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Fulltext Understanding ageing: fear of chronic diseases later in life

Awang H, Mansor N, Nai Peng T, Nik Osman NA

J Int Med Res, 2018 Jan;46(1):175-184.
PMID: 28760083 DOI: 10.1177/0300060517710857

Objectives Ageing is often associated with deteriorating mental and physical health and the need for long-term care, creating a fear of ageing. We investigated what people fear most in terms of disabling chronic diseases and their concerns regarding having long-term illnesses. Methods Data were obtained from an online survey of 518 respondents aged 40 years and older residing in Malaysia, which was based on a convenience sample collected in May 2015 to January 2016. Data were analyzed using chi-squared tests and multinomial logistic regression. Results Of the most dreaded diseases, heart disease and cancer are life-threatening; however, dementia, diabetes, and hypertension persist and have a disabling effect for a long time. While there were variations in the diseases feared most across sex, ethnicity, and place of residence, the biggest worry for all respondents with regard to having a long-term illness was that they would become a burden to their family, a concern that superseded fear of dying. Conclusions We found our survey respondents had a fear of chronic diseases and placing a burden on others. Thus, there is a need to provide motivation for people to adopt a healthy lifestyle, to remain healthy.

Matched MeSH terms: Dementia/physiopathology; Dementia/psychology
Fulltext The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia

Baharudin AD, Din NC, Subramaniam P, Razali R

BMC Public Health, 2019 Jun 13;19(Suppl 4):447.
PMID: 31196141 DOI: 10.1186/s12889-019-6868-0

BACKGROUND: The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD).
METHODS: This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits.
RESULTS: Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden (p

Matched MeSH terms: Dementia/psychology*
Preventing cognitive decline and dementia from cerebral small vessel disease: The LACI-1 Trial. Protocol and statistical analysis plan of a phase IIa dose escalation trial testing tolerability, safety and effect on intermediary endpoints of isosorbide mononitrate and cilostazol, separately and in combination

Blair GW, Appleton JP, Law ZK, Doubal F, Flaherty K, Dooley R, et al.

Int J Stroke, 2018 07;13(5):530-538.
PMID: 28906205 DOI: 10.1177/1747493017731947

Rationale The pathophysiology of most lacunar stroke, a form of small vessel disease, is thought to differ from large artery atherothrombo- or cardio-embolic stroke. Licensed drugs, isosorbide mononitrate and cilostazol, have promising mechanisms of action to support their testing to prevent stroke recurrence, cognitive impairment, or radiological progression after lacunar stroke. Aim LACI-1 will assess the tolerability, safety, and efficacy, by dose, of isosorbide mononitrate and cilostazol, alone and in combination, in patients with ischemic lacunar stroke. Sample size A sample of 60 provides 80+% power (significance 0.05) to detect a difference of 35% (90% versus 55%) between those reaching target dose on one versus both drugs. Methods and design LACI-1 is a phase IIa partial factorial, dose-escalation, prospective, randomized, open label, blinded endpoint trial. Participants are randomized to isosorbide mononitrate and/or cilostazol for 11 weeks with dose escalation to target as tolerated in two centers (Edinburgh, Nottingham). At three visits, tolerability, safety, blood pressure, pulse wave velocity, and platelet function are assessed, plus magnetic resonance imaging to assess cerebrovascular reactivity in a subgroup. Study outcomes Primary: proportion of patients completing study achieving target maximum dose. Secondary symptoms whilst taking medications; safety (hemorrhage, recurrent vascular events, falls); blood pressure, platelet function, arterial stiffness, and cerebrovascular reactivity. Discussion This study will inform the design of a larger phase III trial of isosorbide mononitrate and cilostazol in lacunar stroke, whilst providing data on the drugs' effects on vascular and platelet function. Trial registration ISRCTN (ISRCTN12580546) and EudraCT (2015-001953-33).

