Displaying publications 1 - 20 of 39 in total

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  1. Vanoh D, Shahar S, Rosdinom R, Din NC, Yahya HM, Omar A
    Clin Interv Aging, 2016;11:579-87.
    PMID: 27274208 DOI: 10.2147/CIA.S102925
    BACKGROUND AND AIM:
    Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS).
    METHODOLOGY:
    A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis.
    RESULTS: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively.
    CONCLUSION: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.
    KEYWORDS: TUA-WELLNESS; mild cognitive impairment; screening; sensitivity; specificity
  2. Momtaz YA, Haron SA, Hamid TA, Ibrahim R, Masud J
    Clin Interv Aging, 2015;10:49-53.
    PMID: 25565786 DOI: 10.2147/CIA.S69220
    Despite several studies attempting to identify the risk factors for dementia, little is known about the impact of childhood living conditions on cognitive function in later life. The present study aims to examine the unique contribution of food insufficiency in childhood to dementia in old age.
  3. Ahmad MH, Shahar S, Teng NI, Manaf ZA, Sakian NI, Omar B
    Clin Interv Aging, 2014;9:1551-61.
    PMID: 25258524 DOI: 10.2147/CIA.S60462
    This study aimed to determine the factors associated with exercise behavior based on the theory of planned behavior (TPB) among the sarcopenic elderly people in Cheras, Kuala Lumpur. A total of 65 subjects with mean ages of 67.5±5.2 (men) and 66.1±5.1 (women) years participated in this study. Subjects were divided into two groups: 1) exercise group (n=34; 25 men, nine women); and 2) the control group (n=31; 22 men, nine women). Structural equation modeling, based on TPB components, was applied to determine specific factors that most contribute to and predict actual behavior toward exercise. Based on the TPB's model, attitude (β=0.60) and perceived behavioral control (β=0.24) were the major predictors of intention to exercise among men at the baseline. Among women, the subjective norm (β=0.82) was the major predictor of intention to perform the exercise at the baseline. After 12 weeks, attitude (men's, β=0.68; women's, β=0.24) and subjective norm (men's, β=0.12; women's, β=0.87) were the predictors of the intention to perform the exercise. "Feels healthier with exercise" was the specific factor to improve the intention to perform and to maintain exercise behavior in men (β=0.36) and women (β=0.49). "Not motivated to perform exercise" was the main barrier among men's intention to exercise. The intention to perform the exercise was able to predict actual behavior regarding exercise at the baseline and at 12 weeks of an intervention program. As a conclusion, TPB is a useful model to determine and to predict maintenance of exercise in the sarcopenic elderly.
  4. Singh DK, Manaf ZA, Yusoff NA, Muhammad NA, Phan MF, Shahar S
    Clin Interv Aging, 2014;9:1415-23.
    PMID: 25187701 DOI: 10.2147/CIA.S64997
    The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions.
  5. Chin KY, Ima-Nirwana S
    Clin Interv Aging, 2014;9:1247-59.
    PMID: 25120355 DOI: 10.2147/CIA.S67016
    BACKGROUND: Previous animal models have demonstrated that tocotrienol is a potential treatment for postmenopausal osteoporosis. This study evaluated the antiosteoporotic effects of annatto-derived tocotrienol (AnTT) using a testosterone-deficient osteoporotic rat model.
    METHODS: Forty rats were divided randomly into baseline, sham, orchidectomized, AnTT, and testosterone groups. The baseline group was euthanized without undergoing any surgical treatment or intervention. The remaining groups underwent orchidectomy, with the exception of the sham group. AnTT 60 mg/kg/day was given orally to the AnTT group, while the testosterone group received testosterone enanthate 7 mg/kg per week intramuscularly for 8 weeks. Structural changes in trabecular bone at the proximal tibia were examined using microcomputed tomography. Structural and dynamic changes at the distal femur were examined using histomorphometric methods. Serum osteocalcin and C-terminal of type 1 collagen crosslinks were measured. Bone-related gene expression in the distal femur was examined.
    RESULTS: There were significant degenerative changes in structural indices in the orchidectomized group (P<0.05), but no significant changes in dynamic indices, bone remodeling markers, or gene expression (P>0.05) when compared with the sham group. The AnTT group showed significant improvement in structural indices at the femur (P<0.05) and significantly increased expression of bone formation genes (P<0.05). Testosterone was more effective than AnTT in preventing degeneration of bone structural indices in the femur and tibia (P<0.05).
    CONCLUSION: AnTT supplementation improves bone health in testosterone-deficient rats by enhancing bone formation. Its potential should be evaluated further by varying the dosage and treatment duration.
    KEYWORDS: bone remodeling; osteoporosis; testosterone; tocotrienol
  6. Momtaz YA, Hamid TA, Ibrahim R
    Clin Interv Aging, 2014;9:813-9.
    PMID: 24872683 DOI: 10.2147/CIA.S61636
    There are several negative stereotypes about older adults that have negatively influenced people's attitude about aging. The present study compared emotional well-being between older adults and adolescents.
  7. Momtaz YA, Haron SA, Ibrahim R, Hamid TA
    Clin Interv Aging, 2014;9:863-70.
    PMID: 24904206 DOI: 10.2147/CIA.S62205
    BACKGROUND: The positive effect of social cohesion on well-being in older adults has been well documented. However, relatively few studies have attempted to understand the mechanisms by which social cohesion influences well-being. The main aim of the current study is to identify social pathways in which social cohesion may contribute to well-being.

