Displaying publications 41 - 60 of 12689 in total

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  1. He AJ, Tang VFY
    Health Policy, 2021 03;125(3):351-362.
    PMID: 33422336 DOI: 10.1016/j.healthpol.2020.12.020
    Against the backdrop of rapid ageing populations, there is an increasing recognition of the need to integrate various health services for the elderly, not only to provide more coordinated care, but also to contain the rapid cost inflation driven primarily by the curative sector. Funded by the Asia-Pacific Observatory on Health Systems and Policies, this scoping review seeks to synthesize the received knowledge on care integration for the elderly in four Asian societies representing varying socioeconomic and health-system characteristics: Singapore, Hong Kong, Malaysia, and Indonesia. The search for English-language literature published between 2009 and 2019 yielded 67 publications in the final sample. The review finds that both research and practice regarding health service integration are at a preliminary stage of development. It notes a marked trend in seeking to integrate long-term elderly care with curative and preventive care, especially in community settings. Many distinctive models proliferated. Integration is demonstrated not only horizontally but also vertically, transcending public-private boundaries. The central role of primary care is highly prominent in almost all the integration models. However, these models are associated with a variety of drawbacks in relation to capacity, perception, and operation that necessitate further scholarly and policy scrutiny, indicating the robustness and persistence of siloed healthcare practices.
    Matched MeSH terms: Aged; Health Services for the Aged*
  2. Genitsaridi E, Kypraios T, Edvall NK, Trpchevska N, Canlon B, Hoare DJ, et al.
    Prog Brain Res, 2021;263:59-80.
    PMID: 34243891 DOI: 10.1016/bs.pbr.2021.04.006
    The spatial percept of tinnitus is hypothesized as an important variable for tinnitus subtyping. Hearing asymmetry often associates with tinnitus laterality, but not always. One of the methodological limitations for cross-study comparisons is how the variables for hearing asymmetry and tinnitus spatial perception are defined. In this study, data from two independent datasets were combined (n=833 adults, age ranging from 20 to 91 years, 404 males, 429 females) to investigate characteristics of subgroups with different tinnitus spatial perception focusing on hearing asymmetry. Three principle findings emerged. First, a hearing asymmetry variable emphasizing the maximum interaural difference most strongly discriminated unilateral from bilateral tinnitus. Merging lateralized bilateral tinnitus (perceived in both ears but worse in one side) with unilateral tinnitus weakened this relationship. Second, there was an association between unilateral tinnitus and ipsilateral asymmetric hearing. Third, unilateral and bilateral tinnitus were phenotypically distinct, with unilateral tinnitus being characterized by older age, asymmetric hearing, more often wearing one hearing aid, older age at tinnitus onset, shorter tinnitus duration, and higher percentage of time being annoyed by tinnitus. We recommend that careful consideration is given to the definitions of hearing asymmetry and tinnitus spatial perception in order to improve the comparability of findings across studies.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  3. Ismail R, Meng LL
    J Dermatol, 1988 Apr;15(2):168-71.
    PMID: 3049733
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  4. Huang X, Tey NP, Lai SL
    Asia Pac J Public Health, 2024 May;36(4):352-357.
    PMID: 38590147 DOI: 10.1177/10105395241244960
    China's aging population has witnessed a surge in widowed older adults, raising concerns about their mental health. Losing a spouse is a profoundly distressing experience with enduring effects on well-being. Despite the proverbial belief in time's healing power, existing studies often neglect the potential decline in depressive symptoms during widowhood. Drawing data from the 2015 and 2018 China Health and Retirement Longitudinal Study, this study delved into the impact of widowhood duration on depression among 8370 older adults and uncovered significantly higher depression scores among widowed individuals, particularly in the initial three years. This study revealed that widowhood contributes to heightened depression levels even after accounting for sociodemographic factors. Although the depressive impact lessens over time, it persists beyond three years, underscoring the need for heightened awareness and support for this vulnerable population.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  5. Jairoun AA, Ping CC, Ibrahim B
    Sci Rep, 2024 Apr 19;14(1):9014.
    PMID: 38641627 DOI: 10.1038/s41598-024-58574-x
    Predicting the course of kidney disease in individuals with both type 1 and type 2 diabetes mellitus (DM) is a significant clinical and policy challenge. In several regions, DM is now the leading cause of end-stage renal disease. The aim of this study to identify both modifiable and non-modifiable risk factors, along with clinical markers and coexisting conditions, that increase the likelihood of stage 3-5 chronic kidney disease (CKD) development in individuals with type 2 DM in the United Arab Emirates (UAE). This was a single-center retrospective cohort study based on data derived from electronic medical records of UAE patients with DM who were registered at outpatient clinics at Tawam Hospital in Al Ain, UAE, between January 2011 and December 2021. Type 2 DM patients aged ≥ 18 years who had serum HbA1c levels ≥ 6.5% were included in the study. Patients with type 1 DM, who had undergone permanent renal replacement therapy, who had under 1 year of follow-up, or who had missing or incomplete data were excluded from the study. Factors associated with diabetic patients developing stage 3-5 CKD were identified through Cox regression analysis and a fine and gray competing risk model to account for competing events that could potentially hinder the development of CKD. A total of 1003 patients were recruited for the study. The mean age of the study cohort at baseline was 70.6 ± 28.2 years. Several factors were found to increase the risk of developing stage 3-5 CKD: advancing age (HR 1.005, 95% CI 1.002-1.009, p = 0.026), a history of hypertension (HR 1.69, 95% CI 1.032-2.8, p = 0.037), a history of heart disease (HR 1.49, 95% CI 1.16-1.92, p = 0.002), elevated levels of serum creatinine (HR 1.006, 95% CI 1.002-1.010, p = 0.003), decreased levels of estimated glomerular filtration rate (eGFR) (HR 0.943, 95% CI, 0.938-0.947; p 
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  6. Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH, El-Dahiyat F
    Sci Rep, 2024 Mar 27;14(1):7284.
    PMID: 38538618 DOI: 10.1038/s41598-024-56765-0
    Adherence to scheduled physician screenings for renal function monitoring in patients with chronic kidney disease (CKD) or those at high risk remains suboptimal despite the endorsement of regular screenings by several clinical practice guidelines. Our study aims to assess the effectiveness of a point-of-care CKD screening program led by these pharmacists using the PICCOLO device while recognizing the unique position of community pharmacists in primary care. We conducted an 11-month prospective point-of-care interventional research study in the United Arab Emirates to evaluate the performance of a community pharmacist-led CKD screening program for high-risk patients. Six diverse community pharmacies were selected based on staff availability, patient volume, and their offered range of services. Eligible individuals with risk factors for CKD were identified during medication evaluations. The PICCOLO Comprehensive Metabolic Panel facilitated on-site blood analysis, delivering estimated Glomerular Filtration Rate (eGFR) results within 10 to 15 min. Data also included eGFR categories, demographic information, and insights into lifestyle and health habits collected through a questionnaire. Pharmacists conducted comprehensive medication reviews and offered referrals and lifestyle guidance as part of the program. The study encompassed a total of 400 patients, with an average age of 69 ± 13.4 years within the study cohort. Notably, 38.8% (155 individuals) of the 400 patients were found to have undiagnosed CKD stages 3-5. Univariate logistic regression analysis revealed a significant association between a higher incidence of CKD stages 3-5 and factors such as older age, a history of hypertension, vascular disease, and diabetes mellitus. In the multivariate regression model, age and a history of diabetes mellitus emerged as significant predictors of an elevated risk of CKD. This study sheds light on the viability and impact of CKD screening programs conducted by community pharmacists, particularly in detecting CKD stages 3-5. The findings have implications for healthcare policies, as they can influence the enhancement of early detection and management of CKD. Moreover, these insights may catalyze focused screening initiatives and strengthen collaboration between community pharmacies and healthcare systems to benefit patients at high risk of CKD.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  7. Liew J, Gianfrancesco M, Harrison C, Izadi Z, Rush S, Lawson-Tovey S, et al.
    RMD Open, 2022 Apr;8(1).
    PMID: 35387864 DOI: 10.1136/rmdopen-2021-002187
    OBJECTIVE: While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2.