Matched MeSH terms: Dementia/etiology; Dementia/prevention & control*
Fulltext Pre-existing neurological conditions and COVID-19 co-infection: Data from systematic reviews, meta-analyses, and scoping reviews

Boruah AP, Thakur KT, Gadani SP, Kothari KU, Chomba M, Guekht A, et al.

J Neurol Sci, 2023 Dec 15;455:120858.
PMID: 37948972 DOI: 10.1016/j.jns.2023.120858

BACKGROUND: Pre-existing neurological diseases have been identified as risk factors for severe COVID-19 infection and death. There is a lack of comprehensive literature review assessing the relationship between pre-existing neurological conditions and COVID-19 outcomes. Identification of high risk groups is critical for optimal treatment and care.
METHODS: A literature review was conducted for systematic reviews, meta-analyses, and scoping reviews published between January 1, 2020 and January 1, 2023. Literature assessing individuals with pre-existing neurological diseases and COVID-19 infection was included. Information regarding infection severity was extracted, and potential limitations were identified.
RESULTS: Thirty-nine articles met inclusion criteria, with data assessing >3 million patients from 51 countries. 26/51 (50.9%) of countries analyzed were classified as high income, while the remaining represented middle-low income countries (25/51; 49.0%). A majority of evidence focused on the impact of cerebrovascular disease (17/39; 43.5%) and dementia (5/39; 12.8%) on COVID-19 severity and mortality. 92.3% of the articles (36/39) suggested a significant association between neurological conditions and increased risk of severe COVID-19 and mortality. Cerebrovascular disease, dementia, Parkinson's disease, and epilepsy were associated with increased COVID severity and mortality.
CONCLUSION: Pre-existing neurological diseases including cerebrovascular disease, Alzheimer's disease and other dementias, epilepsy, and Parkinson's disease are significant risk factors for severity of COVID-19 infection and mortality in the acute infectious period. Given that 61.5% (24/39) of the current evidence only includes data from 2020, further updated literature is crucial to identify the relationship between chronic neurological conditions and clinical characteristics of COVID-19 variants.

Matched MeSH terms: Dementia*
Fulltext Identification of two novel mutations, PSEN1 E280K and PRNP G127S, in a Malaysian family

Ch'ng GS, An SS, Bae SO, Bagyinszky E, Kim S

Neuropsychiatr Dis Treat, 2015;11:2315-22.
PMID: 26396515 DOI: 10.2147/NDT.S86334

Alzheimer's disease (AD) is the most common form of dementia, which can be categorized into two main forms: early onset AD and late onset AD. The genetic background of early onset AD is well understood, and three genes, the APP, PSEN1, and PSEN2 have been identified as causative genes. In the current study, we tested three siblings from Malaysia who were diagnosed with early onset dementia, as well as their available family members. The family history was positive as their deceased father was similarly affected. Patients were tested for mutations in APP, PSEN1, PSEN2, and PRNP. A novel variant, E280K, was discovered in exon 8 of PSEN1 in the three siblings. In silico analyses with SIFT, SNAP, and PolyPhen2 prediction tools and three-dimensional modeling were performed, and the results suggested that the mutation is probably a pathogenic variant. Two additional pathogenic mutations were previously been described for codon 280, E280A, and E280G, which could support the importance of the E280 residue in the PS1 protein contributing to the pathogenic nature of E280K. Additional ten family members were screened for the E280K mutation, and all of them were negative. Six of them presented with a variety of neuropsychiatric symptoms, including learning disabilities, epilepsy, and schizophrenia, while four family members were asymptomatic. A novel PRNP G127S mutation was found in a step-niece of the three siblings harboring the PSEN1 E280K mutation. In silico predictions for PRNP G127S mutation suggested that this might be possibly a damaging variant. Additional studies to characterize PRNP G127S would be necessary to further understand the effects of this mutation.

Matched MeSH terms: Dementia
Fulltext Tackling dementia globally: the Global Dementia Prevention Program (GloDePP) collaboration

Chan KY, Adeloye D, Asante KP, Calia C, Campbell H, Danso SO, et al.