    METHODS: The data for this study (taken from 1,880 older adults, aged 60 years and older) were drawn from a national survey conducted during 2008-2009. The survey employed a two-stage stratified sampling process for data collection. Structural equation modeling was used to test mediating and moderating analyses.

    RESULTS: The proposed model documented a good fit to the data (GFI =98; CFI =0.99; RMSEA =0.04). The findings from bootstrap analysis and the Sobel test revealed that the impact of social cohesion on well-being is significantly mediated by social embeddedness (Z=5.62; P<0.001). Finally, the results of a multigroup analysis test showed that social cohesion influences well-being through the social embeddedness mechanism somewhat differently for older men than women.

    CONCLUSION: The findings of this study, in addition to supporting the importance of neighborhood social cohesion for the well-being of older adults, also provide evidence that the impact of social cohesion towards well-being is mediated through the mechanism of social embeddedness.

  8. Al Aqqad SM, Chen LL, Shafie AA, Hassali MA, Tangiisuran B
    Clin Interv Aging, 2014;9:201-7.
    PMID: 24489461 DOI: 10.2147/CIA.S52356
    Nursing home residents are mainly older people with multiple diseases and taking multiple medications. The quality use of medication and its association with health related quality of life (HRQoL) have not been reported in Malaysia. This study aims to investigate the association between the use of potentially inappropriate medications (PIMs) and the changes observed in the HRQoL among older nursing home residents.
  9. Shahar S, Kamaruddin NS, Badrasawi M, Sakian NI, Abd Manaf Z, Yassin Z, et al.
    Clin Interv Aging, 2013;8:1365-75.
    PMID: 24143082 DOI: 10.2147/CIA.S46826
    Sarcopenia, characterized as muscle loss that occurs with aging, is a major health problem in an aging population, due to its implications on mobility, quality of life, and fall risk. Protein supplementation could improve the physical fitness by increasing protein anabolism, and exercise has a documented evidence of positive effect on functional status among the elderly. However, the combined effect of both protein supplementation and exercise has not been investigated among sarcopenic elderly in the Asian population. Thus, this study aimed to determine the effectiveness of exercise intervention and protein supplementation either alone or in combination for 12 weeks, on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia. Sixty five sarcopenic elderly Malays aged 60-74 years were assigned to the control group, exercise group (ExG), protein supplementation group (PrG), or the combination of exercise and protein supplementation group. A significant interaction effect between body weight and body mass index (BMI) was observed, with the PrG (-2.1% body weight, -1.8% BMI) showing the highest reductions. Further, there was a decrease in % body fat (-4.5%) and an increase in fat-free mass (kg) (+5.7%) in the ExG after 12 weeks (P < 0.05). The highest increments in lower and upper body strength were observed in the PrG (73.2%) and ExG (47.6%), respectively. In addition, the ExG showed a reduction in superoxide dismutase (SOD) levels, and both interventions did not alter either lipid or protein oxidation. In conclusion, the exercise program was found to improve muscle strength and body composition, while protein supplementation reduced body weight and increased upper body strength, among sarcopenic elderly in Malaysia.
  10. Momtaz YA, Hamid TA, Masud J, Haron SA, Ibrahim R
    Clin Interv Aging, 2013;8:1413-20.
    PMID: 24174873 DOI: 10.2147/CIA.S51877
    BACKGROUND: There is a growing body of literature indicating that attitudes toward aging significantly affect older adults' psychological well-being. However, there is a paucity of scientific investigations examining the role of older adults' attitudes toward aging on their spouses' psychological well-being. Therefore, the present study aimed to examine the dyadic effects of attitude toward aging on the psychological well-being of older couples.
