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  1. Azizan A, Justine M, Kuan CS
    Curr Gerontol Geriatr Res, 2013;2013:282315.
    PMID: 24489539 DOI: 10.1155/2013/282315
    Background. This study determines the effects of a behavioral program on exercise adherence (step counts) and level of exercise self-efficacy (ESE) in community-dwelling older persons. Methods. Sixty-three participants (age = 63.8 ± 4.5 years) were enrolled in this controlled quasi-experimental study. They were divided into 3 groups: (1) EBG performed a 6-week exercise intervention followed by a 5-week behavioral program, (2) EG performed exercise intervention similar to EBG, and (3) control group (CG) did not receive any interventions. Step counts were measured based on the scores recorded by a pedometer while ESE was measured by a self-reported ESE scale. Results. Data analysis showed significant differences due to time effect (F(1,2) = 39.884, P < 0.01, and η = .399); time and group interactions (F(2,60) = 112.683, P < 0.01, and η = .790); and between-group effect (F(2,60) = 12.524, P < 0.01, and η = .295) for step counts. As for ESE, significant differences were also found for time effect (F(2,4) = 66.628, P < 0.05, and η = .526); time and group interactions (F(2,60) = 4.562, P = 0.014, and η = .132); and between-group effect (F(2,60) = 13.632, P < 0.05, and η = .312). EBG presented with significantly higher mean changes for both step counts and ESE compared to other groups (all P < 0.05). Conclusion. This study suggests that the addition of a behavioral program is superior as compared to exercising alone on increasing exercise adherence and level of self-efficacy in older persons.
  2. Azidah AK, Hasniza H, Zunaina E
    Curr Gerontol Geriatr Res, 2012;2012:539073.
    PMID: 22693496 DOI: 10.1155/2012/539073
    The purpose of this study is to determine the prevalence of falls and its associated factors among elderly diabetes type 2 patients attending a tertiary center in Malaysia. We conducted a cross-sectional study among 288 elderly diabetes type 2. The data collected includes data on sociodemographic, diabetes history, comorbid diseases, drug use, and activity of daily living (Barthel's index). The patient also was examined physically, and balance and gait assessment was carried out. Prevalence of falls among elderly diabetes was 18.8%. Female gender (OR: 2.54, P < 0.05), age group more than 75 (OR: 2.97, P < 0.05), retinopathy (OR: 2.19, P < 0.05), and orthostatic hypotension (OR: 2.87, P < 0.05) were associated with higher risk for falls. High balance and gait score was associated with reduced risk of fall in elderly diabetes (OR: 0.89, P < 0.05). In conclusion, the factors that are associated with higher risk for falls among elderly diabetes were female sex, age group more than 75, presence of retinopathy, and orthostatic hypotension. Those who had higher balance and gait score were found to be less likely to fall compared with those with lower score.
    Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia
    Questionnaires, Scales, Device: Tinetti Balance and Gait Assessment; 5.07 Semmes- Weinstein monofilament; Barthel’s index
    Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
  3. Ishak NA, Zahari Z, Justine M
    Curr Gerontol Geriatr Res, 2016;2016:8583963.
    PMID: 27872641
    This study aims to compare muscle functions and functional performances between older persons with and without low back pain (LBP) and to determine the association between muscle functions and functional performances. This is a cross-sectional study, involving 95 older persons (age = 70.27 ± 7.26 years). Anthropometric characteristics, muscle functions, and functional performances were measured. Data were analyzed using ANOVA, Pearson's correlation, and multiple linear regression. The functional performances showed no significant differences (females LBP versus non-LBP, males LBP versus non-LBP) (p < 0.05). For muscle functions, significant differences were found (females LBP versus non-LBP) for abdominal muscle strength (p = 0.006) and back muscle strength (p = 0.07). In the LBP group, significant correlations were found between back and abdominal muscle strength and hand grip strength (r = 0.377 and r = 0.396, resp.), multifidus control and lower limb function (r = 0.363) in females, and back muscle strength and lower limb function (r = 0.393) in males (all p < 0.05). Regression analysis showed that abdominal and back muscle strengths were significant predictors of hand grip strength (p = 0.041 and p = 0.049, resp.), and multifidus control was a significant predictor of lower limb function in females (p = 0.047). This study demonstrates that older women with LBP exhibit poorer muscle functions compared to older women without LBP.
  4. Lau H, Mat Ludin AF, Rajab NF, Shahar S
    Curr Gerontol Geriatr Res, 2017;2017:4218756.
    PMID: 29109736 DOI: 10.1155/2017/4218756
