In the past decade, the population in Malaysia has been rapidly ageing. This poses new challenges and issues that threaten the ability of the elderly to independently age in place. A multistage cross-sectional study on 789 community-dwelling elderly individuals aged 60 years and above was conducted in an urban district in Malaysia to assess the geriatric syndrome of frailty. Using a multidimensional frailty index, we detected 67.7% prefrail and 5.7% frail elders. Cognitive status was a significant correlate for frailty status among the respondents as well as those who perceived their health status as very poor or quite poor; but self-rated health was no longer significant when controlled for sociodemographic variables. Lower-body weakness and history of falls were associated with increasing frailty levels, and this association persisted in the multivariate model. This study offers support that physical disability, falls, and cognition are important determinants for frailty. This initial work on frailty among urban elders in Malaysia provides important correlations and identifies potential risk factors that can form the basis of information for targeted preventive measures for this vulnerable group in their prefrail state.
Indoor air quality (IAQ) has recently gained substantial traction as the airborne transmission of infectious respiratory disease becomes an increasing public health concern. Hospital indoor environments are complex ecosystems and strategies to improve hospital IAQ require greater appreciation of its potentially modifiable determinants, evidence of which are currently limited. This mini-review updates and integrates findings of previous literature to outline the current scientific evidence on the relationship between hospital IAQ and building design, building operation, and occupant-related factors. Emerging evidence has linked aspects of building design (dimensional, ventilation, and building envelope designs, construction and finishing materials, furnishing), building operation (ventilation operation and maintenance, hygiene maintenance, access control for hospital users), and occupants' characteristics (occupant activities, medical activities, adaptive behavior) to hospital IAQ. Despite the growing pool of IAQ literature, some important areas within hospitals (outpatient departments) and several key IAQ elements (dimensional aspects, room configurations, building materials, ventilation practices, adaptive behavior) remain understudied. Ventilation for hospitals continues to be challenging, as elevated levels of carbon monoxide, bioaerosols, and chemical compounds persist in indoor air despite having mechanical ventilation systems in place. To curb this public health issue, policy makers should champion implementing hospital IAQ surveillance system for all areas of the hospital building, applying interdisciplinary knowledge during the hospital design, construction and operation phase, and training of hospital staff with regards to operation, maintenance, and building control manipulation. Multipronged strategies targeting these important determinants are believed to be a viable strategy for the future control and improvement of hospital IAQ.