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Mohammed Z, Kee QT, Fadzil NM, Abd Rahman MH, Din NC, Mariappan V, Shahar S. Association between vision and cognitive function among community-dwelling older adults in Selangor, Malaysia. Int J Ophthalmol 2023; 16:115-120. [PMID: 36659949 PMCID: PMC9815982 DOI: 10.18240/ijo.2023.01.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
AIM To determine the association between distance and near visual acuity (VA) and cognitive function among older adults in Selangor, Malaysia. METHODS A total of 230 older adults (age ≥60y) participated in this study. Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart, respectively. Global cognitive function was assessed using the Mini-Mental State Examination (M-MSE) and the Malay language version of the Montreal Cognitive Assessment (M-MoCA). Digit Symbol (DS) subtest was used to measure information processing. RESULTS No significant association was observed between vision and M-MSE and M-MoCA scores. However, poor distance and near VA were found to be significantly associated with low DS scores [distance VA: β=-0.01, R 2=0.1, P=0.02; odds ratio (OR)=2.84, 95% confidence interval (CI), 1.10-7.33, P=0.03; near VA: β=-0.05, R 2=0.08, P=0.00; OR=3.32, 95%CI, 1.28-8.59, P=0.01]. CONCLUSION Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.
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Affiliation(s)
- Zainora Mohammed
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Qiu-Ting Kee
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Norliza Mohamad Fadzil
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Mohd Harimi Abd Rahman
- Programme of Optometry and Vision Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Rehabilitation and Special Needs Study, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Vanitha Mariappan
- Center of Toxicology and Risk Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Programme of Dietetic, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz 50300, Kuala Lumpur, Malaysia.
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Syed Alwi SM, Mazlan M, Mohd Taib NA, Che Din N, Narayanan V. A Delphi technique toward the development of a cognitive intervention framework module for breast cancer survivors with cognitive impairment following chemotherapy. PLoS One 2022; 17:e0277056. [PMID: 36395277 PMCID: PMC9671464 DOI: 10.1371/journal.pone.0277056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Chemotherapy-related cognitive impairment (CRCI) is a well-known phenomenon among breast cancer survivors. Cognitive impairment among breast cancer survivors can significantly affect their quality of life and ability to function independently. However, there is a lack of specific and focused cognitive intervention to improve their cognitive performances. This study aimed to develop a tailored cognitive intervention framework module by adapting the attention and memory interventions from the Cognitive Rehabilitation Manual of the Brain Injury Interdisciplinary Special Interest Group (BI-SIG) of the American Congress of Rehabilitation Medicine (ACRM) and incorporating them with the relevant exercises for cognitive rehabilitation for Malaysian breast cancer survivors with CRCI based on the consensus agreement of the expert panel. Methods and analysis The Delphi consensus technique was conducted online to review and evaluate the framework module. A panel of experts, including rehabilitation medicine physicians, occupational therapists, and clinical psychologists in Malaysia, was invited to participate in this study. For each round, the expert consensus was defined as more than 90% of the expert panel agreeing or strongly agreeing with the proposed items. Results A total of 33 practitioners completed the three Delphi rounds. 72.7% of the expert panel have been practising in their relevant clinical fields for more than six years (M = 10.67, SD = 5.68). In Round 1, 23% of the experts suggested that the framework module for attention training required further improvements, specifically in the language (M = 1.97, SD = 0.75) and instructions (M = 2.03, SD = 0.71) provided. In Round 2, 15% of the experts recommended additional changes in the instruction (M = 2.15, SD = 0.67) for attention training. Amendments made to the framework module in line with the recommendations provided by the experts resulted in a higher level of consensus, as 94% to 100% of the experts in Round 3 concluded the framework module was suitable and comprehensive for our breast cancer survivors. Following the key results, the objectives were practical, and the proposed approaches, strategies, and techniques for attention and memory training were feasible. The clarity of the instructions, procedures, verbatim transcripts, and timeframe further enhanced the efficacy and utility of the framework module. Conclusions This study found out that the cognitive intervention framework module for breast cancer survivors with cognitive impairment following chemotherapy can be successfully developed and feasible to be implemented using Delphi technique.
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Affiliation(s)
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Normah Che Din
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Malek Rivan NF, Shahar S, Fakhruddin NNINM, You YX, Che Din N, Rajikan R. The effect of dietary patterns on mild cognitive impairment and dementia incidence among community-dwelling older adults. Front Nutr 2022; 9:901750. [PMID: 36003836 PMCID: PMC9395130 DOI: 10.3389/fnut.2022.901750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple studies have shown that dietary patterns have beneficial health effects on cognitive function. However, information on this relationship is presently limited, particularly among older adults. Thus, this study aimed to determine the effects of dietary patterns on mild cognitive impairment (MCI) and dementia incidence among Malaysian community-dwelling older adults. In this prospective cohort study, a total of 280 participants aged 60 years and above were included in the 5-year follow-up analysis. Participants' sociodemographic, medical history, anthropometry, blood pressure, body composition, biochemical indices, cognitive assessments, psychosocial functions, functional status, and dietary intake were obtained. MCI was classified based on Petersen criteria, whereas dementia status was assessed using clinical dementia rating (CDR). Univariate analysis was performed for all variables, followed by multinomial regression analysis to identify the ability of dietary patterns in predicting the incidence of MCI and dementia. After controlling for confounding factors, the findings indicated that "local snacks-fish and seafood-high salt foods" dietary pattern was associated with an increased risk of MCI incidence, where the T3 [adjusted OR = 3.943 (95% CI: 1.212-12.832), p = 0.032] had the highest OR compared to T2 [adjusted OR = 3.252 (95% CI: 1.108-9.546), p = 0.023]. Meanwhile, a negative association across the tertiles of tropical fruits-oats dietary pattern and dementia incidence was observed [T2: adjusted OR = 0.152 (95% CI: 0.026-0.871), p = 0.034; T3: Adjusted OR = 0.101 (95% CI: 0.011-0.967), p = 0.047]. In conclusion, specific dietary patterns, particularly "local snacks-fish and seafoods-high salt foods," were shown to increase the risk of MCI, while increasing intakes of "tropical fruits-oats" dietary patterns would protect against the dementia incidence among Malaysian older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nik Nur Izzati Nik Mohd Fakhruddin
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Yee Xing You
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslee Rajikan
- Dietetics Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ibrahim N, Ong HC, Wahab S, Che Din N, Ahmad M, Amit N, Siau CS, Mohamad MS. Perceived burden, psychological distress, and quality of life among family caregivers of individuals with schizophrenia. J Multicult Couns & Deve 2022. [DOI: 10.1002/jmcd.12267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Norhayati Ibrahim
- Faculty of Health Sciences Centre for Healthy Ageing and Wellness Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
- Institute of Islam Hadhari Universiti Kebangsaan Malaysia Bangi Malaysia
| | - Hui Chien Ong
- Faculty of Health Sciences Centre for Healthy Ageing and Wellness Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Suzaily Wahab
- Faculty of Medicine Department of Psychiatry Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Normah Che Din
- Faculty of Health Sciences Centre for Healthy Ageing and Wellness Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Mahadir Ahmad
- Faculty of Health Sciences Centre for Community Health Studies Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Noh Amit
- Faculty of Health Sciences Centre for Community Health Studies Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Ching Sin Siau
- Faculty of Health Sciences Centre for Community Health Studies Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia
| | - Mohd Suhaimi Mohamad
- Faculty of Social Sciences and Humanities School of Psychology and Human Development Universiti Kebangsaan Malaysia Bangi Malaysia
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Long GC, Umat C, Din NC. Socio-Emotional Development of Children with Cochlear Implant: A Systematic Review. Malays J Med Sci 2022; 28:10-33. [PMID: 35115884 PMCID: PMC8793967 DOI: 10.21315/mjms2021.28.5.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 10/26/2020] [Indexed: 11/02/2022] Open
Abstract
Background Attaining socio-emotional competence is challenging for children with hearing impairment. There is wide recognition of children with cochlear implant (CI) indicating significant improvement in their speech and language abilities, however many factors may restrict their chance of having reciprocal social interactions. A significant improvement in speech and language does not automatically affirm the quality of social interactions. This present observation on social-emotional development addressed a more current representative population of children with hearing loss who have benefitted from cochlear implantation. Methods The research conducted a systematic review of selected articles from Scopus and PubMed databases, retrieved through three search-process keywords, namely socio-emotional, children and CI. The inclusion criteria only included journal articles published in English with empirical data from the year 2010-2019. The initial search had identified 189 potential abstracts and after removal of duplicates, only 38 eligible studies met the inclusion criteria. Results Among 38 studies reviewed, 19 studies showed comparable socio-emotional skills with peers in social interaction, empathy, emotion theory of mind and comprehension skills. Conversely, the other 19 studies presented underprivileged results in socio-emotional functioning mainly in identifying facial expression, regulating emotion and emotional cues in the auditory domain. Conclusion This review concluded that the socio-emotional development among children with CI, both at preschool-age and school-age, was not justified due to the heterogeneity in studies across measurement and small sample size. Also, the conclusion recommended extensive cross-referencing, mixed-mode research design, detailed distinguishing of socio-emotional functioning and identification of diverse groups of the population with impaired hearing as an approach to provide empirical evidence on socio-emotional functioning among children with CI in the future.
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Affiliation(s)
- Geh Cha Long
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Cila Umat
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Rehabilitation & Special Needs Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Che Din N, Umat C, Abdul Wahat NH, Talib AB. Mapping the evidence of multidimensional health approaches in treating individuals with Prader-Willi Syndrome: A scoping review protocol. BMJ Open 2022; 12:e047638. [PMID: 35022164 PMCID: PMC8756288 DOI: 10.1136/bmjopen-2020-047638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Prader-Willi Syndrome (PWS) is one of the rare diseases involving genetics and affects various body systems. The disease is known due to the absence of paternal genes on chromosome 15q11-q13. Multisystem complex conditions require interdisciplinary healthcare treatment. However, to the best of our knowledge, there is little evidence of an established successful model of an interdisciplinary approach in managing rare diseases like PWS. METHODS AND ANALYSIS The scoping review process follows the five-staged Arksey and O'Malley (2005) methodology framework excluding the optional consultation stage (stage 6): the definition of the research questions (step 1); the eligibility criteria and search strategy are defined (stage 2); the study selection process based on the eligibility criteria identified will follow (stage 3); a framework developed for this review will then inform the extraction and charting of data from the included studies (step 4) and results will be aggregated and summarised with criteria relevant for health professionals and policymakers (stage 5). We will search for electronic databases (MEDLINE/PubMed, Scopus, Web of Science), grey literature sources and critical studies' reference lists to determine the appropriate inclusion criteria. Three researchers will review all abstracts and full-text studies for inclusion. ETHICS AND DISSEMINATION This scoping review methodology does not require ethical approval since it aims to synthesise information from available publications. A scoping review article will be submitted for publication to a scientific journal following this protocol.
