studies do not investigate nutritional assessment or management experimentally. Individualising the nutritional management protocol was recommended due to the absence of management guidelines for ECF patients.
  5. Apparent bioavailability of isoflavones in urinary excretions of postmenopausal Malay women consuming tempeh compared with milk
    Haron H, Ismail A, Shahar S, Azlan A, Peng LS
    Int J Food Sci Nutr, 2011 Sep;62(6):642-50.
    PMID: 21574819 DOI: 10.3109/09637486.2011.570742
    Quantitation of isoflavones in humans is important to establish the benefits of these compounds to the populations. Urinary isoflavones are frequently used as a biomarker of isoflavone bioavailability from food or supplement since urine contains 100-fold higher concentrations of isoflavones. The objective of the present study was to determine and compare the urinary excretions of daidzein (DA), genistein (GE) and equol (EQ) in postmenopausal Malay women following the consumption of tempeh and milk in a calcium absorption study and to test the hypothesis that the excretion of isoflavones following consumption of tempeh maybe higher compared with milk. The amounts of DA (47.06 ± 4.18 μmol/h), GE (33.27 ± 3.71 μmol/h) and EQ (24.35 ± 4.34 μmol/h) excreted in urine following tempeh consumption were significantly higher (P < 0.05) compared with those in milk (3.51 ± 0.62 μmol/h DA, 2.79 ± 0.35 μmol/h GE and 0 μmol/h EQ). Almost all studied postmenopausal Malay women were able to excrete EQ following consumption of 240 g tempeh but only one subject can be classified as an equol producer. We concluded that most postmenopausal Malay women excreted DA, GE and EQ in their urine following tempeh consumption and the amount of the excreted isoflavones were higher compared with those in milk. However, further studies are needed to determine whether longer periods of time are required to capture EQ producers.
  6. Fulltext Effect of Talbinah food consumption on depressive symptoms among elderly individuals in long term care facilities, randomized clinical trial
    Badrasawi MM, Shahar S, Abd Manaf Z, Haron H
    Clin Interv Aging, 2013;8:279-85.
    PMID: 23493965 DOI: 10.2147/CIA.S37586
    Talbinah is a barley syrup cooked with milk and sweetened by honey. In his famous Hadith on Talbinah, the Prophet Mohammad (SAW) recommended it when sad events happen for its effect on soothing hearts and relieving sadness. This 3-week crossover designed, randomized clinical trial was conducted to determine the effect of Talbinah on mood and depression among institutionalized elderly people in Seremban. A sample of 30 depressed elderly subjects (21 men and 9 women) was selected from the long term care facility. Three different interview-based validated scales (Geriatric Depression Scale, Depression Anxiety Stress Scales, and Profile of Mood States) were used to determine mood, depression, stress, and anxiety at week 0, 3, 4, and 7. The nutritional value of Talbinah was examined using proximate food analysis, minerals content analysis, and differential amino acid analysis. The results indicated that Talbinah is a high carbohydrate food (86.4%) and has a high tryptophan: branch chain amino acids ratio (1:2). A Wilcoxon nonparametric test showed that there was a statistically significant decrease on depression, stress, and mood disturbances scores among the intervention group (P < 0.05) for all parameters. In conclusion, Talbinah has the potential to reduce depression and enhance mood among the subjects. Ingestion of functional foods such as Talbinah may provide a mental health benefit to elderly people.
    Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-12R), Depression Anxiety Stress Scales (DASS-21); Profile of Mood States (POMS-65)
  7. Wide range of body composition measures are associated with cognitive function in community-dwelling older adults
    Won H, Abdul Manaf Z, Mat Ludin AF, Shahar S
    Geriatr Gerontol Int, 2017 Apr;17(4):554-560.
    PMID: 27231255 DOI: 10.1111/ggi.12753
    AIM: Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults.

    METHODS: A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass.

    RESULTS: The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P 

  8. Fulltext Predictors of Nonalcoholic Fatty Liver Disease Among Middle-Aged Iranians
    Etminani R, Manaf ZA, Shahar S, Azadbakht L, Adibi P
    Int J Prev Med, 2020;11:113.
    PMID: 33088441 DOI: 10.4103/ijpvm.IJPVM_274_19
    Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran.

    Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria.

    Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables).

    Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.

  9. The effects of polyphenols-rich tropical fruit juice on cognitive function and metabolomics profile - a randomized controlled trial in middle-aged women
    Rosli H, Shahar S, Rajab NF, Che Din N, Haron H
    Nutr Neurosci, 2021 Mar 05.
    PMID: 33666540 DOI: 10.1080/1028415X.2021.1880312
    Objectives: Polyphenols, particularly anthocyanins, have received attention in improving health issues during old age, including decline in cognitive function and other health parameters. We aimed to determine the effects of polyphenols-rich tropical fruit TP 3-in-1™ juice towards improving cognitive function, oxidative stress and metabolomics profiles among middle-aged women.Methods: This clinical trial involved 31 subjects with signs of poor cognitive function, as assessed using the Rey Auditory Verbal Learning Test (RAVLT). They were randomized to receive either TP 3-in-1™ juice (n = 16) or placebo (n = 15). Study subjects consumed 500 ml of beverages for three times per day, three days per week, for a period of ten weeks. Juice supplementation provided 9135 mg GAE of total phenolic content and 194.1 mg cyanidin-3-glucoside of total anthocyanin monomer.Results: There was a significant interaction effects on RAVLT immediate recall (p 
  10. Fulltext The stingless bee honey protects against hydrogen peroxide-induced oxidative damage and lipopolysaccharide-induced inflammation in vitro
    Ooi TC, Yaacob M, Rajab NF, Shahar S, Sharif R
    Saudi J Biol Sci, 2021 May;28(5):2987-2994.
    PMID: 34025176 DOI: 10.1016/j.sjbs.2021.02.039
    Oxidative stress, DNA damage, and unresolved inflammation are the predisposing factors of many chronic and degenerative diseases, including cancer. Stingless bee honey (SBH) is recognized to have high medicinal value by traditional medicine practitioners and has been used to treat various illnesses traditionally. This study aimed to determine the antioxidant, anti-inflammatory, and genoprotective effects of SBH by using in vitro cell culture models. The sugar content, total phenolic content, radical scavenging activity, and ferric reducing antioxidant power (FRAP) of SBH were determined in this study. Then, the protective effect of SBH against hydrogen peroxide (H2O2)-induced cell death and DNA damage was studied by using WIL2-NS human lymphoblastoid cell line, while the lipopolysaccharide (LPS)-induced RAW 264.7 murine macrophages cell line was used to study the anti-inflammatory effects of SBH. Results from this present study showed that the major sugar contents of SBH were fructose (19.39 + 0.01%) and glucose (14.03 ± 0.03%). Besides, the total phenolic content, the radical scavenging activity, and the FRAP value of SBH were 15.38 ± 0.02 mg GAE/100 g of honey, 34.04 ± 0.21%, and 206.77 + 1.76 μM AAE/100 g honey respectively. Pretreatment with SBH protected WIL2-NS cells from H2O2-induced cell death and DNA damage (p 
  11. Fulltext Knowledge, Attitude and Practice (KAP) of Malay Elderly on Salt Intake and Its Relationship With Blood Pressure
    Haron H, Kamal NF, Yahya HM, Shahar S
    Front Public Health, 2020;8:559071.
    PMID: 33614563 DOI: 10.3389/fpubh.2020.559071
