Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM.
Ayurveda, a traditional system of medicine that originated over three millennia ago in the South Asian region, offers extensive insights about food and health based on certain unique conceptual as well as theoretical positions. Health is defined as a state of equilibrium with one's self (svasthya) but which is inextricably linked to the environment. Ayurvedic principles, such as the tridosa (three humors) theory, provide the relationship between the microcosm and the macrocosm that can be applied in day-to-day practice. Classical Ayurveda texts cover an array of themes on food ranging from diversity of natural sources, their properties in relation to seasons and places and to their specific function both in physiological and pathological states. The epistemic perspective on health and nutrition in Ayurveda is very different from that of biomedicine and modern nutrition. However, contemporary knowledge is reinventing and advancing several of these concepts in an era of systems biology, personalized medicine, and the broader context of a more holistic transition in sciences in general. Trans-disciplinary research could be important not only for pushing the boundaries of food and health sciences but also for providing practical solutions for contemporary health conditions. This article briefly reviews the parallels in Ayurveda and biomedicine and draws attention to the need for a deeper engagement with traditional knowledge systems, such as Ayurveda. It points out that recreation of the methodologies that enabled the holistic view point about health in Ayurveda may unravel some of the complex connections with Nature.
INTRODUCTION: Regular physical activity is an important aspect of self-management among older people with type 2 diabetes but many remain inactive. Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalized feedback (PF) or peer support (PS); and there was no study on older people of Asian heritage. Hence, this trial evaluated whether PF only or combined with PS improves physical activity among older Malays with type 2 diabetes (T2DM) compared to usual care only.
MATERIALS AND METHODS: A three-arm randomized controlled trial was conducted in a primary healthcare clinic in Malaysia. Sixty-nine sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were randomized to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36. Intervention groups performed unsupervised walking activity and received written feedback on physical activity. The PS group also received group and telephone contacts from trained peer mentors. The primary outcome was pedometer steps. Secondary outcomes were self-reported physical activity, cardiovascular risk factors, cardiorespiratory fitness, balance, quality of life, and psychosocial wellbeing.
RESULTS: Fifty-two (75.4%) completed the 36-week study. The PS group showed greater daily pedometer readings than the PF and controls (p = 0.001). The PS group also had greater improvement in weekly duration (p
Objectives: Sufficient knowledge and positive attitudes are crucial to the prevention of COVID-19. However, little is known about public awareness and attitudes regarding COVID-19 in China. The impact of COVID-19 on the societal well-being and anxiety levels of the public has never been documented. The aim of this study was to survey the knowledge, attitudes, impact, and anxiety levels of the people of China in relation to the COVID-19 outbreak. Method: A cross-sectional population survey using an online questionnaire was undertaken between Jan 24 and Feb 24, 2020. The study participants were residents of mainland China over the age of 18 years. The attitude items in this study measured the perceived threat of COVID-19 based on the Health Belief Model. Anxiety was measured with the State-Trait Anxiety Inventory (STAI), a self-reported questionnaire that measure both state (STAI-S), and trait anxiety (STAI-T) Results: A total of 2,446 completed responses were received. The mean and standard deviation (SD) for the total knowledge score was 20.3 (SD ± 2.9) out of a possible score of 23. The social disruption and household economic impact were notable, particularly in provinces with higher cumulative confirmed cases. The majority of responses indicated a low perceived susceptibility of being infected (86.7% [95%CI 85.4-88.1]), with a fair proportion of respondents perceiving a higher severity (62.9% [95% CI 61.0-64.8]). The mean total impact score was 9.9 (SD ± 3.8) out of a possible score of 15. The mean score for STAI-S was 48.7 (SD ± 10.8), whereas the mean STAI-T score was 45.7 (SD ± 8.5). By demographics, women reported significantly higher odds for higher levels of both STAI-S (OR = 1.67) and STAI-T (OR = 1.30) compared to men. People of a younger age were also more likely to experience higher STAI-S and STAI-T. Higher perceived susceptibility and severity and impact were strong predictors of higher levels of STAI-S and STAI-T. Conclusion: Our findings can assist in tailoring public communication to change people's knowledge and attitudes. The present study also underlined the importance of the promotion of mental health during infectious disease outbreaks to help in moderating the perceived threat, social and household economic impact, targeting the vulnerable segment of the population.
