Displaying publications 41 - 60 of 129 in total

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  1. Suzana, S., Lee, Y.H., Chong, H.Y., Nurfatina, M.D., Nurwhidayu, A.W., Siah, P.J., et al.
    Malays J Nutr, 2014;20(1):27-37.
    MyJurnal
    Introduction: Feeding difficulty and functional disability are common problems among patients with dementia but their influence on caregivers' burden has not been addressed comprehensively. Thus, this study aimed to determine the association between feeding problems, functional status and caregiver burden among patients with dementia who receive outpatient treatment at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala Lumpur, Malaysia, as compared to their non-demented counterparts. Methods: A cross-sectional comparative study was conducted among 30 patients with dementia (12 men, 18 women, mean age 75 ± 7 years old) and 60 subjects without dementia (25 men, 35 women, mean age 69 ± 7 years), as well as their caregivers. Subjects' functional status, feeding problems and also caregiver burden were assessed using Activities of Daily Livings (ADLs) and Instrumental Activities of Daily Living (IADL) questionnaire, The Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) and Zarit Burden Interview (ZBI), respectively. Subjects were also measured for height and weight. Results: Patients with dementia needed supervision (50%) and physical help during mealtime (40%). The mean functional status score of these patients was higher than the patients without dementia (p<0.05). Caregiver burden score was positively correlated with the EdFED-Q score (r=0.405, p<0.05) but negatively correlated with functional status score (r=­0.475, p<0.01). Further, multiple regression analysis showed that after adjustment for age, EdFED-Q score and functional status remained correlated with caregiver burden at R2 of 0.210. Conclusion: Caregiver burden is associated with feeding problems and functional disability among patients with dementia. There is a need to educate the caregivers in order to improve the quality of life of both carers and the demented patients.
    Key words: Caregiver burden, dementia, feeding problems, functional status, outpatient
    Study site: Psychiatric and medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Dementia
  2. Ambigga Devi SK, Suthahar A, Ramli AS, Ng KK, Radziah AR, Marymol K
    Malays Fam Physician, 2011;6(2-3):74-8.
    PMID: 25606229 MyJurnal
    Dementia is a large and growing problem in the ageing population but often not diagnosed in its earlier stages which is Mild Cognitive Impairment (MCI). MCI represents the phase between normal ageing and early dementia. About 12% of patients with MCI develop dementia per year, usually Alzheimer's disease. It is a diagnosis given to individuals who have cognitive impairments beyond that is expected for their age and education. However, this condition does not interfere significantly with daily activities as these individuals retain their critical thinking and reasoning skills. Nevertheless, due to its complexity and vague initial presentation, many cases of MCI can be missed. Therefore, it is imperative for primary care physicians to recognise these symptoms as opposed to normal ageing memory changes, and refer these patients to the memory clinic early to confirm the diagnosis. This paper illustrates a common primary care presentation of a patient with MCI. As there is no proven pharmacological treatment for MCI, the mainstay of management is to provide lifestyle intervention and long term support to these patients in the community. Primary care physicians should work as a team with the geriatrician, allied health personnel, support groups and caregivers in providing this care.
    Matched MeSH terms: Dementia
  3. Mah SL, George P
    Malays Fam Physician, 2018;13(2):26-28.
    PMID: 30302180
    Dementia is typically characterized by the deterioration of cognitive abilities and is a common disorder among the elderly in Malaysia. However, behavioral and psychological symptoms are also present in approximately 90% of dementia patients.1 We report the manifestation of these symptoms in an elderly woman with dementia and the treatment thereof.
    Matched MeSH terms: Dementia
  4. Syed Mohamed Aljunid, Namaitijiang Maimaiti, Zafar Ahmed, Amrizal Muhammad Nur, Norashidah Mohamed Nor, Normazwana Ismail, et al.
    MyJurnal
    As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.
    Matched MeSH terms: Dementia
  5. Rosdinom, R., Norzarina, M.Z., Ruzanna, Z., Zanariah, M.S.
    MyJurnal
    Caring for a family member with dementia is associated with distress and several caregiver factors are known to be determinants of burden of care.
    Objective: To determine the relationship between the caregivers’ sociodemographic variables and their perceived burden of care. 
    Methods: Patients diagnosed as having dementia with their caregivers were selected through a non-randomised sampling method from the psychogeriatric and memory clinics in Universiti Kebangsaan Malaysia Medical Centre and Hospital Kuala Lumpur. Burden of care was assessed using the Zarit Burden Interview.
