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Perceived health status and daily activity participation of older Malaysians

Ng ST, Tengku-Aizan H, Tey NP

Asia Pac J Public Health, 2011 Jul;23(4):470-84.
PMID: 20685663 DOI: 10.1177/1010539510374751

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

Matched MeSH terms: Activities of Daily Living*
Impact of tight control strategy on rheumatoid arthritis in Sarawak

Teh CL, Wong JS

Clin Rheumatol, 2011 May;30(5):615-21.
PMID: 20886247 DOI: 10.1007/s10067-010-1583-3

The aim of our study is to describe the impact of tight control strategy on the care of RA patients in Sarawak General Hospital. We performed a prospective study of all patients with a diagnosis of RA who received treatment at the Rheumatology Clinic in Sarawak General Hospital over a 1-year period. Systematic DAS-driven treatment adjustments aimed to achieve low disease activity (DAS 28-ESR <2.6) were carried out in the clinic over the 1-year period. Disease activity and treatment regimes of all 142 patients were collected for at baseline and 1 year later for statistical analysis. Our patients have a significantly lower DAS 28 with a mean of 2.99 ± 0.95 compared with baseline of 4.31 ± 1.34 (p < 0.000). More patients were in remission 1 year later compared to baseline (36.6% vs 11.3%). Tight control strategy has a positive impact on the care of RA patients in our centre. By optimising the care of RA through tight control strategy, RA can be better controlled in our centre.

Study site: Rheumatology clinic, Sarawak general hospital

Matched MeSH terms: Activities of Daily Living
Depressive symptoms, visual impairment, and its influence on physical disability and functional limitation

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

J Am Geriatr Soc, 2011 Mar;59(3):557-9.
PMID: 21391950 DOI: 10.1111/j.1532-5415.2010.03301.x
Matched MeSH terms: Activities of Daily Living*
Asian adaptation and validation of an English version of the multiple sclerosis international quality of life questionnaire (MusiQoL)

Thumboo J, Seah A, Tan CT, Singhal BS, Ong B

Ann Acad Med Singap, 2011 Feb;40(2):67-73.
PMID: 21468459

INTRODUCTION: The Multiple Sclerosis International Quality of Life questionnaire (MusiQoL) is a self-administered, multi-dimensional, patient-based health-related quality of life (HRQoL) instrument. With increasing prevalence of multiple sclerosis (MS) in Asian countries, a valid tool to assess HRQoL in those patients is needed. The aim of this study was to evaluate patient acceptability, content validity and psychometric properties of an Asian version of the English MusiQoL in Singapore, Malaysia and India.
MATERIALS AND METHODS: English speaking patients older than 18 years of age with a defi nite diagnosis of MS were included. The self-administered survey material included the adapted HRQoL questionnaire, a validated generic HRQoL questionnaire: the short-form 36 (SF-36), as well as a checklist of 14 symptoms. We assessed the internal and external validity of the adapted MusiQoL.
RESULTS: A total of 81 patients with MS were included in the study. The questionnaire was generally well accepted. In the samples from Malaysia and Singapore, all scales exhibited good internal consistency (Cronbach's alpha >0.70). Correlation to SF-36 was generally good, demonstrating high construct validity (P <0.001) in some aspects of the MusiQoL.
CONCLUSION: The Asian adaptation of the English version of the MusiQoL in evaluating HRQoL seems to be a valid, reliable tool with adequate patient acceptability and internal consistency.

Matched MeSH terms: Activities of Daily Living
Factors associated with cognitive impairment in patients with Parkinson disease: an urban study

Rosdinom R, Fazli A, Ruzyanei NJ, Azlin B, Srijit D

Clin Ter, 2011;162(1):23-9.
PMID: 21448542

BACKGROUND AND AIMS: Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment.
MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale.
RESULTS: Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness.
CONCLUSION: Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.

