Displaying all 11 publications

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  1. Norazman CW, Adznam SN, Jamaluddin R
    PMID: 32916809 DOI: 10.3390/ijerph17186549
    Frailty is a multidimensional syndrome, which is a worldwide concern within the field of geriatrics due to the aggravating effect on the physical and mental functions of the elderly. This study aimed to determine the prevalence and risk factors of the frailty syndrome among urban-living community-dwelling elderly in Malaysia. A cross-sectional study was conducted among 301 community-dwelling elders. Frailty status was assessed using the Fried phenotype criteria. Depressive symptoms were assessed using the Geriatric Depression Scale (M-GDS-14), whereas the functional abilities and cognitive status were measured using the Lawton Instrumental Activities of Daily Living (Lawton IADL) scale and the Mini-Mental State Examination (MMSE-M), respectively. Malnutrition risk was observed through the abridged version (Short Form) of the Mini Nutritional Assessment (MNA-SF). Multinomial logistic regression analysis was employed to determine the significant predictors of the frailty syndrome. Three hundred and one elderly persons engaged in this study, with a mean age of 67.08 ± 5.536 ranging between 60 to 84 years old. The prevalence values of frailty and pre-frail were 15.9% and 72.8%, respectively, in which women appeared to be at a higher risk of frailty. The multivariate model revealed that frailty could be predicted from an increase in age, lower household income, being at risk of malnutrition, wasting (low skeletal muscle mass), and high serum C-reactive protein (CRP) level. A holistic approach is suggested for managing the frailty syndrome as it involves a decline in the multiple components of the geriatric syndrome.
  2. Norazman CW, Adznam SN, Jamaluddin R
    Nutrients, 2020 Jun 08;12(6).
    PMID: 32521618 DOI: 10.3390/nu12061713
    Studies have been carried out on the association between frailty and malnutrition, but the similarities and divergence of the relationship remain debatable. This study aimed to explore the prevalence of malnutrition risk and frailty as well as the overlapping constructs. The associations that emerged were assessed independently of other risk factors. A total of 301 community-dwelling older adults with a mean age of 66.91 ± 5.59 years old were randomly recruited. Fried Criteria and Mini Nutritional Assessment-Short Form (MNA-SF) were used to assess frailty status and malnutrition, respectively. Other related nutritional assessments were assessed (body mass index (BMI), circumference measures, body fat % and skeletal muscle mass). The prevalence of frailty was 14.6% and prefrail was 59.7%; 29.6% were at risk of malnutrition, and 3.3% were malnourished. Malnutrition risk was significantly associated with a higher number of chronic diseases, BMI, circumference of mid-upper arm (MUAC), and calf, (CC)and skeletal muscle mass (SMM) and frailty, whereas frailty was significantly associated with higher number of chronic diseases, SMM and malnutrition. Frailty syndrome can be predicted with increasing age, body fat, lower skeletal muscle and malnutrition. Those who were frail were found to be five times more likely to be at risk of malnutrition. Results suggested that frailty and malnutrition shared considerable overlap, which emphasised the interrelated but discrete concepts. Therefore, the assessment of malnutrition is imperative and could be used as a practical implication in assessing frailty syndrome.
  3. Ashri MHM, Saad HA, Adznam SN
    PMID: 33807907 DOI: 10.3390/ijerph18052626
    The current rapid growth of the economy has necessitated an assessment of health-related quality of life (HRQOL) and its associated factors among employees. Unfortunately, there are still limited data available in this area among the Malaysian working population in government sectors. The aim of this study was to evaluate the factors associated with HRQOL among government employees in Putrajaya, Malaysia. This cross-sectional study recruited 460 eligible government employees who worked in the area of Putrajaya through simple random sampling. The self-administered questionnaire was distributed to these participants to collect information on the SF-36 profile of scores, sociodemographic factors, lifestyle factors, and medical history. The results of this study signify that most of the participants were identified as having good HRQOL with the mean score of overall HRQOL was 72.42 ± 14.99. Multivariate analysis showed that being younger, receiving a better monthly personal income, a smaller household number, performing more physical activity, not having any chronic disease, and not using any long-term medication were significantly positively associated with overall HRQOL. The participants who did not have a family history of chronic disease were reported to be significantly associated with better mental component summary (MCS). Further, males were significantly positively associated with bodily pain (BP) and general health (GH) only, whereas better occupational status was limited to social functioning (SF). In conclusion, the results of this study provide motivation for future research and initiatives for improving the physical, emotional, and social well-being of government employees.
  4. Shahar S, Adznam SN, Lee LK, Yusof NA, Salleh M, Mohamed Sakian NI
    Public Health Nurs, 2013 Mar;30(2):140-9.
    PMID: 23452108 DOI: 10.1111/j.1525-1446.2012.01051.x
    This study aimed to determine the effectiveness of a nutrition education intervention package in improving anthropometric, clinical and biochemical indicators of rural older Malays with metabolic syndrome (MS).
  5. Mohd Hamidin FA, Adznam SN, Ibrahim Z, Chan YM, Abdul Aziz NH
    SAGE Open Med, 2018;6:2050312118775581.
    PMID: 29872529 DOI: 10.1177/2050312118775581
    Objective: Frailty is a clinical syndrome with increased risk of poor health outcomes and particularly prevalent in older adults and community population. The study's aim was therefore to determine the prevalence of frailty and its association with sociodemographic and socioeconomic characteristics, health-related status, and anthropometric measurements among community-dwelling older adults.