    Results: Age, gender, educational achievement, ethnicity and kinship of the 65 caregivers did not show any significant statistical difference in relation to their perceived burden. Conclusion: Burden in caring after patients with dementia was not significantly determined by the sociodemographic characteristics of their caregivers
    Study site: Psychogeriartic clinics and memory clinics of Pusat Perubatan University Kebangsaan Malaysia (PPUKM) and Hospital Kuala Lumpur (HKL), Kuala Lumpur, Malaysia
    Matched MeSH terms: Dementia
  6. Loo, J.L., Syed-Mohamad, S.N., Razali, R.
    MyJurnal
    Introduction: Grief may be complicated in patients with dementia, posing a challenge to caregivers and healthcare professionals. A case of major vascular neurocognitive disorder with pathological jealousy and major depressive disorder in grief is reported.
    Case: A 73 year-old Malay lady with diabetes mellitus, hypertension, dyslipidemia, and right cerebrovascular
    accident developed major vascular neurocognitive disorder with pathological jealousy and major depressive disorder. She presented with unmanageable agitation and depression after her late husband’s death. She also experienced
    a bizarre delusion of her husband’s resurrection and infidelity. Her psychotropic medications were optimised and her bizarre delusion was challenged daily using validation and distraction techniques. Combined pharmacotherapy and behavioural therapy managed to resolve her psychiatric symptoms and facilitate her grief process.
    Conclusion: Grief reaction in major vascular neurocognitive disorder patients is often atypical. Individualized treatment comprising both pharmacotherapy and behavioural therapy should be offered to treat atypical grief and the underlying disease.
    Matched MeSH terms: Dementia
  7. Jasraj, S., Viknesh, N.
    MyJurnal
    Psychiatric services have progressed well throughout history, marked by a shift from heavily inpatient asylums to outpatient management via deinstitutionalization, and advances in psychopharmacology. An overview of important themes is discussed at public mental health level. Firstly, differences between sexes are touched upon from theoretical and societal perspectives. Next, among the disabled, the phenomenon of diagnostic overshadowing, attributing apparent mental health problems to learning disability, contributes to their overall poorer quality of life. Mental health at both extremes of age is another important theme, whereby dementia and depression are keenly observed in the older age group, while maternal risk factors and parenting play a role in the mental well-being of the younger age group. Fourthly, inequalities, stigma and discrimination, are rife among people living with mental illness, and thereby detrimental in their road to recovery. Deinstitutionalization is explained as being more than just downsizing the inpatient load, gaining prominence with the emergence of community psychiatry services, and found to be helpful in overcoming stigma. Demographically, it was demonstrated that developing countries, as opposed to developed countries, have advantages in their approaches to psychiatric services, including better integration of people living with mental illness into society. Lastly, the psychological well-being of mental health workers should not be discounted, with measures such as stress management and resilience training proving to be key in combating burnout.
    Matched MeSH terms: Dementia
  8. Nuraisyah Hani Zulkifley, Suriani Ismail, Rosliza Abdul Manaf, Lim Poh Ying
    MyJurnal
    The role of caregivers is very important in the management of person with dementia, where it is not uncommon for them to experience psychological distress. However, the level of distress can be managed and reduced through stra- tegic educational intervention. A systematic review has been conducted through searching Medline, Science direct, Cochrane library and EMBASE databases to provide a narrative synthesis that elaborate on methods and outcomes of the educational intervention among informal caregiver of person with dementia. From a total of 5125 records, eight studies were selected and included in this review, where the results show that educational intervention can be implemented either as individual or group intervention. Group intervention methods mainly focus on training pro- grams such as workshops and lectures, and also group-based discussions. While for individual intervention, most of the activities were implemented through self-learning using technology or computer-based systems. In conclusion, based on the outcome of the studies, both methods of implementations are found to be useful in reducing psycho- logical distress of the informal caregiver.
    Matched MeSH terms: Dementia
  9. Shiang Cheng Lim, Wan Ying Gan, Yoke Mun Chan
    MyJurnal
    Introduction: Cognitive decline and cognitive impairment among older adults is a rising public health concern because of its association with increased risk of dementia, disability and mortality. In Malaysia, early identification of cognitive impairment is uncommon due to lack of understanding of risk profile of the elderly population. The objective of this study was to determine factors associated with cognitive impairment among community-dwell- ing older adults. Methods: This cross-sectional study was conducted among 698 community-dwelling older adults aged 60 years old and above in Klang Valley, Malaysia by using multi-stage sampling to determine the risk factors and predictors of cognitive impairment from a multidimensional approach. Multivariate logistic regression analysis was performed to determine the relationship between socio-demographic characteristics, physical activity, physical functional status and cognitive impairment. Results: Increased of age (OR = 1.056), being female (OR = 2.219) and Indian (OR = 2.722) were the risk factors for cognitive impairment, while years of education (OR = 0.765), physically active (OR = 0.823) and better physical function (OR = 0.843) were significantly associated with decreased risk of cognitive impairment. Marital and nutritional status failed to predict the risk of cognitive impairment. Conclusion: Given the protective effects of physical activity and physical function on the cognitive decline at later age, relevant policymakers should formulate appropriate health education programmes to promote regular physical activity to improve physical and cognitive function among Malaysians across all ages.