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Affiliation(s)
- Normah Che Din
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Cila Umat
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Nor Haniza Abdul Wahat
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory, Malaysia
| | - Azhar Bin Talib
- Prader-Willi Syndrome Association (PWSA) Malaysia, Jalan Enggang, Taman Keramat, Kuala Lumpur
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You YX, Shahar S, Mohamad M, Rajab NF, Che Din N, Lau HJ, Abdul Hamid H. Is There Any Relationship Between Biochemical Indices and Anthropometric Measurements With Dorsolateral Prefrontal Cortex Activation Among Older Adults With Mild Cognitive Impairment? Front Hum Neurosci 2022; 15:765451. [PMID: 35046782 PMCID: PMC8762169 DOI: 10.3389/fnhum.2021.765451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Working memory is developed in one region of the brain called the dorsolateral prefrontal cortex (DLPFC). The dysfunction of this region leads to synaptic neuroplasticity impairment. It has been reported that several biochemical parameters and anthropometric measurements play a vital role in cognition and brain health. This study aimed to investigate the relationships between cognitive function, serum biochemical profile, and anthropometric measurements using DLPFC activation. A cross-sectional study was conducted among 35 older adults (≥60 years) who experienced mild cognitive impairment (MCI). For this purpose, we distributed a comprehensive interview-based questionnaire for collecting sociodemographic information from the participants and conducting cognitive tests. Anthropometric values were measured, and fasting blood specimens were collected. We investigated their brain activation using the task-based functional MRI (fMRI; N-back), specifically in the DLPFC region. Positive relationships were observed between brain-derived neurotrophic factor (BDNF) (β = 0.494, p < 0.01) and Mini-Mental State Examination (MMSE) (β = 0.698, p < 0.01); however, negative relationships were observed between serum triglyceride (β = −0.402, p < 0.05) and serum malondialdehyde (MDA) (β = −0.326, p < 0.05) with right DLPFC activation (R2 = 0.512) while the participants performed 1-back task after adjustments for age, gender, and years of education. In conclusion, higher serum triglycerides, higher oxidative stress, and lower neurotrophic factor were associated with lower right DLPFC activation among older adults with MCI. A further investigation needs to be carried out to understand the causal-effect mechanisms of the significant parameters and the DLPFC activation so that better intervention strategies can be developed for reducing the risk of irreversible neurodegenerative diseases among older adults with MCI.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Suzana Shahar,
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hui Jin Lau
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Ibrahim N, Che Din N, Amit N, Ghazali SE, Mohd Safien A, Siau CS. Psychometric Properties and the Cut-Off Point of the English Version of the Yatt Suicide Attitude Scale. INQUIRY 2022; 59:469580221096276. [PMID: 35485917 PMCID: PMC9067032 DOI: 10.1177/00469580221096276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: The Malay version of the Yatt Suicide Attitude Scale (YSAS) was found to be reliable and valid for use in the Malaysian context. This study aims to validate and determine the cut-off points of the English version of the YSAS for a wider application by English-speaking researchers and practitioners. Methods: The English version of the YSAS, the Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Kessler’s K10 Psychological Distress Scale were distributed to 527 university students. Factor analysis was employed in the evaluation of its construct validity. The determination of the convergent and concurrent validity was determined by way of a bivariate correlation with the SBQ-R and Kessler’s K10 scales. Cronbach’s alpha and Receiver Operating Characteristic-analysis were also used to measure the internal consistency reliability as well as evaluate the screening properties of the scale. Results: The English YSAS and its ideation and attempt subdomains exhibited a high internal consistency value (>.8). The scale also had a cumulative variance of 76.39% and acceptable convergent and concurrent validity when compared to the SBQ-R and K10. The instrument demonstrated a better specificity in terms of the total score and suicide attempt and a better sensitivity trait on the suicidal ideation score. Conclusion: The English YSAS is a valid and reliable scale to assess suicidality, suicidal ideation, and suicide attempt among Malaysian university students.
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Affiliation(s)
- Norhayati Ibrahim
- Clinical Psychology and Behavioral Health Program, Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Normah Che Din
- Clinical Psychology and Behavioral Health Program, Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noh Amit
- Clinical Psychology and Behavioral Health Program, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shazli E. Ghazali
- Clinical Psychology and Behavioral Health Program, Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aisyah Mohd Safien
- Clinical Psychology and Behavioral Health Program, Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Clinical Psychology and Behavioral Health Program, Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rivan NFM, Singh DKA, Shahar S, Wen GJ, Rajab NF, Din NC, Mahadzir H, Kamaruddin MZA. Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults. BMC Geriatr 2021; 21:593. [PMID: 34696720 PMCID: PMC8543922 DOI: 10.1186/s12877-021-02525-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up. Methods In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants’ socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05. Results Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78–4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19–6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23–7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75–5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11–24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11–22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults. Conclusion Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Goh Jing Wen
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Mohd Safien A, Ibrahim N, Subramaniam P, Shahar S, Din NC, Ismail A, Singh DKA, Mat Ludin AF. Randomized Controlled Trials of a Psychosocial Intervention for Improving the Cognitive Function among Older Adults: A Scoping Review. Gerontol Geriatr Med 2021; 7:23337214211025167. [PMID: 34395815 PMCID: PMC8361523 DOI: 10.1177/23337214211025167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022] Open
Abstract
Aim: The goal is to explore available evidence and provide greater clarity to what is described as psychosocial intervention to improve cognitive function among older population with MCI as well as identifying areas for future research. Methods: An electronic literature search of PubMed, Cochrane, Ebscohost, Medline, Scopus, and gray resource was conducted to find articles published in English language between 2010 and September 2020. This review focused on research undertaken using randomized clinical trials study design. We extracted information regarding the publication date, geographical location, study setting, intervention mechanism, type of cognitive measurement used, and outcome of the studies. References of this literature were also reviewed to ensure comprehensive search. Result: Out of 240 potential records found, a total of 27 articles were identified following the first round of screening and deletion of duplicates. Full-text article reviews and analysis in the second round of screening narrowed the selection down to four articles. Another three relevant articles obtained from references were also included making a total of seven articles in the final analysis. Findings: Psychosocial intervention strategies for improvement of cognitive function, done in various setting all over the globe, covered a range of approaches including art therapy, visual art therapy, therapeutic writing therapy, reminiscence activity, and cognitive behavioral approach. Most were conducted in weekly basis within 1-to-2-hour duration of session. Cognitive function of older adult in psychosocial intervention group was significantly improved in two studies. Three studies showed no significant improvement at all in the cognitive function, and another one reported success in improving cognitive function over time in the intervention group than in control group. One study did not describe the interaction effect. Different types of cognitive measurement also were used to quantify different domains of cognitive function in the reviewed studies. Conclusion: The idea of using psychosocial intervention for improving cognitive function has begun to increasingly accepted recently. Findings from the limited studies are encouraging, although the outcome of the cognitive function was mixed. Large-scale and longer duration of psychosocial intervention with bigger sample size is warranted for future studies.
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Affiliation(s)
| | | | | | | | | | - Aniza Ismail
- Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Syed Alwi SM, Narayanan V, Mohd Taib NA, Che Din N. Chemotherapy-related cognitive impairment (CRCI) among early-stage breast cancer survivors in Malaysia. J Clin Exp Neuropsychol 2021; 43:534-545. [PMID: 34369307 DOI: 10.1080/13803395.2021.1945539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Breast cancer survivors frequently develop cognitive impairment following chemotherapy which can significantly hamper their well-being, ability to function independently, and overall quality of life. Evidence of cognitive functioning in breast cancer survivors from lower and middle-income countries remains scarce. We examined the prevalence of cognitive impairment among Malaysian multiethnic early-stage breast cancer survivors one to three years post-chemotherapy.Methods: This cross-sectional study included 160 breast cancer survivors from the University Malaya Medical Center (UMMC). The cognitive assessments used included the Montreal Cognitive Assessment (MoCA-BM), the Rey Auditory and Verbal Learning Test (RAVLT-BM), and the digit span and arithmetic of the Working Memory Index (WMI) of Wechsler Adult Intelligence Scale-IV (WAIS-IV). Data were analyzed using independent sample t-tests and Pearson's correlation.Results: Our breast cancer survivors demonstrated poor performances in MoCA-BM (31.9%) RAVLT-BM, recall (53.8%), and WMI of WAIS-IV (51.3%) with 30.6% of them performed poorly in all three cognitive tests administered. There were no significant mean group differences in cognitive performances between <24 months after chemotherapy and ≥24 months after chemotherapy.Conclusions: A high proportion of breast cancer survivors exhibited poor performances in the cognitive assessments. Cognitive rehabilitation programmes tailored to the needs of these survivors should be incorporated into cancer care management.