    Methods: A total of 279 older adults aged 60 years and above were randomly selected. Respondents were classified as non-frail (<2 criteria) or frail (≥3 criteria) based on the 'phenotype of frailty'. A binary logistic regression was used to determine predictors of frailty.

    Results: The prevalence of frailty was 18.3%. The frail older adults were positively associated with advanced age, being unmarried, hospitalisation in the previous year, poor self-rated health, and lower body mass index.

    Discussion: These results give an overview on underlying effects and guiding actions for prevention programmes functioning to reverse and minimise the adverse effects of frailty syndrome.

  6. Yen WC, Shariff ZM, Adznam SN, Sulaiman N, Siew CY
    Asia Pac J Clin Nutr, 2018 7 27;27(4):886-892.
    PMID: 30045435 DOI: 10.6133/apjcn.072017.02
    BACKGROUND AND OBJECTIVES: Information on the growth status of indigenous children is useful for developing intervention strategies, but the data are limited. This study determined the prevalence of undernutrition among under-five indigenous children (Orang Asli) and tracked the growth status of Orang Asli children aged 0-3 years.

    METHODS AND STUDY DESIGN: This study had two phases: a cross-sectional growth study of under-five Orang Asli children (N=304; Phase 1) and a 2-year prospective cohort growth study of Orang Asli children aged 0-3 years (N=214; Phase 2) in the Temerloh district of Pahang, Malaysia. Weight-for-age, length/height-for-age, weight-for-length/height, and body mass index-for-age were determined.

    RESULTS: The prevalence rates of stunting, underweight, wasting, and thinness in under-five Orang Asli children (Phase 1) were 64%, 49%, 14%, and 12%, respectively. In the cohort of 214 children (Phase 2), weight-for-age was initially documented and maintained closely at -1.50 standard deviations (SD) in the first 6 months, but it declined to approximately -2.00 SD at 15 months and remained close to -2.00 SD thereafter. Length/height-for-age declined rapidly to approximately -2.50 SD at 18 months and fluctuated between -2.30 and -2.50 SD thereafter. Weight-for-length/height increased sharply to -0.40 SD at 2-3 months, declined gradually to less than -1.00 SD at 12 months, and plateaued between -1.00 and -1.30 SD thereafter.

    CONCLUSIONS: Undernutrition is prevalent among Orang Asli children, with length rather than weight faltering being more pronounced in the first 2 years of life. Identifying the causes of early growth retardation in this population is required to inform future preventive strategies.

  7. Tajik E, Abd Latiff L, Adznam SN, Awang H, Yit Siew C, Abu Bakar AS
    J Sports Med Phys Fitness, 2017 Oct;57(10):1382-1387.
    PMID: 28004901 DOI: 10.23736/S0022-4707.16.06658-5
    BACKGROUND: Inadequate physical activity has adverse health consequences among adolescents. Mental health problem can be developed by lack of physical activity however it is controversial. The current study aimed to examine the association between level of physical activity with depression, anxiety and stress symptoms among adolescents.

    METHODS: A representative sample of 1747 adolescents (13-14 years) was randomly selected from 6 schools in a south part of Malaysia. Respondents were asked to fill consent form, and questionnaires including Depression Anxiety and Stress Scale-21 and Physical Activity Questionnaire for Adolescents.

    RESULTS: Majority of respondents (71.9%) was Malay and more than half of the adolescents had low physical activity. About 40% had depression symptoms, followed by anxiety symptoms (65.9%) and stress symptoms (38.5%). Level of physical activity was significantly associated with gender, anxiety and stress (P<0.001). There were no associations with race, religion and depression symptom.

    CONCLUSIONS: This study provides some evidence among school-going adolescents related to anxiety and stress symptoms and low physical activities. Further studies are needed to show the protection effects of higher physical activity for depression, anxiety and stress symptoms in adolescents.

