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Allen F, Guarnizo-Herreño CC, Fan SY, Tsakos G. Does subsidizing the cost of care impact on dental attendance patterns among older adults? Community Dent Oral Epidemiol 2024; 52:328-335. [PMID: 38084824 DOI: 10.1111/cdoe.12934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To assess whether eligibility for an age-related universal (pioneer generation [PG]) subsidy incentivises dental attendance by older Singaporeans. METHODS Data were collected between 2018 and 2021 from in-person interviews of Singaporean adults aged 60-90 years using a questionnaire and a clinical examination. The questionnaire included details of age, gender, ethnicity, education, residential status, socio-economic status, marital status, eligibility for subsidy (community health assistance/CHAS, PG or both) and frequency of dental attendance. The clinical examination recorded number of teeth (categorized as edentulous, 1-9 teeth;10-19 teeth; ≥20 teeth). To estimate the effect of the PG subsidy on dental attendance pattern, a regression discontinuity (RD) analysis was applied using age as the assignment variable. RESULTS A total of 1172 participants aged 60-90 years (64.2% female) were recruited, with 498 (43%) being eligible for the PG subsidy. For those eligible for PG subsidy, there was a higher proportion of regular attenders than irregular attenders (53.6% vs. 46.4%). In age adjusted RD analysis, those eligible for the PG subsidy were 1.6 (95% CI: 1.0, 2.7) times more likely to report regular attendance than their PG non-eligible counterparts. The association remained strong (OR 2.1; 95% CI: 1.1-3.7) even after further controlling for demographics, socioeconomic factors, number of teeth and eligibility for the CHAS subsidy. CONCLUSIONS Being eligible for the PG subsidy substantially increased the odds of regular dental attendance.
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Affiliation(s)
- Finbarr Allen
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Cork Dental School and Hospital, University College Cork, Cork, Ireland
| | | | - Sim Yu Fan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
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Lim ZH, Ng TKS, Bao Z, Yu J, Mahendran R. LFC study: Protocol for a longitudinal follow-up cohort study on ageing and mental health in community-dwelling older adults in Singapore. MethodsX 2024; 12:102606. [PMID: 38379721 PMCID: PMC10877946 DOI: 10.1016/j.mex.2024.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
The rapid pace of population ageing worldwide has prompted the need to better understand the ageing process. The current study, titled the Longitudinal Follow-up of the CHI (LFC) study, was a 3-year follow-up study of an earlier study titled the Community Health and Intergenerational (CHI) study. The LFC study looked to examine longitudinal changes in their cognitive functioning and psychosocial outcomes across the 3-year period. Additionally, the current study built upon the earlier CHI study by collecting neuroimaging data and exploring the long-term effects of non-pharmacological interventions, which were not examined in the prior study. A total of 653 community-dwelling participants from the baseline CHI study cohort were invited to take part in the LFC study, where they underwent a battery of neuropsychological assessments, psychosocial questionnaires, a Magnetic Resonance Imaging scan and a voice recording segment. The current study would holistically track longitudinal changes in cognitive functioning and psychosocial outcomes in the ageing population in Singapore. Unique associations between linguistics and neuroimaging data alongside cognitive and psychosocial outcomes would be explored. This study also serves to guide the development of new interventions for older adults and assist in improving the well-being of the local and global ageing population.
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Affiliation(s)
- Zhi Hao Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, MD1 – Tahir Foundation Building, 117549, Singapore
| | - Ted Kheng Siang Ng
- Department of Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - Zhiming Bao
- Department of English Language and Literature, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Block AS7, Level 5, 5 Arts Link, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 50 Nanyang Ave, 639798, Singapore
| | - Rathi Mahendran
- Mind Science Centre, National University of Singapore, Mind Care Clinic @ SBF, 160 Robinson Road, #05-07 SBF Center, 068914, Singapore
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Cao L, Han K, Lin L, Hing J, Ooi V, Huang N, Yu J, Ng TKS, Feng L, Mahendran R, Kua EH, Bao Z. Reversal of the concreteness effect can be detected in the natural speech of older adults with amnestic, but not non-amnestic, mild cognitive impairment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12588. [PMID: 38638800 PMCID: PMC11024957 DOI: 10.1002/dad2.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Patients with Alzheimer's disease present with difficulty in lexical retrieval and reversal of the concreteness effect in nouns. Little is known about the phenomena before the onset of symptoms. We anticipate early linguistic signs in the speech of people who suffer from amnestic mild cognitive impairment (MCI). Here, we report the results of a corpus-linguistic approach to the early detection of cognitive impairment. METHODS One hundred forty-eight English-speaking Singaporeans provided natural speech data, on topics of their choice; 74 were diagnosed with single-domain MCI (38 amnestic, 36 non-amnestic), 74 cognitively healthy. The recordings yield 267,310 words, which are tagged for parts of speech. We calculate the per-minute word counts and concreteness scores of all tagged words, nouns, and verbs in the dataset. RESULTS Compared to controls, subjects with amnestic MCI produce fewer but more abstract nouns. Verbs are not affected. DISCUSSION Slower retrieval of nouns and the reversal of the concreteness effect in nouns are manifested in natural speech and can be detected early through corpus-based analysis. Highlights Reversal of the concreteness effect is manifested in patients with Alzheimer's disease (AD) and semantic dementia.The paper reports a corpus-based analysis of natural speech by people with amnestic and non-amnestic mild cognitive impairment (MCI) and cognitively healthy controls.People with amnestic MCI produce fewer and more abstract nouns than people with non-amnestic MCI and healthy controls. Verbs appear to be unaffected.The imageability problem can be detected in natural everyday speech by people with amnestic MCI, which carries a higher risk of conversion to AD.
