MATERIALS AND METHODS: This cross-sectional study was carried out on 226 respondents, using a questionnaire which had 4 sections: socio-demographic data, personal information, family information and social information. Data was analyzed using SPSS® version 16. For categorical variables, comparisons were made using Chi-square and for numerical variables a t-test was performed.
RESULTS: The current smoker prevalence rate was 20.8% which showed a significant association between smoking and individual factors: level of knowledge on the effects of smoking (p < 0.05), significant association was seen between smoking and marital status of parents, smoking status of male siblings and various other aspects of the individuals themselves.
CONCLUSIONS: Concerted efforts involving various parties should be taken to curb or prevent this problem or the number of teenage smokers in the country will increase. This in the long run will invite problems to the well being of the adolescents themselves, their families, community and the nation as a whole.
RECENT FINDINGS: Methods of acquisition and analysis of BPV and cognitive measurements and their relationship were extracted from selected articles. Of 656 studies identified, 53 articles were selected. Twenty-five evaluated long-term (LTBPV), nine mid-term (MTBPV), 12 short-term (STBPV) and nine very short-term BPV (VSTBPV) with conflicting findings on the relationship between BPV and cognition. Variations existed in devices, period and procedure for acquisition. The studies also utilized a wide range of methods of BPV calculation. Thirteen cognitive assessment tools were used to measure global cognition or domain functions which were influenced by the population of interest. The interpretation of available studies was hence limited by heterogeneity. There is an urgent need for standardization of BPV assessments to streamline research on BPV and cognition. Future studies should also establish whether BPV could be a potential modifiable risk factor for cognitive decline, as well as a marker for treatment response.
METHODS: Cross-sectional analysis of the Malaysian Elders Longitudinal Research (MELoR) study involving community-dwelling individuals aged >55 years was conducted. Information on sociodemographic factors, medical history, and lifestyle were obtained by computer-assisted interviews in participants' homes. Cognitive performance was assessed with the Montreal Cognitive Assessment (MoCA) tool during subsequent hospital-based health checks. Hierarchical multiple linear regression analyses were conducted with continuous MoCA scores as the dependent variable.
RESULTS: Data were available for 1,140 participants, mean (standard deviation [SD]) = 68.48 (7.23) years, comprising 377 (33.1%) ethnic Malays, 414 (36.3%) Chinese, and 349 (30.6%) Indians. Mean (SD) MoCA scores were 20.44 (4.92), 23.97 (4.03), and 22.04 (4.83) for Malays, Chinese, and Indians, respectively (p = 0.01). Age >75 years, <12 years of education, and low functional ability were common risk factors for low cognitive performance across all three ethnic groups. Cognitive performance was positively associated with social engagement among the ethnic Chinese (β [95% CI] = 0.06 [0.01, 0.11]) and Indians (β [95% CI] = 0.16 [0.09, 0.23]) and with lower depression scores (β [(95% CI] = -0.08 [-0.15, -0.01]) among the ethnic Indians.
CONCLUSION: Common factors associated with cognitive performance include age, education, and functional ability, and ethnic-specific factors were social engagement and depression. Interethnic comparisons of risk factors may form the basis for identification of ethnic-specific modifiable risk factors for cognitive decline and provision of culturally acceptable prevention measures.
METHOD: This was a prospective study utilizing data from the Malaysian Elders Longitudinal Research (MELoR) study, which involved community-dwelling older adults aged 55 years and above at recruitment. Baseline (2013-2015) and wave 3 (2019) data were analyzed. Sarcopenia risk was determined using the strength, assistance walking, rising from a chair, climbing stairs, and falls (SARC-F) tool, with SARC-F ≥ 4 indicating sarcopenia. Baseline physical performance test scores were dichotomized using ROC-determined cut-offs.
RESULT: Data were available from 774 participants with mean age of 68.13 (SD = 7.13) years, 56.7% women. Cut-offs values for reduced GS, TUG, FR, and HGS were: <0.7 m/s (72.9% sensitivity and 53% specificity), >11.5 s (74.2%; 57.2%), <22.5 cm (73%; 54.2%) and HGS male <22 kg (70.0%; 26.7%) and female <17 kg (70.0%; 20.3%) respectively. Except for FR = 1.76 (1.01-3.06), GS = 2.29 (1.29-4.06), and TUG = 1.77 (1.00-3.13) were associated with increased sarcopenia risk after adjustments for baseline demographics and sarcopenia.
CONCLUSION: The defined cut-off values may be useful for the early detection of five-year sarcopenia risk in clinical and community settings. Despite HGS being a commonly used test to assess strength capacity in older adults, we advocate alternative strength measures, such as the sit-to-stand test, to be included in the assessment. Future studies should incorporate imaging modalities in the classification of sarcopenia to corroborate current study findings.
METHODS: Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers.
RESULTS: Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss.
CONCLUSION: Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.
DESIGN: Cross-sectional study.
SETTING: Teaching Hospital.
PARTICIPANTS: 1085 individuals aged 55 years or over.