    METHODS: We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients' demographic and clinical characteristics and COVID-19 symptoms and outcomes.

    RESULTS: SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36-83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died.

    CONCLUSION: More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.

    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  8. Apalasamy YD, Awang H, Mansor N, Othman A, Jani R, Nik Osman NNA, et al.
    Asia Pac J Public Health, 2024 Nov;36(8):705-710.
    PMID: 39212135 DOI: 10.1177/10105395241275232
    Older adults are at greater risk of mental health issues. This study examined the factors influencing mental well-being among 2230 Malaysian older adults, using data from the 2018 to 2019 Malaysia Ageing and Retirement Survey. The World Health Organization-Five Well-Being Index (WHO-5) was used to assess mental well-being, and linear regression analysis identified the significant factors. Women had lower mental well-being scores than men (P = .012, β = -0.016). Chinese (P = .024, β = -0.020), Indian (P < .001, β = -0.043), and other ethnicities (P < .001, β = -0.031) reported lower scores than Malays. The factors associated with better well-being were secondary (P = .001, β = 0.032) and tertiary education (P < .001, β = 0.063), and good (P < .001, β = 0.081) and moderate (P < .001, β = 0.038) health status. Diseases-limiting activities were associated with poor well-being (P < .001, β = -0.030). Support from family (P < .001, β = 0.062) and friends (P < .001, β = 0.032), social activity participation (P < .001, β = 0.026), and functional ability (P < .001, β = 0.043) were significant positive factors. There is a need for targeted interventions to enhance mental health among Malaysian older adults.
    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  9. Dharmalingam TK, Rajah U, Muniandy RK
    Med J Malaysia, 2023 Jul;78(4):472-475.
    PMID: 37518914
    INTRODUCTION: Patients with chronic pain have been one of the most difficult patients to manage during the COVID-19 pandemic. As pain physicians navigate through this pandemic in order to maintain contact with their patients, telemedicine emerged as a very useful tool. It helped patients to access care despite being in distant areas, or during the lockdown period. The objective of this research is to assess the perception of chronic pain patients who received telemedicine therapy. Self-efficacy and coping level of pain among these chronic pain patients were also assessed.