    The increase of ageing population has raised public attention on the concept of successful ageing. Studies have shown that vitamin D, telomere length, and brain-derived neurotrophic factor (BDNF) have been associated with cognitive function. Therefore, this study aimed to identify neuroprotective factors for cognitive decline in different ageing groups. A total of 300 older adults aged 60 years and above were recruited in this population based cross-sectional study. Participants were categorized into three groups: mild cognitive impairment (MCI) (n = 100), usual ageing (UA) (n = 100), and successful ageing (SA) (n = 100). Dietary vitamin D intake was assessed through Diet History Questionnaire (DHQ). Out of the 300 participants, only 150 were subjected to fasting blood sample collection. These samples were used for serum vitamin D and plasma BDNF measurements. Whole blood telomere length was measured using RT-PCR method. The results show that the reduction of the risk of MCI was achieved by higher serum vitamin D level (OR: 0.96, 95% CI: 0.92-0.99, p < 0.05), higher plasma BDNF level (OR: 0.51, 95% CI: 0.30-0.88,  p < 0.05), and longer telomere (OR: 0.97, 95% CI: 0.95-0.99,  p < 0.001). In conclusion, participants with higher vitamin D level, higher BDNF level, and longer telomere length were more likely to age successfully.
  5. Abidin NZ, Mitra SR
    Curr Gerontol Geriatr Res, 2021;2021:6634474.
    PMID: 33790963 DOI: 10.1155/2021/6634474
    Osteosarcopenic obesity (OSO) describes the concurrent presence of obesity, low bone mass, and low muscle mass in an individual. Currently, no established criteria exist to diagnose OSO. We hypothesized that obese individuals require different cut-points from standard cut-points to define low bone mass and low muscle mass due to their higher weight load. In this study, we determined cutoff values for the screening of osteosarcopenia (OS) in obese postmenopausal Malaysian women based on the measurements of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and functional performance test. Then, we compared the cutoff values derived by 3 different statistical modeling methods, (1) receiver operating characteristic (ROC) curve, (2) lowest quintile of the study population, and (3) 2 standard deviations (SD) below the mean value of a young reference group, and discussed the most suitable method to screen for the presence of OS in obese population. One hundred and forty-one (n = 141) postmenopausal Malaysian women participated in the study. Bone density was assessed using calcaneal quantitative ultrasound. Body composition was assessed using bioelectrical impedance analyzer. Handgrip strength was assessed using a handgrip dynamometer, and physical performance was assessed using a modified Short Physical Performance Battery test. ROC curve was determined to be the most suitable statistical modeling method to derive the cutoffs for the presence of OS in obese population. From the ROC curve method, the final model to estimate the probability of OS in obese postmenopausal women is comprised of five variables: handgrip strength (HGS, with area under the curve (AUC) = 0.698 and threshold ≤ 16.5 kg), skeletal muscle mass index (SMMI, AUC = 0.966 and threshold ≤ 8.2 kg/m2), fat-free mass index (FFMI, AUC = 0.946 and threshold ≤ 15.2 kg/m2), broadband ultrasonic attenuation (BUA, AUC = 0.987 and threshold ≤ 52.85 dB/MHz), and speed of sound (SOS, AUC = 0.991 and threshold ≤ 1492.15 m/s). Portable equipment may be used to screen for OS in obese women. Early identification of OS can help lower the risk of advanced functional impairment that can lead to physical disability in obese postmenopausal women.
  6. Thiam CN, Ooi CY, Seah YK, Chuan DR, Looi I, Ch'ng ASH
    Curr Gerontol Geriatr Res, 2021;2021:7570592.
    PMID: 34394346 DOI: 10.1155/2021/7570592
    Background: Frailty potentially influences clinicians' decision making on treatment provided they can select the appropriate assessment tools. This study aims to investigate the difference between the FRAIL scale and the Clinical Frailty Scale (CFS) in assessing frailty among community-dwelling older adults attending the General Medical Clinic (GMC) in Seberang Jaya Hospital, Penang, Malaysia.

    Methods: The medical records of 95 older patients (age ≥ 65) who attended the GMC from 16 December 2019 to 10 January 2020 were reviewed. Frailty was identified using the FRAIL scale and the CFS. Patient characteristics were investigated for their association with frailty and their difference in the prevalence of frailty by the FRAIL scale and CFS.

    Results: The CFS identified nonsignificant higher prevalence of frailty compared to the FRAIL scale (21/95; 22.1% vs. 17/95; 17.9%, ratio of prevalence = 1.235, p=0.481). Minimal agreement was found between the FRAIL scale and the CFS (Kappa = 0.272, p < 0.001). Three out of 5 components of the FRAIL scale (resistance, ambulation, and loss of weight) were associated with frailty by the CFS. Higher prevalence of frailty was identified by the CFS in those above 70 years of age. The FRAIL scale identified more patients with frailty in ischaemic heart disease patients.

    Conclusion: Patient characteristics influenced the choice of the frailty assessment tool. The FRAIL scale and the CFS may complement each other in providing optimized care to older patients who attended the GMC.

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