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Affiliation(s)
- Luwen Cao
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Kunmei Han
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Li Lin
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
- School of Foreign StudiesEast China University of Political Science and LawShanghaiChina
| | - Jiawen Hing
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Vincent Ooi
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Nick Huang
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
| | - Junhong Yu
- Cognitive and Brain Health LaboratorySchool of Social SciencesNanyang Technological UniversitySingaporeSingapore
| | - Ted Kheng Siang Ng
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Rush Institute for Healthy Aging, Department of Internal MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Lei Feng
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Centre for Healthy Longevity, Clinic LAlexandra HospitalSingaporeSingapore
| | - Rathi Mahendran
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Ee Heok Kua
- Department of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Zhiming Bao
- Department of English, Linguistics and Theatre StudiesNational University of SingaporeSingaporeSingapore
- Institute of Corpus Studies and ApplicationsShanghai International Studies UniversityShanghaiChina
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Lee RZY, Yang WFZ, Mahendran R, Suárez L. Psychometric properties of the World Health Organization WHOQOL-AGE Scale in Singapore. Eur J Ageing 2024; 21:10. [PMID: 38506975 PMCID: PMC10954592 DOI: 10.1007/s10433-024-00803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 03/22/2024] Open
Abstract
WHOQOL-AGE is a promising quality of life (QOL) tool that has not been fully validated in Asia. The present study aimed to verify its factor structure and psychometric properties among community-dwelling older adults in Singapore. This study was cross-sectional and used data (N = 593) from the Community Health and Intergenerational study that interviewed older adults between 2018 and 2021. Confirmatory factor analysis (CFA) was used to examine the factor structure of the WHOQOL-AGE, and Cronbach's alpha coefficients were employed to examine internal consistency. Spearman's rho correlations coefficients between WHOQOL-AGE and other related scales (Satisfaction with Life and the Friendship) examined convergent validity. A Pearson's correlation coefficient between WHOQOL-AGE and compassion scale examined discriminant validity. An independent t test was used to demonstrate known-groups validity, examining differences in QOL scores between individuals with and without chronic medical conditions. Findings supported a bifactor model with more satisfactory goodness-of-fit indices than the original two-factor model and the two-correlated factor model. WHOQOL-AGE showed adequate internal consistency (Cronbach's alpha coefficients > .70). Good convergent validity was demonstrated by moderate-to-large correlations between WHOQOL-AGE and satisfaction with life (rs = .54) as well as social connectedness (rs = .33). Discriminant validity was shown by low correlations between WHOQOL-AGE and compassion (r = .19). Findings also indicated good known-groups validity (p < 0.01). The WHOQOL-AGE showed promising psychometric properties using an Asian convenience sample and can be useful in large-scale studies or busy clinical settings.
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Affiliation(s)
- Rachael Zhi Yi Lee
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore
- Clarity Singapore Limited, Block 854 Yishun Road #01-3511, Singapore, 760854, Singapore
| | - Winson Fu Zun Yang
- Department of Psychological Science, Texas Tech University, 2700 18th St, Lubbock, TX, USA
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rathi Mahendran
- Yeo Boon Khim, Mind Science Centre, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore
- Mind Care Clinic @ SBF, 160 Robinson Road, #05-07 SBF Center, Singapore, 068914, Singapore
| | - Lidia Suárez
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore, 387380, Singapore.
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Nickolls BJ, Relton C, Hemkens L, Zwarenstein M, Eldridge S, McCall SJ, Griffin XL, Sohanpal R, Verkooijen HM, Maguire JL, McCord KA. Randomised trials conducted using cohorts: a scoping review. BMJ Open 2024; 14:e075601. [PMID: 38458814 PMCID: PMC10928784 DOI: 10.1136/bmjopen-2023-075601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/24/2023] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Cohort studies generate and collect longitudinal data for a variety of research purposes. Randomised controlled trials (RCTs) increasingly use cohort studies as data infrastructures to help identify and recruit trial participants and assess outcomes. OBJECTIVE To examine the extent, range and nature of research using cohorts for RCTs and describe the varied definitions and conceptual boundaries for RCTs using cohorts. DESIGN Scoping review. DATA SOURCES Searches were undertaken in January 2021 in MEDLINE (Ovid) and EBM Reviews-Cochrane Methodology Registry (Final issue, third Quarter 2012). ELIGIBILITY CRITERIA Reports published between January 2007 and December 2021 of (a) cohorts used or planned to be used, to conduct RCTs, or (b) RCTs which use cohorts to recruit participants and/or collect trial outcomes, or (c) methodological studies discussing the use of cohorts for RCTs. DATA EXTRACTION AND SYNTHESIS Data were extracted on the condition being studied, age group, setting, country/continent, intervention(s) and comparators planned or received, unit of randomisation, timing of randomisation, approach to informed consent, study design and terminology. RESULTS A total of 175 full-text articles were assessed for eligibility. We identified 61 protocols, 9 descriptions of stand-alone cohorts intended to be used for future RCTs, 39 RCTs using cohorts and 34 methodological papers.The use and scope of this approach is growing. The thematics of study are far-ranging, including population health, oncology, mental and behavioural disorders, and musculoskeletal conditions.Authors reported that this approach can lead to more efficient recruitment, more representative samples, and lessen disappointment bias and crossovers. CONCLUSION This review outlines the development of cohorts to conduct RCTs including the range of use and innovative changes and adaptations. Inconsistencies in the use of terminology and concepts are highlighted. Guidance now needs to be developed to support the design and reporting of RCTs conducted using cohorts.