  8. Law LS, Sulaiman N, Gan WY, Adznam SN, Mohd Taib MN
    PMID: 32244318 DOI: 10.3390/ijerph17072354
    In spite of the high prevalence of overweight and obesity among the Orang Asli (OA) of Malaysia being an increasing concern due to the associated adverse health implications, information regarding this issue is scarce. This cross-sectional study is aimed to investigate the predictors of overweight and obesity and its association with blood pressure and quality of life among Senoi OA women. A total of 19 villages at Batang Padang, Perak, were selected out of a total of 56 villages using a simple random sampling, in which 355 Senoi OA women were participated in the study. Face-to-face interviews were conducted to obtain information on sociodemographic characteristics, dietary intake, physical activity, and quality of life. Weight, height and blood pressure were also measured. The prevalence of overweight and obesity were 32.4% and 26.2%, respectively. In terms of multiple linear regression, monthly household income, total energy intake, and metabolic equivalents (METs) for domestic activities were found to have significantly contributed to body mass index (BMI). Furthermore, BMI contributed significantly towards levels of blood pressure and quality of life after controlling for monthly household income, total energy intake, and METs for domestic activities. In conclusion, there should be urgent attention to poverty and overweight/obesity among the OA women. The findings would aid in alerting policy makers and health professionals as underweight is no longer a sole nutritional problem among OA but it appears to be coexisting with overweight and obesity. Strategies for improving their socioeconomic status, promoting a balanced and moderate diet, and encouraging involvement of OA women in physical activities should be implemented to prevent overweight and obesity.
  9. Shahar S, Ibrahim Z, Fatah AR, Rahman SA, Yusoff NA, Arshad F, et al.
    Asia Pac J Clin Nutr, 2007;16(2):346-53.
    PMID: 17468093
    A multidimensional assessment of nutritional and health status comprised of subjective global assessment (SGA), anthropometry function, biochemistry, dietary intake, social and health aspects was carried out on 820 older people (52.8% men and 47.2% women) from four rural areas of Peninsular Malaysia. A proportion of the subjects had been classified as either overweight (25.7%) or chronic energy deficient (20.3%). Although 49% of subjects had normal body weight, 68.4% have been classified as having mild to moderate malnutrition according to the SGA. Only 1.1% and 2.3% had low serum albumin and ferritin, respectively. Almost 80% of subjects, especially men, were at high risk of cardiovascular diseases on the basis of the assessment of total cholesterol and LDL-cholesterol. The majority of the subjects (87.2%) were fully independent in performing daily tasks, with men having a significantly higher score compared to women (p<0.001). However, men were less likely to be able to perform a flexibility test (50.7%) than were women (27.0%) (p<0.05). The mean energy intake for men (1412 +/- 461 kcal/d) and women (1201 +/- 392 kcal/d) were below the Recommended Nutrient Intake (RNI) for Malaysia, although this is a difficult assertion to make in an age-group which generally experiences declining energy expenditure. Moreover, 52.5% of men and 47.5% of women might have underreported their food intake. Dietary micronutrients most likely to be deficient were thiamin, riboflavin and calcium. It is concluded that a substantial proportion of rural elderly Malays had problems related to both undernutrition and overnutrition. An appropriate nutrition intervention program is needed to improve the nutritional status of rural elderly Malays.
  10. Mohd Suffian NI, Adznam SN', Abu Saad H, Chan YM, Ibrahim Z, Omar N, et al.
    Nutrients, 2020 Sep 10;12(9).
    PMID: 32927741 DOI: 10.3390/nu12092758
    The ageing process has been associated with various geriatric issues including frailty. Without early prevention, frailty may cause multiple adverse outcomes. However, it potentially may be reversed with appropriate interventions. The aim of the study is to assess the effectiveness of nutritional education and exercise intervention to prevent frailty among the elderly. A 3-month, single-blind, two-armed, cluster randomized controlled trial of the frailty intervention program among Malaysian pre-frail elderly will be conducted. A minimum of total 60 eligible respondents from 8 clusters (flats) of Program Perumahan Rakyat (PPR) flats will be recruited and randomized to the intervention and control arm. The intervention group will receive a nutritional education and a low to moderate multi-component exercise program. To date, this is the first intervention study that specifically targets both the degree of frailty and an improvement in the outcomes of frailty using both nutritional education and exercise interventions among Malaysian pre-frail elderly. If the study is shown to be effective, there are major potential benefits to older population in terms of preventing transition to frailty. The findings from this trial will potentially provide valuable evidence and serve as a model for similar future interventions designed for elderly Malaysians in the community.
  11. Shahar S, Adznam SN, Rahman SA, Yusoff NA, Yassin Z, Arshad F, et al.
    BMC Geriatr, 2012 Jun 07;12:24.
    PMID: 22676577 DOI: 10.1186/1471-2318-12-24
    BACKGROUND: It is well known that older adults are often vulnerable to malnutrition. This action research was conducted to develop a nutrition education package for promoting healthy ageing and reducing risk of chronic diseases among older adults in a rural area of Malaysia.

    METHODS: This study was designed and conducted in three stages, including needs assessment, development of the package and analysis of acceptance among 33 older adults aged 60 years and over in rural communities, and 14 health staff members at rural health clinics. Subjects completed a questionnaire including sociodemographic factors and acceptance evaluation of the nutrition education package with respect to content, graphics and design. Data were analysed descriptively using numbers and percentages.

    RESULTS: A nutrition education package comprising a booklet, flipchart and placemats was developed. A total of 42.4% of the older adults expressed that the sentences in the flipchart needed to be simplified and medical terms explained. Terminology (60%), illustrations (20%) and nutrition recommendations (20%) were the aspects that prevented elderly subjects from fully understanding the booklet. Information on the placemats was easily understood by subjects.

    CONCLUSIONS: A well accepted nutrition education package for promoting healthy ageing and reducing risk of chronic diseases was developed that incorporated modifications based on feedback from older adult subjects and health clinic staff in a rural area. It is a tool that can effectively be used for health education in this population.

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