    Matched MeSH terms: Dementia
  10. Mah, S.L., George, P.
    Malaysian Family Physician, 2018;13(2):26-28.
    MyJurnal
    Dementia is typically characterized by the deterioration of cognitive abilities and is a common disorder
    among the elderly in Malaysia. However, behavioral and psychological symptoms are also present
    in approximately 90% of dementia patients.1 We report the manifestation of these symptoms in an
    elderly woman with dementia and the treatment thereof.
    Matched MeSH terms: Dementia
  11. Rosdinom R, Ng IT, Teh EE, Norhayati A, Ng CG, Yeoh SH, et al.
    Clin Ter, 2014;165(6):287-93.
    PMID: 25524183 DOI: 10.7417/CT.2014.1770
    OBJECTIVES: There is a lack of local instruments to assess behavioural and psychological symptoms of dementia (BPSD). This 2-stage cross-sectional study was aimed at validating a Malay translated version of the Neuropsychiaric Inventory (MvNPI).

    MATERIALS AND METHODS: It was conducted on a selected group of 138 elderly outpatients with dementia and their caregivers in Hospital Pulau Pinang. Severity of dementia was assessed using the Malay-translated version of Mini Mental State Examination (MMSE). The original NPI was translated and then back-translated before it was pilot-tested. The MvNPI was administered twice, a week apart on the same caregiver by the same investigator.

    RESULTS: The individual items and total scale score of MvNPI had high internal consistency, with Corrected Item-Total Correlation ranging from satisfactory to good (0.41 to 0.77). The Cronbach's alpha for all the NPI domains showed high internal consistency (0.83), and subtotal for severity and distress scores were perfect (0.998 to 1.00). There was no significant difference between test-retest mean scores (p>0.05) and their correlations were perfect (0.996 to 1.00). Content validity indicated mild and inverse relationship between MMSE scores and severity, and distress score (-0.281 and -0.268, respectively, with p<0.001). Discriminant validity calculated using Mann-Whitney U test was found to be significant (p<0.001) in differentiating severity of cognitive impairment. Factor analysis revealed four possible components existed in MvNPI.

    CONCLUSIONS: The MvNPI is a valid and reliable tool for assessing BPSD among Malay speaking populations of Malaysia and its neighbouring South East Asian countries.

    Study site: Hospital Pulau Pinang
    Matched MeSH terms: Dementia/psychology*
  12. Muthupalaniappen L, Rosdinom R, Suguna M
    Clin Ter, 2012;163(1):31-2.
    PMID: 22362231
    Pisa syndrome or pleurothotonus is the persistent flexion of the body and head to one side giving the appearance of the leaning tower of Pisa. It is most commonly caused by typical and atypical antipsychotic drugs. We report a case of Pisa Syndrome caused by prolonged use of high dose cholinesterase inhibitor, rivastigmine. Symptoms subsided when rivastigmine was withdrawn and did not reappear when a different cholinesterase inhibitor, donepezil was introduced. Physicians should be aware of Pisa syndrome and should alert patient of this possibility when starting and stepping up medications. The purpose of reporting this case is to create awareness among general practitioners as it is a reversible condition which responds to removal of the offending drug.
    Matched MeSH terms: Dementia/drug therapy
  13. Tang CT, Belani LK, Das S, Jaafar MZ
    Clin Ter, 2013;164(1):43-6.
    PMID: 23455743 DOI: 10.7417/T.2013.1511
    Dementia is a common symptom observed in many psychiatric and neurodegenerative diseases. Alzheimer's disease is the most common form of senile dementia seen in the general population. Multiple factors like oxidative stress, apoptosis, mitochondrial dysfunction and inflammation may be related to the neurodegenerative states. Many drugs like cholinesterase have been used for treatment but the progression of the disease still poses a challenge to the clinician. During recent times, herbs have gained much popularity as supplements because of the cost effectiveness, easy availability and fewer side effects. Early diagnosis and proper treatment may help in the prevention of mortality and morbidity concerned with any neurodegenerative disease. Understanding the cellular and molecular biology of the mode of the action of herbal products may be beneficial for researchers and clinicians. The present review article attempts to look into the potential herbal extracts which may act as an antioxidant in combating dementia.