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Affiliation(s)
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Normah Che Din
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ponvel P, Shahar S, Singh DKA, Ludin AFM, Rajikan R, Rajab NF, Ai-Vyrn C, Din NC, Ibrahim N, Subramaniam P, Haron H, Ismail A, Sharif R, Ramasamy K, Majeed ABA, Ali NM, Mohamad M, Noah SAM, Ibrahim AM, Safien AM, Khalid NM, Fadzil NHM, Mangialasche F, Kivipelto M. Multidomain Intervention for Reversal of Cognitive Frailty, Towards a Personalized Approach (AGELESS Trial): Study Design. J Alzheimers Dis 2021; 82:673-687. [PMID: 34092633 PMCID: PMC8385532 DOI: 10.3233/jad-201607] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Cognitive frailty (CF) is identified as one of the main precursors of dementia. Multidomain intervention has been found to delay or prevent the onset of CF. Objective: The aim of our present study is to determine the effectiveness of a comprehensive, multidomain intervention on CF; to evaluate its cost effectiveness and the factors influencing adherence toward this intensive intervention. Methods: A total of 1,000 community dwelling older adults, aged 60 years and above will be screened for CF. This randomized controlled trial involves recruitment of 330 older adults with CF from urban, semi-urban, and rural areas in Malaysia. Multidomain intervention comprised of physical, nutritional, cognitive, and psychosocial aspects will be provided to participants in the experimental group (n = 165). The control group (n = 165) will continue their usual care with their physician. Primary outcomes include CF status, physical function, psychosocial and nutritional status as well as cognitive performance. Vascular health and gut microbiome will be assessed using blood and stool samples. A 24-month intensive intervention will be prescribed to the participants and its sustainability will be assessed for the following 12 months. The effective intervention strategies will be integrated as a personalized telerehabilitation package for the reversal of CF for future use. Results: The multidomain intervention developed from this trial is expected to be cost effective compared to usual care as well as able is to reverse CF. Conclusion: This project will be part of the World-Wide FINGERS (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) Network, of which common identifiable data will be shared and harmonized among the consortia.
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Affiliation(s)
- Pavapriya Ponvel
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Roslee Rajikan
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chin Ai-Vyrn
- Geriatric Division, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | - Mazlyfarina Mohamad
- Centre for Diagnostic, Therapeutic & Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shahrul Azman Mohd Noah
- Centre for Artificial Intelligence Technology, Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Malaysia
| | - Azianah Mohd Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aisyah Mohd Safien
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Mustafa Khalid
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Hidayah Md Fadzil
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Alzheimer Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Alzheimer Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
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You YX, Shahar S, Mohamad M, Rajab NF, Haron H, Che Din N, Abdul Hamid H. Neuroimaging Functional Magnetic Resonance Imaging Task-Based Dorsolateral Prefrontal Cortex Activation Following 12 Weeks of Cosmos caudatus Supplementation Among Older Adults With Mild Cognitive Impairment. J Magn Reson Imaging 2021; 54:1804-1818. [PMID: 34080265 DOI: 10.1002/jmri.27762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Cosmos caudatus (CC) is traditional Asian vegetable, commonly consumed among the Southeast Asian population. It has been reported to be high in flavonoids and might potentially improve brain activity among older adults with mild cognitive impairment (MCI). The effect of CC in brain activation improvement using neuroimaging is yet to be discovered. PURPOSE To investigate the effects of CC supplement on brain activity using functional magnetic resonance imaging (fMRI) among older adults with MCI. STUDY TYPE Prospective, randomized, double-blind, placebo-controlled trial. POPULATION/SUBJECTS Twenty older adults with mild cognitive impairment (60-75 years old), 14 of them (70%) were female subjects. FIELD STRENGTH/SEQUENCE A 3.0-T, T1-weighted anatomical images, T2*-weighted imaging data, A single shot, gradient echo-echo planar imaging (EPI) sequence. ASSESSMENT All subjects were asked to consume two 500 mg capsules of either CC supplement or placebo (maltodextrin) daily for 12 weeks. Cognitive function was measured using validated neuropsychological tests (i.e. Mini-mental State Examination and Digit Span) and task-based fMRI (N-back and Stroop Color Word Test) at baseline and 12th week. Brodmann's area 9, 46 and anterior cingulate cortex were selected as the regions of interest to define dorsolateral prefrontal cortex (DLPFC) in fMRI analysis. STATISTICAL TESTS Normality test was performed with the Shapiro-Wilk test. Two-way repeated ANOVA determined the intervention effects of the CC supplementation on brain activity after adjustments for covariates. Significance level at P < 0.05 for independent-t test and Chi square test; adjusted P < 0.0042 for two-way repeated ANOVA after Bonferroni correction. RESULTS Findings showed significant improvements in digit span (partial η2 = 0.559), increment in right DLPFC activation while performing 1-back task (partial η2 = 0.586) and left DLPFC activation while performing Stroop Color Word Test (SCWT) (congruent) task (partial η2 = 0.432) at 12th week of CC supplementation. CONCLUSION CC supplementation might have the ability to improve DLPFC activation, potentially leading to improved working memory among older adults with MCI after 12 weeks of administration. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Yee Xing You
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Nutritional Sciences Program and Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Vasantha Kumar P, Subramaniam P, Che Din N. The utility and cultural specificity of cognitive-based interventions in preventing cognitive decline among healthy older adults in Asia: A systematic review. Asian J Psychiatr 2021; 60:102646. [PMID: 33873045 DOI: 10.1016/j.ajp.2021.102646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The effects of aging and its associated cognitive decline is particularly acute in Asia given the exponential growth of older adults as a proportion of the population as a whole. Many structured cognitive interventions have been proposed to prevent the cognitive decline typically seen in older age, but their utility as a viable means of achieving these goals is questionable. OBJECTIVES To summarize and synthesize evidence on the utility and methodological quality of cognitive-based interventions on cognitive performance and associated secondary outcomes among healthy older adults in Asia, as well as novel, culture-specific components of cognitive interventions across the region. DATA SOURCES The PubMed/Medline, Web of Science, Scopus, and ScienceDirect databases were searched through May 2020. ELIGIBILITY Studies including individuals aged 60 years and above, who had no previous history of physical and/or mental illness. Few restrictions placed on intervention design, duration and mode of delivery, provided that participants were randomized to study conditions, and intervention included components addressing at least one cognitive domain. RESULTS A total of 17 studies from six countries met the eligibility criteria and were included in the final review. Evidence from those studies indicated that cognitive interventions may be most effective when the design and aims were directed towards improvement in specific cognitive domains, but evidence regarding long-term effectiveness in preventing progression to clinical-level cognitive deficits is still unclear. Several studies highlighted culture-specific activities as components of their interventions, though these will need to be further outlined and standardized clearly in future research.
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Affiliation(s)
- Prashanth Vasantha Kumar
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Normah Che Din
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Isa SNI, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, Mohd Ismail MF, Mohd Suradi NR. Quality of Life Among Caregivers of Children with Special Needs in Kelantan, Malaysia: The Importance of Psychosocial Mediators. Malays J Med Sci 2021; 28:128-141. [PMID: 33958967 PMCID: PMC8075598 DOI: 10.21315/mjms2021.28.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/07/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is an important aspect of well-being for the caregivers of children with disability, making it a noteworthy outcome. Little is known about the challenges faced by the caregivers in Asian countries and its association to their QoL. The purpose of this study was to examine a model describing the relationship between sociodemographic and disability-related factors on caregivers' QoL, mediated by the caregivers' psychosocial factors such as perceived stress, coping skills, and social support. METHODS A cross-sectional study was conducted involving caregivers of children with special needs in Kelantan, a state of Peninsular Malaysia. A total of 383 caregivers completed questionnaires measuring sociodemographics, disability-related factors, psychosocial factors and QoL outcome. Structural equation modelling was performed to examine the relations of the variables in the conceptual model. RESULTS In the final model, childcare dependency, caregiver's age, financial support, negative perception of stress and maladaptive coping skills were significant predictors of QoL (R 2 = 0.65). Caregiver's age had a direct effect on QoL, while financial support had an indirect effect on QoL via negative perception of stress. Childcare dependency had direct and indirect effects on QoL via negative perception of stress. Higher perceived stress was associated with lower QoL directly and indirectly via maladaptive coping skills. The final model fitted the data well (root mean square error of approximation [RMSEA] = 0.046; CFI = 0.923; χ2/df = 1.798). CONCLUSION Intervention strategies to improve the QoL of caregivers should target the family unit and take into account the factors of child's disability, demographic and caregiver's psychosocial status.
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Affiliation(s)
- Siti Nor Ismalina Isa
- Department of Basic Sciences, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam Campus, Selangor, Malaysia
| | - Ismarulyusda Ishak
- Biomedical Science Programme, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nur Zakiah Mohd Saat
- Biomedical Science Programme, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Syarif Husin Lubis
- Biomedical Science Programme, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Faiz Mohd Ismail
- Biomedical Science Programme, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Riza Mohd Suradi
- School of Mathematical Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
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Rosli H, Shahar S, Rajab NF, Che Din N, Haron H. The effects of polyphenols-rich tropical fruit juice on cognitive function and metabolomics profile - a randomized controlled trial in middle-aged women. Nutr Neurosci 2021; 25:1577-1593. [PMID: 33666540 DOI: 10.1080/1028415x.2021.1880312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: Polyphenols, particularly anthocyanins, have received attention in improving health issues during old age, including decline in cognitive function and other health parameters. We aimed to determine the effects of polyphenols-rich tropical fruit TP 3-in-1™ juice towards improving cognitive function, oxidative stress and metabolomics profiles among middle-aged women.Methods: This clinical trial involved 31 subjects with signs of poor cognitive function, as assessed using the Rey Auditory Verbal Learning Test (RAVLT). They were randomized to receive either TP 3-in-1™ juice (n = 16) or placebo (n = 15). Study subjects consumed 500 ml of beverages for three times per day, three days per week, for a period of ten weeks. Juice supplementation provided 9135 mg GAE of total phenolic content and 194.1 mg cyanidin-3-glucoside of total anthocyanin monomer.Results: There was a significant interaction effects on RAVLT immediate recall (p < 0.05) and Comprehensive Trail Making Test (CTMT) Trail 4 (p < 0.05). Metabolomics analysis showed the presence of metabolites related to polyphenols intake and cognitive functions with the intervention group showed increased urinary excretion of thyroxine and 3-methyladenine. Thyroxine and 3-methyladenine give stability to human transthyretin (TTR) and activate autophagy, respectively, which are associated with the pathogenesis of Alzheimer's disease.Conclusion: The result shows the potential of TP 3-in-1™ juice which is rich in anthocyanins in improving cognitive function, particularly learning, memory, processing speed, sequencing, mental flexibility and visual-motor skills domains, among middle-aged women.