Matched MeSH terms: Activities of Daily Living
Fulltext A biomechanical study of grip and pinch strength among Malaysian elderly population

Zahari Taha, Ruhaizin Sulaiman

Pertanika Journal of Science & Technology, 2011;19(2):293-305.
MyJurnal

The physical strength of the elderly aged above 60 years is typically 10 to 30% less than the young adult population of ages between 25 to 35 years. This reduction of strength has a strong impact on the activity of the daily living (ADL) of the elderly population. There has been little research done studying on the physical strength of the elderly population in Malaysia. The objective of this study was to determine the static strength of the elderly population in Malaysia. In particular, the grip and pinch strength were investigated as these two static strengths are extensively used in their instrumental activity of daily living (IADL). The results were then compared to the strength of the university students. A total of 30 subjects (15 males and 15 females) participated in the study. Their age ranged between 60 to 83 years, with the mean of age of 67.1 years. The comparison group comprised a total of 30 university students (20 male, 10 female) aged between 23 to 24 years, with the mean of age of 23.2 years. Grip and pinch strengths of both groups were measured and analysed using a descriptive statistics. It was found that the elderly male subjects are stronger in both strength measurements than their female counterpart. The 95th percentile of the female grip strength was slightly lower than that of the male while the male pinch strength was 31.07% higher. It was also found that the male students had higher strengths compared to the females. The grip strength of the elderly was 30.66% lower than the university student, while their pinch strength was 13.42% lower. Both static strengths of the elderly were found to be lower than those of the university students. This supported the research hypotheses postulating that the static strength had a negative correlation with age. In terms of gender differences, the male subjects were found to be stronger than the females.

Matched MeSH terms: Activities of Daily Living
Fulltext The validation of the EQ-5D in Malaysian dialysis patients

Faridah A, Jamaiyah H, Goh A, Soraya A

Med J Malaysia, 2010 Jun;65 Suppl A:114-9.
PMID: 21488470

The EQ-5D is a quality of life instrument that measures five dimensions of health. This study investigated the reliability and validity of its use in the Malaysian dialysis population. Test-retest reliability, convergent and discriminant validity were assessed. Responses of 86 subjects who completed both surveys were used in analysis. Test-retest reliability using Cohen's kappa was acceptable in four out of five dimensions, with the exception of self-care. Convergent validity was present. Discriminant validity was found in only two out of six hypotheses tested. In conclusion, the EQ-5D has potential in this population but further study is required.

Matched MeSH terms: Activities of Daily Living
Massive heterotopic ossification in Guillain-Barré syndrome: a rare case report

Ohnmar H, Roohi SA, Naicker AS

Clin Ter, 2010;161(6):529-32.
PMID: 21181081

Heterotopic ossification (HO) is the abnormal development of bone within soft tissue and a rare complication in Guillain-Barré syndrome (GBS). Only a few cases had been reported so far. We present the case of a 39-year-old man who had been diagnosed to have GBS about 10 years ago, presenting with severe limitation of both active and passive range of motion in bilateral shoulder, elbow and hip joints and was found to have massive heterotopic ossification. In our patient, it could be a myriad of factors such as prolonged ICU stay with mechanical ventilation and hypoxia, long-standing immobilization and hypomobility with incomplete flaccid paralysis.

Matched MeSH terms: Activities of Daily Living
Fulltext Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

BMC Public Health, 2010;10:492.
PMID: 20716377 DOI: 10.1186/1471-2458-10-492

The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.

Matched MeSH terms: Activities of Daily Living*
An action research on promotion of healthy ageing and risk reduction of chronic disease: a need assessment study among rural elderly Malays, care givers and health professionals

Nur Asyura Adznam S, Shahar S, Rahman SA, Yusof NA, Arshad F, Yassin Z, et al.

J Nutr Health Aging, 2009 Dec;13(10):925-30.
PMID: 19924355

OBJECTIVE: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process.
DESIGN: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects.
RESULTS: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects.
CONCLUSION: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays.

Matched MeSH terms: Activities of Daily Living
Development and evaluation of 'neck pain and functional limitation scale': a validation study in the Asian context