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Affiliation(s)
- Beverley Jane Nickolls
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Clare Relton
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Lars Hemkens
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA
- Meta-Research Innovation Center Berlin (METRICS-B), Berlin Institute of Health, Berlin, Germany
| | - Merrick Zwarenstein
- Department of Family Medicine, Western University, London, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Sandra Eldridge
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Stephen J McCall
- National Perinatal Epidemiology Unit, Clinical Trials Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Ras Beirut, Lebanon
| | - Xavier Luke Griffin
- Bone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK
- Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Ratna Sohanpal
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Helena M Verkooijen
- University Medical Centre Utrecht, Utrecht, The Netherlands
- University of Utrecht, Utrecht, The Netherlands
| | - Jonathon L Maguire
- University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
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Yu J, Ng TKS, Mahendran R. Cognitive and physical age gaps in relation to mild cognitive impairment and behavioral phenotypes. GeroScience 2024; 46:1129-1140. [PMID: 37428365 PMCID: PMC10828169 DOI: 10.1007/s11357-023-00864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/28/2023] [Indexed: 07/11/2023] Open
Abstract
We can study how fast our biological aging clocks tick by calculating the difference (i.e., age gaps) between machine learning estimations of biological age and chronological age. While this approach has been increasingly used to study various aspects of aging, few had applied this approach to study cognitive and physical age gaps; not much is known about the behavioral and neurocognitive factors associated with these age gaps. In the present study, we examined these age gaps in relation to behavioral phenotypes and mild cognitive impairment (MCI) among community-dwelling older adults. Participants (N = 822, Agemean = 67.6) were partitioned into equally-sized training and testing samples. Cognitive and physical age-prediction models were fitted using nine cognitive and eight physical fitness test scores, respectively, within the training samples, and subsequently used to estimate cognitive and physical age gaps for each subject in the testing sample. These age gaps were then compared among those with and without MCI and correlated with 17 behavioral phenotypes in the domains of lifestyle, well-being, and attitudes. Across 5000 random train-test split iterations, we showed that older cognitive age gaps were significantly associated with MCI (versus cognitively normal) and worse outcomes across several well-being and attitude-related measures. Both age gaps were also significantly correlated with each other. These results suggest accelerated cognitive and physical aging were linked to worse well-being and more negative attitudes about the self and others and reinforce the link between cognitive and physical aging. Importantly, we have also validated the use of cognitive age gaps in the diagnosis of MCI.
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Affiliation(s)
- Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 48 Nanyang Avenue, 639798, Singapore, Singapore.
| | - Ted Kheng Siang Ng
- Department of Internal Medicine, Rush University Medical Center, Illinois, Chicago, USA
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
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Siew SKH, Yu J, Kua EH, Mahendran R. Psychosocial profiles within community-dwelling older adults with Mild Cognitive Impairment: A prevalence and latent profile analysis study. Asian J Psychiatr 2023; 82:103503. [PMID: 36791608 DOI: 10.1016/j.ajp.2023.103503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/31/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Mild Cognitive Impairment (MCI) is an at-risk stage for dementia and accurate prevalence studies are lacking in Singapore. From the literature, it is evident that psychosocial factors increase the risk of conversion to dementia. In this study, we sought to establish the prevalence of MCI in Singapore and study the associated psychosocial factors using latent profile analysis. METHOD 902 community-dwelling older adults, aged between 60 and 99 years old (Mage = 70.48 years), were recruited as part of the Community Health and Intergenerational Study (CHI). They completed neurocognitive assessments and questionnaires on depression and anxiety symptoms, quality of life, social support, satisfaction with life, and social connectivity. Petersen's criteria was used to diagnose MCI. Within the MCI sample, 166 subjects' psychosocial scores were entered into a latent profile analysis to identify profiles of psychosocial functioning. RESULTS The prevalence of MCI in our sample was 21.5%. They had significantly lower years of education and perceived social support and higher depressive symptoms than the normal ageing group. Three distinct profiles emerged within the MCI group corresponding to a positive (45.2%), neutral (38.5%), and negative (16.3%) pattern of psychosocial scores. These profiles did not differ significantly in terms of demographic or cognitive variables. DISCUSSION The three psychosocial profiles might reflect the differing implications of MCI on a person's well-being and the negative psychosocial profile might likely be most at risk of conversion to dementia. Future longitudinal studies are required to confirm these implications.
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Affiliation(s)
- Savannah Kiah Hui Siew
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Psychology, School of Social Sciences, Nanyang Technological University, Singapore.