The COVID-19 pandemic that emerged in 2019 has inflicted numerous clinical and public health challenges worldwide. It was declared a public health emergency by the World Health Organization and activated response teams at almost all Malaysian healthcare facilities. Upon activation of the National Crisis Preparedness and Response Center in January 2020, the National Institutes of Health Malaysia established a COVID-19 operation room at the facility level to address the rise in COVID-19 infection cases each day. The National Institutes of Health COVID-19 operation room committee formed a workforce mobilization team for an effective and efficient mobilization system to fulfill requests received for human resource aid within the Ministry of Health Malaysia facilities. Selected personnel would be screened for health and availability before mobilization letters and logistics arrangements if necessary. The workforce from the National Institutes of Health, consisting of various job positions, were mobilized every week, with each deployment cycle lasting 2 weeks. A total of 128 personnel from the six institutes under the National Institutes of Health were mobilized: tasks included fever screening, active case detection, health management at quarantine centers, and management of dead bodies. A well-organized data management system with a centralized online system integration could allow more rapid deployment and answer some of the key questions in managing a similar pandemic in the future. With improving infected COVID-19 cases throughout the country, the National Institutes of Health COVID-19 operation room was effectively closed on June 15, 2020, following approval from the Deputy Director-General of Health.
The coronavirus disease 2019 (COVID-19) pandemic is still evolving and affecting millions of lives. E-government and social media have been used widely during this unprecedented time to spread awareness and educate the public on preventive measures. However, the extent to which the 2 digital platforms bring to improve public health awareness and prevention during a health crisis is unknown. In this study, we examined the influence of e-government and social media on the public's attitude to adopt protective behavior. For this purpose, a Web survey was conducted among 404 Malaysian residents during the Recovery Movement Control Order (RMCO) period in the country. Descriptive and multiple regression analyses were conducted using IBM SPSS software. Social media was chosen by most of the respondents (n = 331 or 81.9%) as the source to get information related to COVID-19. Multiple regression analysis suggests the roles of e-government and social media to be significantly related to people's attitudes to engage in protective behavior. In conclusion, during the COVID-19 outbreak, public health decision makers may use e-government and social media platforms as effective tools to improve public engagement on protective behavior. This, in turn, will help the country to contain the transmission of the virus.
Interleukin 6 (IL-6) is one of the markers of immune system activation indicating existent infection and inflammation. We present here a case of a 55-year-old male COVID-19 patient with an unusual high level of interleukin 6 (IL-6). Further investigation revealed he had hepatocellular carcinoma (HCC) with underlying hepatitis B. He did not present with respiratory symptoms although a baseline chest x-ray showed changes, and the patient was categorized as Class 3A of COVID-19. Routine investigations proceeded with high-resolution computed tomography and IL-6 to monitor for progression to severe COVID-19. Notably, there was a high IL-6 level but other parameters did not show he was in severe COVID-19. In this report, we conclude that elevated IL-6 level in a COVID-19 patient is not necessarily associated with severe COVID-19.
