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Aim: Quality of life (QoL) among the older persons provides valuable insights into the potential modifiable risk factors that affect well-being in later life. This study aimed to describe the QoL and psychosocial factors of QoL of older persons in Malaysia., Methods: We used the 19-item Control, Autonomy, Self-realization and Pleasure scale, a validated instrument that measures psychological well-being related to QoL in older persons. Scores range from 0 to 57, and higher scores indicate better QoL. We included several factors as covariates. Analysis of complex samples was carried out using Stata 15. Descriptive analysis was carried out to determine QoL by sociodemographic characteristics and other factors. Linear regression analysis was used to identify psychosocial factors that influence QoL., Results: A total of 3444 individuals aged ≥60 years completed all 19-item Control, Autonomy, Self-realization and Pleasure items. The estimated mean QoL score was 47.01 (95% CI 46.30-47.72). Adjusted for confounders, QoL was lower among individuals with no formal education (-2.554, 95% CI -3.684, -1.424), probable depression (-1.042, 95% CI -1.212, -0.871) and food insecurity (-0.815, 95% CI -1.083, -0.548). QoL continued to improve with improved ADL score (0.302, 95% CI 0.052, 0.552), IADL score (0.646, 95% CI 0.382, 0.909) and better social support (0.308, 95% CI 0.187, 0.429)., Conclusions: Lower education, depression, food insecurity, presence of limited functional status and poor social support negatively influenced QoL in older Malaysians. This study identified potentially modifiable factors that could be targeted for interventions to enhance QoL of older persons in Malaysia. Geriatr Gerontol Int 2020; 20: 92-97., (© 2020 Japan Geriatrics Society.)

Like many other countries across the globe, Malaysia is rapidly graying. It is projected that older adults will comprise 10–15% of the country's total population in the next decade. Despite the surge in chronic diseases and a rise in dependency in daily living activities among Malaysian elders, formal support and long-term care services (LTC) have not been adequately developed. The existing tax-funded health care system – currently under huge financial strain – has no systematic or comprehensive LTC provision in place. This paper highlights the need for sustainable and equitable LTC services in Malaysia while drawing insight from existing LTC provision and financing arrangements in neighboring countries. It offers several recommendations to move forward in LTC planning using an approach that is unique to the Malaysian context. Key points: The rapid demographic transition in Malaysia is not matched by its existing LTC provision. Malaysia can draw lessons and insight on LTC services and arrangements from neighboring countries. Strategies in developing LTC in Malaysia should align with societal values, make use of existing local resources and take into account issues of sustainability and equity. [ABSTRACT FROM AUTHOR]

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]

The aim of this study was to determine the incidence of physical inactivity and identify the predictors for low physical activity among community-dwelling older persons living in Malaysia in 3 years follow-up. In this prospective study, physical activity levels were measured using the Physical Activity Scale for the Elderly. The arbitrary cutoff for Physical Activity Scale for the Elderly in this study was ≤70.9 for low and >141 for high physical activity levels. Out of the 955 physically active participants at baseline, 555 of them (mean [SD] age 68.82 [4.92] years) were successfully followed up to 3 years. Cumulative incidence of being physically inactive was 21% with rate of 7 per 100 person-years. It was found that being older (<.001), from Malay ethnic group (<.05), smokers (<.01), having lower gait speed (<.001), and lower cognitive status (<.05) were predictors for physical inactivity among Malaysian community-dwelling older persons in 3 years follow-up. These factors should be taken into consideration when planning for intervention and promotion strategies to increase physical activity levels among Malaysian older persons. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the structural relationship between the emotional and social support provided for individuals with caring responsibilities for elderly relatives, and the quality of care actually delivered. In addition, the moderating role of gender is explored.Design/methodology/approach A quantitative research design was utilised in which 200 usable questionnaires were collected from 250 respondents comprised of young adults who adopt a caregiving roles in respect of elderly parents or other close elderly relatives. The structural equation modelling (SEM) technique was selected for data analysis, and the Analysis of moment structure software version 21 was used.Findings The SEM results revealed that emotional support for caregivers was the most important predictor affecting the intergenerational care of multi-ethnic elderly people. Additionally, a moderation analysis revealed that the relative influence in this connection was more pronounced among female caregivers. An increase in the emotional support received by the recipient was found to enhance the level of the relationship, and to result in closer intergenerational ties in the care of the multi-ethnic elderly. Furthermore, the receipt of social support positively influences the judgement of an individual, and expands that person’s social network, which can subsequently have a favourable impact on the way in which one fulfils their caring role. The significant effect of social support provided for intergenerational caregivers in the context of the multi-ethnic elderly was higher in the group of male caregivers than in the group of female caregivers.Practical implications This study sends a strong message to policy-makers in developing countries about the need to consider within their National Policy for the Elderly, improvements in the national action plan for a holistic and integrated approach to ensure the well-being of caregivers and the elderly.Originality/value The results of the study help young adults to understand the importance of emotional and social support in boosting their relationships with parents and families and motivating intergenerational efforts in the care of the multi-ethnic elderly. Harmony within families is an important ideal in any circumstance, but in the scenario of ageing family members it may be even more essential to try to achieve it. [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]

