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  1. Ponvel, P., Devinder K.A. Singh, Yan Hang, M., Muniandy Y., Mokhtar, S.
    Medicine & Health, 2018;13(2):122-132.
    MyJurnal
    While socio-demographic, physical and other factors are associated with neck pain, there is scanty literature about how these factors are associated with disability in adults suffering from this condition. We aimed to determine the socio-demographic and physical (strength and range of motions) related factors of disability in adults with non-specific chronic neck pain. A total of 34 adults with neck pain, with mean age 55 (10.80) years from a physiotherapy clinic in a teaching hospital participated in this study. Socio-demographic details such as body mass index (BMI), current employment status, hours of exercise done a week were obtained. Severity of pain was evaluated using the Numerical Rating Scale (NRS). Disability level was assessed using Neck Disability Index. Cervical range of motion was measured using the Cervical Range of Motion device. A hand dynamometer was used to measure the dominant hand grip muscle strength. The data was analyzed using descriptive and stepwise linear regression analysis. More than half the participants were females, above 50 years, in the overweight group (BMI>25 kg/m2), currently unemployed and had severe neck pain (NRS >7). Handgrip strength was the only factor found to be significantly (p
  2. Murukesu RR, Singh DKA, Subramaniam P, Tan XV, Mohamd Izhar IA, Ponvel P, et al.
    PMID: 31779256 DOI: 10.3390/ijerph16234716
    AIM: There is limited information about the association between frailty, cognitive status and functional fitness in older adults living in institutions. We aimed to determine the prevalence of frailty and its association with cognitive status and functional fitness among pre-frail and frail Malaysian older adults residing in institutions on the west coast of Peninsular Malaysia.

    METHODS: This study included 302 ambulating Malaysian institutionalised older adults. Frailty was identified using Fried's frailty criteria. Cognitive status was assessed using the Mini Mental State Examination and Addenbrooke's Cognitive Examination. Functional fitness was assessed using the Senior Fitness test. The association between frailty groups, cognitive status and functional fitness was analysed using binary logistic regression.

    RESULTS: Prevalence of frailty, prefrailty and robustness in the older adults was 56.6%, 40.7% and 2.9%, respectively. Frailty was found to be associated with hypertension (OR 2.15, 95% CI: 1.11-4.16, p = 0.024), lower cognitive status (Addenbrooke's Cognitive Examination) (OR 0.98, 95% C.I: 0.96-0.99, p = 0.038), and lower dynamic balance and mobility (Timed Up and Go test) (OR 1.09, 95% CI: 1.01-1.16, p = 0.024).

    CONCLUSION: Frailty is highly prevalent among Malaysian institutionalised older adults. Hypertension, cognitive impairment and lower dynamic balance and mobility were found to be risk factors of frailty. Screening of frailty and its associated factors should be prioritized among institutionalised older adults in view of early prevention and rehabilitation.

  3. Ponvel P, Shahar S, Singh DKA, Ludin AFM, Rajikan R, Rajab NF, et al.
    J Alzheimers Dis, 2021;82(2):673-687.
    PMID: 34092633 DOI: 10.3233/JAD-201607
    BACKGROUND: Cognitive frailty (CF) is identified as one of the main precursors of dementia. Multidomain intervention has been found to delay or prevent the onset of CF.

    OBJECTIVE: The aim of our present study is to determine the effectiveness of a comprehensive, multidomain intervention on CF; to evaluate its cost effectiveness and the factors influencing adherence toward this intensive intervention.

    METHODS: A total of 1,000 community dwelling older adults, aged 60 years and above will be screened for CF. This randomized controlled trial involves recruitment of 330 older adults with CF from urban, semi-urban, and rural areas in Malaysia. Multidomain intervention comprised of physical, nutritional, cognitive, and psychosocial aspects will be provided to participants in the experimental group (n = 165). The control group (n = 165) will continue their usual care with their physician. Primary outcomes include CF status, physical function, psychosocial and nutritional status as well as cognitive performance. Vascular health and gut microbiome will be assessed using blood and stool samples. A 24-month intensive intervention will be prescribed to the participants and its sustainability will be assessed for the following 12 months. The effective intervention strategies will be integrated as a personalized telerehabilitation package for the reversal of CF for future use.

    RESULTS: The multidomain intervention developed from this trial is expected to be cost effective compared to usual care as well as able is to reverse CF.

    CONCLUSION: This project will be part of the World-Wide FINGERS (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) Network, of which common identifiable data will be shared and harmonized among the consortia.

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