Background: COVID-19 developed into a global pandemic in 2020 and poses challenges regarding the prevention and control capabilities of countries. A large number of inbound travelers from other regions could lead to a renewed outbreak of COVID-19 in the local regions. Globally, as a result of the imbalance in the control of the epidemic, all countries are facing the risk of a renewed COVID-19 outbreak brought about by travelers from epidemic areas. Therefore, studies on a proper management of the inbound travelers are urgent. Methods: We collected a total of 4,733,414 inbound travelers and 174 COVID-19 diagnosed patients in Yunnan province from 21 January 2020 to 20 February 2020. Data on place of origin, travel history, age, and gender, as well as whether they had suspected clinical manifestations for inbound travelers in Yunnan were collected. The impact of inbound travelers on the local epidemic was analyzed with a collinear statistical analysis and the effect of the control measures on the epidemic was evaluated with a sophisticated modeling approach. Results: Of the 174 COVID-19 patients, 60.9% were not from Yunnan, and 76.4% had a history of travel in Hubei. The amount of new daily cases in Yunnan was significant correlated with the number of inbound travelers from Hubei and suspected cases among them. Using Susceptible-Exposed-Infectious-Recovered (SEIR) model analysis, we found that the prevention and control measures dropped the local R0 down to 1.07 in Yunnan province. Conclusions: Our preliminary analysis showed that the proper management of inbound travelers from outbreak areas has a significantly positive effect on the prevention and control of the virus. In the process of resettlement, some effective measures taken by Yunnan province may provide an important reference for preventing the renewed COVID-19 outbreak in other regions.
Background: In the past decade, Yemen has witnessed several disasters that resulted in a crumbled healthcare system. With the declaration of COVID-19 a global pandemic, and later the appearance of first confirmed cases in Yemen, there is an urgent need to assess the preparedness of healthcare facilities (HCFs) and their capacities to tackle a looming COVID-19 outbreak. Herein, we present an assessment of the current state of preparedness and capabilities of HCFs in Yemen to prevent and manage the COVID-19 outbreak. Methods: An online survey for HCFs was developed, validated, and distributed. The questionnaire is divided into five main sections: (1) Demographic variables for participants. (2) HCFs capabilities for COVID-19 outbreak. (3) Support received to face the emergence and spread of COVID-19. (4). Current practices of infection prevention and control measures in the HCFs. The last section focused on the recommendations to ensure effective and timely response to this outbreak in Yemen. Descriptive analysis was used to analyze data using statistical package for social sciences (SPSS), version 23. Results: Responses were received from healthcare workers (HCWs) from 18 out of 22 governorates in Yemen. Out of the 296 HCWs who participated in the study, the vast majority (93.9%) believed that the healthcare system in Yemen does not have the resources and capabilities to face and manage a COVID-19 outbreak. Approximately 82.4% of participants rated the general preparedness level of their HCFs as very poor or poor. More specifically, the majority of HCWs rated their HCFs as very poor or poor in term of availability of the following: an adequate number of mechanical ventilators (88.8%), diagnostic devices (88.2%), ICU rooms and beds (81.4%), and isolation rooms (79.7%). Conclusions: The healthcare facilities in Yemen are unprepared and lack the most basic resources and capabilities to cope with or tackle a COVID-19 outbreak. With the current state of a fragile healthcare system, a widespread outbreak of COVID-19 in Yemen could result in devastating consequences. There is an urgent need to provide support to the healthcare workers and HCFs that are on the frontline against COVID-19.
Introduction: Several vaccine candidates are being clinically tested in response to the 2019 coronavirus disease (COVID-19) pandemic. This study was conducted to assess the acceptance of a 50 or 95% effective COVID-19 vaccine, when it becomes available in southeast Asia, among the general population in Indonesia. Methods: A cross-sectional online survey was conducted between March 25 and April 6, 2020. Participants were asked if they would accept a free vaccine which was 95 or 50% effective. Using a logistic regression model, we assessed the associations between sociodemographic characteristics, exposure to COVID-19 information, or perceived risk of infection with acceptance of a hypothetical COVID-19 vaccine. Results: Among 1,359 respondents, 93.3% of respondents (1,268/1,359) would like to be vaccinated for a 95% effective vaccine, but this acceptance decreased to 67.0% (911/1,359) for a vaccine with 50% effectiveness. For a 95% effective vaccine, being a healthcare worker and having a higher perceived risk of COVID-19 infection were associated with higher acceptance, adjusted odds ratio (aOR): 2.01; 95%CI: 1.01, 4.00 and aOR: 2.21; 95%CI: 1.07, 4.59, respectively; compared to civil servants, being retired was associated with less acceptance (aOR: 0.15; 95%CI: 0.04, 0.63). For a 50% effective vaccine, being a healthcare worker was also associated with greater acceptance, aOR: 1.57; 95%CI: 1.12, 2.20. Conclusion: Acceptance of a COVID-19 vaccine was highly influenced by the baseline effectiveness of the vaccine. Preparing the general population to accept a vaccine with relatively low effectiveness may be difficult.