    Matched MeSH terms: Dementia/diagnosis; Dementia/drug therapy*
  14. Sa’ida Munira Johari, Suzana Shahar, Roslee Rajikan, Safiyyah A. Aziz
    MyJurnal
    Mild cognitive impairment (MCI) is a common disorder among elderly and may worsen to dementia. The aim of this study is to develop a nutrition and lifestyle booklet to implement better lifestyle modification, as an effort to delay cognitive decline. A series of discussions with a research group comprising of dieticians, nutritionists, a geriatrician and a public health physician were conducted to ascertain the content of the booklet. There were seven guidelines in the booklet including; eat more fish, eat more foods rich in folic acid, eat more fruits and vegetables, exercise regularly, do activities to stimulate memory, stop smoking and alcohol drinking and stay cheerful and positive. Evaluation of acceptance for the booklet was carried out which comprised of assessment on content, graphic and design among elderly and health staff at health clinic in Cheras. The assessment involved 15 Malay elderly subjects aged 60 to 81 years (mean age 66.1 ±6.6 years), with 60.0% men and 40.0% women and 10 health staff aged 36.6 ± 12.0 years, with range of 27 to 58 years, consists of 20.0% men and 80.0% women also participated. Most of elderly subjects (80.0%, n = 12) indicated they understood information in the booklet. Meanwhile, 20.0% (n = 3) of elderly expressed they did not fully understand the content of the booklet in particular on sentence and terminology. All health staff (100.0%) understood the information in the booklet. This booklet was well accepted by elderly subjects and health staff, however adding more graphics, simplifying sentence structures and minimizing scientific terminologies to improve understanding were suggested. The booklet has the potential to increase the nutritional and health knowledge of elderly specifically with MCI. This would motivate them to adopt healthy eating and lifestyle, thus reducing cognitive decline and prevent dementia.
    Keywords: Cognitive, education, booklet, elderly, lifestyle
    Matched MeSH terms: Dementia
  15. Ponnusamy Subramaniam, Kwai Ching Kan, Shazli Ezzat Ghazali, Rosdinom Razali
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):243-244.
    MyJurnal
    Introduction: There are increasing trend in using information and communication technology to enhance the deliverance of reminiscence work for people with dementia. Thus this study aimed to explore the feasibility of Digital Memory Album (DMA) to support reminiscence work and subsequently evaluate the psychosocial benefits of the DMA system for older adults with dementia living in community. Method: This was an exploratory case study involved five participants with mild to moderate dementia and their primary caregivers. Each participant had an opportunity to review their own life history using Life Review Experience Form (LREF) with the researcher for 8 consecutive weeks in which subsequently facilitated in development of a personalised digital life story. Caregivers provided additional information to support the development of DMA. The whole process was audio recorded. The digital life story was presented in multimedia format and displayed using the DMA. The DMA was given to the participants for review. Qualitative data was collected using semi structure questions with the participants and caregivers immediately after the completion of DMA and 6 weeks after having the DMA as a gift. Results: Analysis of the audio-records and interview data indicated that DMA promoted psychosocial wellbeing which included enjoyment, comfort, stimulate long term memory and enhanced communication and social interactions with family members and friends. Caregivers expressed the DMA helped them in recollecting the past and better understanding of their loved ones. It also reoriented their focus on their loved ones from their disability to the remaining strength. Conclusion: For the first time, this study demonstrates the feasibility of using DMA in improving the psychosocial wellbeing for people with dementia in Malaysia.
    Matched MeSH terms: Dementia
  16. 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*
  17. Sahadevan S, Saw SM, Gao W, Tan LC, Chin JJ, Hong CY, et al.
    J Am Geriatr Soc, 2008 Nov;56(11):2061-8.
    PMID: 19016940 DOI: 10.1111/j.1532-5415.2008.01992.x
    To study the prevalence of dementia in Singapore among Chinese, Malays, and Indians.
    Matched MeSH terms: Dementia/ethnology*
  18. 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*
  19. Almahdi EM, Zaidan AA, Zaidan BB, Alsalem MA, Albahri OS, Albahri AS
    J Med Syst, 2019 May 29;43(7):207.
    PMID: 31144129 DOI: 10.1007/s10916-019-1336-z
    This paper presents comprehensive insights into mobile patient monitoring systems (MPMSs) from evaluation and benchmarking aspects on the basis of two critical directions. The current evaluation criteria of MPMSs based on the architectural components of MPMSs and possible solutions are discussed. This review highlights four serious issues, namely, multiple evaluation criteria, criterion importance, unmeasurable criteria and data variation, in MPMS benchmarking. Multicriteria decision-making (MCDM) analysis techniques are proposed as effective solutions to solve these issues from a methodological aspect. This methodological aspect involves a framework for benchmarking MPMSs on the basis of MCDM to rank available MPMSs and select a suitable one. The benchmarking framework is discussed in four steps. Firstly, pre-processing and identification procedures are presented. Secondly, the procedure of weight calculation based on the best-worst method (BWM) is described. Thirdly, the development of a benchmark framework by using the VIKOR method is introduced. Lastly, the proposed framework is validated.
    Matched MeSH terms: Dementia/epidemiology
  20. 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*
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