    METHODS: Data for the present study, consisting of 300 couples aged 50 years and older, were drawn from a community-based survey entitled "Poverty among Elderly Women: Case Study of Amanah Ikhtiar" conducted in Peninsular Malaysia. An actor-partner interdependence model using AMOS version 20 (Europress Software, Cheshire, UK) was used to analyze the dyadic data.
    RESULTS: The mean ages of the husbands and wives in this sample were 60.37 years (±6.55) and 56.33 years (±5.32), respectively. Interdependence analyses revealed significant association between older adults' attitudes toward aging and the attitudes of their spouses (intraclass correlation =0.59; P<0.001), and similar interdependence was found for psychological well-being (intraclass correlation =0.57; P<0.001). The findings from AMOS revealed that the proposed model fits the data (CMIN/degrees of freedom =3.23; goodness-of-fit index =0.90; confirmatory fit index =0.91; root mean square error of approximation =0.08). Results of the actor-partner independence model indicated that older adults' psychological well-being is significantly predicted by their spouses' attitudes toward aging, both among older men (critical ratio =2.92; P<0.01) and women (critical ratio =2.70; P<0.01). Husbands' and wives' own reports of their attitudes toward aging were significantly correlated with their own and their spouses' psychological well-being.
    CONCLUSION: The findings from this study supported the proposed Spousal Attitude-Well-Being Model, where older adults' attitudes toward aging significantly affected their own and their spouses' psychological well-being. The theoretical and practical implications of the findings are discussed.
    KEYWORDS: aged; attitude toward aging; psychological well-being
  11. Badrasawi MM, Shahar S, Abd Manaf Z, Haron H
    Clin Interv Aging, 2013;8:279-85.
    PMID: 23493965 DOI: 10.2147/CIA.S37586
    Talbinah is a barley syrup cooked with milk and sweetened by honey. In his famous Hadith on Talbinah, the Prophet Mohammad (SAW) recommended it when sad events happen for its effect on soothing hearts and relieving sadness. This 3-week crossover designed, randomized clinical trial was conducted to determine the effect of Talbinah on mood and depression among institutionalized elderly people in Seremban. A sample of 30 depressed elderly subjects (21 men and 9 women) was selected from the long term care facility. Three different interview-based validated scales (Geriatric Depression Scale, Depression Anxiety Stress Scales, and Profile of Mood States) were used to determine mood, depression, stress, and anxiety at week 0, 3, 4, and 7. The nutritional value of Talbinah was examined using proximate food analysis, minerals content analysis, and differential amino acid analysis. The results indicated that Talbinah is a high carbohydrate food (86.4%) and has a high tryptophan: branch chain amino acids ratio (1:2). A Wilcoxon nonparametric test showed that there was a statistically significant decrease on depression, stress, and mood disturbances scores among the intervention group (P < 0.05) for all parameters. In conclusion, Talbinah has the potential to reduce depression and enhance mood among the subjects. Ingestion of functional foods such as Talbinah may provide a mental health benefit to elderly people.
    Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-12R), Depression Anxiety Stress Scales (DASS-21); Profile of Mood States (POMS-65)
  12. Shahar S, Aziz AF, Ismail SN, Yahya HM, Din NC, Manaf ZA, et al.
    Clin Interv Aging, 2015;10:1505-20.
    PMID: 26445532 DOI: 10.2147/CIA.S86411
    BACKGROUND: Polygonum minus (PM) or locally known in Malaysia, as "kesum" is rich in micronutrients and natural antioxidants. However, its beneficial effect on outcome associates with oxidative stress including cognitive function is yet to be discovered. We assessed the efficacy of PM extract (LineMinus™) on cognitive function and psychosocial status among middle-aged women in Klang Valley of Malaysia.