The article discusses the highlights of the South East Asian Conference on Ageing titled "Improving Well Being in Later Life" held July 17-18, 2010 at Kuala Lumpur, Malaysia. It notes that 96 participants from 16 countries attended the conference. Two keynote addresses were presented, by Professor Doctor Armando Barrientos on the need for a global extension of social protection and by Professor Doctor Hal Kendig about lessons on well being from the Australian experience. It cites that there were also four plenary papers and 39 oral paper presentations.

This paper examines money attitudes and associated retirement issues of academics in higher education in Malaysia. Systematic random sampling was used in selecting the target respondents. A questionnaire was personally administered on 458 academics in 16 universities in Malaysia. The survey found that academics exhibited positive attitudes toward money, and income appears to be the prime motivator. Consistent with the findings of prior studies, position, age and educational levels were strong indicators of an academic's annual income. The survey found that female academics and those from public universities had more positive attitudes towards retirement. In retirement planning, the respondents considered the availability of other income after retirement the most important factor, while payment for children's education was the key potential conflict area. The findings provide important insights for the top management of higher education of the necessity of pre-retirement counseling and assistance to ease the passage to retirement for academics. [ABSTRACT FROM AUTHOR]

Malaysia is steadily progressing toward an aging population demographic pattern. While aging is a natural process, its impact can be painful individually as well as for the nation. Individually there is a loss of a paying job after retirement, loss of physical and mental fitness, and also occasionally the loss of social integration due to lack of mobility. For a nation, an aging population means a growing dependency ratio, a greater need of care, and more medical facilities for this age group. This article looks at the various economic and social implications of the aging population in Malaysia in general, and in the rural and urban setting specifically. The paper focuses on a research sample of 132 (66 rural, 66 urban) elderly persons. The findings suggest that the demographic patterns of the elderly vary from the rural to the urban setting, with differing issues that need to be addressed to alleviate problems encountered related to loneliness, lack of financial stability, and emotional strain. Policy suggestion will be geared toward providing a solution to problems at hand as well as aiding the working group members to prepare and sustain a comfortable livelihood for the aged in their later years. [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]

Malaysia is becoming an aging nation, with 32 medical schools providing 5,000 graduates every year. The extent these graduates have been trained in core concepts in geriatric medicine remains unclear. This work aims to describe the current state of teaching provision on aging and geriatric medicine to the medical undergraduates in Malaysia. A survey was developed by geriatric medicine experts from the Malaysian Society of Geriatric Medicine (MSGM) to review the teaching provision based on the recommended MSGM Undergraduate Geriatric Medicine Curriculum and was sent to all medical schools across the country. The response rate was 50% (16 out of 32 medical schools). Among 16 medical schools, 10 (62.5%) delivered the learning outcomes as part of an integrated curriculum, and five via a mixed geriatric and integrated curriculum at varying degrees of completeness, ranging from 19% to 94%. One particular medical school did not deliver any of the core topics as part of its undergraduate curriculum. It has been identified that the strongest barrier to delivery was lack of expertise, followed by the fact that the topics were not included in the current curriculum. Improvement in teaching provision should be implemented through a concerted effort to adopt a geriatric medical curriculum nationwide, while future research should aim at the interventions taken to address the barriers in its provision. [ABSTRACT FROM AUTHOR]

