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Objectives: This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia. Methods: Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses. Results: Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health. Conclusion: Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people. [ABSTRACT FROM AUTHOR]

This Case Study paper presents the first exploration of Speculative Design as a participatory democracy method for navigating the future of ageing in Malaysia. Speculative Design in the context of Global South is emerging, but without much data on how it is applied within different socio-economic conditions from the Global North countries. This Case Study considers the challenges and opportunities of employing Speculative Design as policy identification and development method from the context of Malaysia, a Global South country with its own unique characteristics. The paper concludes by suggesting that the novelty of Speculative Design as a policy-design approach in Global South countries, such as in Malaysia, requires the right selection of provocations and culturally familiar content to ease introduction of the methodology. Also, the efficacy of this approach as a participatory design application would require further enculturation within targeted communities, as well as sustained engagement through Champions. • Employing Speculative Design in a Global South context requires adaptation to local contexts. • Future thinking is unfamiliar to many societies still facing non-equitable development. • Participatory Speculative Design can disrupt the top-down policy-making in Malaysia. • More research is required to better localize and measure the proposed method impact. [ABSTRACT FROM AUTHOR]

This paper addresses the issue of lifelong learning as experienced by a Malaysian female senior citizen in the current era. Data were retrieved from the participant's reflections which had been chronicled during the course of her learning in 2011. A linguistic analysis was applied to detect major issues described in the reflections which were written in English. These were then itemised under specific headings while the contents of the reflections were then categorised according to these headings. The overall findings suggest that lifelong learning was perceived to be a rewarding experience although the advancing age affected some aspects of her health, memory, vision, physical movement and so her attitude towards learning. The outcome of this paper suggests that lifelong learning was undertaken by the senior citizen for personal satisfaction and this learning process can be made more pleasant if some of the challenges identified can be addressed duly and aptly. In this regard, tertiary institutions may want to look into the development of retiree-friendly curriculum design, retiree-friendly course materials, flexible assessments, retiree-friendly locations and infrastructure as well as conducive learning environments. Senior citizens can contribute to the development of a nation because of their rich experiences and knowledge. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major cause of morbidity and mortality worldwide. Although multiple studies have assessed the prevalence of hypertension among older people, no study has examined the unmet need for hypertension care among older people in Malaysia. This study uses the hypertension care cascade to identify the prevalence of unmet needs for hypertension care and their determinants among the older population in Selangor.Methods: This is a cross-sectional study involving a total of 1204 participants recruited from different areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria were Malaysians aged ≥ 60 years who could converse in Bahasa Malaysia.Results: Among the 637 participants with hypertension, 18% (117) had not been previously screened but were found to have BP ≥ 140/90 mmHg, 21% (136) were undiagnosed, 3% (17) were untreated, 42% (267) were treated with antihypertensive medication but still had high blood pressure, and 16% (100) had hypertension that was controlled with medication. The hypertension care cascade demonstrates that 18% (117) of those with hypertension had never been screened for hypertension; 26% (136/520) of those who were screened never received a diagnosis; 4% (17/384) of those who were diagnosed did not receive treatment; and 73% (267/367) of those who were treated did not reach the threshold for control. The prevalence of total unmet needs was 84% (537/637). Statistically significant determinants of having any unmet need for hypertension care were smoking status and medical history, with adjusted odds ratios and 95% confidence intervals (CIs) in the multivariate analysis of 0.5 (95% CI: 0.3-0.9) for being a smoker, 2.8 (95% CI: 1.1-6.9) for having a history of stroke and 1.6 (95% CI: 1.0-2.5) for having a history of diabetes mellitus.Conclusions: The prevalence of unmet need for hypertension care among the older population in Selangor is 84% (537/637), which is alarmingly high. This study highlights where and how much of the loss of care for hypertension happens in the care cascade and provides insight into the efforts required to improve effective service coverage to manage the increasing burden of hypertension associated with population ageing. [ABSTRACT FROM AUTHOR]

Background: It is well known that older adults are often vulnerable to malnutrition. This action research was conducted to develop a nutrition education package for promoting healthy ageing and reducing risk of chronic diseases among older adults in a rural area of Malaysia. Methods: This study was designed and conducted in three stages, including needs assessment, development of the package and analysis of acceptance among 33 older adults aged 60 years and over in rural communities, and 14 health staff members at rural health clinics. Subjects completed a questionnaire including sociodemographic factors and acceptance evaluation of the nutrition education package with respect to content, graphics and design. Data were analysed descriptively using numbers and percentages. Results: A nutrition education package comprising a booklet, flipchart and placemats was developed. A total of 42.4% of the older adults expressed that the sentences in the flipchart needed to be simplified and medical terms explained. Terminology (60%), illustrations (20%) and nutrition recommendations (20%) were the aspects that prevented elderly subjects from fully understanding the booklet. Information on the placemats was easily understood by subjects. Conclusions: A well accepted nutrition education package for promoting healthy ageing and reducing risk of chronic diseases was developed that incorporated modifications based on feedback from older adult subjects and health clinic staff in a rural area. It is a tool that can effectively be used for health education in this population. [ABSTRACT FROM AUTHOR]

Objective: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process. Design: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects. Results: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects. Conclusion: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays. [ABSTRACT FROM AUTHOR]