METHODS: A total of 755 older adults aged ≥60 years were recruited. Their cognitive performance was determined using the Clinical Dementia Rating. Fried's criteria was applied to identify physical frailty, and the Beck Depression Inventory assessed their mental states.
RESULTS: A total of 39.2% (n = 304) of the participants were classified as cognitive frail. In this cognitive frail subpopulation, 8.6% (n = 26) had clinical depressive symptoms, which were mostly somatic such as disturbance in sleep pattern, work difficulty, fatigue, and lack of appetite. Older adults with cognitive frailty also showed significantly higher depression levels as compared with the noncognitive frail participants (t (622.06) = -3.38; P = 0.001). There are significant associations between depression among older adults with cognitive frailty and multimorbidity (P = 0.009), polypharmacy (P = 0.009), vision problems (P = 0.046), and hearing problems (P = 0.047). The likelihood of older adults with cognitive frailty who experience impairments to their vision and hearing, polypharmacy, and multimorbidity to be depressed also increased by 2, 3, 5, and 7-fold.
CONCLUSIONS: The majority of the Malaysian community-dwelling older adults were in a good mental state. However, older adults with cognitive frailty are more susceptible to depression due to impairments to their hearing and vision, multimorbidity, and polypharmacy. As common clinical depressive symptoms among older adults with cognitive frailty are mostly somatic, it is crucial for health professionals to recognize these and not to disregard them as only physical illness. Geriatr Gerontol Int 2024; 24: 225-233.
METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).
RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.
DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p
METHOD: This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs.
RESULT: Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia.
CONCLUSION: The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.
METHODS: The dataset was obtained from the AGELESS trial screening phase conducted from October 2021 to March 2022, involving 476 community-dwelling Malaysian older adults (67.7 years old ± 6.1). Digital technology usage was assessed and CF was determined using Fried's criteria and Clinical Dementia Rating. A binary logistic regression was used to determine the sociodemographic factors associated with digital technology use among older adults with CF.
RESULTS: The findings suggest a digital divide between older adults with CF and robust in Malaysia. CF individuals (72.1%) were less likely to utilise digital technology, mainly smartphone than robust older adults (89.6%). More than 70% of older people owned social media on their smartphones, namely, WhatsApp. The most frequent online activities in both groups were family interaction and obtaining current news. CF older adults were less likely to play games on their smart devices. Usage of digital technology was more common among male, younger age, attained formal education more than 6 years, had a higher monthly household income, and robust participants.
CONCLUSIONS: The usage of digital technology was inversely related to CF status. CF older adults were less likely to integrate digital technology into their daily living compared to robust even though they were familiar with it. The use of digital technology should be reinforced among female, advanced age, widowers/divorcees without formal education and those from lower- or middle-income statuses, and cognitively frail older people.
METHODS: A total of 535 individuals aged 52 years and above from the previous cohort and interventional studies in Peninsular Malaysia were contacted during the Movement Control Order (MCO) issued during the COVID-19 pandemic. Telephonic interviews were conducted to obtain participant information concerning socio-demography, physical activity, subjective well-being (SWB) as assessed using flourishing scale, coping strategies, and general psychological health (GHQ-12). Simple linear regression (SLR) and multiple linear regression (MLR) analyses were performed to identify the factors associated with GHQ-12. The associated factors were further analysed using mediation analysis to determine the potential of coping strategies as a mediator.
RESULTS: It was observed that participants had a low mean GHQ-12 score (M = 0.80, SD = 2.19), indicating good psychological health. Living arrangement, physical activity, and flourishing scale were associated with psychological health (R2 = 0.412, p
PATIENTS AND METHODS: The available data related to cognitive frailty among a sub-sample of older adults aged 60 years and above (n=815) from two states in Malaysia were analysed. In the LRGS-TUA study, a comprehensive interview-based questionnaire was administered to obtain the socio-demographic information of the participants, followed by assessments to examine the cognitive function, functional status, dietary intake, lifestyle, psychosocial status and biomarkers associated with cognitive frailty. The factors associated with cognitive frailty were assessed using a bivariate logistic regression (BLR).
RESULTS: The majority of the older adults were categorized as robust (68.4%), followed by cognitively pre-frail (37.4%) and cognitively frail (2.2%). The data on the cognitively frail and pre-frail groups were combined for comparison with the robust group. A hierarchical BLR indicated that advancing age (OR=1.04, 95% CI:1.01-1.08, p<0.05) and depression (OR=1.49, 95% CI:1.34-1.65, p<0.001) scored lower on the Activity of Daily Living (ADL) scale (OR=0.98, 95% CI:0.96-0.99, p<0.05), while low social support (OR=0.98, 95% CI:0.97-0.99, p<0.05) and low niacin intake (OR=0.94, 95% CI:0.89-0.99, p<0.05) were found to be significant factors for cognitive frailty. Higher oxidative stress (MDA) and lower telomerase activity were also associated with cognitive frailty (p<0.05).