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Affiliation(s)
- Hanisah Rosli
- Center for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Faculty of Allied Health Sciences, University of Cyberjaya, Cyberjaya, Malaysia
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Center for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Center for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Center for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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You YX, Shahar S, Rajab NF, Haron H, Yahya HM, Mohamad M, Din NC, Maskat MY. Effects of 12 Weeks Cosmos caudatus Supplement among Older Adults with Mild Cognitive Impairment: A Randomized, Double-Blind and Placebo-Controlled Trial. Nutrients 2021; 13:nu13020434. [PMID: 33572715 PMCID: PMC7912368 DOI: 10.3390/nu13020434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 01/10/2023] Open
Abstract
Cosmos caudatus (CC) contains high flavonoids and might be beneficial in neuroprotection. It has the potential to prevent neurodegenerative diseases. Therefore, we aimed to investigate the effects of 12 weeks of Cosmos caudatus supplement on cognitive function, mood status, blood biochemical profiles and biomarkers among older adults with mild cognitive impairment (MCI) through a double-blind, placebo-controlled trial. The subjects were randomized into CC supplement (n = 24) and placebo group (n = 24). Each of them consumed one capsule of CC supplement (250 mg of CC/capsule) or placebo (500 mg maltodextrin/capsule) twice daily for 12 weeks. Cognitive function and mood status were assessed at baseline, 6th week, and 12th week using validated neuropsychological tests. Blood biochemical profiles and biomarkers were measured at baseline and 12th week. Two-way mixed analysis of variance (ANOVA) analysis showed significant improvements in mini mental state examination (MMSE) (partial η2 = 0.150, p = 0.049), tension (partial η2 = 0.191, p = 0.018), total mood disturbance (partial η2 = 0.171, p = 0.028) and malondialdehyde (MDA) (partial η2 = 0.097, p = 0.047) following CC supplementation. In conclusion, 12 weeks CC supplementation potentially improved global cognition, tension, total mood disturbance, and oxidative stress among older adults with MCI. Larger sample size and longer period of intervention with incorporation of metabolomic approach should be conducted to further investigate the underlying mechanism of CC supplementation in neuroprotection.
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Affiliation(s)
- Yee Xing You
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Correspondence: ; Tel.: +60-3-9289-7651
| | - Nor Fadilah Rajab
- Biomedical Science Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hasnah Haron
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Hanis Mastura Yahya
- Nutritional Sciences Programme and Centre for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (H.H.); (H.M.Y.)
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Programme and Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Normah Che Din
- Health Psychology Programme, Centre of Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Mohamad Yusof Maskat
- Department of Food Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Malaysia;
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Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, Sharif R, Rajab NF. Dietary Supplement Intake and Its Association with Cognitive Function, Physical Fitness, Depressive Symptoms, Nutritional Status and Biochemical Indices in a 3-Year Follow-Up Among Community Dwelling Older Adults: A Longitudinal Study. Clin Interv Aging 2021; 16:161-175. [PMID: 33531799 PMCID: PMC7847381 DOI: 10.2147/cia.s266587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 09/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults. Methods Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013–2014) and at follow-up (2015–2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data. Results The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users. Conclusion Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.
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Affiliation(s)
- Divya Vanoh
- Nutrition & Dietetics Programme, School of Health Science, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Center for Healthy Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Lau H, Shahar S, Mohamad M, Rajab NF, Yahya HM, Din NC, Hamid HA. The effects of six months Persicaria minor extract supplement among older adults with mild cognitive impairment: a double-blinded, randomized, and placebo-controlled trial. BMC Complement Med Ther 2020; 20:315. [PMID: 33076878 PMCID: PMC7574246 DOI: 10.1186/s12906-020-03092-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 09/20/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Persicaria minor extract exhibits antioxidant and anti-inflammatory properties and has potential effects on cognitive function and mood. However, the effects of P.minor on brain activation and biomarkers have not been studied among older adults. This multicentre, randomized, double-blinded, placebo-controlled study aimed to investigate the effect of 6 months P.minor extract supplement (Biokesum®) on cognition, mood, biomarkers, and brain activation among older adults with Mild Cognitive Impairment (MCI). METHOD A total of 36 Malaysian community-dwelling older adults with MCI (60-75-year-old) were randomized into Biokesum® (n = 18) and placebo group (n = 18). Each subject consumed one capsule of Biokesum® (250 mg/capsule) or placebo (maltodextrin, 280 mg/capsule) twice daily for 6 months. Cognitive function and mood were assessed at baseline, 3rd, and 6th-month using neuropsychological tests (MMSE, Digit Span, RAVLT, Digit Symbol, and Visual Reproduction) and Profile of Mood State (POMS) questionnaire. Blood lipid profile, fasting blood glucose, and biomarkers (MDA, LPO, COX-2, iNOS, and BDNF) were measured at baseline and 6th month. By the end of the intervention, there were 30 compliers (Biokesum®: N = 15; Placebo: N = 15) and 6 dropouts. For brain activation assessment, 15 subsamples (Biokesum®: N = 8; Placebo: N = 7) completed N-back and Stroop tasks during fMRI scanning at baseline and 6th month. The dorsolateral prefrontal cortex (Brodmann's area 9 and 46) was identified as a region of interest (ROI) for brain activation analysis using SPM software. RESULTS Two-way mixed ANOVA analysis showed significant improvements in Visual Reproduction II (p = 0.012, partial η2 = 0.470), tension (p = 0.042, partial η2 = 0.147), anger (p = 0.010, partial η2 = 0.207), confusion (p = 0.041, partial η2 = 0.148), total negative subscales (p = 0.043, partial η2 = 0.145), BDNF (p = 0.020, partial η2 = 0.179) and triglyceride (p = 0.029, partial η2 = 0.237) following 6 months of Biokesum® supplementation. Preliminary finding also demonstrated significant improvement at 0-back task-induced right DLPFC activation (p = 0.028, partial η2 = 0.652) among subsamples in Biokesum® group. No adverse events were reported at the end of the study. CONCLUSION Six months Biokesum® supplementation potentially improved visual memory, negative mood, BDNF, and triglyceride levels among older adults with MCI. Significant findings on brain activation at the right DPLFC must be considered as preliminary. TRIAL REGISTRATION Retrospectively registered on 30th August 2019 [ ISRC TN12417552 ].
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Affiliation(s)
- Huijin Lau
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Centre for Diagnostic and Applied Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Center for Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Batu 9 Cheras, Kuala Lumpur, Malaysia
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Amit N, Ismail R, Zumrah AR, Mohd Nizah MA, Tengku Muda TEA, Tat Meng EC, Ibrahim N, Che Din N. Relationship Between Debt and Depression, Anxiety, Stress, or Suicide Ideation in Asia: A Systematic Review. Front Psychol 2020; 11:1336. [PMID: 32765333 PMCID: PMC7381269 DOI: 10.3389/fpsyg.2020.01336] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/20/2020] [Indexed: 01/10/2023] Open
Abstract
Background: This article aims to review research manuscripts in the past 5 years that focus on the effects of debt on depression, anxiety, stress, or suicide ideation in Asian countries. Methods: A search for literature based on the PRISMA guidelines was conducted on Medline, PubMed, Web of Science, Scopus, and ScienceDirect, resulting in nine manuscripts meeting inclusion criteria. The studies were conducted in Thailand, Korea, Singapore, Pakistan, India, Cambodia, and China. Results: The findings of the studies show that there is evidence to support that being in debt is related to Asian participants experiencing depression, anxiety, stress, or suicide ideation. However, the studies are limited to quantitative studies only. The definition of debt is also unclear in most manuscripts. Few manuscripts also examined how other factors influence the relationship between debt and mental illness. Conclusion: There are limited studies on the psychological effects of debt on the Asian population. Future studies should focus on the relationship between debt and psychological well-being among this population.
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Affiliation(s)
- Noh Amit
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Psychology and Human Wellbeing Research Centre (PsiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Abdul Rahim Zumrah
- Faculty of Leadership and Management, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Mohd Azmir Mohd Nizah
- Faculty of Leadership and Management, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | | | - Edbert Chia Tat Meng
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rivan NFM, Shahar S, Rajab NF, Singh DKA, Che Din N, Mahadzir H, Mohamed Sakian NI, Ishak WS, Abd. Rahman MH, Mohammed Z, You YX. Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study. Int J Environ Res Public Health 2020; 17:E1547. [PMID: 32121194 PMCID: PMC7084438 DOI: 10.3390/ijerph17051547] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 01/01/2023]
Abstract
(1) Background: Cognitive frailty (CF) is the simultaneous presence of physical frailty and cognitive impairment with an increased risk of dementia. Considering that the risk factors of CF are mostly elucidated from cross-sectional studies, we conducted a community-based longitudinal study to determine the incidence and the predictors of CF among Malaysian older adults.; (2) Methods: Out of 490 older adults participating in the Malaysian Towards Useful Aging (TUA) study, 282 were successfully followed-up at five-years for an analysis of the CF incidence. CF was defined as a comorbid physical frailty (>1 Fried criteria) and mild cognitive impairment (Petersen criteria). A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, physical function, dietary intake, psychosocial, and biochemical indices. Univariate analyses were performed for each variable, followed by a regression analysis to identify the predictors of CF that accounted for confounding effects between the studied factors; (3) Results: The incidence rate of CF was 7.1 per 100 person-years. Advancing age (OR=1.12, 95% CI:1.04-1.21, p < 0.05), depression (OR=1.20, 95% CI:1.05-1.37, p < 0.05), decreased processing speed, assessed by a lower digit symbol score (OR=0.67, 95%CI:0.0.56-0.80, p < 0.05), decreased functional mobility measured using Timed-Up-and-Go (TUG) (OR=1.23, 95% CI:1.04-1.46, p < 0.05), low vitamin D intake (OR:0.36, 95% CI:0.14-0.93, p < 0.05) and physical frailty (OR=2.16, 95% CI:1.02-4.58, p < 0.05) were predictors for CF incidence; and (4) Conclusions: Our study results could be used as an initial reference for future studies to formulate effective preventive management and intervention strategies to decelerate CF development among older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Batu 9 Cheras, Kuala Lumpur 50300, Malaysia;
| | - Noor Ibrahim Mohamed Sakian
- Occupational Therapy Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Wan Syafira Ishak
- Audiology Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Mohd Harimi Abd. Rahman
- Optometry and Vision Sciences Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (M.H.A.R.); (Z.M.)