Sudden outbreak of a new pathogen in numbers of pneumonic patients in Wuhan province during December 2019 has threatened the world population within a short period of its occurrence. This respiratory tract-isolated pathogen was initially named as novel coronavirus 2019 (nCoV-2019), but later termed as SARS-CoV-2. The rapid spreading of this infectious disease received the label of pandemic by the World Health Organization within 4 months of its occurrence, which still seeks continuous attention of the researchers to prevent the spread and for cure of the infected patients. The propagation of the disease has been recorded in 215 countries, with more than 25.5 million cases and a death toll of more than 0.85 million. Several measures are taken to control the disease transmission, and researchers are actively engaged in finding suitable therapeutics to effectively control the disease to minimize the mortality and morbidity rates. Several existing potential candidates were explored in the prevention and treatment of worsening condition of COVID-19 patients; however, none of the formulation has been approved for the treatment but used under medical supervision. In this article, a focus has been made to highlight on current epidemiology on the COVID-19 infection, clinical features, diagnosis, and transmission, with special emphasis on treatment measures of the disease at different stages of clinical research and the global economic influence due to this pandemic situation. Progress in the development on vaccine against COVID-19 has also been explored as important measures to immunize people. Moreover, this article is expected to provide information to the researchers, who are constantly combating in the management against this outbreak.
Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.
Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.
Background: Fear of falling (FoF) is a common issue among older people, impacting on psychological health, functional performance and mortality. Many factors associated with fear of falling have been investigated but little is known about the role of home hazards. Home hazards can be due to unsafe environmental and functional features. This study is aims to evaluate the association between home hazards with fear of falling among community-dwelling individuals aged 55 years and over. Methods: Baseline data with 1,489 older individuals from the Malaysian Elders Longitudinal Research (MELoR) study were analyzed. Home visits for interview and observations in the home were conducted with the participants. FoF was established with a single-item question and home hazards with the Home Falls and Accidents Screening Tool (HOME FAST). Results: The majority (76.4%) of older participants experienced FoF. The history of falls was not associated with FoF (p = 0.868), but FoF was associated with participants limiting their daily activities (p < 0.001). Home hazards were less likely (p = 0.023) and functional issues were more likely (p < 0.001) to be associated with a high degree of FoF. However, both home hazards domains were not associated with activity restriction due to FoF. Conclusions: Education about home hazards from the perspective of person-environment interaction may encourage home hazards management and reduce FoF which should be evaluated in future studies.
Background: The novel coronavirus (COVID-19) pandemic has significantly increased the rate of mortality and morbidity worldwide due to its rapid transmission rate. The mental health status of individuals could have a negative impact attributed to this global situation. Therefore, this study was intended to explore the symptoms of depression and anxiety among healthcare workers (HCWs) of Pakistan during the ongoing COVID-19 pandemic. Methods: A cross-sectional survey was undertaken by administering a web-based questionnaire between May and June 2020. Two tools, including the Patient Health Questionnaire (PHQ9) and Generalized Anxiety Disorder-7 (GAD-7), were employed to measure anxiety and depression symptoms among HCWs. The data analyses were carried out using descriptive statistics, Man Whitney, and Kruskal Wallis tests. Results: Of 1094 HCWs who participated in this online survey, 742 (67.8%) were physicians, followed by nurses (n = 277, 25.3%) and pharmacists (n = 75, 6.9%). The survey respondents had a median depression and anxiety score of 5.00 (7.00-3.00) and 8.00 (11.00-5.00), respectively. A considerable number of HCWs (82.2%) utilized online psychological resources to deal with their psychological distress. Female HCWs, nurses, frontline HCWs, and HCWs aged 30-49 years were more likely to suffer from depression and anxiety (p < 0.05). Conclusion: During the recent ongoing pandemic of COVID-19, there is a mild level of symptoms of depression and anxiety among HCWs. Our findings call for urgent psychological interventions for vulnerable groups of Pakistani HCWs.