Objectives Older adults tend to have poorer Theory of Mind (ToM) than their younger counterparts, and this has been shown in both Western and Asian cultures. We examined the role of working memory (WM) in age differences in ToM, and whether this was moderated by education and culture (the United Kingdom vs. Malaysia). Methods We used 2 ToM tests with differing demands on updating multiple mental states (false belief) and applying social rules to mental state processing (faux pas). We also looked at the role of education, socioeconomic status, and WM. A total of 298 participants from the United Kingdom and Malaysia completed faux pas, false belief, and WM tasks. Results Age effects on some aspects of ToM were greater in the Malaysian compared to the UK sample. Malaysian older adults were poorer at faux pas detection, aspects of false belief, and WM compared to young adults. In subsequent moderated mediation analyses, we found that, specifically in the Malaysian sample, the mediating effects of WM on the age and ToM relationship occurred at the lowest levels of education. Discussion This pattern of results may reflect changes in the familiarity and cognitive load of explicit mental state attribution, along with cultural differences in the pace and nature of cognitive aging. Cultural differences in education and WM should be considered when researching age differences in ToM. [ABSTRACT FROM AUTHOR]

Although ageing is not yet a high priority tissue for health planners, policy makers and clinicians in most developing countries there will be a growing need in coming years to pay more attention to the important health issues associated with population ageing in the developing world. This paper reports some of the relevant findings of a cross-national study (sponsored by the World Health Organization) of the health and social aspects of ageing in four developing countries--Republic of Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar eleven-country WHO study in Europe. In very broad terms, the overall demographic, physical, mental health and social patterns and trends associated with ageing as demonstrated by age-group and sex differences were consistent throughout the four countries studied. Comparisons with European findings in other similar studies underlined the fundamental universality of age-related changes in biophysical, behavioural and social characteristics. The importance of the family in developing countries was evident, with about three-quarters of those aged 60 and over in the four countries living with children, often in extended family situations. Levels of adverse health-related behaviour and the prospect of changing patterns of morbidity with further increases in the total and proportional numbers of aged persons point to a need for emphasis on preventive health measures and programmes directed to the maintenance of the physical and mental health of the ageing population.

Consequent to rapidly declining mortality and birth rates, developing countries, including Malaysia, can expect a rapid increase in the population aged 60 years and above. The health of the elderly is intimately tied up with both biophysical as well as psychosocial factors which include status loss, loneliness, fear of illness and death, poverty, harmful life-styles and deterioration of the quality of life. The effects of these psychosocial factors can manifest as sleep difficulties, worry and anxiety, depression, loss of interest, and a feeling of tiredness. In extreme cases, there may be auditory or visual hallucinations or paranoia. In the present paper, which is based upon a WHO sponsored study of 1001 elderly Malaysians, it is noted that 36% of the elderly have sleep difficulties, 47% "feel tired", 31% have a "loss of interest" and 22% are "worried tense". However 71% of the elderly are able to correctly perform at least 12 of 15 cognitive tests. 20% of elderly men smoke 15 or more cigarettes a day while 44% smoke at least one cigarette a day. 40% of elderly men indicate that their families complain about the amount of alcohol they drink. Undoubtedly primary health care programmes need to be re-oriented to the problems and needs of the elderly in countries such as Malaysia.

While ageing is still clearly not a high priority issue for health planners, policy makers and clinicians in developing countries of Asia and the Pacific, there will be a growing need in coming years to pay more and more attention to the important health issues associated with population ageing in countries which make up this region of the world. This paper reports some of the relevant findings of a WHO sponsored cross national study of the health and social aspects of ageing in four of the countries, namely Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar WHO eleven country study in Europe. The paper argues that there is an urgent need to develop health care strategies which will minimise the impact of population ageing and will maintain the growing numbers of old people in relatively good physical and mental health through preventive measures and through programmes directed to the maintenance of physical and mental health.