    Hypertension is a worldwide problem and a major global health burden with high salt intake as one of the factors often related to it. Public exposure to a high salt diet has contributed to the increase in prevalence of hypertension among the Malaysian population. Improving the knowledge, attitudes and practices (KAP) related to salt intake is a key component of effective blood pressure control. Therefore, this study was aimed to determine the association of KAP of healthy salt intake toward blood pressure among the elderly residing in a semi urban area of Klang Valley Malaysia. A cross-sectional study using convenience sampling was conducted among Malay elderly, aged 60-81 years old residing in Bandar Baru Bangi. Subjects were required to answer the questionnaire via face to face interview regarding KAP of Salt Intake, together with sociodemographic and health profiles. Anthropometry parameters and blood pressure were measured. A total of 94 elderly [57.5% women with mean Body Mass Index (BMI) of 26. 46 ± 4.16, 42.5% men with mean BMI of 27.31 ± 5.19] have participated in the study. Results indicated that the overall KAP score was average (57.4%). However, majority showed a positive attitude toward reducing the salt intake. BMI was found to have significant correlation with blood pressure (r = 0.278, p < 0.05). Higher education level was significantly (p < 0.05) associated with good knowledge scores while younger subjects have a positive attitude toward healthy intake of salt (p < 0.05). Subjects with higher knowledge scores were also observed to have the more controlled blood pressure compared to those who scored less. Attitude and practices score showed no significance difference (p > 0.05) with blood pressure. Younger age, higher level of education and living partner or elderly was significantly (p < 0.05) associated with lower systolic and diastolic blood pressure. Overall, this study showed that knowledge toward healthy salt intake, BMI, education level, and living with others were significantly associated with the blood pressure among the elderly. Further education and intervention is required to improve knowledge on healthy salt intake among elderly as part of the prevention from hypertension.
  12. Dietary Pattern, Genomic Stability and Relative Cancer Risk in Asian Food Landscape
    Sharif R, Shahar S, Rajab NF, Fenech M
    Nutr Cancer, 2021 Jul 20.
    PMID: 34282666 DOI: 10.1080/01635581.2021.1952627
    The incidence of cancer globally is increasing, partly due to lifestyle factors. Despite a better understanding of cancer biology and advancement in cancer management and therapies, current strategies in cancer treatment remain costly and cause socioeconomic burden especially in Asian countries. Hence, instead of putting more efforts in searches for new cancer cures, attention has now shifted to understanding how to mitigate cancer risk by modulating lifestyle factors. It has been established that carcinogenesis is multifactorial, and the important detrimental role of oxidative stress, chronic inflammation, and genomic instability is evident. To date, there is no study linking dietary pattern and genomic stability in cancer risk in the Asian food landscape. Thus, this present review article discusses recent literature on dietary pattern and genomic stability and its relationship with cancer risk in Asia.
  13. Docosahexaenoic acid-concentrated fish oil supplementation in subjects with mild cognitive impairment (MCI): a 12-month randomised, double-blind, placebo-controlled trial
    Lee LK, Shahar S, Chin AV, Yusoff NA
    Psychopharmacology (Berl), 2013 Feb;225(3):605-12.
    PMID: 22932777 DOI: 10.1007/s00213-012-2848-0
    RATIONALE: Epidemiological studies have suggested a beneficial effect of fish oil supplementation in halting the initial progression of Alzheimer's disease. However, it remains unclear whether fish oil affects cognitive function in older people with mild cognitive impairment (MCI).