CONCLUSION: Older age, a lower niacin intake, lack of social support, depression and lower functional status were identified as significant factors associated with cognitive frailty among older Malaysian adults. MDA and telomerase activity can be used as potential biomarkers for the identification of cognitive frailty.
METHODS: A total of 2084 community dwelling older adults from wave I and II were recruited through a multistage random sampling method. TUG was performed using the standard protocol and scores were then stratified based on with and without mild cognitive impairment (MCI), gender and in a 5-year age groups ranging from ages of 60's to 80's.
RESULTS: 529(16%) participants were identified to have MCI. Past history of falls and medical history of hypertension, heart disease, joint pain, hearing and vision problem, and urinary incontinence were found to have influenced TUG performance. Cognitive status as a mediator, predicted TUG performance even when both gender and age were controlled for (B 0.24, 95% CI (0.02-0.47), β 0.03, t 2.10, p = 0.36). Further descriptive analysis showed, participants with MCI, women and older in age took a longer time to complete TUG, as compared to men with MCI across all age groups with exceptions for some age groups.
CONCLUSION: These results suggested that MCI needs to be taken into consideration when testing older adults using TUG, besides age and gender factors. Data using fast speed TUG may be required among older adults with and without MCI for further understanding.
Design: This was a retrospective cohort study.
Setting: The study was conducted in a community setting.
Participants: The participants were 1,086 community-dwelling older adults, with mean age of 69.6±5.6 years. Participants were categorized into fallers and nonfallers based on their history of falls in the past 12 months.
Method: Participants' sociodemographic data was taken, and SRMQ consisting of five falls-related questions was administered. Participants performed the TUG test twice, and the mean was taken as the result.
Results: A total of 161 participants were categorized as fallers (14.8%). Multivariate logistic regression analysis showed that the model (χ(2)(6)=61.0, p<0.001, Nagelkerke R(2)=0.10) consisting of the TUG test, sociodemographic factors (gender, cataract/glaucoma and joint pain), as well as the SRMQ items "previous falls history" (Q1) and "worried of falls" (Q5), was more robust in terms of falls risk association compared to that with TUG on its own (χ(2)(1)=10.3, p<0.001, Nagelkerke R(2)=0.02).
Conclusion: Combination of sociodemographic factors and SRMQ with TUG is more favorable as an initial falls risk screening tool among community-dwelling older adults. Subsequently, further comprehensive falls risk assessment may be performed in clinical settings to identify the specific impairments for effective management.
AIM: This study aims to determine the use of one of three physical performance tests (2-minute step, 2-minute walk, and 1-minute sit to stand) to effectively estimate cardiorespiratory fitness among older adults with CF.
METHODS: In this cross-sectional study, community-dwelling individuals aged 60 years old and above in Klang Valley were screened for CF. The participants performed three physical performance tests (2-minute walk, 2-minute step, and 1-minute sit to stand) followed by treadmill-based maximal exercise testing on another day.
RESULTS: A total of 32 older adults with cognitive frailty (mean age; SD: 67.1;4.7 years) participated in this study. Nearly half of them had hypertension (43.5 %), hypercholesterolemia (43.5 %), and multimorbidity (47.8 %). Among the endurance tests performed, only the 2-minute walk test independently predicted VO2 max by sex-specific with men (R2 = 0.58, p = 0.03) and women (R2 = 0.34, p = 0.01). The 2-minute walk test had good agreement with VO2 max (ICC = 0.77, 95 % CI: -3.1-2.4).
CONCLUSION: The 2-minute walk test is a valid tool for estimating cardiorespiratory fitness among older adults with CF. However, it should be further tested across a larger population.
METHODS: Analysis of data obtained from the Towards Useful Aging (TUA) study (2014-2016), wave 1 (baseline) and wave 2 (1½ years of follow-up) was conducted. For the baseline, comprehensive, interview-based questionnaires were administered to 1227 subjects who were 60 years old and above. MCI is a unique transitional state between normal ageing and dementia. MCI characteristics include a decline and disturbance of cognition, minimal impairment of complex activities, ability to perform regular daily functions, and absence of dementia. The incidence of MCI was assessed using comprehensive neuropsychological batteries. The study then performed a logistic regression analysis to examine the effect of each possible predictor of MCI. This analysis began with univariate analyses and a separate review of the effect of every variable. Binary logistic analyses followed hereafter.