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tan LT, Østbye T, Visaria A, Malhotra R. Derivation, and establishment of the validity and reliability, of the CASP-11-SG quality of life scale among community-dwelling older adults. Qual Life Res 2023; 32:295-306. [PMID: 36068420 DOI: 10.1007/s11136-022-03238-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The number and proportion of older adults, aged ≥ 60 years, in Singapore is rapidly increasing. A valid and reliable quality of life (QoL) measure will enable assessment of their situation and help evaluate social and clinical interventions, potentially improving care. This study aims to evaluate the validity and reliability of the control, autonomy, self-realization, and pleasure (CASP)-12v.3 QoL scale and establish a scale suitable for use among older adults in Singapore. METHODS Data from 3526 community-dwelling older adults from a national survey was used. Measurement properties of the CASP-12v.3 scale were evaluated. Confirmatory factor analysis (CFA; testing single- and two-factor models with residual covariances for negatively worded items and a bifactor model) was performed in half of the sample and exploratory factor analysis (EFA) was performed in the other half. The results led to revised CFA models and the CASP-11-SG scale. The CASP-11-SG scale's measurement properties, convergent, and known-groups validity, and measurement equivalence/invariance (ME/I) across English and Chinese languages were evaluated. RESULTS Item 3 'I feel free to plan for the future' of the CASP-12v.3 scale had low correlation with other items of the control/autonomy subscale, low item-total correlation and high item-scale correlation. While CFA and EFA supported the two-factor model, removing item 3 improved model fit. The resulting CASP-11-SG scale (Cronbach's alpha: 0.81) demonstrated convergent and known-groups validity and partial ME/I across English and Chinese languages. CONCLUSION The CASP-11-SG scale, with satisfactory psychometric properties, can be used for assessing QoL among older adults in Singapore.
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Affiliation(s)
- Li Ting Tan
- Duke-NUS Medical School, Singapore, Singapore
| | - Truls Østbye
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Abhijit Visaria
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
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Ng TKS, Han MFY, Loh PY, Kua EH, Yu J, Best JR, Mahendran R. Differential associations between simple physical performance tests with global and specific cognitive functions in cognitively normal and mild cognitive impairment: a cross-sectional cohort study of Asian community-dwelling older adults. BMC Geriatr 2022; 22:798. [PMID: 36229767 PMCID: PMC9563467 DOI: 10.1186/s12877-022-03434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical performance declines and executive dysfunctions are predictors of dementia. However, their associations are not well understood in Asian older adults without dementia (cognitively normal [CN] and mild cognitive impairment [MCI]), especially in a single study. Objective Examine the associations between physical performance measures with executive function (EF)-based and non-EF-based neurocognitive tests and whether preclinical dementia cognitive status i.e., CN and MCI, moderated these associations. Methods We examined cross-sectional cohort of 716 community-dwelling older adults without dementia (CN = 562 and MCI = 154) using multivariable linear regression models. We associated three simple physical performance measures, namely timed-up-and-go (TUG), fast gait speed (FGS), and 30-s chair stand test (30 s-CST), with a comprehensive neurocognitive test battery measuring EF and non-EF cognitive functions. Moderating effects of cognitive status on the associations were examined. In all models, we controlled for pertinent covariates, including age, education, medical and psychiatric status. Results Upon controlling for covariates, TUG was most strongly and positively associated with multiple EF-based neurocognitive tests, followed by FGS, with 30 s-CST having the weakest associations. For all physical performance measures, no significant associations with non-EF-based neurocognitive tests were detected. Cognitive status significantly moderated the associations between all physical measures and several neurocognitive tests, with stronger associations in the MCI than CN. Conclusion Compared to FGS and 30 s-CST, TUG had the most robust associations with multiple EF-based cognitive functions. Given their differential associations with global and detailed neurocognitive tests and significant moderating effects of cognitive status, findings highlight a need to carefully consider the choices of simple physical performance tests when using these tests with a heterogenous group of community-dwelling older adults without dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03434-4.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore. .,Edson College of Nursing and Health Innovation, Arizona State University, Health North, Suite 301, 550 N 3rd Street, Phoenix, AZ, 85004, USA.
| | - Madeline Fu Yun Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Ping Yeap Loh
- Department of Human Science, Faculty of Design, Kyushu University, Shiobaru 4-9-1, Fukuoka, 815-8540, Japan
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.,Department of Psychological Medicine, National University Hospital, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - Junhong Yu
- Psychology, School of Social Sciences, Nanyang Technological University, 50 Nanyang Avenue, Singapore, 639798, Singapore
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, 515 W Hastings St, Vancouver, B.C, V6B 5K3, Canada
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.,Department of Psychological Medicine, National University Hospital, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
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Wang J, Qin W, Pang M, Zhao B, Xu J, Li S, Kong F. The Effect of Chronic Disease and Mental Health on Sleep Quality among Migrant Elderly Following Children in Weifang City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12734. [PMID: 36232032 PMCID: PMC9564950 DOI: 10.3390/ijerph191912734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Few studies have focused on the sleep quality among migrant elderly following children (MEFC). This study aimed to investigate the effects of chronic disease and mental health on the sleep quality of MEFC in Weifang, China. A cross-sectional study was conducted by multi-stage cluster random sampling, and in total 613 participants were enrolled. Sleep quality and mental health were assessed by the Pittsburgh Sleep Quality Index (PSQI) and the Depression, Anxiety, and Stress Scale (DASS-21), respectively. Chronic disease was assessed by the question "how many chronic diseases do you have?" A descriptive analysis and chi-square test were used to describe participants' sociodemographic variables, chronic disease, mental health, and sleep quality. The relationship between chronic disease, mental health, and sleep quality was explored by establishing binary logistic regression models. The results showed that 18.3% of MEFC's sleep quality was poor. MEFCs who were male were more likely to report good sleep quality. MEFCs who have similar monthly family income compared with others around, with multimorbidity, depression, and anxiety were more likely to report poor sleep quality. Nearly 1/5 of MEFCs were having poor sleep quality in this study. Results indicated that chronic diseases, depression, and anxiety were risk factors for the sleep quality of MEFC. Implications for the government, communities, and families of MEFC were given for improving their sleep quality.