    OBJECTIVES: This study investigated the effects of fish oil supplementation on cognitive function in elderly person with MCI.

    METHODS: This was a 12-month, randomised, double-blind, placebo-controlled study using fish oil supplementation with concentrated docosahexaenoic acid (DHA). Thirty six low-socioeconomic-status elderly subjects with MCI were randomly assigned to receive either concentrated DHA fish oil (n = 18) or placebo (n = 18) capsules. The changes of memory, psychomotor speed, executive function and attention, and visual-constructive skills were assessed using cognitive tests. Secondary outcomes were safety and tolerability of the DHA concentrate.

    RESULTS: The fish oil group showed significant improvement in short-term and working memory (F = 9.890; ηp (2) = 0.254; p 

  14. Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge
    Johari N, Manaf ZA, Ibrahim N, Shahar S, Mustafa N
    Clin Interv Aging, 2016;11:1455-1461.
    PMID: 27799751
    PURPOSE: Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia.

    METHODS: A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life.

    RESULTS: Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life (R(2)=0.633, F(3, 67)=38.462; P<0.001), whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain (R(2)=0.558, F(2, 68)=42.953; P<0.001). Social support and cognitive status were the determinants of social relationship (R(2)=0.539, F(2, 68)=39.763; P<0.001) and also for the environmental domain of the quality of life (R(2)=0.496, F(2, 68)=33.403; P<0.001).

    CONCLUSION: The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients' quality of life.

  15. Fulltext History of falls and its relationship with nutritional status among elderly patients. [Sejarah jatuh dan hubungannya dengan status pemakanan di kalangan pesakit warga tua]
    Cheng SH, Shahar S, Lee FS, Ramli A
    Sains Malaysiana, 2012;41:379-385.
    Rising risk of falls has been associated with injury and dysfunction among the elderly. Therefore, this study was conducted to determine the prevalence of falls and association with nutritional status among 143 elderly patients from medical ward and clinic in Hospital Kuala Lumpur. Anthropometric indicators and bone health status using quantitative ultrasound (QUS) were also assessed. History of falls, functional status and dietary intake based on dietary history was assessed
    through questionnaire which was administered by face-to-face interview with the subjects. Data were analyzed using SPSS software version 16.0 and Foodworks. The past-year prevalence of falls (falls at least once in the previous 12 months) in this study was 32.9%. The past year prevalence of falls in women (40.2%) was higher than in men (17.4%) (p<0.01). Women who had calcium intake less than 300 mg/d (adjusted OR = 3.07, 95% CI = 1.02-9.24) and protein intake < 1 g/kg body weight (adjusted OR = 3.68, 95% CI = 0.98-13.84) were more likely to have a higher risk of falls. In conclusion, one third of the subjects, especially women in this study had a history of falls. Elderly people should be assessed for calcium and protein intake and those with calcium intake less than 300 mg/day and protein intake less than 1 g/kg body weight should be given intervention to reduce falls risk factor and subsequent fall-related co-morbidity.
    Keywords: Elderly patients; falls; nutritional status
  16. Fulltext The Effectiveness of a Depression Literacy Program on Stigma and Mental Help-Seeking Among Adolescents in Malaysia: A Control Group Study With 3-Month Follow-Up
    Ibrahim N, Mohd Safien A, Siau CS, Shahar S
    Inquiry, 2020 2 6;57:46958020902332.
    PMID: 32009506 DOI: 10.1177/0046958020902332
    This study evaluated the effectiveness of a depression literacy program on depression literacy, mental health stigma, and help-seeking attitude among adolescents with a monthly household income of RM3900 a month or less (B40) in Malaysia. The program included a lecture, mental awareness activities, and a short video on depression. Residents from a boarding school for lower income families were involved in this study (N = 101); 53 of them underwent the program and another 48 served as the control group. There were significant improvements for all variables in the intervention group (better depression literacy, reduced self-stigma, reduced negative beliefs on mental health, and increased help-seeking) at posttest. However, the results were sustained at 3-month follow-up only for the depression literacy, mental help-seeking attitude, and self-stigma of seeking help variables when compared with the control group. The findings highlight the need to improve the program to enhance the effectiveness and sustainability of the outcomes.
  17. Fulltext A Mobile App (FallSA) to Identify Fall Risk Among Malaysian Community-Dwelling Older Persons: Development and Validation Study
    Singh DKA, Goh JW, Shaharudin MI, Shahar S
    JMIR Mhealth Uhealth, 2021 10 12;9(10):e23663.
    PMID: 34636740 DOI: 10.2196/23663
    BACKGROUND: Recent falls prevention guidelines recommend early routine fall risk assessment among older persons.

    OBJECTIVE: The purpose of this study was to develop a Falls Screening Mobile App (FallSA), determine its acceptance, concurrent validity, test-retest reliability, discriminative ability, and predictive validity as a self-screening tool to identify fall risk among Malaysian older persons.