RESULTS: During the follow-up after 1½ years, 179 (14.6%) of the participants who did not exhibit MCI at baseline were observed to have developed MCI. Among the participants who did not exhibit MCI at baseline, the incidence rate was 10.5 per 100 person-years. Male sex and lack of engagement in mental activities were predictors of MCI among participants without MCI at baseline.
CONCLUSION: After the 1½-year follow-up, the incidence rate for MCI was considerably high among the respondents. Being male and being less engaged in mental activities were predictors of the occurrence of MCI. Mental activities need to be promoted for the prevention of MCI incidence among older adults.
AIMS: A community-based longitudinal study was performed to determine the incidence and to identify possible predictors of multimorbidity among multiethnic older adults population in Malaysia.
METHODS: Comprehensive interview-based questionnaires were administered among 729 participants aged 60 years and above. Data were analyzed from the baseline data of older adults participating in the Towards Useful Aging (TUA) study (2014-2016) who were not affected by multimorbidity (349 without any chronic diseases and 380 with one disease). Multimorbidity was considered present in an individual reporting two or more chronic diseases.
RESULTS: After 1½ years of follow-up, 18.8% of participants who were initially free of any diseases and 40.9% of those with one disease at baseline, developed multimorbidity. The incidence rates were 13.7 per 100 person-years and 34.2 per 100 person-years, respectively. Female gender, smoking, and irregular preparing of food (lifestyle) were predictors for incidence of multimorbidity, especially in those without any disease, while Body Mass Index (BMI) 22-27 kg/m2 and inadequate daily intake of iron were identified as predictors of multimorbidity among participants who already have one disease.
CONCLUSIONS: The incidence rates of multimorbidity among Malaysian older adults were between the ranges of 14-34 per 100 person-years at a 1½-year follow-up. Gender, smoking, BMI 22-27 kg/m2, inadequate daily intake of iron and lack of engagement in leisure or lifestyle physical activities were possible predictors in the development of multimorbidity. There is a need to formulate effective preventive management strategies to decelerate multimorbidity among older adults.
METHODS: A systematic literature search (MEDLINE, EMBASE, PsycINFO, EBSCOHOST, Scopus and EmCare) was undertaken from February 2018 to May 2020. Observational studies measuring associations between EF and PF subdomains among older adults were included.
RESULTS: Twenty-nine studies met the inclusion criteria. Twenty-seven studies reported associations between EF and PF. There were bidirectional associations between slower processing speed and slower gait speed; slower processing speed and lower muscle strength; and lower verbal fluency and slower gait speed. Lower muscle strength was unilaterally associated with lower working memory.
CONCLUSIONS: We found consistent bidirectional associations between processing speed with gait speed and muscle strength, and verbal fluency and gait speed. There was a unidirectional association between muscle strength and working memory. Common causal mechanisms for EF and PF require further studies.
METHODS: Both quantitative and qualitative methods were used. A questionnaire was completed by 179 undergraduates (34 males and 145 females) aged between 18 to 25 years old. This was followed by an online, in-depth, one-to-one interview among 10 female undergraduates who reported severe musculoskeletal pain. The two sets of findings were integrated using a triangulation protocol.
RESULT: The three most common musculoskeletal pains experienced by undergraduates due to online learning were low back (73.2%), followed by neck (68.7%) and shoulder (58.7%) pain. The six main themes identified from the interviews were: (1) Musculoskeletal pain characteristics; (2) academic issues; (3) difficulties faced by undergraduates due to teaching and learning; (4) emotions towards work/study; (5) work environment; and (6) time spent working at a workstation. Upper back pain was identified to be associated with personal (p < 0.05) and most environmental factors (p < 0.05). From the triangulation model, it was shown that personal, academic stressors and environmental factors were mainly from the workstation, uncomfortable environment, working posture and time spent at the workstation, which all contributed to musculoskeletal pain.
CONCLUSIONS: This study showed that exercise, academic stressors, and environmental factors were associated with musculoskeletal pain among undergraduates due to online teaching and learning sessions. There may be a need to integrate an online prevention of musculoskeletal pain education package based on a biopsychosocial model with online teaching and learning for undergraduates.
METHODS: A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models.
RESULTS: Incident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs.
DISCUSSION: Dementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
METHODS: A total of 144 community dwelling older adults (mean age of 70.69 ± 4.3 years) participated in this study. Physical performance were assessed using timed up and go (TUG), gait speed (GS), chair stand and hand grip tests. Fall Awareness Behaviour (FaB) and Fall Risk Assessment Questionnaires (FRAQ) were administered to assess behaviour and fall prevention knowledge respectively.
RESULTS: Stepwise linear regression analysis showed that the practice of fall awareness behaviour (R2 = 0.256) was significantly associated with being male [95% C.I: 2.178 to 7.789, p