Urinary incontinence (UI) is a common disorder among older adults, with a global prevalence between 2% to 58%. UI has been associated with social isolation, increased morbidity and reduced quality of life (QoL). The aim of this study was to investigate the sociodemographic, clinical, cognitive and physical function risk factors of UI among Malaysian community dwelling older adults. This study is part of a larger scale population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). A total of 1560 Malaysian community dwelling older adults aged 60 years and above were screened in this phase III LRGS study. Participants sociodemographic and clinical history were obtained. Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT) and Digit Span tested cognitive function. Timed Up and Go Test (TUG), Hand Grip Strength Test, Chair Stand Test and Lawton Instrumental Activities of Daily Living tested physical function. The overall prevalence of UI was 15.7% (n = 245) in this study, with 11.8% (n = 88) in men and 19.3% (n = 157) in women. Logistic regression analysis showed that TUG (Adjusted odds ratio [OR], 1.071; 95% confidence interval [CI], 1.02-1.13), MMSE (OR, 0.93; CI, 0.90-0.97), weight (OR, 1.02; CI, 1.00-1.03), and constipation (OR 0.60; CI, 0.46-0.78) (p < 0.005) were significant risk factors of UI. The results indicate, decreased physical and cognitive function; increase in weight and having constipation increased the risk of UI. Maintaining optimum mobility, cognitive function, body weight and constipation prevention are vital in the prevention and management of UI among older adults.
Older adults who fall recurrently have sub-optimal physical performance especially muscle strength, mobility and balance. Recurrent falls lead to a heightened fear of falls. However, there is limited information regarding other domains of physical performance, namely flexibility and endurance. In addition, there is still limited knowledge pertaining fear of falls and physical activity levels among Malaysian community-dwelling older adults who are recurrent fallers. The aim of our study was to compare fear of falls, physical performance and physical activity levels among older adults with falls and recurrent falls. This cross- sectional study was carried out in two Malaysian urban districts. Physical performance was examined using Functional Fitness MOT (FFMOT). Modified Baecke Questionnaire and Activities-Specific Balance Confidence (ABC-6) Scale were administered to evaluate the level of daily physical activity and fear of falls respectively. A total of 35 older adults participated in this study, 20 fallers (mean age: 71.95±8.22) and 15 recurrent fallers (mean age: 76.73±8.82) respectively. Our study results showed that older adults with recurrent falls had significantly reduced lower extremity strength, dynamic balance, endurance, balance confidence in activities of daily living and physical activity levels compared to faller group (p < 0.05). Although flexibility and upper limb strength were not significantly different among fallers and recurrent fallers, overall improvement in physical performance should be targetted in falls prevention and management. This is vital to prevent further deterioration in physical performance among older adults with recurrent falls.
Falls are a public health concern among older adults. There is a need to take significant measures such as screening for the risk of a fall as a means of prevention and management. A cross-sectional study was conducted to determine discriminative and predictive ability of physical performance measures in identifying the risk of fall among Malaysian community dwelling older adults. Three hundred twenty-five Malaysian community dwelling older adults aged 60 years and above (67.67+ 5.5 years) participated in this study. This study was a part of a larger longitudinal study ‘LRGS TUA’. Physiological Profile Assessment (PPA), a comprehensive tool for quantifying risk of fall was used as a standard measure of comparison to 6 Meter Gait Speed (GS), Timed Up and Go (TUG) and Walking While Talking (WWT) tests to establish discriminative and predictive ability. Participants recorded incidence of falls in a ‘falls diary’ over a span of six months. To determine the optimum cut off scores of the test identified to classify fall risk, receiver operator curves (ROC) were used and its sensitivity and specificity were calculated. A significant mean difference between fallers and non-fallers was demonstrated only with TUG test (p<0.05). TUG test cut off score in discriminating older adults at risk of fall was established at eight seconds, with a sensitivity and specificity of 83.95% and 32.4%, respectively, in this study. Eighty-four percent older adults who experienced a fall in our study were identified to be at risk of fall when screened using this TUG cut off score. Our study results suggested TUG test to be an optimal screening tool for risk of fall among community dwelling older adults.