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Affiliation(s)
- Jieru Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Wen Qin
- Shandong University Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Mingli Pang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, 1 Yonseidae-gil, Wonju 26493, Korea
| | - Jing Xu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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Yap AC, Mahendran R, Kua EH, Zhou W, Wang DY. Olfactory dysfunction is associated with mild cognitive impairment in community-dwelling older adults. Front Aging Neurosci 2022; 14:930686. [PMID: 36004001 PMCID: PMC9393534 DOI: 10.3389/fnagi.2022.930686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Olfactory impairment is aging related and is associated with cognitive decline in older adults. However, it remains unclear if an olfactory impairment is associated with mild cognitive impairment (MCI) and the degree of impairment in the MCI subtypes. Materials and methods In a cohort of community-living older adults aged 60 years and above, 670 participants were recruited from the Community Health and Intergenerational (CHI) Study. Olfactory function was assessed using a locally developed nine-item smell test in association with neurocognitive assessments. Analysis of covariance (ANCOVA) was used to examine the association of smell identification score and clinical cognitive status while considering demographic, clinical, and neuropsychological factors with Bonferroni correction for group comparisons. Results Age-related smell detection between normal aging (NA) and MCI participants had no significant difference. The overall mean smell identification score in older adults was negatively correlated with age. The mean smell identification score of MCI participants was also not significantly different as compared with NA, but an amnestic MCI multiple domain (aMCI_MD) subgroup had significantly lower (impaired) mean smell identification scores compared with the NA and MCI single domain (amnestic and non-amnestic) group. Conclusion This study demonstrated that olfactory identification impairment is a comorbidity in older adults with amnestic MCI (aMCI) and is a potential marker associated with an early stage of a neurocognitive disorder. The smell test could act as a screening tool to help in the early detection of smell impairment for heterogeneous syndromes of MCI among community-dwelling older adults. Clinicians and researchers could benefit from utilizing the locally developed smell test to screen their patients or research participants before the initiation of an appropriate health intervention or in a clinical trial.
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Affiliation(s)
- Ai Che Yap
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
- *Correspondence: Ee Heok Kua,
| | - Weibiao Zhou
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
- Weibiao Zhou,
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- De Yun Wang,
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12
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Allen F, Fan SY, Loke WM, Na TM, Keng Yan GL, Mittal R. The relationship between self-efficacy and oral health status of older adults. J Dent 2022; 122:104085. [DOI: 10.1016/j.jdent.2022.104085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022] Open
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Mittal R, Loke WM, Seng DOL, Na TM, Yan GLK, Allen PF. Willingness to Pay for Preventive Dental Care Amongst Older Adults. Int Dent J 2021; 72:499-505. [PMID: 34980497 PMCID: PMC9381377 DOI: 10.1016/j.identj.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aims of this study were (1) to investigate willingness to pay (WTP) for preventive and curative dental care procedures and (2) to determine the factors that influence older adults' WTP for dental care. METHODOLOGY Older, independently living adults from Singapore aged 60 years and older and eligible for government-subsidised dental care were nonrandomly recruited for this study. Data were collected using questionnaires and a clinical examination which recorded details of caries experience, number and distribution of posterior occluding contacts, prosthodontic status, and periodontal status. Using a contingent valuation method, participants were asked to rate WTP in Singapore dollars [SGD$] for 4 aspects of care: dental fillings, dental scaling, dental extraction, and disease prevention advice. Negative binomial regression was used to assess the relationship between the predictor variables associated with WTP for dental fillings, scaling, extraction, and preventive advice. RESULTS The mean value of WTP for a dental filling was SGD$30.23 (SGD$31.05), for scaling was SGD$30.28 (SGD$29.46), for dental extraction was SGD$35.08 (SGD$58.54). In a multivariate model, factors associated with higher WTPfees were as follows: (1) dental filling: age (younger), level of education (higher), and frequency of dental visits (regular); (2) scaling: level of education (higher), agree that dental problems affect overall health, and frequency of dental visits (regular); (3) dental extractions: age (younger), level of education (higher), frequency of dental visits (regular), and prosthodontic status (not wearing); (4) preventive advice: age (younger), gender (male), ethnicity (Chinese), level of education (higher), marital status (married), self-perceived oral health (good), and dental visits (regular). CONCLUSIONS The findings of our study suggest that older adults are willing to pay most for extraction and least for preventive advice.