    METHODS: A randomized, double-blind, placebo-controlled trial among 35 healthy middle-aged women was performed, and subjects were randomized to receive either 250 mg PM or placebo of 100 mg maltodextrin each were taken twice daily for 6 weeks. Subjects were assessed for neuropsychological test, psychosocial status, and anthropometric at baseline, week 3, and week 6. Biomarkers were also determined at baseline and week 6.

    RESULTS: The supplementation of PM showed significant intervention effect on Digit Span test (P<0.05) social functioning domain of 36-Item Short Form Health Survey (P<0.05) among subjects with mood disturbance. While, among subjects with good mood, PM supplementation improved Wechsler Abbreviated Scale of Intelligence (WASI) for IQ verbal (P=0.016) and Full Scale IQ of WASI (P=0.004). There were no adverse effects reported for the supplementation as indicated using biomarkers, including liver function and clinical symptoms.

    CONCLUSION: Supplementation of PM is safe to be consumed for 6 weeks, with potential benefits to attention, short-term memory, improved quality of life, and mood, as well as IQ.

  13. Chin KY, Nirwana SI, Ngah WZ
    Clin Interv Aging, 2015;10:1377-80.
    PMID: 26346636 DOI: 10.2147/CIA.S90233
    Previous reports of patients undergoing parathyroidectomy and of patients receiving teriparatide as antiosteoporotic treatment have suggested a plausible relationship between parathyroid hormone (PTH) and uric acid. However, similar data at population level were lacking. The current study aimed to determine the relationship between PTH and uric acid in a group of apparently healthy Malaysian men.
  14. Singh DK, Pillai SG, Tan ST, Tai CC, Shahar S
    Clin Interv Aging, 2015;10:1319-26.
    PMID: 26316727 DOI: 10.2147/CIA.S79398
    Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests.
  15. Eshkoor SA, Hamid TA, Mun CY, Ng CK
    Clin Interv Aging, 2015;10:687-93.
    PMID: 25914527 DOI: 10.2147/CIA.S73922
    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide.
  16. Lau H, Shahar S, Mohamad M, Rajab NF, Yahya HM, Din NC, et al.
    Clin Interv Aging, 2019;14:43-51.
    PMID: 30613138 DOI: 10.2147/CIA.S183425
    Background: Dorsolateral prefrontal cortex (DLPFC) is a key node in the cognitive control network that supports working memory. DLPFC dysfunction is related to cognitive impairment. It has been suggested that dietary components and high-density lipoprotein cholesterol (HDL-C) play a vital role in brain health and cognitive function.

    Purpose: This study aimed to investigate the relationships between dietary nutrient intake and lipid levels with functional MRI (fMRI) brain activation in DLPFC among older adults with mild cognitive impairment.

    Participants and methods: A total of 15 community-dwelling older adults with mild cognitive impairment, aged ≥60 years, participated in this cross-sectional study at selected senior citizen clubs in Klang Valley, Malaysia. The 7-day recall Diet History Questionnaire was used to assess participants' dietary nutrient intake. Fasting blood samples were also collected for lipid profile assessment. All participants performed N-back (0- and 1-back) working memory tasks during fMRI scanning. DLPFC (Brodmann's areas 9 and 46, and inferior, middle, and superior frontal gyrus) was identified as a region of interest for analysis.

    Results: Positive associations were observed between dietary intake of energy, protein, cholesterol, vitamins B6 and B12, potassium, iron, phosphorus, magnesium, and HDL-C with DLPFC activation (P<0.05). Multivariate analysis showed that vitamin B6 intake, β=0.505, t (14)=3.29, P=0.023, and Digit Symbol score, β=0.413, t (14)=2.89, P=0.045; R2=0.748, were positively related to DLPFC activation.