    MATERIALS AND METHODS: This is a cross-sectional study involving patients who are under follow-up at the Chronic Pain Clinic, Hospital Pulau Pinang for more than a year and received telemedicine during this pandemic. Participants had to fill out a self-administered questionnaire. Once respondents completed the questionnaires, the answered questionnaires were collected for analysis.

    RESULTS: A total of 154 patients between 22 and 88 years old were included in this study. Most of the participants had a history of pain for more than 3 years (44.2%). The majority of our patients are still working (55.8%). From the patients who were working, 7.8% of them lost their jobs during the pandemic. 31.2% of patients reported that the pain condition had worsened while the rest did not experience any difference in their pain condition. More than half (59%) of the patients' reported telemedicine was beneficial for their pain management, while only 41% felt that their telemedicine was helpless for their pain management during the pandemic.

    CONCLUSION: Telemedicine is beneficial for patients with chronic pain. Telemedicine can be used poste-pandemic and may produce a good outcome with patients.

    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  10. Salari N, Ghasemi H, Mohammadi L, Behzadi MH, Rabieenia E, Shohaimi S, et al.
    J Orthop Surg Res, 2021 Oct 17;16(1):609.
    PMID: 34657598 DOI: 10.1186/s13018-021-02772-0
    BACKGROUND: Osteoporosis affects all sections of society, including families with people affected by osteoporosis, government agencies and medical institutes in various fields. For example, it involves the patient and his/her family members, and government agencies in terms of the cost of treatment and medical care. Providing a comprehensive picture of the prevalence of osteoporosis globally is important for health policymakers to make appropriate decisions. Therefore, this study was conducted to investigate the prevalence of osteoporosis worldwide.

    METHODS: A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. The PubMed, Science Direct, Web of Science, Scopus, Magiran, and Google Scholar databases were searched with no lower time limit up till 26 August 2020. The heterogeneity of the studies was measured using the I2 test, and the publication bias was assessed by the Begg and Mazumdar's test at the significance level of 0.1.

    RESULTS: After following the systematic review processes, 86 studies were selected for meta-analysis. The sample size of the study was 103,334,579 people in the age range of 15-105 years. Using meta-analysis, the prevalence of osteoporosis in the world was reported to be 18.3 (95% CI 16.2-20.7). Based on 70 studies and sample size of 800,457 women, and heterogenicity I2: 99.8, the prevalence of osteoporosis in women of the world was reported to be 23.1 (95% CI 19.8-26.9), while the prevalence of osteoporosis among men of the world was found to be 11.7 (95% CI 9.6-14.1 which was based on 40 studies and sample size of 453,964 men.). The highest prevalence of osteoporosis was reported in Africa with 39.5% (95% CI 22.3-59.7) and a sample size of 2989 people with the age range 18-95 years.

    CONCLUSION: According to the medical, economic, and social burden of osteoporosis, providing a robust and comprehensive estimate of the prevalence of osteoporosis in the world can facilitate decisions in health system planning and policymaking, including an overview of the current and outlook for the future; provide the necessary facilities for the treatment of people with osteoporosis; reduce the severe risks that lead to death by preventing fractures; and, finally, monitor the overall state of osteoporosis in the world. This study is the first to report a structured review and meta-analysis of the prevalence of osteoporosis worldwide.

    Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged
  11. Tan C C K Ho GH, Bahadzor B, Praveen S, Goh EH, Syahril AS, Zulkifli MZ
    Clin Ter, 2013;164(4):319-21.
    PMID: 24045515 DOI: 10.7417/CT.2013.1580
    Gas-forming infection of the kidneys can affect either the parenchyma or the collecting system. They are known as emphysematous pyelonephritis (EPN) and emphysematous pyelitis (EP) respectively. Bilateral EPN is a fairly established entity and numerous articles about this condition have been published. However, much less is known about bilateral EP. We report a rare case of bilateral EP and a literature review of this disease. A 66-year-old woman with long-standing bilateral staghorn calculi presented with bilateral EP and severe sepsis. She was treated with antibiotics and bilateral double-J stents to drain the upper urinary tracts. She recovered after 1 month of intensive care and medical therapy. Percutaneous nephrolithotomy (PCNL) had been scheduled to treat her staghorn calculi. A literature search on MEDLINE and Google Scholar with the terms "bilateral emphysematous pyelitis" only found 1 case report in English and another 2 reports in the Korean language that discussed bilateral EP. The collective experience of these few cases, including the present case, suggests that bilateral EP runs a more benign course than bilateral EPN. It should be diagnosed as soon as possible with computed tomography (CT) scans of the renal system. Current evidence shows that can be treated successfully with timely antibiotics. Drainage of the collecting system either percutaneously or with placement of double-J stents might facilitate recovery.
    Matched MeSH terms: Aged
  12. Forsyth DR, Chia YC
    Med J Malaysia, 2009 Mar;64(1):46-50.
    PMID: 19852321
    As Malaysia ages its health and social care systems will have to adapt to a changing pattern of disease and dependency. Improved public health measures extend life expectancy at the relative expense of increased prevalence of currently incurable conditions such as dementia and Parkinson's disease. In this article we discuss how these demographic changes will impact and suggest possible means of coping with the altered epidemiology of disease and disability. Malaysia will need to swiftly develop sufficient expertise in acute Geriatric Medicine, rehabilitation of older people; the management of long-term conditions in older people with multiple complex problems within Primary Care; as well as an infrastructure for home and institutional care.
    Matched MeSH terms: Aged; Health Services for the Aged*; Middle Aged
  13. Poi PJH
    Med J Malaysia, 1997 Sep;52(3):202-5.
    PMID: 10968085
    Matched MeSH terms: Aged; Health Services for the Aged*; Middle Aged
  14. Singh P, Chong PY
    Med J Malaysia, 1987 Sep;42(3):209-11.
    PMID: 3506648
    Matched MeSH terms: Aged
  15. Yassin Z, Terry RD
    Med J Malaysia, 1990 Dec;45(4):310-8.
    PMID: 2152052
    Health indices of 317 healthy elderly Malay females 55 years and older from two rural subdistricts in Negeri Sembilan were collected through personal interviews. About 33% of the respondents perceived their health condition as good to excellent, 63.4% rated their health status compared to a year earlier as about the same, 48.3% had no worry about their health, and 49.2% perceived themselves as physically active as their peers. Arthritis was the major ailment which affected the daily activities of about 64% of the respondents. The classical age-related problems of poor hearing, poor sight and difficulty in chewing were also prevalent among these elderly.
    Matched MeSH terms: Aged*; Aged, 80 and over; Middle Aged
  16. Gip LS, Chong KF, Omar AR
    Med J Malaysia, 1978 Dec;33(2):150-3.
    PMID: 755167
    Matched MeSH terms: Middle Aged
  17. Deva MP
    Family Practitioner, 1988;11:22-24.
    Matched MeSH terms: Aged
  18. Mohd Mydin FH, Othman S, Choo WY, Hairi NNM, Hairi FM, Syed Karim SN, et al.
    J Elder Abuse Negl, 2021 04 25;33(2):151-167.
    PMID: 33899705 DOI: 10.1080/08946566.2021.1919272
    This quasi-experimental study examined the effect of Supporting Family Doctors to Address Elder Abuse (SAFE) educational intervention among family doctors practicing at public primary care clinics in Malaysia. SAFE is an intensive, multimodal, locally tailored, and culturally sensitive face-to-face educational intervention on elder abuse. A significant mean score improvement of knowledge [Baseline: 5.33 (SD:1.33) to 6-month post-intervention: 6.45 (SD: 1.35); p<0.001] and perceived behavioral control [Baseline: 50.83 (SD: 8.87) to six-month post-intervention: 56.16 (SD: 9.56); p<0.001] observed in the intervention group compared to the control group. No significant difference in attitude, subjective norm, and practice scores between the two groups over time. SAFE educational intervention for family doctors was effective to improve but not sustainable knowledge and perceived behavioral control toward elder abuse identification and management. We recommend SAFE educational intervention as part of the continuous medical education for family doctors supplemented with a change in organization and national policy.
    Matched MeSH terms: Aged
  19. Bousquet J, Agache I, Blain H, Jutel M, Ventura MT, Worm M, et al.
    Allergy, 2021 10;76(10):2952-2964.
    PMID: 33811358 DOI: 10.1111/all.14838
    Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
    Matched MeSH terms: Aged
  20. Mahadev V, Seng NT, Woo LG
    Med J Malaysia, 1976 Jun;30(4):328-30.
    PMID: 979740
    Matched MeSH terms: Middle Aged
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