J Glob Health, 2019 Dec;9(2):020103.
PMID: 31893025 DOI: 10.7189/jogh.09.020103
Matched MeSH terms: Dementia/prevention & control*
Prevalence and factors associated with physical inactivity among older adults in Malaysia: A cross-sectional study

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.

Matched MeSH terms: Dementia
Fulltext The mortality and outcome of delirium, dementia and other organic disorders: a two-year study

Chandrasekaran, Prem Kumar, Jambunathan, Stephen Thevanathan, Nor Zuraida Zainal

ASEAN Journal of Psychiatry, 2007;8(1):3-8.
MyJurnal

This is a cross-sectional, two-year follow up study. The authors determined the varied presentations of delirium, dementia and other organic disorders to assess their mortality and outcome. They described the diagnosis of patients suffering from the psychiatric effects of those organic states and compared their symptom resolution and mortality between those with the acute and chronic varieties during their index hospitalization and again, 24 months later. Although mortality rates did not differ, patients with the acute syndrome had significantly better outcomes in terms of symptom resolution as compared to those with the chronic syndrome (p=0.001). Patients with symptom resolution upon discharge did not show statistically significant lower mortality rates.

Matched MeSH terms: Dementia
Negative religious coping mediates dementia caregiver burden and depression in a Malaysian setting

Cheang YW, Ng CG, Petrus CF, Ramly SS, Teh EE, Ng YH, et al.

Psychogeriatrics, 2023 Jul;23(4):738-741.
PMID: 37283246 DOI: 10.1111/psyg.12989
Matched MeSH terms: Dementia*
A case of TREM2 mutation presenting with features of progressive non-fluent aphasia and without bone involvement

Chee KY, Gaillard F, Velakoulis D, Ang CL, Chin LK, Ariffin R

Aust N Z J Psychiatry, 2017 Nov;51(11):1157-1158.
PMID: 28462591 DOI: 10.1177/0004867417707821
Matched MeSH terms: Dementia/diagnosis*; Dementia/genetics; Dementia/pathology; Dementia/physiopathology
Fulltext Neuroleptic malignant syndrome: a case report

Chin CN

Med J Malaysia, 1986 Jun;41(2):176-8.
PMID: 3821616

The neuroleptic malignant syndrome is a rare but potentially fatal complication of neuroleptic administration. Many clinicians may not be familiar with this complication. This case report highlights the clinical features of neuroleptic malignant syndrome and its management.

Matched MeSH terms: Dementia/drug therapy*
Psychogeriatrics in South-East Asia

Chiu HF, Ng LL, Nivataphand R, Yong KC, Lengkong Y, Buenaventura RD, et al.

Int J Geriatr Psychiatry, 1997 Oct;12(10):989-94.
PMID: 9395930

A common phenomenon in South-East Asia is ageing of the population. This article describes the various stages of development of psychogeriatrics in Hong Kong, Singapore, Malaysia, Thailand, Indonesia and the Philippines. It is only in the last few years that more systematic development of psychogeriatric services has begun under the pressure of an ageing population. The model of service delivery in Hong Kong can serve as an example of development of psychogeriatric services in South-East Asia.

Matched MeSH terms: Dementia/ethnology*; Dementia/epidemiology; Dementia/psychology
Social support and burden among caregivers of patients with dementia in Malaysia

Choo WY, Low WY, Karina R, Poi PJ, Ebenezer E, Prince MJ

Asia Pac J Public Health, 2003;15(1):23-9.
PMID: 14620494 DOI: 10.1177/101053950301500105

This study aims to examine selected factors of dementia patients and their caregivers that were associated with the burden of family caregivers. This cross sectional study involves face-to-face interview with family caregivers of patients with dementia. Participants were recruited through convenient sampling from geriatric and psychiatry outpatient clinics from three government hospitals, one university hospital, one rural health centre and Alzheimer Disease caregivers' support groups. 70 caregivers took part in the study. Measures included patient and caregiver demographic variables and caregiver burden using the Zarit Burden Interview (ZBI). Caregiver burden was found to be significantly associated with both ethnicity and informal support. Chinese caregivers were found to have a higher level of burden compared to Indians and Malays. Informal support, in particular assistance from family members, was significantly associated with a lower burden perceived by the caregivers. However, the study shows that formal support such as assistance from maids and private nurses did not alleviate the burden of caregivers. Results highlighted the importance of improving the coping skills in burdened caregivers particularly among family members with dementia relatives. Interventions should be designed for specific needs of caregivers of different ethnicities.