MEASUREMENTS: Phase Angle was obtained using bioimpedance analysis with the Bodystat QuadScan® 4000. Diabetes mellitus was considered present with fasting hyperglycaemia (serum fasting glucose >6.66 mmol/l), HbA1c > 42 mmol/mol (6.1%), or self-reported Diabetes or the consumption of glucose-lowering agents.
RESULTS: The mean age of the (standard deviation) of the 1,085 participants was 68.11 (7.12) years and 60.7% were women. Among male participants, individuals with PhA within the lowest quartile (PhA ≤4.9) were significantly more likely to have diabetes mellitus [odds Ratio (95% confidence interval, CI), 2.02 (1.17-3.47)] following adjustments for age, body mass index and other comorbidities. The above relationship was attenuated following further adjustment hypoglycaemic medications. Men on oral hypoglycaemic agents had significantly reduced PhA [mean difference (95% CI), -0.44 (-0.67 to -0.22)]. No significant relationship between PhA and diabetes existed among women.
CONCLUSION: The association between lower PhA (≤4.9) in men aged 55 and over and diabetes which is accounted for by oral hypoglycaemic agents. The mechanisms underlying this relationship remain unclear. This relationship should also be evaluated further to determine the potential of PhA as a prognostic tool for diabetes.
METHODS: Community-dwelling adults aged 55 years and over were recruited through electoral roll sampling. Data obtained at baseline and follow-up (FU) at two and five years were included. Falls in the preceding 12 months were recorded.
RESULTS: Of the 1499 individuals (mean (SD) age= 68.9(7.5) yrs and 53.3% female) with information on baseline ACB exposure, 575(38.4%) had ACB scores of 1-2 and 117(7.8%) had ACB scores ≥3. Differences in age, ethnicity, smoking status, diabetes, hypertension, cardiovascular disease, arthritis and education existed between ACB groups. Fall occurrence differed between ACB groups at recruitment (p = 0.004) and 2-year FU (p = 0.001) but not at 5-year FU (p = 0.053). Logistic regression revealed an independent association between ACB 1-2 and falls at baseline (odds ratio, OR (95% confidence interval, CI) =1.412(1.035-1.926)) and ACB≥3 and falls at 2-yr FU (OR (95%CI) =2.098(1.032-4.263)) following adjustment for confounders.
CONCLUSION: Low level exposure to drugs with anticholinergic properties was associated cross-sectionally with falls, while exposure to higher levels were prospectively associated with falls at 2-year but not at 5-year FU. Future studies should determine whether avoidance of drugs with anticholinergic effects will lead to reduction in falls.
METHODS: This was a single-center, prospective, and single-blind randomized controlled trial conducted at the University Malaya Medical Centre. Patients older than 65 years presenting to the hospital emergency department or geriatric clinic with 1 injurious fall or 2 falls in the past year and with impaired functional mobility were included in the study. The intervention group received a modified OEP intervention (n = 34) for 3 months, while the control group received conventional care (n = 33). All participants were assessed at baseline and 6 months.
RESULTS: Twenty-four participants in both OEP and control groups completed the 6-month follow-up assessments. Within-group analyses revealed no difference in grip strength in the OEP group (P = 1.00, right hand; P = .55, left hand), with significant deterioration in grip strength in the control group (P = .01, right hand; P = .005, left hand). Change in grip strength over 6 months significantly favored the OEP group (P = .047, right hand; P = .004, left hand). Significant improvements were also observed in mobility and balance in the OEP group.
CONCLUSIONS: In addition to benefits in mobility and balance, the OEP also prevents deterioration in upper limb strength. Additional benefits of exercise interventions for secondary prevention of falls in term of sarcopenia and frailty should also be evaluated in the future.
METHODS: Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment.
RESULTS: Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments.
CONCLUSION: Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline.
AIM: To investigate the effects of COVID-19 pandemic on self-management, pain, and physical function in older adults awaiting TKA in Malaysia.
METHODS: This cross-sectional study has the data of participants, who matched the criteria and scheduled for TKA for the first time, extracted from the TKA registry in the Department of Orthopaedics and Traumatology, Hospital Canselor Tuanku Mukhriz. Data on pain status, and self-management, physical frailty, and instrumental activities daily living were also collected. Multiple linear regression analysis with a significant level of 0.05 was used to identify the association between waiting time and pain on physical frailty and functional performance.
RESULTS: Out of 180 had deferred TKA, 50% of them aged 50 years old and above, 80% were women with ethnic distribution Malay (66%), Chinese (22%), Indian (10%), and others (2%) respectively. Ninety-two percent of the participants took medication to manage their pain during the waiting time, while 10% used herbs and traditional supplements, and 68% did exercises as part of their osteoarthritis (OA) self-management. Thirty-six participants were found to have physical frailty (strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire score > 4) which accounted for 72%. Increased pain was associated with physical frailty with odds ratio, odds ratio (95% confidence interval): 1.46 (1.04-2.05). This association remained significant even after the adjustment according to age and self-management.
CONCLUSION: While deferring TKA during a pandemic is unavoidable, patient monitoring for OA treatment during the waiting period is important in reducing physical frailty, ensuring the older patients' independence.