| | - Zainora Mohammed
- Optometry and Vision Sciences Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (M.H.A.R.); (Z.M.)
| | - Yee Xing You
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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Subramaniam SR, Khoo CS, Raymond AA, Che Din N, Syed Zakaria SZ, Tan HJ. Prevalence and factors of verbal learning and memory dysfunction in patients with epilepsy - A single centre study. J Clin Neurosci 2020; 73:31-36. [PMID: 32094071 DOI: 10.1016/j.jocn.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 12/03/2019] [Accepted: 02/08/2020] [Indexed: 12/01/2022]
Abstract
The objective of this study is to determine prevalence and factors leading to verbal learning and memory dysfunction among patients with epilepsy. A total of 211 subjects were recruited. Their verbal memory was assessed by Rey's Auditory Verbal Learning Test (RAVLT). This test was further subdivided into four major spheres for analysis, namely the verbal learning, interference list, immediate memory and delayed memory. All data collected were analyzed using Statistical Package for Social Sciences. Among the 211 patients, 55% (n = 116) had focal seizures and the remaining 45% (n = 95) had generalized seizures. Prevalence of verbal learning and memory impairment was high at 39.97% overall, and found most commonly in patients with focal impaired awareness seizures. Verbal learning and immediate memory dysfunction were significantly lower in focal impaired awareness group compared to others. Age more than 50 years, exposure to three or more antiepileptic drugs and use of carbamazepine more than 1000 mg a day were the predictors in poor verbal memory outcome. No statistical difference was observed in the mean RAVLT scores among the gender and hand dominance groups. Between patients with and without electroencephalogram changes as well as brain magnetic resonance imaging changes, the mean RAVLT scores showed no statistically significant difference. Verbal learning and memory impairment is prevalent among the epilepsy patients. The consequences of the memory impairment can be as debilitating as the seizure control. RAVLT is a reliable and practical test in the clinical setting.
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Affiliation(s)
- Siva Rao Subramaniam
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Azman Ali Raymond
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Hui Jan Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Rivan NFM, Shahar S, Rajab NF, Singh DKA, Din NC, Mahadzir H. 112 Cognitive Frailty, Physical Frailty and Loneliness Predicts the Incidence of Falls among Community-Dwelling Older Adults. Age Ageing 2019. [DOI: 10.1093/ageing/afz164.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although frailty is a well-known risk factor for falls, the concomitant effects of physical frailty and cognitive impairments or known as cognitive frailty (CF), in predicting the incidence falls is not established.
Methods
In a prospective cohort study, we examined the predictive ability of CF towards the incidence of falls among older adults from Malaysian Towards Useful Aging (TUA) study. A total of 400 participants aged > 60 years were successfully followed up at five years. Participants were interviewed on their sociodemographic data, medical and falls history. Assessments to examine cognitive function, physical functional status, psychosocial and dietary intake were conducted. Univariate analysis was performed for every variable, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls.
Results
After adjusting for the covariates, CF (Odd Ratio (OR) = 2.976, 95% Confidence Interval (CI): 1.776-4.987, p<0.05), physical frailty (OR = 2.882, 95% CI: 1.187-6.999, p<0.05), women (OR = 2.229, 95% CI: 1.362-3.648, p<0.05), and loneliness (OR = 1.329, 95% CI: 1.028-1.718, p<0.05) were the significant predictors for the incidence of falls.
Conclusion
Both cognitive and physical frailty were significant predictors of future falls among community-dwelling older adults. It is important to provide an effective intervention to prevent falls in this high-risk group of older adults.
This study was funded by the Long-term Research Grant Scheme (LGRS) provided by the Ministry of Education Malaysia (LRGS/BU/2012/UKM-UKM/K/01) and Grand Challenge Grant funded by the National University of Malaysia (DCP-2017-002/1).
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Malaysia
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Che Din N, Mohd Nawi L, Ghazali SE, Ahmad M, Ibrahim N, Said Z, Amit N, Subramaniam P. Preliminary Analysis of the Factor Structure, Reliability and Validity of an Obsessive-Compulsive Disorder Screening Tool for Use with Adults in Malaysia. Int J Environ Res Public Health 2019; 16:E4763. [PMID: 31795076 PMCID: PMC6927007 DOI: 10.3390/ijerph16234763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 12/02/2022]
Abstract
This is a preliminary study to examine the factor structure, reliability, and validity of an obsessive-compulsive disorder (OCD) screening tool for use in the Malaysian setting. A total of 199 Malaysian adults were recruited for this study. After cleaning and normalizing the data, 190 samples were left to be analyzed. Principle component analysis using varimax rotation was then performed to examine various factors derived from psychometric tools commonly used to assess OCD patients. The screening tool exhibited three factors that fit the description of obsessions and compulsions from the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM 5), as well as other common symptoms that co-morbid with OCD. The labels given to the three factors were: Severity of Compulsions, Severity of Obsessions, and Symptoms of Depression and Anxiety. Reliability analysis showed high reliability with a Cronbach's alpha of 0.94, whereas convergent validity of the tool with the Yale Brown Obsessive-compulsive Scale-Self Report demonstrated good validity of r = 0.829. The three-factor model explained 68.91% of the total variance. Subsequent studies should focus on OCD factors that are culturally unique in the Malaysian context. Future research may also use online technology, which is cost-efficient and accessible, to further enhance the screening tool.
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Affiliation(s)
- Normah Che Din
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (L.M.N.); (S.E.G.); (M.A.); (N.I.); (Z.S.); (N.A.); (P.S.)
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Hussin NM, Shahar S, Yahya HM, Din NC, Singh DKA, Omar MA. Incidence and predictors of mild cognitive impairment (MCI) within a multi-ethnic Asian populace: a community-based longitudinal study. BMC Public Health 2019; 19:1159. [PMID: 31438929 PMCID: PMC6704715 DOI: 10.1186/s12889-019-7508-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 08/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limited information is available from longitudinal studies regarding the predictors and incidence of MCI in older Asian adults. Thus, a community-based longitudinal study was conducted to determine the incidence of MCI among multi-ethnic older adults in Malaysia. The role of health and lifestyle as predictors of MCI was also examined. METHODS Analysis of data obtained from the Towards Useful Aging (TUA) study (2014-2016), wave 1 (baseline) and wave 2 (1½ years of follow-up) was conducted. For the baseline, comprehensive, interview-based questionnaires were administered to 1227 subjects who were 60 years old and above. MCI is a unique transitional state between normal ageing and dementia. MCI characteristics include a decline and disturbance of cognition, minimal impairment of complex activities, ability to perform regular daily functions, and absence of dementia. The incidence of MCI was assessed using comprehensive neuropsychological batteries. The study then performed a logistic regression analysis to examine the effect of each possible predictor of MCI. This analysis began with univariate analyses and a separate review of the effect of every variable. Binary logistic analyses followed hereafter. RESULTS During the follow-up after 1½ years, 179 (14.6%) of the participants who did not exhibit MCI at baseline were observed to have developed MCI. Among the participants who did not exhibit MCI at baseline, the incidence rate was 10.5 per 100 person-years. Male sex and lack of engagement in mental activities were predictors of MCI among participants without MCI at baseline. CONCLUSION After the 1½-year follow-up, the incidence rate for MCI was considerably high among the respondents. Being male and being less engaged in mental activities were predictors of the occurrence of MCI. Mental activities need to be promoted for the prevention of MCI incidence among older adults.
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Affiliation(s)
- Norlela Mohd Hussin
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia.
| | - Hanis Mastura Yahya
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Institute of Public Health, Ministry of Health, Jalan Bangsar, Federal Hill, 59000, Kuala Lumpur, Malaysia
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Malek Rivan NF, Shahar S, Rajab NF, Singh DKA, Din NC, Hazlina M, Hamid TATA. Cognitive frailty among Malaysian older adults: baseline findings from the LRGS TUA cohort study. Clin Interv Aging 2019; 14:1343-1352. [PMID: 31413555 PMCID: PMC6663036 DOI: 10.2147/cia.s211027] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/15/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study was aimed at determining the presence of cognitive frailty and its associated factors among community-dwelling older adults from the "LRGS-Towards Useful Aging (TUA)" longitudinal study. PATIENTS AND METHODS The available data related to cognitive frailty among a sub-sample of older adults aged 60 years and above (n=815) from two states in Malaysia were analysed. In the LRGS-TUA study, a comprehensive interview-based questionnaire was administered to obtain the socio-demographic information of the participants, followed by assessments to examine the cognitive function, functional status, dietary intake, lifestyle, psychosocial status and biomarkers associated with cognitive frailty. The factors associated with cognitive frailty were assessed using a bivariate logistic regression (BLR). RESULTS The majority of the older adults were categorized as robust (68.4%), followed by cognitively pre-frail (37.4%) and cognitively frail (2.2%). The data on the cognitively frail and pre-frail groups were combined for comparison with the robust group. A hierarchical BLR indicated that advancing age (OR=1.04, 95% CI:1.01-1.08, p<0.05) and depression (OR=1.49, 95% CI:1.34-1.65, p<0.001) scored lower on the Activity of Daily Living (ADL) scale (OR=0.98, 95% CI:0.96-0.99, p<0.05), while low social support (OR=0.98, 95% CI:0.97-0.99, p<0.05) and low niacin intake (OR=0.94, 95% CI:0.89-0.99, p<0.05) were found to be significant factors for cognitive frailty. Higher oxidative stress (MDA) and lower telomerase activity were also associated with cognitive frailty (p<0.05). CONCLUSION Older age, a lower niacin intake, lack of social support, depression and lower functional status were identified as significant factors associated with cognitive frailty among older Malaysian adults. MDA and telomerase activity can be used as potential biomarkers for the identification of cognitive frailty.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300Kuala Lumpur, Malaysia
| | - Mahadzir Hazlina
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rosli H, Shahar S, Din NC, Haron H, Rajab NF. Prevalence of Poor Mental Health and Cognitive Status among Middle-Aged Adults and Its Predictors in Relation to Polyphenols Intake. Malays J Med Sci 2019; 26:72-89. [PMID: 31303852 PMCID: PMC6613464 DOI: 10.21315/mjms2019.26.3.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 03/19/2019] [Indexed: 10/30/2022] Open
Abstract
Background Decline in mental health and cognitive status starts to show its sign during middle-age and is affected by dietary factors, namely the polyphenols intake. Polyphenols have received attention in improving health issues related to aging, including decline in mental health and cognitive. The aim of this study is to determine the prevalence of poor mental health and cognitive status among middle-aged adults and its predictors in relation to polyphenols intake. Methods Subjects' food intakes were calculated by using dietary history questionnaire and food frequency questionnaire for polyphenols. The subjects' mental health and cognitive status were measured by general health questionnaire-28 (GHQ-28) and Rey's auditory verbal learning test (RAVLT). Results More than 40% of middle-aged adults were identified as having signs of poor mental health. A total of 67.9% of the subjects had poor cognitive status according to RAVLT immediate recall. Hierarchical binary logistic regression indicated that fat intake was associated with somatic symptoms for both men [adjusted odds ratio (AOR) = 1.04; P < 0.05] and women (AOR = 1.06; P < 0.05). Intake of lignan (AOR = 1.071; P < 0.05) was associated with better RAVLT immediate recall among women. Additionally, high cholesterol (AOR = 3.14; P < 0.05) was associated with poor score of RAVLT delayed recall for women. Conclusions Early detection of poor mental health and cognitive is crucial to prevent Alzheimer's disease in old age.