Matched MeSH terms: Dementia/ethnology; Dementia/nursing*
Fulltext CNS toxoplasmosis induced hydrocephalus revisited and a brief review of AIDS dementia complex

Chow MB

Med J Malaysia, 2013 Jun;68(3):278.
PMID: 23749026
Matched MeSH terms: AIDS Dementia Complex*
Fulltext Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis

Craig L, Hoo ZL, Yan TZ, Wardlaw J, Quinn TJ

J Neurol Neurosurg Psychiatry, 2022 02;93(2):180-187.
PMID: 34782389 DOI: 10.1136/jnnp-2020-325796

An understanding of the epidemiology of poststroke dementia (PSD) is necessary to inform research, practice and policy. With increasing primary studies, a contemporary review of PSD could allow for analyses of incidence and prevalence trends. Databases were searched using a prespecified search strategy. Eligible studies described an ischaemic or mixed stroke cohort with prospective clinical assessment for dementia. Pooled prevalence of dementia was calculated using random-effects models at any time after stroke (primary outcome) and at 1 year (range: 6-18 months), stratified for inclusion of prestroke dementia. Meta-regression explored the effect of year of study. Sensitivity analyses removed low-quality or outlier studies. Of 12 505 titles assessed, 44 studies were included in the quantitative analyses. At any time point after stroke, the prevalence of PSD was 16.5% (95% CI 10.4% to 25.1%) excluding prestroke dementia and 22.3% (95% CI 18.8% to 26.2%) including prestroke dementia. At 1 year, the prevalence of PSD was 18.4% (95% CI 7.4% to 38.7%) and 20.4% (95% CI 14.2% to 28.2%) with prestroke dementia included. In studies including prestroke dementia there was a negative association between dementia prevalence and year of study (slope coefficient=-0.05 (SD: 0.01), p<0.0001). Estimates were robust to sensitivity analyses. Dementia is common following stroke. At any point following stroke, more than one in five people will have dementia, although a proportion of this dementia predates the stroke. Declining prevalence of prestroke dementia may explain apparent reduction in PSD over time. Risk of dementia following stroke remains substantial and front-loaded, with high prevalence at 1 year post event.

Matched MeSH terms: Dementia/epidemiology*
Does substance abuse contribute to further risk of falls in dementia

Eshkoor SA, Hamid TA, Nudin SS, Mun CY

Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 2014;21(3):317-24.
PMID: 23883099 DOI: 10.1080/13825585.2013.819067

This study aimed to predict the risk of falls by focusing on substance abuse in the elderly with dementia. Our national cross-sectional survey included 1210 elderly Malaysian demented subjects. The study identified the effects of age, ethnicity, sex differences, marital status, educational level, and substance abuse on the likelihood of falls in the elderly with dementia. The multivariate logistic regression model was used to analyze data collected from samples. The prevalence of falls was about 17% among subjects and significantly increased with age (p = .006). Furthermore, the results showed that age (OR = 1.03), ethnicity (OR = 1.69), substance abuse (OR = 1.68), and female sex (OR = 1.45) significantly enhanced the risk of falls in respondents (p < .05). Educational level and marital status had no significant effects on the likelihood of falls (p > .05). However, the findings provided evidence of an additional effect of substance abuse on further risk of falls in older adults with dementia.

Matched MeSH terms: Dementia/complications*
Fulltext Mild cognitive impairment and its management in older people

Eshkoor SA, Hamid TA, Mun CY, Ng CK

Clin Interv Aging, 2015;10:687-93.
PMID: 25914527 DOI: 10.2147/CIA.S73922

Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide.