Leonard JH, Choo CP, Manaf MR, Md Isa Z, Mohd Nordin NA, Das S

Indian J Med Sci, 2009 Oct;63(10):445-54.
PMID: 19901483

BACKGROUND: There is a paucity of literature on validated outcome measurement tools for evaluation of neck pain and related disability in the Asian context.
AIM: The main aim of the present study was to design a new tool called neck pain functional limitation scale (NPFLS) for measuring disability related to neck pain and observe its reliability, concurrent validity and criterion validity.
SETTING AND DESIGN: This study was performed at the institutional hospital.
MATERIALS AND METHODS: A total of 157 subjects (neck pain group) and 25 control subjects (control group) without neck pain were recruited for this study. NPFLS was framed as a new tool for this study, which consisted of 5 domains - pain intensity, activities of daily living, social activities, functional activities and psychological factors. Neck Bournemouth questionnaire (NBQ) was used as a gold standard to measure the concurrent validity and criterion validity of the NPFLS.
STATISTICAL ANALYSIS: Criterion validity and concurrent validity between the neck Bournemouth questionnaire (NBQ) and NPFLS scores were tested statistically using Mann-Whitney U test and Spearman correlation test. The reliability was tested by examining the internal consistency to calculate the Cronbach's alpha value for each item in NPFLS.
RESULTS: No significant difference between NPFLS and NBQ was observed using Mann-Whitney U Test, with P value greater than 0.05 (P= 0.557). Besides that, NPFLS had a high concurrent validity (r= 0.916) and good internal consistency with high Cronbach's alpha value of (r= 0.948), which demonstrated strong correlation between the items of NPFLS and NBQ.
CONCLUSION: NPFLS demonstrated good reliability, high concurrent validity and criterion validity in this study. NPFLS can be used to assess neck pain and disability among patients with neck pain.

Matched MeSH terms: Activities of Daily Living
Prevalence and impact of physical disability on Malaysian school-aged children: a population-based survey

Khoo TB, Kassim AB, Omar MA, Hasnan N, Amin RM, Omar Z, et al.

Disabil Rehabil, 2009;31(21):1753-61.
PMID: 19479558 DOI: 10.1080/09638280902751964

To determine the magnitude and impact of physical disability on Malaysian school-aged children between 7 and less than 18 years old.

Matched MeSH terms: Activities of Daily Living*
Fulltext Cement vertebroplasty in the elderly with osteoporotic vertebral fractures. a preliminary study on the change in activity of daily living after treatment

Looi, Collin Seng-Kim

International e-Journal of Science, Medicine & Education, 2009;3(2):-.
MyJurnal

Background: To assess the effect of cement vertebroplasty on the activity of daily living of elderly patients who have sustained a vertebral osteoporotic fracture.
Patients and Methods: Seven patients with clinically significant and radiologically proven osteoporotic vertebral compression fractures suitable to be treated with percutaneous cement vertebroplasty were recruited. Evaluation was based on pre- and postprocedure activity by clinical documentation (including interview) and by a self-developed questionnaire (including quality of life).
Results: Following the procedure, 54% of patients resumed their activities of daily living with minimal pain while 46% of patients were able to do so without any pain (p

Matched MeSH terms: Activities of Daily Living
Comparison of two methods in deriving a short version of oral health-related quality of life measure

Saub R, Locker D, Allison P

Community Dent Health, 2008 Sep;25(3):132-6.
PMID: 18839717

To compare two methods of developing short forms of the Malaysian Oral Health Impact Profile (OHIP-M) measure.

Matched MeSH terms: Activities of Daily Living
Epidemiology of insomnia in Malaysian adults: a community-based survey in 4 urban areas

Zailinawati AH, Ariff KM, Nurjahan MI, Teng CL

Asia Pac J Public Health, 2008;20(3):224-33.
PMID: 19124316 DOI: 10.1177/1010539508316975

This study aimed to determine the prevalence and pattern of insomnia in a Malaysian population aged 30 to 70 years. The sample consisted of 1611 subjects, recruited by stratified random sampling and interviewed using a semistructured questionnaire conducted in 2004. This was a community-based survey in 4 Malaysian states. The prevalence of insomnia symptom was 33.8%, and 12.2% of the subjects had chronic insomnia. Insomnia was more common among elderly; those who were separated, divorced, or widowed; and those who smoked at bedtime. Subjects with insomnia had a higher prevalence of feeling depressed (12.7), loss of concentration (19.1%), exhaustion (17.2%), poor memory (9.2%), decreased work productivity (6.4%), and perceived poor health status (40.9%; all, P < .05). A total of 22.2% of those with insomnia had excessive daytime sleepiness based on their Epworth Sleepiness Score (P =

Matched MeSH terms: Activities of Daily Living
Fulltext Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after stroke

Jahangir AW, Tan HJ, Norlinah MI, Nafisah WY, Ramesh S, Hamidon BB, et al.