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Affiliation(s)
- Hanisah Rosli
- Community Rehabilitation and Ageing Research Centre (H-Care), Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.,Faculty of Allied Health Sciences, Cyberjaya University College of Medical Sciences, Persiaran Bestari, Cyberjaya, Selangor Darul Ehsan, Malaysia.,Dietetics Program, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Community Rehabilitation and Ageing Research Centre (H-Care), Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.,Dietetics Program, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Community Rehabilitation and Ageing Research Centre (H-Care), Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.,Health Psychology Program, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Hasnah Haron
- Community Rehabilitation and Ageing Research Centre (H-Care), Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.,Nutritional Science Program, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Community Rehabilitation and Ageing Research Centre (H-Care), Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.,Biomedical Science Program, Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
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Ibrahim N, Che Din N, Ahmad M, Amit N, Ghazali SE, Wahab S, Abdul Kadir NB, Halim FW, A Halim MRT. The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia. BMC Public Health 2019; 19:553. [PMID: 31196009 PMCID: PMC6565529 DOI: 10.1186/s12889-019-6861-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The high number of adolescents and young adults harbouring suicidal ideation, as reported by the Ministry of Health Malaysia, is alarming. This cross-sectional study aims to examine the association between social support and spiritual wellbeing in predicting suicidal ideation among Malaysian adolescents. Methods A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB). Results The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents. Conclusion Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.
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Affiliation(s)
- Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mahadir Ahmad
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noh Amit
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Shazli Ezzat Ghazali
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzaily Wahab
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Bandar Tun Razak Cheras, Malaysia
| | - Nor Ba'yah Abdul Kadir
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Fatimah Wati Halim
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
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Baharudin AD, Din NC, Subramaniam P, Razali R. The associations between behavioral-psychological symptoms of dementia (BPSD) and coping strategy, burden of care and personality style among low-income caregivers of patients with dementia. BMC Public Health 2019; 19:447. [PMID: 31196141 PMCID: PMC6565534 DOI: 10.1186/s12889-019-6868-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Background The main aim of this study was to determine the association between Behavioral and Psychological Symptoms of Dementia (BPSD) and caregiver burden, and the mediating role of coping strategy and personality style of caregivers to patients with dementia (PWD). Methods This cross-sectional study was conducted among 202 caregivers to PWD in home-based settings. Recruited caregivers were administered questionnaires regarding BPSD which was measured using Neuropsychiatric Inventory-Questionnaire (NPI-Q), caregiver burden using Zarit Burden Interview (ZBI), Brief COPE for coping strategies and Big-Five Inventory which measured personality traits. Results Majority of the caregivers were female (71.3%), aged 50 and above (55%), single (46%), married (43.6%), working full time (45%) while the rest work part time (22.3%), unemployed (7.4%) and retiree (25.2%), and majority were parents (58.9%) and spouse (18.3%). The duration of caregiving was less than a year (33.7%) while the rest are more than a year. Results demonstrated that the most frequent types of BPSD exhibited by PWD was irritability, followed by apathy and agitation. All of the types of BPSD showed to be significantly correlated to caregiver burden except for anxiety, elation and appetite. Of personality traits, only conscientiousness was found to mediate the relationship between BPSD and caregiver burden (p < .05). Self-distraction, active coping, planning and acceptance were the coping strategies that demonstrated to have mediation effect on the relationship between BPSD and caregiver burden. Conclusion Presentation of BPSD is correlated to caregiver burden which is partially mediated by coping strategies and personality styles.
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Affiliation(s)
- Aishah Diyana Baharudin
- Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Normah Che Din
- Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
| | - Ponnusamy Subramaniam
- Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Rosdinom Razali
- Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Wilayah Persekutuan, Malaysia
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Din NC, Ibrahim N, Amit N, Kadir NBA, Halim MRTA. Reasons for Living and Coping with Suicidal Ideation among Adolescents in Malaysia. Malays J Med Sci 2019; 25:140-150. [PMID: 30914870 PMCID: PMC6419889 DOI: 10.21315/mjms2018.25.5.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 09/20/2018] [Indexed: 11/06/2022] Open
Abstract
Introduction The rate of suicide ideation everywhere continues to increase, and adolescents are therefore at risk of displaying suicidal behaviour. This study examined the protective role of the reasons for living and coping strategies in reducing suicidal ideation among young adolescents in Malaysia. Methods A cross-sectional survey was conducted among 176 adolescents aged between 13 and 19 years of age with the majority being Malay and Muslim. The Brief Reasons for Living for Adolescents (BRFL-A), Jalowiec Coping Scale and Suicide Ideation Scale were employed. Results The results showed that the reasons for living and palliative coping strategy correlated negatively with suicide ideation; although, further analysis using multiple regression revealed that family alliance and optimistic and palliative coping strategies were found to be significant reasons for living that protect adolescents from suicidal thoughts. Also, those adolescents who used emotive and evasive coping strategies had higher suicidal ideation. Conclusion Cultural and social values continue to play an important role in protecting adolescents in Malaysia from suicidal behaviour.
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Affiliation(s)
- Normah Che Din
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Noh Amit
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A Aziz, 50300 Kuala Lumpur, Malaysia
| | - Nor Ba'yah Abdul Kadir
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Centre of Human and Societal Well-being, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor, Malaysia
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Ibrahim N, Che Din N, Amit N, Ghazali SE, Mohd Safien A. Development and validation of Yatt Suicide Attitude Scale (YSAS) in Malaysia. PLoS One 2019; 14:e0209971. [PMID: 30811425 PMCID: PMC6392240 DOI: 10.1371/journal.pone.0209971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 12/16/2018] [Indexed: 01/28/2023] Open
Abstract
Introduction Despite suicide rate becoming a growing trend in research locally and globally, there is no standard measuring instrument developed in Malaysia. The aim of this study is to establish the first ever Malay version of suicide screening tool that is suitable and fit with multiracial and complex culture of Malaysia. Methods This study comprises of three phases, namely (1) items selection phase, (2) pilot study phase, and (3) scale validation phase. During the first phase, the items were selected from items pools which gathered from previous suicide ideation/ attitude scales. Then the pilot study was carried out to examine the items for Yatt Suicide Attitude Scale (YSAS). Lastly, the Yatt Suicide Attitude Scale (YSAS) validation study was conducted with 219 university students. Results Initial version of YSAS comprised 16 items and three components. After factor analysis, the questionnaire was reduced into only two components (Suicide Ideation and Suicide Attempt) with 5 items each. Both of the components obtained high reliability value (.89 and.86 respectively) and the questionnaire accounted for 67.84% of the total variance. Conclusion The analysis showed that YSAS has an acceptable reliability and validity for Malaysian population. Although these findings corroborate literature on development of suicide ideation assessment instrument for specific cultural context, there is a need to further examine its reliability with clinical population and general population of different cultural context in Malaysia.
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Affiliation(s)
- Norhayati Ibrahim
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- * E-mail:
| | - Normah Che Din
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noh Amit
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shazli Ezzat Ghazali
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aisyah Mohd Safien
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Lau H, Shahar S, Mohamad M, Rajab NF, Yahya HM, Din NC, Hamid HA. Relationships between dietary nutrients intake and lipid levels with functional MRI dorsolateral prefrontal cortex activation. Clin Interv Aging 2018; 14:43-51. [PMID: 30613138 PMCID: PMC6307498 DOI: 10.2147/cia.s183425] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Dorsolateral prefrontal cortex (DLPFC) is a key node in the cognitive control network that supports working memory. DLPFC dysfunction is related to cognitive impairment. It has been suggested that dietary components and high-density lipoprotein cholesterol (HDL-C) play a vital role in brain health and cognitive function. Purpose This study aimed to investigate the relationships between dietary nutrient intake and lipid levels with functional MRI (fMRI) brain activation in DLPFC among older adults with mild cognitive impairment. Participants and methods A total of 15 community-dwelling older adults with mild cognitive impairment, aged ≥60 years, participated in this cross-sectional study at selected senior citizen clubs in Klang Valley, Malaysia. The 7-day recall Diet History Questionnaire was used to assess participants’ dietary nutrient intake. Fasting blood samples were also collected for lipid profile assessment. All participants performed N-back (0- and 1-back) working memory tasks during fMRI scanning. DLPFC (Brodmann’s areas 9 and 46, and inferior, middle, and superior frontal gyrus) was identified as a region of interest for analysis. Results Positive associations were observed between dietary intake of energy, protein, cholesterol, vitamins B6 and B12, potassium, iron, phosphorus, magnesium, and HDL-C with DLPFC activation (P<0.05). Multivariate analysis showed that vitamin B6 intake, β=0.505, t (14)=3.29, P=0.023, and Digit Symbol score, β=0.413, t (14)=2.89, P=0.045; R2=0.748, were positively related to DLPFC activation. Conclusion Increased vitamin B6 intake and cognitive processing speed were related to greater activation in the DLPFC region, which was responsible for working memory, executive function, attention, planning, and decision making. Further studies are needed to elucidate the mechanisms underlying the association.