    METHODS: FallSA acceptance was tested among 15 participants (mean age 65.93 [SD 7.42] years); its validity and reliability among 91 participants (mean age 67.34 [SD 5.97] years); discriminative ability and predictive validity among 610 participants (mean age 71.78 [SD 4.70] years). Acceptance of FallSA was assessed using a questionnaire, and it was validated against a comprehensive fall risk assessment tool, the Physiological Profile Assessment (PPA). Participants used FallSA to test their fall risk repeatedly twice within an hour. Its discriminative ability and predictive validity were determined by comparing participant fall risk scores between fallers and nonfallers and prospectively through a 6-month follow-up, respectively.

    RESULTS: The findings of our study showed that FallSA had a high acceptance level with 80% (12/15) of older persons agreeing on its suitability as a falls self-screening tool. Concurrent validity test demonstrated a significant moderate correlation (r=.518, P

  18. Fulltext Correction: A Mobile App (FallSA) to Identify Fall Risk Among Malaysian Community-Dwelling Older Persons: Development and Validation Study
    Singh DKA, Goh JW, Shaharudin MI, Shahar S
    JMIR Mhealth Uhealth, 2021 Oct 28;9(10):e34368.
    PMID: 34710052 DOI: 10.2196/34368
    [This corrects the article DOI: 10.2196/23663.].
  19. Fulltext Associations of Health Literacy with Blood Pressure and Dietary Salt Intake among Adults: A Systematic Review
    Mohd Isa D, Shahar S, He FJ, Majid HA
    Nutrients, 2021 Dec 17;13(12).
    PMID: 34960086 DOI: 10.3390/nu13124534
    Health literacy has been recognized as a significant social determinant of health, defined as the ability to access, understand, appraise, and apply health-related information across healthcare, disease prevention, and health promotion. This systematic review aims to understand the relationship between health literacy, blood pressure, and dietary salt intake. A web-based search of PubMed, Web of Science, CINAHL, ProQuest, Scopus, Cochrane Library, and Prospero was performed using specified search/MESH terms and keywords. Two reviewers independently performed the data extraction and analysis, cross-checked, reviewed, and resolved any discrepancies by the third reviewer. Twenty out of twenty-two studies met the inclusion criteria and were rated as good quality papers and used in the final analysis. Higher health literacy had shown to have better blood pressure or hypertension knowledge. However, the relationship between health literacy with dietary salt intake has shown mixed and inconsistent findings. Studies looking into the main four domains of health literacy are still limited. More research exploring the links between health literacy, blood pressure, and dietary salt intake in the community is warranted. Using appropriate and consistent health literacy tools to evaluate the effectiveness of salt reduction as health promotion programs is required.
  20. Fulltext Identification of Neuroprotective Factors Associated with Successful Ageing and Risk of Cognitive Impairment among Malaysia Older Adults
    Lau H, Mat Ludin AF, Rajab NF, Shahar S
    Curr Gerontol Geriatr Res, 2017;2017:4218756.
    PMID: 29109736 DOI: 10.1155/2017/4218756
    The increase of ageing population has raised public attention on the concept of successful ageing. Studies have shown that vitamin D, telomere length, and brain-derived neurotrophic factor (BDNF) have been associated with cognitive function. Therefore, this study aimed to identify neuroprotective factors for cognitive decline in different ageing groups. A total of 300 older adults aged 60 years and above were recruited in this population based cross-sectional study. Participants were categorized into three groups: mild cognitive impairment (MCI) (n = 100), usual ageing (UA) (n = 100), and successful ageing (SA) (n = 100). Dietary vitamin D intake was assessed through Diet History Questionnaire (DHQ). Out of the 300 participants, only 150 were subjected to fasting blood sample collection. These samples were used for serum vitamin D and plasma BDNF measurements. Whole blood telomere length was measured using RT-PCR method. The results show that the reduction of the risk of MCI was achieved by higher serum vitamin D level (OR: 0.96, 95% CI: 0.92-0.99, p < 0.05), higher plasma BDNF level (OR: 0.51, 95% CI: 0.30-0.88,  p < 0.05), and longer telomere (OR: 0.97, 95% CI: 0.95-0.99,  p < 0.001). In conclusion, participants with higher vitamin D level, higher BDNF level, and longer telomere length were more likely to age successfully.
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