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Affiliation(s)
- Rakhi Mittal
- Faculty of Dentistry, National University of Singapore, Singapore.
| | - Wong Mun Loke
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | - Tan Mei Na
- Faculty of Dentistry, National University of Singapore, Singapore
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14
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Siew SKH, Han MFY, Mahendran R, Yu J. Regression-Based Norms and Validation of the Cambridge Neuropsychological Test Automated Battery among Community-Living Older Adults in Singapore. Arch Clin Neuropsychol 2021; 37:457-472. [PMID: 34530442 DOI: 10.1093/arclin/acab073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The Cambridge Neuropsychological Test Automated Battery (CANTAB) is widely used in research and clinical settings. However, little is known about the use of the CANTAB in the local aging context. This study aimed to develop normative data for various CANTAB measures in community-living older adults in Singapore. Normative data were built using the regression-based approach. A secondary aim was to examine the concurrent validity of CANTAB measures with their traditional neurocognitive test counterparts. METHOD A total of 210 older adults (Mage = 67.27 years, SD = 5.45) from an existing cohort study completed standard neurocognitive tests and a CANTAB battery. A total of 160 were normal aging, 46 diagnosed with Mild Cognitive Impairment (MCI), and one diagnosed with Dementia. Older adults with MCI and Dementia were not included in the calculation of norms but were included in other analyses. For the CANTAB battery, regression-based norms were generated for each CANTAB measure, with age, sex, and education included as covariates. Concurrent validity was examined by correlating the CANTAB measures with their traditional neurocognitive counterparts. RESULTS As expected, performance across most CANTAB measures declined significantly with increasing age and decreasing education levels. There were no significant effects of sex on most CANTAB measures. Our study also showed that some CANTAB measures demonstrated good concurrent validity as they significantly correlated with their traditional neurocognitive test counterparts. CONCLUSIONS We have developed age, sex, and education-specific CANTAB norms for use in the local aging context. The advantages and challenges of using the CANTAB in the local aging context are discussed.
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Affiliation(s)
- Savannah K H Siew
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Madeline F Y Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549.,Psychology, School of Social Sciences, Nanyang Technological University, Singapore 639818
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15
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Yu J, Rawtaer I, Feng L, Kua EH, Mahendran R. The functional and structural connectomes associated with geriatric depression and anxiety symptoms in mild cognitive impairment: Cross-syndrome overlap and generalization. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110329. [PMID: 33865926 DOI: 10.1016/j.pnpbp.2021.110329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Geriatric depression and anxiety disorders often manifest as neuropsychiatric symptoms among those with mild cognitive impairment. Both tend to co-occur, and overlap in symptomology and etiology. Such commonalities are likely to be reflected in the brain as common neural correlates. Using connectome-based predictive modeling (CPM), we examined the functional and structural connectomes predicting depression and anxiety symptoms, and subsequently the overlap and cross-syndrome generalization of the connectomes associated with either disorder. Ninety-one older adults completed self-reported measures of depression and anxiety, and underwent diffusion tensor imaging and resting-state functional magnetic resonance imaging. Functional connectivity (FC) and structural connectivity (SC) matrices were derived from these scans and, in various combinations, entered into CPM models to predict either type of symptoms. Leave-one-out cross-validation was performed. Predictive accuracy was assessed via the correlation between predicted and observed scores (ρpredicted-observed). While FC or SC features alone significantly predicted either type of symptoms, these symptoms were best predicted by models that consisted of both FC and SC features (depression: ρpredicted-observed = 0.497; anxiety: ρpredicted-observed = 0.455). The features common to depression and anxiety were identified and entered into another model which was similarly accurate in predicting either type of symptoms. Moreover, cross-syndrome generalization was observed- the depression-associated features significantly predicted anxiety symptoms (ρpredicted-observed = 0.403) and vice-versa (ρpredicted-observed = 0.378). These FC and SC features are complementary biomarkers of geriatric depression and anxiety symptoms. Both types of symptoms are largely underpinned by common patterns of altered FC and SC, alluding to the transdiagnostic neurobiological susceptibility in both disorders.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore.
| | - Iris Rawtaer
- Department of Psychological Medicine, Sengkang General Hospital, 110 Sengkang E way, 544886, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
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16
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Yu J, Mahendran R. COVID-19 lockdown has altered the dynamics between affective symptoms and social isolation among older adults: results from a longitudinal network analysis. Sci Rep 2021; 11:14739. [PMID: 34282245 PMCID: PMC8289844 DOI: 10.1038/s41598-021-94301-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/06/2021] [Indexed: 01/19/2023] Open
Abstract
The COVID-19 lockdown has drastically limited social interactions and brought about a climate of fear and uncertainty. These circumstances not only increased affective symptoms and social isolation among community dwelling older adults but also alter the dynamics between them. Using network analyses, we study the changes in these dynamics before and during the lockdown. Community-dwelling older adults (N = 419) completed questionnaires assessing depression, anxiety, and social isolation, before the COVID-19 pandemic, as part of a cohort study, and during the lockdown period. The total scores of these questionnaires were compared across time. For the network analyses, partial correlation networks were constructed using items in the questionnaires as nodes, separately at both timepoints. Changes in edges, as well as nodal and bridge centrality were examined across time. Depression and anxiety symptoms, and social isolation had significantly increased during the lockdown. Significant changes were observed across time on several edges. Greater connectivity between the affective and social isolation nodes at lockdown was observed. Depression symptoms have become more tightly coupled across individuals, and so were the anxiety symptoms. Depression symptoms have also become slightly decoupled from those of anxiety. These changing network dynamics reflect the greater influence of social isolation on affective symptoms across individuals and an increased vulnerability to affective disorders. These findings provide novel perspectives and translational implications on the changing mental health context amidst a COVID-19 pandemic situation.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore.