Introduction: With a rapidly aging population, the Malaysian health care system needs to develop solutions to address the lack of resources that are required for the assessment of the older person. The complex nature of geriatric syndromes coupled with the occurrence of multiple comorbid illnesses with aging, make geriatric assessment a resource intensive process. Digital health solutions could play an important role in supporting existing health care systems, especially in low and middle income countries, with limited speciality services in geriatrics. Objective: This is a pilot study aimed at screening for geriatric syndromes through self-administered online surveys in urban community dwelling older Malaysians and assessing the pattern of geriatric syndromes in relation to the frailty status of the study participants. Methods: This is a cross-sectional pilot study conducted between July-September 2020. Community dwelling adults aged 60 years and over were invited to take part in an online survey. Information on sociodemographic variables, comorbidities, and the self-reported results of geriatric syndromes (frailty, sarcopenia, anorexia of aging, urinary incontinence, falls, and cognitive impairment), were collected through the survey. Results: Data was collected for 162 participants over a period of 2 months. The mean (SD) age of the respondents was 66.42 (5.25) years with 64.9% females. Majority of the respondents were of Chinese ethnic origin (67.9%) and had tertiary level of education (75.9%). The average time taken by participants to complete the survey was 16.86 min. Urinary incontinence was the highest reported geriatric syndrome (55.1%) followed by falls (37.6%), anorexia of aging (32.8%), cognitive impairment (27.8%), and sarcopenia (8.3%). Frailty was detected in 4.5% of the study population. Loss of weight in the previous year was the highest reported component of the frailty assessment tool. The presence of sarcopenia, anorexia of aging, poor/fair self-rated health, urinary incontinence, and multimorbidity were significantly higher in older adults who were frail or prefrail. Conclusion: Screening for geriatric syndromes through online surveys is a feasible approach to identify older adults in the community who are likely to benefit from geriatric assessment. However, the demographic profile of the older population that are accessible through such digital platforms is limited.
Background: Functional limitationscommonly affect patients with knee osteoarthritis (OA) which reduces quality of life. The Enabling Self-management and Coping with Arthritic Pain using Exercise (ESCAPE-pain) is an evidence-based programme identified to be suitable for adaptation for the Malaysian health care system. It is important to understand the acceptance from a sociocultural context of the ESCAPE-pain programme from the perspectives of patients with knee OA and healthcare professionals. This qualitative study aims to explore the perspectives of stakeholders to inform the adaptation of the ESCAPE-pain programme into the Malaysian health care system. Method: Semi-structured interviews using interview guides were conducted with 18 patients with knee OA and 14 healthcare professionals including nurses, physiotherapists, occupational therapists, medical doctors, and orthopedic surgeons. The data were transcribed and analyzed using framework analysis. Results: The findings show that patients and healthcare professionals positively accept the programme into their daily living activities and recommend some modifications related to the Malaysian context. This study also highlights strategies to adopt when providing ESCAPE-pain to patients with knee OA. Conclusion: The findings reveal how sociocultural considerations could facilitate uptake and engagement with the ESCAPE-pain programme for home exercise among patients with knee osteoarthritis. These findings may benefit t patients with knee OA in the Malaysian healthcare system, although future research is recommended.