Healthy ageing concepts have been extensively studied in Western societies but few studies have explored the perceptions of older people from other cultural backgrounds. The aim of the study was to explore the conceptualisations of healthy ageing and perceived influences on ageing well amongst relatively healthy older Malays, a major ethnic group in Malaysia. Eight focus groups were conducted, with 38 participants recruited via community groups and leaders. Six themes were identified: spirituality, physical health and function, peace of mind, financial independence, family, and living environment. In this paper, we focus on the role of spirituality in healthy ageing which was a core resource in participants' lives. Participants reported that good physical health was an important resource that facilitated commitment to their spiritual activities. Furthermore, deteriorating functional ability appeared to provide an opportunity to optimise their spirituality, rather than hinder it. Participants wished for a 'peaceful life' and experienced this by enhancing their spirituality. Other ingredients for a peaceful life were financial independence, living in a place they love and having family members who live in harmony. In this community where religious affiliation is a tradition, spirituality can be fundamental for healthy ageing and its inclusion in aged care policy is imperative. However, further exploration on the diversity of individual expression of spirituality is important. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the psychometric properties of the Bahasa Malaysia (BM) version of the Older Americans Resources and Services‐Instrumental Activities of Daily Living (OARS‐IADL) questionnaire among older persons in Malaysia. Methods: The English version of OARS‐IADL was translated to BM. The psychometric properties of the BM version of OARS‐IADL were tested among older persons attending a health‐care facility. Results: Two hundred and seventy‐one older persons participated in the study. The mean age of participants was 67.7 ± 6.1 years. Internal consistency of the items was good (Cronbach's alpha, >0.7). Exploratory factor analysis revealed a single dimension with item factor loadings of >0.5. Confirmatory factor analysis results confirmed a single‐factor model (AVE > 50%, CR > 0.7 and CR > AVE). Conclusion: The BM version of the OARS‐IADL questionnaire is a valid and reliable instrument that can be used to assess the IADL among older persons in Malaysia. [ABSTRACT FROM AUTHOR]

Religion and spirituality gain importance as a person ages. Research has shown that religion has a salutary effect on mental health, and it is associated with health differently across ethnic groups. The current study examined ethnic differences in the association between religion and mental health among older adults in a predominantly Muslim population and multicultural setting. Data of 7068 participants (4418 Malays, 2080 Chinese and 570 Indians) aged ≥55 years that were collected as part of the community health survey conducted in 2013 in the South East Asia Community Observatory (SEACO) were analyzed using bivariate and multiple regressions. Analyses were stratified by ethnicity. The importance of having an enriched religious/spiritual life was associated with higher scores of depression, anxiety and stress among Chinese and higher score of depression among Malays, while belief in a higher power was associated with better mental health among Malays, Chinese and Indians. The current study showed that there were ethnic variations in the associations between religion and mental health, and the associations depended on the religious variable included in the analysis. The findings of this study showed that religion could be another potential channel to improve mental health among older adults by accommodating and understanding their religious beliefs. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major public health issue. It is the leading preventable risk factor for premature death and disability, mainly due to ischemic heart disease and stroke. In Malaysia, the age-adjusted prevalence of hypertension was 35.3% in 2015. Hypertension burden is expected to grow with the ageing population, urbanization, and unhealthy lifestyle. In this review, we aim to describe the current hypertension prevention and control program and its challenges in Malaysia, so that future strategies can be developed to further reduce hypertension prevalence. Methods: A narrative review was conducted in June 2020 using published and grey literature, policy and programme documents, guidelines, official statistics and technical reports that are related to hypertension prevention and control programme in Malaysia. Results: The National Strategic Plan for Non-communicable Diseases presented an overarching framework for primordial, primary, and secondary prevention of NCDs through a multi-faceted approach. The Salt Reduction Strategy has demonstrated a cost-effective, primary population-based prevention. The well-established health care system provided primary and secondary prevention through universal health coverage incorporating the Family Doctor Concept and guided by the Clinical Practice Guideline. Community-based programmes were launched to create a healthy environment that encourages and empowers communities to practice healthy behaviours. Conclusion: Moving the strategic plan forward will require substantial effort and significant capacity building through the whole of government and whole of society approaches. Furthermore, more implementation researches of innovative, cost-effective and sustainable programmes incorporating technologies, are needed to combat the country's emerging hypertension burden. [ABSTRACT FROM AUTHOR]

An increase in the number of residents in nursing homes has become a significant concern due to the rise in medication demand and subsequently medication-related issues, especially in frail elderly. Community pharmacists are the closest healthcare professionals available that can contribute to this population to allow optimal utilization of the prescribed drugs and to prevent drug-related problems. The present study aimed to investigate the awareness of community pharmacists on issues regarding frail elderly and to determine their willingness in collaborative care of frail elderly in nursing homes and the services they are willing to offer. This was a cross-sectional study utilising a set of questionnaire that was delivered to practicing community pharmacists in Peninsular Malaysia from June 2018 until December 2018. Majority of the participants agreed to the fact that aging is the primary cause of frailty (n=98, 88.3%), and that chronic disease is also a cause of frailty (n=96, 86.5%). Most of the community pharmacists were also keen to participate in the collaborative care of frail elderly, and were willing to provide their pharmacy service to the frail elderly. There was a positive correlation between the awareness of community pharmacists on issues regarding frail elderly and their willingness on collaborative care of frail elderly in nursing homes (r=0.374, n=111, p=0.01). Majority of the pharmacists were aware of the issues regarding the frail elderly, and were willing to participate in the collaborative care of frail elderly in nursing home. [ABSTRACT FROM AUTHOR]