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore, Singapore.
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17
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Lim XY, Yap AC, Mahendran R, Yu J. The interplay between anxiety, fear, protective behaviors, compassion, and resilience among older adults during a COVID-19 lockdown: a structural equation modeling study. Transl Behav Med 2021; 11:1172-1178. [PMID: 33793946 PMCID: PMC8139136 DOI: 10.1093/tbm/ibaa143] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The implementation of lockdown measures to curb the transmission of Coronavirus
disease-2019 (COVID-19) has brought about significant psychological impacts and older
adults have been identified as one of the vulnerable groups. In the current COVID-19
context among older adults in the community, the fear of COVID-19, anxiety symptoms,
compassion, resilience, and the practice of protective behaviors are possibly related to
each other in several ways. How these factors relate to each other would have important
implications in managing the spread of the disease and its mental health consequences. To
this end, we modeled their interrelationships using a structural equation model. Older
adults (N = 421), aged 60 and above completed various
questionnairesCOVID-19 Fear Inventory, Short form of the Geriatric Anxiety Inventory,
COVID-19 Risky and Protective Behaviours, Resilience Appraisals Scale, and Compassion
Scale during a COVID-19 lockdown. The relationships between these variables were assessed
within a structural equation model. The findings showed that older adults who are more
compassionate engage in protective behaviors more frequently. Additionally, frequent
practice of protective behaviors and greater resilience predicted lower anxiety among
older adults. Greater fear predicted higher anxiety levels but did not significantly
influence an individuals engagement in protective behaviors. Mental health services are
crucial in fostering resilience and supporting older adults psychologically. Social
services are also necessary in maintaining and enhancing social support for older adults.
Importantly, these findings suggest that public health communications could promote
compassion and avoid using a fear-based approach to increase engagement in protective
behaviors. This study focused on the interrelations between various psychosocial factors (i.e., fear
of COVID-19, compassion, and resilience) and the behavioral (i.e., engagement in
protective health behaviors) and psychological responses (i.e., anxiety) to COVID-19 among
community-dwelling older adults. The study analyzed self-reported data from 421 older
adults who are aged 60 and above. The findings showed that older adults who are more
compassionate engage in protective behaviors more frequently. Additionally, older adults
who showed greater resilience and engage in protective health behaviors more frequently
reported lower anxiety levels. Lastly, greater fear of COVID-19 predicted greater anxiety
among older adults but did not significantly influence their engagement in protective
health behaviors.
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Affiliation(s)
- Xin Ying Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ai Che Yap
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Academic Development Department, Duke-NUS Medical School, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Han MFY, Mahendran R, Yu J. Associations Between Fear of COVID-19, Affective Symptoms and Risk Perception Among Community-Dwelling Older Adults During a COVID-19 Lockdown. Front Psychol 2021; 12:638831. [PMID: 33833722 PMCID: PMC8021922 DOI: 10.3389/fpsyg.2021.638831] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/04/2021] [Indexed: 01/11/2023] Open
Abstract
Fear is a common and potentially distressful psychological response to the current COVID-19 pandemic. The factors associated with such fear remains relatively unstudied among older adults. We investigated if fear of COVID-19 could be associated with a combination of psychological factors such as anxiety and depressive symptoms, and risk perception of COVID-19, and demographic factors in a community sample of older adults. Older adults (N = 413, M age = 69.09 years, SD = 5.45) completed measures of fear of COVID-19, anxiety and depressive symptoms, and risk perception of COVID-19, during a COVID-19 lockdown. These variables, together with demographics, were fitted to a structural equation model. Anxiety and depressive symptoms were highly correlated with each other and were combined into the higher order latent variable of affective symptoms for analyses. The final model revealed that fear of COVID-19 was positively associated with psychological factors of affective symptoms and risk perception. Older age was associated with greater fear of COVID-19. Our findings showed that fear of COVID-19 can be a projection of pre-existing affective symptoms and inflated risk perceptions and highlighted the need to address the incorrect risk perceptions of COVID-19 and socio-affective issues among older adults in the community.
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Affiliation(s)
- Madeline F. Y. Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
| | - Junhong Yu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Han M, Tan XY, Lee R, Lee JK, Mahendran R. Impact of Social Media on Health-Related Outcomes Among Older Adults in Singapore: Qualitative Study. JMIR Aging 2021; 4:e23826. [PMID: 33595437 PMCID: PMC8294634 DOI: 10.2196/23826] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The worldwide spread of digitalization has led to the harnessing of technology to improve health outcomes. Paying attention to older adults' social needs via social media is one way to promote healthy aging. Although 56% of older adults are smartphone users, little is known about their use patterns of social media. OBJECTIVE This exploratory study aims to determine the experiences of social media apps' use among older adults in Singapore and understand their perceptions of its impact on health-related outcomes. METHODS This study used a qualitative research design with an interpretative approach. Using maximum variation purposive sampling, normal aging older adults (N=16) who were aged between 60 and 80 years and experienced in the use of internet-enabled technology were recruited from an existing community study. Semistructured, in-depth interviews were conducted. Employing a thematic analysis, interviews were transcribed verbatim and analyzed for codes inductively. RESULTS The following themes and subthemes were identified as key moderators of older adults' experiences on social media apps: (1) personal attitudes: participants were encouraged to use social media due to the increased accessibility, which enabled the ease of contact, but perceptions that the quality of interactions was compromised and its associated risks reduced their use; and (2) social influences: the desire to bond with co-users and the availability of support increased use. In addition, use of social media apps was perceived to positively impact health through its ability to keep older adults cognitively engaged, improve health communication, and increase social connectedness. However, opinions remained mixed on older adults' vulnerability to social media addiction. CONCLUSIONS Personal and social contexts determine older adults' social media use. This study's findings provide practical insights into how social media can be deployed to improve health-related outcomes in older adults.
