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  1. Yuvaraj R, Murugappan M, Norlinah MI, Sundaraj K, Khairiyah M
    Dement Geriatr Cogn Disord, 2013;36(3-4):179-96.
    PMID: 23899462 DOI: 10.1159/000353440
    OBJECTIVE: Patients suffering from stroke have a diminished ability to recognize emotions. This paper presents a review of neuropsychological studies that investigated the basic emotion processing deficits involved in individuals with interhemispheric brain (right, left) damage and normal controls, including processing mode (perception) and communication channels (facial, prosodic-intonational, lexical-verbal).
    METHODS: An electronic search was conducted using specific keywords for studies investigating emotion recognition in brain damage patients. The PubMed database was searched until March 2012 as well as citations and reference lists. 92 potential articles were identified.
    RESULTS: The findings showed that deficits in emotion perception were more frequently observed in individuals with right brain damage than those with left brain damage when processing facial, prosodic and lexical emotional stimuli.
    CONCLUSION: These findings suggest that the right hemisphere has a unique contribution in emotional processing and provide support for the right hemisphere emotion hypothesis.
    SIGNIFICANCE:
    This robust deficit in emotion recognition has clinical significance. The extent of emotion recognition deficit in brain damage patients appears to be correlated with a variety of interpersonal difficulties such as complaints of frustration in social relations, feelings of social discomfort, desire to connect with others, feelings of social disconnection and use of controlling behaviors.
  2. Hamid TA, Krishnaswamy S, Abdullah SS, Momtaz YA
    Dement Geriatr Cogn Disord, 2010;30(6):533-9.
    PMID: 21252548 DOI: 10.1159/000321672
    The rapid expansion of the aged population in Malaysia is expected to greatly increase the number of persons with dementia in the country. However, data on dementia prevalence at the national level is lacking, and little is known about the sociodemographic risk factors and correlates of dementia. This paper describes a nationwide study of dementia prevalence and its sociodemographic risk factors and health correlates among older Malaysians.
  3. Ng TP, Leong T, Chiam PC, Kua EH
    Dement Geriatr Cogn Disord, 2010;29(2):131-8.
    PMID: 20145399 DOI: 10.1159/000275668
    Ethnic variations in dementia rate have been reported worldwide. Understanding these differences is vital for aetiological research, clinical care and health service planning. While age and gender have been consistently implicated, the reasons behind interethnic variation remain unclear.
  4. Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al.
    Dement Geriatr Cogn Disord, 2009;27(3):247-53.
    PMID: 19246909 DOI: 10.1159/000203888
    BACKGROUND/AIMS: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics).
    METHODS: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves.
    RESULTS: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders.
    CONCLUSION: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.
    Study site: Community, neurology and dementia outpatient clinics, Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC)
  5. Asmuje NF, Mat S, Myint PK, Tan MP
    Dement Geriatr Cogn Disord, 2022;51(5):396-404.
    PMID: 36446343 DOI: 10.1159/000526904
    INTRODUCTION: Despite cognitive impairment being a major health issue within the older population, limited information is available on factors associated with cognitive function among Asian ethnic groups. The objective of this study was to identify ethnic-specific sociodemographic risk factors which are associated with cognitive performance.

    METHODS: Cross-sectional analysis of the Malaysian Elders Longitudinal Research (MELoR) study involving community-dwelling individuals aged >55 years was conducted. Information on sociodemographic factors, medical history, and lifestyle were obtained by computer-assisted interviews in participants' homes. Cognitive performance was assessed with the Montreal Cognitive Assessment (MoCA) tool during subsequent hospital-based health checks. Hierarchical multiple linear regression analyses were conducted with continuous MoCA scores as the dependent variable.

    RESULTS: Data were available for 1,140 participants, mean (standard deviation [SD]) = 68.48 (7.23) years, comprising 377 (33.1%) ethnic Malays, 414 (36.3%) Chinese, and 349 (30.6%) Indians. Mean (SD) MoCA scores were 20.44 (4.92), 23.97 (4.03), and 22.04 (4.83) for Malays, Chinese, and Indians, respectively (p = 0.01). Age >75 years, <12 years of education, and low functional ability were common risk factors for low cognitive performance across all three ethnic groups. Cognitive performance was positively associated with social engagement among the ethnic Chinese (β [95% CI] = 0.06 [0.01, 0.11]) and Indians (β [95% CI] = 0.16 [0.09, 0.23]) and with lower depression scores (β [(95% CI] = -0.08 [-0.15, -0.01]) among the ethnic Indians.

    CONCLUSION: Common factors associated with cognitive performance include age, education, and functional ability, and ethnic-specific factors were social engagement and depression. Interethnic comparisons of risk factors may form the basis for identification of ethnic-specific modifiable risk factors for cognitive decline and provision of culturally acceptable prevention measures.

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