This study was conducted to study the blood pressure pattern and the prevalence of hypertension and its associated factors in a rural community in two coastal villages in rural Kedah, Mahysia. Out of the total population 504 were above 20 years of age and were eligible to participate. There were 227 males and 252 females. The mean systolic blood pressure was found to rise with age, peaking in the 6l·70 years age group, For women the mean blood pressure rose earlier from the age group of 4-l· 50 years. Mean blood pressures rose with increasing body mass index. lt also varied with occupation and education. The retired and unemployed had a higher blood pressure than those employed and there was an inverse relationship with increasing education. The prevalence of hypertension was 33.6%. More females were hypertensive (36.5%) as compared to males (3 0.4%) and this finding was the same for both systolic and diastolic hypertension. Majority (71.4%) of the hypertensives were undiagnosed. 72.5% of hypertensives who were on treatment were not under control. Hypertension was more prevalent among retirees and illiterates. Prevalence of hypertension increased correspondingly with age. Obesity was associated with hypertension. There was no association with family history of hypertension. Multiple logistic regression showed a positive association only for obesity. ln conclusion, given the high prevalence of hypertension at
present, it appears that the prevalence will increase as each age cohort grows older. Obesity, especially among housewives is a significant assorted factor.
The population of the world is ageing and Malaysia is no exception. The proportion of those above 60 will be 9.5% by the year 2020. Cognitive impairment and depression are two common problems in this age group. The objective of this study was to determine the prevalence of cognitive impairment and depression and their associated factors in the elderly population in a rural community in Kedah. The study design was descriptive cross sectional study. A standardized questionnaire was used in two villages in Mukim Kota Kuala Muda. Barthels index, geriatric depression scale and elderly cognitive assessment questionnaire were also used. The prevalence rate of cognitive impairment was 18.5%. Cognitive impairment was higher among females (22.6%) than males (12.8%). 34.8% of the widowed were cognitively impaired and it increases with age 15.1% within age groups 60 to 69 years, 42.9% in age groups 80 to 89 years and the one and only participant above 90 years was cognitively impaired. Among those with disability, the only one with very severe disability had cognitive impairment, 40% among the severely disabled and 33. 3% among the moderately disabled (p<0.05). Those with cognitive impairment were living with some functional disabilities involving feeding (p<0.05), bathing (p<0.05), grooming (p<0.05), dressing (p<0.05), bladder control (p<0.05), toilet use (p<0.05), transfer from bed to chair (p<0.05), mobility on level surfaces (p<0.05) and climbing stairs (p<0.05). The prevalence of depression was found to be 46.4%. Higher among males (48.4%) as compared to females (44.7%). Depression was 50.0% among the age groups 80 to 89 and 52.4% among the age groups 70 to 79. 63.6% of those living alone were depressed as were 54.8% of the unemployed. 43.8% of those depressed had functional disability. The only one with severe disability was depressed and 66. 7% of those with severe disability were depressed. 47.5% of those with hypertension were depressed. It is a matter of concern that even in a small population the rate of cognitive impairment and mental depression is very high. Health screening is an important aspect of health promotion and disease prevention in people over 60 years. Although screening for many conditions cannot conclusively prove benefit, special attention to these factors can decrease morbidity and improve quality of life in aging population.
Key words: elderly, cognitive impairment, depression, rural community, Malaysia
Study site: Two villages in Mukim Kota Kuala Muda, Kuala Muda District, Kedah, Malaysia
Device, Questionnaire & Scale: Barthels index; Geriatric Depression Scale (GDS-30); Elderly Cognitive Assessment Questionnaire