Background: Many studies on biochemical and psychological variables have aimed to elucidate the association between aging and cognitive function. Demographic differences and protein expression have been reported to play a role in determining the cognitive capability of a population.Objective: This study aimed to determine the effect of age on the protein profile of Malay individuals and its association with cognitive competency.Methods: A total of 160 individuals were recruited and grouped accordingly. Cognitive competency of each subject was assessed with several neuropsychological tests. Plasma samples were collected and analyzed with Q Exactive HF Orbitrap. Proteins were identified and quantitated with MaxQuant and further analyzed with Perseus to determine differentially expressed proteins. PANTHER, Reactome, and STRING were applied for bioinformatics output.Results: Our data showed that the Malay individuals are vulnerable to the deterioration of cognitive function with aging, and most of the proteins were differentially expressed in concordance. Several physiological components and pathways were shown to be involved, giving a hint of a promising interpretation on the induction of aging toward the state of the Malays' cognitive function. Nevertheless, some proteins have shown a considerable interaction with the generated protein network, which provides a direction of focus for further investigation.Conclusion: This study demonstrated notable changes in the expression of several proteins as age increased. These changes provide a promising platform for understanding the biochemical factors affecting cognitive function in the Malay population. The exhibited network of protein-protein interaction suggests the possibility of implementing regulatory intervention in ameliorating Malay cognitive function. [ABSTRACT FROM AUTHOR]

Malaysia has an ageing population and an increasing number of older people who live alone. This study explores the social support and care arrangements of older people living alone in rural Malaysia. The study took a qualitative approach: semi-structured interviews were conducted with a purposive sample of Malay (N = 20) and Chinese (N = 20) Malaysians aged over 65. Five cross-cutting themes were identified through a thematic analysis: degrees of aloneness; relationships and social support; barriers to social support; and future illness, care and death. All participants said they lived alone; living arrangements, however, were often complex. For Malays, most support came from nearby adult children and relatives, whereas Chinese participants, who less frequently had adult children living locally, emphasised support from friends and neighbours. Emigrant adult children's assistance was mostly informational and financial, instrumental assistance was either substituted for money, or provided solely during periods of ill-health. Physical decline, limited telephone use, inadequate transportation and fears of crime were barriers to social support. Participants avoided thinking or talking about future care needs. These findings have implications for Malaysian old age policy, which is currently focused on supporting families to care for older relatives. Child migration and a growing preference for a period of independent living in old age may require policies and resources directed at older people as individuals to support their own efforts to remain independent, active and age ‘in place’. [ABSTRACT FROM AUTHOR]

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Multiethnic Malaysia provides a unique case study of divergence in population aging of different sociocultural subgroups within a country. Malaysia represents 3 major ethnicities in Asia--the Malay, Chinese, and Indian. The 3 ethnic groups are at different stages of population aging, as they have undergone demographic transition at different pace amidst rapid social and economic changes. Between 1991 and 2010, the Malaysian population aged 60 and over has more than doubled from about 1 million to 2.2 million, and this is projected to rise to about 7 million or 17.6% of the projected population of 40 million by 2040. In 2010, the aging index ranged from 22.8% among the Bumiputera (Malays and other indigenous groups), to 31.4% among the Indians and 55.0% among the Chinese. Population aging provides great challenges for Malaysia's social and economic development. The increasing prevalence of noncommunicable diseases in older adults, coupled with the erosion of the traditional family support system has increased demands on health care services with an overwhelming need for multidisciplinary and specialized geriatric care. Following the adoption of the National Policy for the Elderly in 1995, issues of population aging have gained increasing attention, especially among researchers. There is an urgent need to increase public awareness, develop infrastructure, as well as support action oriented research that will directly translate to comprehensive and cohesive social strategies, policies, and legislation to protect not just the current older Malaysians but the future of all Malaysians. [ABSTRACT FROM AUTHOR]

