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The current evidence on the relationship between a higher body mass index (BMI) and falls in older adults is conflicting. This study, therefore, evaluated the relationship between BMI and falls and explored underlying mechanisms for this relationship. Data from 1,340 individuals from the Malaysian Elders Longitudinal Research study, obtained through home-based computerassisted interviews and followed by hospital-based health checks, were utilized. A history of the presence of falls in the previous 12 months was obtained. The presence of at least one fall in the past 12 months was associated with a higher BMI (odds ratio = 1.03, 95% confidence interval [1.01, 1.06]). The relationship between a higher BMI and falls was, however, attenuated by a lower percentage of lean body mass, which accounted for 69% of the total effect of BMI on the risk of falls. Future studies should now investigate this aforementioned relationship prospectively. [ABSTRACT FROM AUTHOR]

Introduction: The common assumption that urinary incontinence occurs in osteoarthritis (OA) due to poor mobility is supported by limited evidence. The influence of gender in such associations is also yet to be elucidated. Objective: This study, therefore, identified any potential associations between knee OA symptoms and urinary incontinence and further explore sex differences in the associations. Design: Cross‐sectional study. Setting: University Hospital. Participants: This was a cross‐sectional study from a longitudinal research study comprising 1221 community‐dwelling older persons (57% women), mean age (SD) 68.95 (7.49) years. Main Outcome Measure(s): Presence of urinary incontinence: mixed, stress and urge symptoms. Physical performance and C‐reactive protein levels were also assessed. Results: Two hundred and seventy‐seven (22.83%) individuals reported the presence of urinary incontinence: mixed (41.5%), stress (30%), and urge (28.5%) symptoms. In an unadjusted analysis, stratified by gender, the association between knee pain and urinary incontinence was only present in women with mixed symptoms. After further adjustment of demographics differences and body mass index, the association between knee pain with any urinary incontinence and mixed symptoms remained significant with the odds ratios (95% confidence interval): 1.48 (1.02–2.15) and 1.73 (1.06–2.83), respectively. This relationship was attenuated after further adjustment for waist circumference and impaired lower limb mobility. Conclusion: Our study refutes previous assumptions that urinary incontinence in individuals with OA is attributed to impaired mobility alone, but introduces the role of abdominal obesity in this relationship, particularly in women. Future studies should assess the temporal relationship between body fat distribution and OA with urinary incontinence. [ABSTRACT FROM AUTHOR]

Introduction: Despite cognitive impairment being a major health issue within the older population, limited information is available on factors associated with cognitive function among Asian ethnic groups. The objective of this study was to identify ethnic-specific sociodemographic risk factors which are associated with cognitive performance. Methods: Cross-sectional analysis of the Malaysian Elders Longitudinal Research (MELoR) study involving community-dwelling individuals aged >55 years was conducted. Information on sociodemographic factors, medical history, and lifestyle were obtained by computer-assisted interviews in participants’ homes. Cognitive performance was assessed with the Montreal Cognitive Assessment (MoCA) tool during subsequent hospital-based health checks. Hierarchical multiple linear regression analyses were conducted with continuous MoCA scores as the dependent variable. Results: Data were available for 1,140 participants, mean (standard deviation [SD]) = 68.48 (7.23) years, comprising 377 (33.1%) ethnic Malays, 414 (36.3%) Chinese, and 349 (30.6%) Indians. Mean (SD) MoCA scores were 20.44 (4.92), 23.97 (4.03), and 22.04 (4.83) for Malays, Chinese, and Indians, respectively (p = 0.01). Age >75 years, <12 years of education, and low functional ability were common risk factors for low cognitive performance across all three ethnic groups. Cognitive performance was positively associated with social engagement among the ethnic Chinese (β [95% CI] = 0.06 [0.01, 0.11]) and Indians (β [95% CI] = 0.16 [0.09, 0.23]) and with lower depression scores (β [(95% CI] = −0.08 [−0.15, −0.01]) among the ethnic Indians. Conclusion: Common factors associated with cognitive performance include age, education, and functional ability, and ethnic-specific factors were social engagement and depression. Interethnic comparisons of risk factors may form the basis for identification of ethnic-specific modifiable risk factors for cognitive decline and provision of culturally acceptable prevention measures. [ABSTRACT FROM AUTHOR]