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Affiliation(s)
- Huijin Lau
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Suzana Shahar
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Mazlyfarina Mohamad
- Diagnostic Imaging and Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Center for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Normah Che Din
- Health Psychology Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
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Ibrahim N, Amit N, Che Din N, Ong HC. Gender differences and psychological factors associated with suicidal ideation among youth in Malaysia. Psychol Res Behav Manag 2017; 10:129-135. [PMID: 28496374 PMCID: PMC5417667 DOI: 10.2147/prbm.s125176] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Suicide is a global phenomenon that has been showing an upward trend in recent years. It is the second leading cause of death among youth. Studies on suicidal ideation warrant greater attention, as it leads to suicide attempts and other health risk behaviors. Thus, the objective of this study was to compare gender differences in suicidal ideation and determine the predictors of suicidal ideation among youth. This cross-sectional study was carried out among 232 youths aged between 15 and 25 years from selected urban areas in Malaysia. The results showed that suicidal ideation was higher among male participants compared with female participants. Age was the predictor of suicidal ideation for males, while depression and loss of motivation, as components of hopelessness, were the predictors of suicidal ideation among females. Hence, it is important that professionals conduct early identification tests for suicidality among young people. This will facilitate the early detection of depression and hopelessness, which is important, in order to prevent suicidal behaviors or other problems before these occur.
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Affiliation(s)
- Norhayati Ibrahim
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noh Amit
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hui Chien Ong
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Vanoh D, Shahar S, Din NC, Omar A, Vyrn CA, Razali R, Ibrahim R, Hamid TA. Predictors of poor cognitive status among older Malaysian adults: baseline findings from the LRGS TUA cohort study. Aging Clin Exp Res 2017; 29:173-182. [PMID: 26980453 DOI: 10.1007/s40520-016-0553-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Concepts of successful aging (SA), usual aging (UA), and mild cognitive impairment (MCI) have been developed to identify older adults at high risk of Alzheimer's diseases (AD), however, the predictors have rarely been investigated in a single study. Thus, this study aims to explore the risk factors of MCI as compared to UA and SA among older adults, in a large community based cohort study in Malaysia. METHOD 1993 subjects from four states in Malaysia were recruited. A comprehensive interview-based questionnaire was administered to determine socio-demographic information, followed by assessments to evaluate cognitive function, functional status, dietary intake, lifestyle and psychosocial status. Risk factors of cognitive impairment were assessed using the ordinal logistic regression (OLR). RESULT The prevalence of SA, UA and MCI in this study was 11, 73 and 16 % respectively. OLR indicated that higher fasting blood sugar, hyperlipidemia, disability, lower education level, not regularly involved in technical based activities, limited use of modern technologies, lower intake of fruits and fresh fruit juices and not practicing calorie restriction were among the risk factors of poor cognitive performance in this study. CONCLUSION This study will be a stepping stone for future researchers to develop intervention strategies to prevent cognitive decline.
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Isa SNI, Ishak I, Rahman AA, Saat NZM, Din NC, Lubis SH, Ismail MFM. Perceived Stress and Coping Styles among Malay Caregivers of Children with Learning Disabilities in Kelantan. Malays J Med Sci 2017; 24:81-93. [PMID: 28381931 PMCID: PMC5346006 DOI: 10.21315/mjms2017.24.1.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Caregivers of children with learning disabilities have been shown to experience increased stress and greater negative caregiving consequences than those with typically developing children. There remains a lack of studies focusing on stress and coping mechanisms among caregivers of a wider age group and diagnosis of individuals with disabilities in Asian countries. The current study examines levels of perceived stress and associated child and caregiver factors among caregivers of children with learning disabilities in the Malaysian context. An additional aim was to determine whether caregiver coping styles may be predictors of perceived stress. METHODS The Malay version of the Perceived Stress Scale with 10 items and the Brief COPE Scale were administered to a sample of 190 Malay caregivers of children with learning disabilities registered with community-based rehabilitation centres in Kelantan, a state in Peninsular Malaysia. Multiple linear regression analysis was applied to determine the predictors of perceived stress. RESULTS The mean total perceived stress score of caregivers was 16.96 (SD = 4.66). The most frequently used coping styles found among caregivers included religion, acceptance and positive reframing, while substance use and behavioural disengagement were least frequently used. Higher perceived stress was significantly predicted among caregivers with fewer children, frequent use of instrumental support and behavioural disengagement coping, and lack of emotional support and religious coping. CONCLUSION Findings indicate that the perceived stress levels among caregivers were significantly predicted by different coping styles. It is vital to help the caregivers improve their good coping styles in order to reduce their stress levels.
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Affiliation(s)
- Siti Nor Ismalina Isa
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
- Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia
| | - Ismarulyusda Ishak
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nur Zakiah Mohd Saat
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Syarif Husin Lubis
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Muhammad Faiz Mohd Ismail
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Isa SNI, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, Mohd Ismail MF. Health and quality of life among the caregivers of children with disabilities: A review of literature. Asian J Psychiatr 2016; 23:71-77. [PMID: 27969083 DOI: 10.1016/j.ajp.2016.07.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 05/12/2016] [Accepted: 07/07/2016] [Indexed: 02/08/2023]
Abstract
Families caring for children with disabilities face particular challenges and demands compared to those caring for children without disabilities. Evidence suggests that there is considerable variation in how caregivers of children with disabilities adapt to their caregiving demands and stressors. The different adaptations to the children with disabilities may cause different impacts on the health and well-being of caregivers. This paper provides a brief overview of the literature on the impact of caring for children with disabilities on the health and quality of life of caregivers and the factors related to the health outcomes and quality of life. A literature search was conducted by using various electronic databases, including PsychINFO, ScienceDirect, ProQuest, and MEDLINE using specific key terms. Thirty-one articles published in peer-review journals from the last six years (2009-2014) were reviewed. Most of the studies were quantitative studies. Factors discussed that impact on caregivers' health and quality of life include the caregivers' sociodemographic background and child's disability-related factors. Several mediators and moderators including coping strategies, social support, parental stress, self-esteem and self-efficacy are described in this paper. This review highlighted the importance of these factors to better understand the complex nature of stress processes and the caregivers' adaptations to their children's disabilities.
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Affiliation(s)
- Siti Nor Ismalina Isa
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia; Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia
| | - Ismarulyusda Ishak
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nur Zakiah Mohd Saat
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Syarif Husin Lubis
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Muhammad Faiz Mohd Ismail
- School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Vanoh D, Shahar S, Rosdinom R, Din NC, Yahya HM, Omar A. Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults. Clin Interv Aging 2016; 11:579-87. [PMID: 27274208 PMCID: PMC4869643 DOI: 10.2147/cia.s102925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background and aim Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). Methodology A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.
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Affiliation(s)
- Divya Vanoh
- Dietetic Programme, Centre of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetic Programme, Centre of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Razali Rosdinom
- Department of Psychiatry, University Kebangsaan Medical Centre, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Nutrition Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azahadi Omar
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
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Mohd Zulkifly MF, Ghazali SE, Che Din N, Subramaniam P. The Influence of Demographic, Clinical, Psychological and Functional Determinants on Post-stroke Cognitive Impairment at Day Care Stroke Center, Malaysia. Malays J Med Sci 2016; 23:53-64. [PMID: 27547115 PMCID: PMC4976714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 01/30/2016] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND This study aims to estimate the prevalence and explore the predictors for post-stroke cognitive impairment at the community level in Malaysia. METHODS A total of 50 stroke patients aged 29 to 81-year-old were included in this study. A face to face interview was conducted to gather the demographic and clinical data. Subsequently, assessments including Barthel ADL Index (BI), Addenbrooke's Cognitive Examination-Revised (ACE-R) and Hospital Anxiety and Depression Scale (HADS) were administered to the subjects. RESULTS The results showed that the prevalence of cognitive impairment was 76% among the studied populations. The subjects' race (Fisher's value= 9.56, P < 0.05) and education level (Fisher's value = 7.29, P < 0.05) were significantly associated with the cognitive status. The depression score was significantly higher in cognitively impaired group [t (48) = -4.42, P < 0.001] while the Barthel Index score was significantly lower in cognitively impaired group (median = 18.00, P < 0.05). The univariate logistic analysis demonstrated that Chinese (OR 7.33, 95% CI = 1.61-33.51), lower education level (OR 9.33, 95% CI = 0.89-97.62), right sided lesion (OR 0.29, 95% CI = 0.06-1.54), left face weaknesses (OR 0.40, 95% CI 0.09-1.83), high cholesterol (OR 0.45, 95% CI = 0.12-1.75), depression (OR 2.16, 95% CI = 0.85-1.35), and Barthel Index (OR 0.79, 95% CI = 0.57-1.10) were significant predictors. Finally, multivariate logistic regression verified that depression was the only significant predictor of post-stroke cognitive impairment (OR 2.03, 95% CI = 1.20-3.45). CONCLUSION In conclusion, the prevalence of cognitive impairment in this study was higher than other community based studies and depression was a risk factor for cognitive impairment.