Matched MeSH terms: Dementia/epidemiology; Dementia/prevention & control
Fulltext The effects of sleep quality, physical activity, and environmental quality on the risk of falls in dementia

Eshkoor SA, Hamid TA, Nudin SS, Mun CY

Am J Alzheimers Dis Other Demen, 2013 Jun;28(4):403-7.
PMID: 23698600 DOI: 10.1177/1533317513488921

OBJECTIVES: This study aimed to identify the effects of sleep quality, physical activity, environmental quality, age, ethnicity, sex differences, marital status, and educational level on the risk of falls in the elderly individuals with dementia.
METHODOLOGY: Data were derived from a group of 1210 Malaysian elderly individuals who were noninstitutionalized and demented. The multiple logistic regression model was applied to estimate the risk of falls in respondents.
RESULTS: Approximately the prevalence of falls was 17% among the individuals. The results of multiple logistic regression analysis revealed that age (odds ratio [OR] = 1.03), ethnicity (OR = 1.76), sleep quality (OR = 1.46), and environmental quality (OR = 0.62) significantly affected the risk of falls in individuals (P < .05). Furthermore, sex differences, marital status, educational level, and physical activity were not significant predictors of falls in samples (P > .05).
CONCLUSION: It was found that age, ethnic non-Malay, and sleep disruption increased the risk of falls in respondents, but high environmental quality reduced the risk of falls.

Matched MeSH terms: Dementia/epidemiology*
Fulltext The effects of social support and having a partner on sleep quality in dementia

Eshkoor SA, Hamid TA, Nudin SS, Mun CY

Am J Alzheimers Dis Other Demen, 2013 May;28(3):253-7.
PMID: 23612908 DOI: 10.1177/1533317513481098

OBJECTIVES: This study aimed to determine the effects of social support and having a partner on sleep quality in the elderly patients with dementia.
METHODOLOGY: This research was conducted on 1210 noninstitutionalized elderly Malaysian individuals with dementia. The effects of age, ethnicity, educational level, marital status, sex differences, social support, and having a partner on sleep quality were evaluated in the respondents. The multiple logistic regression analysis was used to predict the risk of sleep disturbances among the participants.
RESULTS: Approximately, 41% of the participants experienced sleep disruption. Further findings showed that ethnicity (odds ratio [OR] = 0.62), social support (OR = 1.35), marital status (OR = 2.21), educational level (OR = 0.65), and having a partner (OR = 0.45) significantly affected sleep quality (P < .05). Sex differences and age were unrelated predictors of sleep disturbances (P > .05).
CONCLUSION: It was concluded that social isolation and being single increased sleep disruption among respondents, but having a partner and ethnic non-Malay decreased the rate of sleep problems.

Matched MeSH terms: Dementia/ethnology*; Dementia/psychology
Fulltext Importance of hypertension and social isolation in causing sleep disruption in dementia

Eshkoor SA, Hamid TA, Nudin SS, Mun CY

Am J Alzheimers Dis Other Demen, 2014 Feb;29(1):61-6.
PMID: 24085252 DOI: 10.1177/1533317513505136

This study aimed to determine the effects of diabetes mellitus (DM), hypertension (HT), heart disease, social isolation, and sociodemographic factors on sleep in the elderly patients with dementia. Samples included 1210 noninstitutionalized, Malaysian elderly patients with dementia. The multiple logistic regression analysis was applied to estimate the risk of sleep disturbances among respondents. Approximately 41% of the patients experienced sleep problems. The results showed that age (odds ratio [OR] = 1.02), social isolation (OR = 1.33), and HT (OR = 1.53) significantly increased sleep disruption in respondents (P .05). It was concluded that age, social isolation, and HT increased sleep disruption but education and ethnic non-Malay reduced the risk of sleep problems. Moreover, HT was the most important variable to increase sleep disturbances in the elderly patients with dementia.

Matched MeSH terms: Dementia/epidemiology*

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