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Affiliation(s)
- Madeline Han
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xin Yi Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rachael Lee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jeong Kyu Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
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20
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Mittal R, Tan KS, Wong ML, Allen PF. Correlation between microbial host factors and caries among older adults. BMC Oral Health 2021; 21:47. [PMID: 33541321 PMCID: PMC7863314 DOI: 10.1186/s12903-021-01408-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 01/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background There is little knowledge about factors which may affect oral health among older adults. The objective of this study was to determine the relationship between Streptococcus mutans (MS) and Lactobacilli (LB) counts and caries among older adults. Methods In this community-based observation study, 141 participants aged 60 years and above were recruited from the west district of Singapore. Alongside the clinical examination, saliva samples were collected to determine Streptococcus mutans (MS) and Lactobacilli (LB) counts, as well as to record salivary flow rate and buffering capacity of saliva. Results Of the 141 participants, 63.8% were female and 94.3% were of Chinese ethnicity. The mean DMFT was 11.08 (s.d. 8.27). 9.9% of participants had at least one decayed tooth, 52.5% had minimum one missing tooth and 86.5% had at least one filled tooth. 67.4% had MS counts of ≥ 105 while LB counts were ≥ 105 for 48.2%. 83.7% had normal salivary flow or hypersalivation (> = 1 mL/min), the buffering capacity of the saliva was alkaline in 61% of the participants. Multivariate analysis showed that participants who had high MS counts were less likely to have a DMFT < 12 [OR (95% CI), 0.29 (0.11–0.77)] whereas participants who had high LB counts were less likely to have a DMFT ≤ 14 [OR (95% CI), 0.45 (0.20–1.002)]. Conclusion Our study showed a positive correlation between MS and LB counts and caries experience in older adults. The mean DMFT was on the low side in our sample despite having a relatively high MS count. This suggests that there are many other factors which vary according to host environment, physiological and biological conditions that may affect MS and LB counts in the oral cavity. Clinical relevance Our study supports the knowledge that the aetiology of dental caries among older adults is a complex process and it would be wrong to consider caries as a same problem with the same solution for all age groups.
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Affiliation(s)
- Rakhi Mittal
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
| | - Kai Soo Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Mun Loke Wong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Wang J, Gong Y, Chen Z, Wu J, Feng J, Yan S, Lv C, Lu Z, Mu K, Yin X. Sleep disturbances among Chinese residents during the Coronavirus Disease 2019 outbreak and associated factors. Sleep Med 2020; 74:199-203. [PMID: 32861011 PMCID: PMC7411535 DOI: 10.1016/j.sleep.2020.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/07/2020] [Accepted: 08/03/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Sleep status can affect the body's immune status and mental health. This study aims to investigate the sleep status of Chinese residents during the outbreak of Coronavirus Disease 2019 (COVID-19) and to evaluate its related risk factors. METHODS This research carried out a cross-sectional survey in February 2020 (during the COVID-19 outbreak) to investigate the sleep status of residents nationwide in the form of an online questionnaire. Of the 8151 respondents, 6437 were eventually included in the analysis. Logistic regression is applied to analyze the associated factors affecting residents' sleep quality. RESULTS During the COVID-19 outbreak, the incidence of sleep disturbances in residents was 17.65%. Increased risk of sleep disturbances was found to be associated with older age, female gender, and poor self-reported health status. Moreover, the odds ratios (ORs) were 1.42 (95% CI: 1.1-2.64), 1.35 (95% CI: 1.16-1.59), 5.59 (95% CI: 4.32-7.23), respectively. Those residents who believed COVID-19 had caused a high number of deaths or who thought COVID-19 was not easy to cure were more likely to experience sleep disorders, and the ORs were 1.73 (95% CI: 1.43-2.09), 1.57 (95% CI: 1.29-1.91), respectively. Regular exercise was a protective factor for sleep disturbances, OR = 0.77 (95% CI: 0.63-0.93). CONCLUSIONS During the outbreak of COVID-19, nearly one-fifth of participants had sleep disorders. It is necessary to pay more attention to people at high risk for sleep disturbances during the outbreak, adopt effective risk communication methods, enhance residents' rational understanding of COVID-19, and develop practical indoor exercise programs for general public to improve sleep quality.
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Affiliation(s)
- Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Jie Feng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, Hainan, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China; Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China; Emergency and Trauma College, Hainan Medical University, Haikou, Hainan, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China
| | - Ketao Mu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China.
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