    Conclusion: Increased vitamin B6 intake and cognitive processing speed were related to greater activation in the DLPFC region, which was responsible for working memory, executive function, attention, planning, and decision making. Further studies are needed to elucidate the mechanisms underlying the association.

  17. Chong CP, Shahar S, Haron H, Din NC
    Clin Interv Aging, 2019;14:1331-1342.
    PMID: 31413554 DOI: 10.2147/CIA.S211534
    Background: Sugar is widely consumed in Malaysia, and the excessive intake of sugar has been associated with cognitive functions. However, the association between sugar intake and cognitive impairment among Malaysian older adults is yet to be determined. Purpose: The objective of this study was to evaluate the associations between types and sources of sugar intake and cognitive functions and to identify their risk in predicting cognitive impairment (MMSE score <24). Subjects and methods: A total of 1,209 subjects aged ≥60 years were recruited through multi-stage random sampling from selected states in Malaysia. Dietary intake was derived using a 7-day dietary history questionnaire and supplemented with a quantitative food frequency questionnaire for added sugar intake. Results: The prevalence of cognitive impairment as defined by Mini-Mental State Examination (MMSE) less than 24 was 31.9%, while the prevalence of mild cognitive impairment was 13.1%. The median (IQR) for total sugar intake was 44.60 g/day (26.21-68.81) or 8 tsp, and free sugar intake was 33.08 g/day (17.48-57.26) or 6 tsp. The higher intake of total sugars, free sugars, sucrose, lactose, sugar-sweetened beverages, sugar-sweetened cakes, and dessert was found to be significantly associated with a lower MMSE score, after adjusting for covariates. On the other hand, the consumption of cooked dishes and fruits was significantly associated with a better MMSE score. The adjusted OR for risk of cognitive impairment (MMSE score <24) was 3.30 (95% CI 2.15-5.08) for total sugars and 3.58 (95% CI 2.32-5.52) for free sugars, comparing the highest with the lowest intake percentiles. Conclusion: Excessive sugar consumption among older adults showed a notable association with poor cognitive functions, but longitudinal studies and clinical trials are further needed to clarify the direction of causality and to investigate the underlying mechanism.
  18. Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, et al.
    Clin Interv Aging, 2021;16:161-175.
    PMID: 33531799 DOI: 10.2147/CIA.S266587
    Purpose: Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults.

    Methods: Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013-2014) and at follow-up (2015-2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data.

    Results: The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users.

    Conclusion: Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.

  19. Chin KY, Kamaruddin AA, Low NY, Ima-Nirwana S
    Clin Interv Aging, 2016;11:767-73.
    PMID: 27358558 DOI: 10.2147/CIA.S108772
    Osteoporosis is a significant health problem in the developing countries and its prevalence data are important for the estimation of health care burden and policy making. This study aimed to determine the age-related changes in bone health and the prevalence of osteoporosis in males and females aged 50 years or above living in Kuala Lumpur, Malaysia.
  20. Mohamad NV, Soelaiman IN, Chin KY
    Clin Interv Aging, 2016;11:1317-1324.
    PMID: 27703340
    Osteoporosis is a condition causing significant morbidity and mortality in the elderly population worldwide. Age-related testosterone deficiency is the most important factor of bone loss in elderly men. Androgen can influence bone health by binding to androgen receptors directly or to estrogen receptors (ERs) indirectly via aromatization to estrogen. This review summarized the direct and indirect effects of androgens on bone derived from in vitro, in vivo, and human studies. Cellular studies showed that androgen stimulated the proliferation of preosteoblasts and differentiation of osteoblasts. The converted estrogen suppressed osteoclast formation and resorption activity by blocking the receptor activator of nuclear factor k-B ligand pathway. In animal studies, activation of androgen and ERα, but not ERβ, was shown to be important in acquisition and maintenance of bone mass. Human epidemiological studies demonstrated a significant relationship between estrogen and testosterone in bone mineral density and fracture risk, but the relative significance between the two remained debatable. Human experimental studies showed that estrogen was needed in suppressing bone resorption, but both androgen and estrogen were indispensable for bone formation. As a conclusion, maintaining optimal level of androgen is essential in preventing osteoporosis and its complications in elderly men.
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