Med J Malaysia, 2007 Oct;62(4):319-22.
PMID: 18551937 MyJurnal

Botulinum toxin is effective in reducing spasticity post stroke. As there are limited data on post stroke spasticity in Asia, we undertake this study to determine the effectiveness and safety of intramuscular injection of botulinum toxin type-A (BTX-A), in the treatment of chronic focal post-stroke hand spasticity, and the impact of BTX-A on the activities of daily living and quality of life, in comparison to placebo, in Malaysian stroke patients. This was a randomized, double-blind, placebo-controlled study to assess the efficacy and safety of BTX-A in 27 subjects with wrist and finger spasticity after a stroke. The outcome measures were assessed with the Modified Ashworth Scale (MAS) to assess spasticity of the flexor muscles, Barthel Index (BI) for activities of daily living and EQ-5D and EQ VAS for quality of life. Assessments were performed at baseline and 1 and 3 months after injection. Compared to placebo, the BTX-A group had greater improvement in the flexor tone of the wrist and fingers (p = 0.001 and p < 0.001, respectively), at first month follow-up visit and sustained the improvement through to three months. Although there was an improvement in the measures of global function and quality of life in the BTX-A group, there was no significant improvement in between the two groups. No serious BTX-A related adverse effects were reported. The results of this study demonstrate that intramuscular injection of botulinum toxin A is safe and effective in the treatment of chronic focal post-stroke spasticity of the hand.

Matched MeSH terms: Activities of Daily Living
Cross-cultural adaptation of the Oral Health Impact Profile (OHIP) for the Malaysian adult population

Saub R, Locker D, Allison P, Disman M

Community Dent Health, 2007 Sep;24(3):166-75.
PMID: 17958078

The aim of this project was to develop an oral health related-quality of life measure for the Malaysian adult population aged 18 and above by the cross-cultural adaption the Oral Health Impact Profile (OHIP).

Matched MeSH terms: Activities of Daily Living
Prevalence of cognitive and functional impairment in a community sample in Ribeirão Preto, Brazil

Lopes MA, Hototian SR, Bustamante SE, Azevedo D, Tatsch M, Bazzarella MC, et al.

Int J Geriatr Psychiatry, 2007 Aug;22(8):770-6.
PMID: 17173353

This study aimed at estimating the prevalence of cognitive and functional impairment (CFI) in a community sample in Ribeirão Preto, Brazil, evaluating its distribution in relation to various socio-demographic and clinical factors.

Matched MeSH terms: Activities of Daily Living/classification*
Item response bias was present in instrumental activity of daily living scale in Asian older adults

Niti M, Ng TP, Chiam PC, Kua EH

J Clin Epidemiol, 2007 Apr;60(4):366-74.
PMID: 17346611

Item response bias (also called differential item functioning, DIF) in Instrumental Activities of Daily Living (IADL) occurs when members of different groups possessing the same disability level do not have the same probability of responding positively for a given item(s). This study aimed to identify the extent of DIF by gender, age, ethnicity, and dementia groups in IADL estimates in Asian (Chinese, Malays, and Indian) elderly subjects.

Matched MeSH terms: Activities of Daily Living*
Fulltext Physical and Mental Health Problems of the Elderly in Nursing Homes in Kuantan, Pahang

Samsul Draman, Mohd Aznan, Md Aris

International Medical Journal Malaysia, 2007;6(1):1-11.
MyJurnal

Aim of study: To describe the residents of nursing home for the elderly in relation to their socio-demographic, physical and mental profiles. Method: A cross-sectional study design was carried out. The elderly in two selected nursing homes in Kuantan, Pahang were interviewed. The respondents were interviewed using a structured questionnaire which included the biodata, social background, and medical illness, presence of cognition, depression and ability to perform basic activities of daily living (ADL). Results: Results are available for 36 respondents out of 41 residents, giving a response rate of 87.8%. Chinese (77.8%), male (63.9%), single or divorced (50%), and low income (69.4%) was consisted the majority. Most respondents (86.1%) suffered from chronic illness, 61.1% were functional dependent (according to Barthel index), 33.3% have cognitive impairment (according ECAQ) and 22.2% have depression (according to GDS-14). The most common functional dependence was mobility on level surface (47.2%), followed by climbing stairs (38.9%).Conclusion: This study had identified chronic illness, cognitive impairment, depression, and functional decline as major health problems of the elderly in nursing homes that require greater attention and intervention.

Matched MeSH terms: Activities of Daily Living

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