Aim: While the impact of osteoarthritis (OA) on the older person's quality of life (QoL) has been established, the associations are complicated by numerous potential mediators and variations in diagnostic criteria. This study was conducted to explore the relationship between OA and QoL and the influence of physical performance, symptoms severity, and psychological factors on this potential relationship using 3 different methods of identification of OA. Methods: This cross-sectional study used data from the Malaysian Falls Assessment and Intervention Trial study. Radiological OA (ROA), clinical OA (COA), or self-reported physician-diagnosed OA (SOA) was determined using established criteria. Quality of life was measured with the 19-item Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire. Results: Of 370 participants (219 fallers, 151 nonfallers), mean (SD) age = 73.71 (6.57) years, COA (odds ratio [OR] 95% confidence interval [CI]; 1.38 [0.64-2.94]) and SOA (1.84 [1.19-2.84]) were associated with CASP-19 of 47 and less but not ROA. The association between SOA and CASP-19 of 47 and less was attenuated by physical performance while COA was no longer associated with CASP-19 of 47 and less after adjustment for psychological status. Conclusion: Our findings hold important clues to unraveling factors that influence QoL in older adults with OA and will inform future intervention studies aimed at reducing the burden of OA among older adults. [ABSTRACT FROM AUTHOR]

While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults. Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers. Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss. Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure. [ABSTRACT FROM AUTHOR]

Aim: To compare and contrast falls characteristics between older adults with body mass index of 25.0 kg/m² or greater and less than 25.0 kg/m² and to further identify potential underlying mechanisms if differences existed. Subjects and Methods: This was a cross-sectional study using data from fallers identified during the first wave of the Malaysian Elders Longitudinal Research study. Basic demographics, falls characteristics, fear of falling, medical comorbidities, and lifestyle factors were obtained during a home-based computer-assisted interview, while anthropometric measurements, body composition, and physical performance were collected during the hospital-based health check. Results: Of the 302 individuals with 1 or more falls in the previous 12 months, mean age (SD) = 69.6 (7.7) years, 152 individuals (50.3%) were in the body mass index of 25.0 group or greater. Fallers with body mass index of 25.0 or greater were more likely to have fallen in the bedroom and on the stairs (adjusted odds ratio = 2.50; 95% confidence interval, 1.10-5.73) and less likely to fall in the afternoon (adjusted odds ratio = 0.47; 95% confidence interval, 0.26-0.83) after adjustment for potential confounders. Conclusions: Our study suggests that mechanisms of falls may differ in those with excess body weight, who may benefit from specific targeted fall prevention programmes. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify factors that influence the implementation of fall prevention programs from the perspectives of the family physician (FP). Methods: A cross-sectional survey was conducted with all 1800 members of the Academy of Family Medicine, Malaysia. Results: Sixty (54%) and 75 (67%) FPs did not routinely ask older people about falls and fear of falling, respectively. Seventy-nine FPs (71%) reported being unfamiliar with any guidelines for screening for fall risk. Conclusion: Our study revealed major gaps in the delivery of evidence-based fall prevention in practice by Malaysian FPs. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between vitamin D and knee pain among participants of the Malaysian Elders Longitudinal Research (MELoR) study. Method: This was a cross-sectional study from the MELoR study consisting of a representative group of 1011 community-dwelling older persons (57% female), mean age 86.5 (54-94) years; 313 were Malays, 367 Chinese and 330 Indians. Participants were asked if they had knee pain. Levels of serum 25-hydroxy cholecalciferol (25- [OH]D), an indicator of vitamin D status, were measured using routine laboratory techniques. Results: In unadjusted analysis, presence of knee pain was significantly associated with vitamin D deficiency (odds ratio [OR] 1.42; 95% confidence interval (CI) 1.08-1.85, P 0.011). Vitamin D levels were significantly associated with ethnicity differences where Malays (OR 7.08; 95% CI 4.94-10.15) and Indians (OR 6.10; 95% CI 4.28-9.71) have lower levels of vitamin D compared to Chinese. Subsequent multivariate analysis revealed that the association between vitamin D deficiency and knee pain was confounded by ethnic differences. Conclusion: A previous study suggested that vitamin D deficiency was associated with knee pain. This relationship was reproduced in our study, but we further established that the association was explained by ethnic variations. As vitamin D status is dependent on skin tone, diet and sunlight exposure, which are all effected by ethnicity, future studies are now required to determine whether a true relationship exists between vitamin D and knee pain. [ABSTRACT FROM AUTHOR]

The CASP-19 is an age-specific measure of quality of life. It comprises four domains: control, autonomy, self-realisation and pleasure, and is widely used in large cohort studies in temperate climates. Our objective was to translate the CASP-19 into Bahasa Malaysia and validate it for use in older Malaysians in their three commonly used languages of English, Bahasa Malaysia and Traditional Chinese. CASP-19 showed good internal consistency and test-retest reliability with acceptable construct validity compared with the 12-item short-form health survey. Factor analysis found the best fit for the Taiwanese five-domain model. The validity of CASP-19 may be limited by cultural differences. [ABSTRACT FROM AUTHOR]