Background: Falls are a significant incident among older adults affecting one in every three individuals aged 65 and over. Fall risk increases with age and other factors, namely instability. Recent studies on the use of fall detection devices in the Malaysian community are scarce, despite the necessity to use them. Therefore, this study aimed to investigate the association between the prevalence of falls with instability. This study also presents a survey that explores older adults' perceptions and expectations toward fall detection devices. Methods: A cross-sectional survey was conducted involving 336 community-dwelling older adults aged 50 years and older; based on randomly selected participants. Data were analyzed using quantitative descriptive analysis. Chi-square test was conducted to investigate the associations between self-reported falls with instability, demographic and walking characteristics. Additionally, older adults' perceptions and expectations concerning the use of fall detection devices in their daily lives were explored. Results: The prevalence of falls was 28.9%, where one-quarter of older adults fell at least once in the past 6 months. Participants aged 70 years and older have a higher fall percentage than other groups. The prevalence of falls was significantly associated with instability, age, and walking characteristics. Around 70% of the participants reported having instability issues, of which over half of them fell at least once within 6 months. Almost 65% of the participants have a definite interest in using a fall detection device. Survey results revealed that the most expected features for a fall detection device include: user-friendly, followed by affordably priced, and accurate. Conclusions: The prevalence of falls in community-dwelling older adults is significantly associated with instability. Positive perceptions and informative expectations will be used to develop an enhanced fall detection incorporating balance monitoring system. Our findings demonstrate the need to extend the fall detection device features aiming for fall prevention intervention.
Background: Research on rehabilitation for falls after stroke is warranted. However, published evidence on fall interventions with stroke survivors is limited and these are mainly international studies that may be less relevant for Southeast Asia. Objective: This review aims to systematically identify literature related to stroke rehabilitation for falls and risk of falls in Southeast Asia. Methods: A scoping review with stakeholders' consultation was implemented. An electronic search was conducted up to December 2020 on 4 databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only original studies conducted in Southeast Asia were selected. Results: The initial search yielded 3,112 articles, however, only 26 were selected in the final analysis. Most of the articles focused on physical rehabilitation and implemented conventional therapies. While the literature may reflect practice in Southeast Asia, stakeholders perceived that the literature was inadequate to show true practice, was not informative and missed several aspects such as functional, cognitive, and psychological interventions in managing falls. Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Majority of the articles were written by physiotherapists while others were from physicians, occupational therapists, and an engineer but few from other healthcare practitioners (i.e., speech therapists, psychologists) or disciplines interested in falls. Conclusions: Falls prevention among stroke survivors has received a lack of attention and is perceived as an indirect goal in stroke rehabilitation in Southeast Asia. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.
Background: While prospective recording is considered as the gold standard, retrospective recall is widely utilized for falls outcomes due to its convenience. This brings about the concern on the validity of falls reporting in Southeast Asian countries, as the reliability of falls recall has not previously been studied. This study aimed to evaluate the reliability of retrospective falls recall compared to prospective falls recording. Methods: A secondary analysis of data from two prospective recording methods, falls diary and falls calendar, from two different research projects were obtained and analyzed. Retrospective falls recall was collected either through phone interview or follow-up clinic by asking the participants if they had fallen in the past 12 months. Results: Two-hundred-sixty-eight and 280 elderly participated in the diary and calendar groups, respectively. Moderate (46%) and poor (11%) return rates were found on completed diary and calendar recording. Under-(32%) and overreporting (24%) of falls were found in diary compared to only 4% of overreporting for the calendar. Retrospective recall method achieved 57% response rate for the diary group (followed up at clinic) and 89% for the calendar group (followed up via telephone interview). Agreement between retrospective and prospective reporting was moderate for the diary (kappa =0.44; p < 0.001) and strong for the calendar (kappa = 0.89; p < 0.001). Conclusion: Retrospective recall is reliable and acceptable in an observation study within healthy community older adults, while the combination of retrospective and prospective falls recording is the best for an intervention study with frailer older population. Telephone interview is convenient, low cost, and yielded a high response rate.