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Affiliation(s)
- Mohd Faizal Mohd Zulkifly
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
- Center for Neuroscience Services and Research (P3Neuro), Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Shazli Ezzat Ghazali
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Shahar S, Aziz AF, Ismail SNA, Yahya HM, Din NC, Manaf ZA, Badrasawi MM. The effect of Polygonum minus extract on cognitive and psychosocial parameters according to mood status among middle-aged women: a randomized, double-blind, placebo-controlled study. Clin Interv Aging 2015; 10:1505-20. [PMID: 26445532 PMCID: PMC4590418 DOI: 10.2147/cia.s86411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Polygonum minus (PM) or locally known in Malaysia, as “kesum” is rich in micronutrients and natural antioxidants. However, its beneficial effect on outcome associates with oxidative stress including cognitive function is yet to be discovered. We assessed the efficacy of PM extract (LineMinus™) on cognitive function and psychosocial status among middle-aged women in Klang Valley of Malaysia. Methods A randomized, double-blind, placebo-controlled trial among 35 healthy middle-aged women was performed, and subjects were randomized to receive either 250 mg PM or placebo of 100 mg maltodextrin each were taken twice daily for 6 weeks. Subjects were assessed for neuropsychological test, psychosocial status, and anthropometric at baseline, week 3, and week 6. Biomarkers were also determined at baseline and week 6. Results The supplementation of PM showed significant intervention effect on Digit Span test (P<0.05) social functioning domain of 36-Item Short Form Health Survey (P<0.05) among subjects with mood disturbance. While, among subjects with good mood, PM supplementation improved Wechsler Abbreviated Scale of Intelligence (WASI) for IQ verbal (P=0.016) and Full Scale IQ of WASI (P=0.004). There were no adverse effects reported for the supplementation as indicated using biomarkers, including liver function and clinical symptoms. Conclusion Supplementation of PM is safe to be consumed for 6 weeks, with potential benefits to attention, short-term memory, improved quality of life, and mood, as well as IQ.
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Affiliation(s)
- Suzana Shahar
- Dietetics Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ainor Farahin Aziz
- Nutritional Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nur Arina Ismail
- Nutritional Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hanis Mastura Yahya
- Nutritional Sciences Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Dietetics Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Manal M Badrasawi
- Dietetics Programme, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Mohd Zulkifly MF, Ghazali SE, Che Din N, Desa A, Raymond AA. The Ability of Recovery Locus of Control Scale (RLOC) and Post-traumatic Stress Symptoms (PTSS) to Predict the Physical Functioning of Stroke Patients. Malays J Med Sci 2015; 22:31-41. [PMID: 28239266 PMCID: PMC5295747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 07/14/2015] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND The aim of this study was to address the ability of the recovery locus of control scale (RLOC) and post-traumatic stress symptoms (PTSS) to predict physical functioning among stroke patients. In addition, the best predictors within the subdomains of the RLOC and PTSS were also investigated. METHODS A total of 147 stroke patients aged 33-85 years who had intact cognitive functioning were involved in the study. The Recovery Locus of Control Scale (RLOC), the Impact of Event Scale-Revised (IES-R), and the Barthel Index (ADL) were administered to respondents six weeks after stroke. RESULTS The results showed that the RLOC and PTSS were significant predictors and were capable of predicting 31% of the physical functioning of stroke patients (adjusted R2 = 0.31; P < 0.001). Furthermore, with respect to clinical factors, the affected lesion side contributed to predicting 7% of the physical functioning (R2= 0.07; P < 0.001). A hierarchical regression analysis found that the internal recovery locus of control (IRLOC) was a predictor capable of explaining 18% of the predicted physical functioning (adjusted R2= 0.18; P < 0.001). Meanwhile, avoidance was the most influential significant predictor among PTSS, contributing to 24% of the predicting physical functioning (adjusted R2= 0.24; P < 0.001). CONCLUSION In conclusion, the RLOC and PTSS were capable of predicting physical functioning among stroke patients.
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Affiliation(s)
- Mohd Faizal Mohd Zulkifly
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
- Center for Neuroscience Services & Research (P3Neuro), Health Campus, University of Science Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia
| | - Shazli Ezzat Ghazali
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Asmawati Desa
- School of Psychology and Human Development, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor, Malaysia
| | - Azman Ali Raymond
- UKM Medical Centre, Faculty of Medicine, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
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Won H, Singh DKA, Din NC, Badrasawi M, Manaf ZA, Tan ST, Tai CC, Shahar S. Relationship between physical performance and cognitive performance measures among community-dwelling older adults. Clin Epidemiol 2014; 6:343-50. [PMID: 25328418 PMCID: PMC4198152 DOI: 10.2147/clep.s62392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Cognitive impairment is correlated with physical function. However, the results in the literature are inconsistent with cognitive and physical performance measures. Thus, the aim of this study was to determine the association between cognitive performance and physical function among older adults. Methods A total of 164 older adults aged ≥60 years and residing in low-cost housing areas in Kuala Lumpur, Malaysia participated in this study. Cognitive performance was measured using the Mini Mental State Examination, clock drawing test, Rey auditory verbal learning test, digit symbol test, digit span test, matrix reasoning test, and block design test. Physical performance measures were assessed using the ten step test for agility, short physical performance battery test for an overall physical function, static balance test using a Pro.Balance board, and dynamic balance using the functional reach test. Results There was a negative and significant correlation between agility and the digit symbol test (r=−0.355), clock drawing test (r=−0.441), matrix reasoning test (r=−0.315), and block design test (r=−0.045). A significant positive correlation was found between dynamic balance, digit symbol test (r=0.301), and matrix reasoning test (r=0.251). The agility test appeared as a significant (R2=0.183, R2=0.407, R2=0.299, P<0.05) predictor of some cognitive performance measures, including the digit span test, clock drawing test, and Mini Mental State Examination. Conclusion These results suggest that a decline in most cognitive performance measures can be predicted by poor execution of a more demanding physical performance measure such as the ten step test for agility. It is imperative to use a more complex and cognitively demanding physical performance measure to identify the presence of an overall cognitive impairment among community-dwelling older adults. It may also be beneficial to promote more complex and cognitively challenging exercises and activities among older adults for optimal physical and cognitive function.
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Affiliation(s)
- Huiloo Won
- Nutrition Science Program, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Normah Che Din
- Health Psychology Program, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Manal Badrasawi
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sin Thien Tan
- Physiotherapy Program, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chu Chiau Tai
- Physiotherapy Program, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Din NC, Ghazali SE, Ibrahim N, Ahmad M, Said Z, Ghazali AR, Razali R, Shahar S. Health Needs Assessment of Older People in an Agricultural Plantation. INT J GERONTOL 2014. [DOI: 10.1016/j.ijge.2013.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Razali R, Jean-Li L, Jaffar A, Ahmad M, Shah SA, Ibrahim N, Din NC, Nik Jaafar NR, Midin M, Sidi H, Ahmad S. Is the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) a better instrument than the Malay version of the Mini Mental State Examination (M-MMSE) in screening for mild cognitive impairment (MCI) in the elderly? Compr Psychiatry 2014; 55 Suppl 1:S70-5. [PMID: 24314103 DOI: 10.1016/j.comppsych.2013.04.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 04/07/2013] [Accepted: 04/17/2013] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Mild Cognitive Impairment (MCI) is a known precursor to Alzheimer disease, yet there is a lack of validated screening instruments for its detection among the Malaysian elderly. OBJECTIVE To compare the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) with the Malay version of the Mini Mental State Examination (M-MMSE) in the detection of MCI among the Malaysian elderly. METHODOLOGY This is a cross-sectional study conducted at the primary care centre of Universiti Kebangsaan Malaysia, Kuala Lumpur from December 2011 to mid-January 2012. Subjects aged 60 and above were recruited using systematic sampling method. Cut-off scores of 22/23 for MoCA-BM and 25/26 for M-MMSE were adopted. Kappa value and Pearson's correlation coefficient were used to ascertain the correlation between MOCA-BM and M-MMSE. Data were analysed using Mann-Whitney and Chi Square tests. RESULTS The mean age of the 180 subjects enrolled was 65.3 years (SD=5.4). They had a median of 6 years (IqR 25-75=5-11) total formal education. The prevalence of MCI using MoCA-BM and M-MMSE was 55.6% and 32.8% respectively. The odds of developing MCI were 1.153 (95% CI=1.055, 1.261; p<0.05) for every 1 year increase in age, 0.813 (95% CI=0.690, 0.959; p<0.05) with every extra year of education. Increasing age and lower education level were significantly associated with MCI. The MoCA-BM showed good internal consistency with Cronbach's alpha of 0.80. It had moderate correlation with M-MMSE (Pearson correlation coefficient=0.770, p<0.001) and moderate agreement for detecting MCI with Kappa values of 0.497 (p<0.001). CONCLUSION The prevalence of MCI was higher using MoCA-BM compared to M-MMSE. Both instruments showed moderate concordance for screening MCI with correlation of their scores.
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Affiliation(s)
- Rosdinom Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
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Wan Mohd Azam WMY, Din NC, Ahmad M, Ghazali SE, Ibrahim N, Said Z, Ghazali AR, Shahar S, Razali R, Maniam T. Loneliness and depression among the elderly in an agricultural settlement: mediating effects of social support. Asia Pac Psychiatry 2013; 5 Suppl 1:134-9. [PMID: 23857850 DOI: 10.1111/appy.12061] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Loneliness has long been known to have strong association with depression. The relationship between loneliness and depression, however, has been associated with other risk factors including social support. The aim of this paper is to describe the role of social support in the association between loneliness and depression. METHODS This cross-sectional study examined the mediating effects of social support among 161 community-based elderly in agricultural settlement of a rural area in Sungai Tengi, Malaysia. Subjects were investigated with De Jong Gierveld Loneliness Scale, Geriatric Depression Scale and Medical Outcome Survey Social Support Survey. Data were analyzed using Pearson correlation, linear and hierarchical regression. RESULTS Results indicated that social support partially mediated the relationship between loneliness and depression. DISCUSSION This suggests that social support affects the linear association between loneliness and depression in the elderly.
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Ibrahim N, Din NC, Ahmad M, Ghazali SE, Said Z, Shahar S, Ghazali AR, Razali R. Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia. Asia Pac Psychiatry 2013; 5 Suppl 1:59-66. [PMID: 23857839 DOI: 10.1111/appy.12068] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia. METHODS A total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross-sectional study. Three standardized instruments - the 12-item Short Form (SF-12), 15-item Geriatric Depression Scale (GDS-15) and Medical Outcome Study Social Support (MOS-Social Support) - were used to assess for quality of life, depression and social support. RESULTS Quality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF-12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression. DISCUSSION This study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well-being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life.
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Affiliation(s)
- Norhayati Ibrahim
- Health Psychology Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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