We explored knowledge, attitudes, and practices associated with the menopause transition particular to women in the multi-ethnic cultural context of Singapore. Fifty-eight Chinese, Malay, and Indian Singaporean women participated in interviews that were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Women from all three ethnicities described an attitude of acceptance surrounding menopause and the changes associated with it. While they thought it was important to be informed, they did not seek out information about menopause and did not view health professionals as useful sources of information. Management practices were diverse and rarely involved accessing health professionals. [ABSTRACT FROM PUBLISHER]

The aim of this study was to examine the moderating role of gender on relations among social support functions and life satisfaction in older Malaysians. The study sample was 1,800 older residents in a community; all were at least 60 years old. This study was a cross-sectional and corelational survey, and the data were collected by multistage stratified sampling. This study revealed that fewer social support functions, and therefore less life satisfaction, were available for females than for males. The results of moderated regression analyses demonstrated that gender interacted only on the relationship between positive social interaction support and tangible support with life satisfaction. Specifically, at a high tangible support level, females had lower life satisfaction when compared to a low tangible support level. There may be a need for new programs and services to provide other aspects of social support to older female adults to improve and maintain life satisfaction in later life. [ABSTRACT FROM PUBLISHER]

In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting. [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]

Malaysian rice (Oryza sativa L.) cultivars MR84 and MR185 were grown in greenhouse chambers and exposed to four different levels of ozone from 28th August, 2001 to 22nd January, 2002. Four ozone levels were selected in close relation to the Malaysian peri-urban ambient level (approximately 30 ppb, 8 hr mean), the Malaysian guideline level (approximately 60 ppb) and possible future higher ozone levels (approximately 90 ppb). Both morphological and physiological parameters showed distinctive impacts of ozone treatments. The plants treated with the highest ozone concentration showed different morphological development, probably induced by severe foliar injury and physiological adaptation of the plants to the ozone stress. The physiological measurements revealed a high sensitivity at the early and late vegetative stages. It was concluded that MR84, which was found to be physiologically sensitive, responded to ozone relatively quickly and altered its morphology to compensate for effects on growth and yield, while MR185, found to be physiologically insensitive, responded to ozone stress slowly which resulted in more severe impacts on growth and yield parameters. Slight growth stimulation was observed at the lowest (30 ppb) ozone level for MR185, whilst negative impacts on growth occurred at both of the higher ozone levels. The study provided useful insights into the earlier findings of an open-top chamber filtration study on the same cultivars in the field at a peri-urban site in Malaysia. The present study proved that yield could be reduced substantially when other parameters associated with grain yield were affected, which was accompanied by increasing yellowing of leaves and premature senescence. [ABSTRACT FROM AUTHOR]

Background: Skin tears (STs) are among the most prevalent wounds found in long-term care (LTC) settings. Given our aging population, the burden related to STs will further increase. Skin tears are frequently under-recognised and under-treated as they are often misunderstood as expected outcomes of normal skin changes associated with aging. When coupled with age-related co-morbidities, STs may exhibit prolonged healing times leading to complications such as infection. Emerging evidence suggests that pain is a common symptom associated with STs affecting people's ability to function and their quality of life. While many factors have been purported to be associated with ST development, there is little evidence to corroborate their roles in ST risks. The primary purpose of this study was to examine risk factors associated with ST development in the Ontario LTC population. Methods: A prospective study design was used to determine the risk factors associated with ST development. Prior to the study, a systematic literature review was conducted to identify previously identified risk factors and inform the study. A total of 380 individuals over the age of 65 years from 4 LTC facilities in Ontario were followed over 4 weeks. The participants were examined for STs at the beginning of the study and at week 4 to determine if STs had occurred and to record the ST type, location, and associated factors. Results: The study demonstrated a ST prevalence of 20.8% and an incidence of 18.9%. History of a previous ST (p=.012) and presence of non-modifiable skin changes (p<.001) were identified as key risk factors associated with ST development and are supported by the literature review. The study also identified two key modifiable risk factors; requiring assistance with activities of daily living (p<.001) and resisting care (p =.001). Conclusion: Our study results provide much-needed Canadian data for benchmarking the burden of STs in the LTC population. By identifying modifiable and non-modifiable risk factors, healthcare professionals can establish prevention programs targeted at reduction of risks for ST development. This study is an important first step towards developing a risk predictor scale for ST development in the LTC population. [ABSTRACT FROM AUTHOR]