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Background: Cognitive frailty describes the co‐occurrence of cognitive impairment and physical frailty and is classified into reversible and irreversible phenotypes. Data on the impact of COVID‐19 pandemic imposed lockdowns, locally known as the Movement Control Order (MCO), on the psychological status of cognitively frail older adults remain scarce. Therefore, this study aimed to determine the relationship between depression, anxiety, stress and cognitive frailty among older adults during the MCO. Method: Participants aged above 60 years from three ageing cohorts in Malaysia were interviewed virtually. The Fatigue, Resistance, Ambulation, Illness and Loss of Weight scale, blind Montreal Cognitive Assessment, 15‐item Geriatric Depression Scale, anxiety subscale of Depression, Anxiety and Stress Scale and four‐item Perceived Stress Scale measured frailty, mild cognitive impairment (MCI), depression, anxiety and stress, respectively. Results: Cognitive frailty data were available for 870 participants, age (mean ± SD) = 73.44 ± 6.32 years and 55.6% were women. Fifty‐seven (6.6%) were robust, 24 (2.8%) had MCI, 451 (51.8%) were pre‐frail, 164 (18.9%) were pre‐frail+MCI, 119 (13.7%) were frail and 55 (6.3%) were frail+MCI. There were significant differences in depression and anxiety scores between the controlled MCO and recovery MCO. Using multinomial logistic regression, pre‐frail (mean difference (95% confidence interval, CI) = 1.16 (0.932, 1.337), frail (1.49 (1.235, 1.803) and frail+MCI (1.49 (1.225, 1.822)) groups had significantly higher depression scores, frail (1.19 (1.030, 1.373)) and frail+MCI (1.24 (1.065, 1.439)) had significantly higher anxiety scores and pre‐frail (1.50 (1.285, 1.761)), frail (1.74 (1.469, 2.062)) and frail+MCI (1.81 (1.508, 2.165)) had significantly higher stress scores upon adjustments for the potential confounders. The MCO was a potential confounder in the relationship between depression and prefrail+MCI (1.08 (0.898, 1.340)). Conclusion: Frail individuals with or without MCI had significantly higher depression, anxiety and stress than those who were robust. Increased depression and stress were also observed in the pre‐frail group. Interventions to address psychological issues in older adults during the COVID‐19 pandemic could target prefrail and frail individuals and need further evaluation. [ABSTRACT FROM AUTHOR]

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]

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]

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]

The consumption of medications with anticholinergic activity has been suggested to result in the adverse effects of mental confusion, visual disturbance, and muscle weakness, which may lead to falls. Existing published evidence linking anticholinergic drugs with falls, however, remains weak. This study was conducted to evaluate the relationship between anticholinergic cognitive burden (ACB) and the long-term risk of hospitalization with falls and fractures in a large population study. The dataset comprised information from 25,639 men and women (aged 40–79 years) recruited from 1993 to 1997 from Norfolk, United Kingdom into the European Prospective Investigation into Cancer (EPIC)-Norfolk study. The time to first hospital admission with a fall with or without fracture was obtained from the National Health Service hospital information system. Cox-proportional hazards analyses were conducted to adjust for confounders and competing risks. The fall hospitalization rate was 5.8% over a median follow-up of ~ 19.4 years. The unadjusted incidence rate ratio for the use of any drugs with anticholinergic properties was 1.79 (95% CI 1.66–1.93). The hazard ratios (95% CI) for ACB scores of 1, 2–3, and ≥ 4 compared with ACB = 0 for fall hospitalization were 1.20 (1.09–1.33), 1.42 (1.25–1.60), and 1.39 (1.21–1.60) after adjustment for age, gender, medical conditions, physical activity, and blood pressure. Medications with anticholinergic activity are associated with an increased risk of subsequent hospitalization with a fall over a 19-year follow-up period. The biological mechanisms underlying the long-term risk of hospitalization with a fall or fracture following baseline ACB exposure remains unclear and requires further evaluation. [ABSTRACT FROM AUTHOR]

Introduction: osteoarthritis (OA) of knee has been reported as a risk factor for falls and reduced balance in the elderly. This systematic review evaluated the effectiveness of physical therapies in improving balance and reducing falls risk among patients with knee OA.Methods: a computerised search was performed to identify relevant studies up to November 2013. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the PeDro score.Results: a total of 15 randomised controlled trials involving 1482 patients were identified. The mean PeDro score was 7. The pooled standardised mean difference in balance outcome for strength training = 0.3346 (95% CI: 0.3207–0.60, P = 0.01 < 0.00001, P for heterogeneity = 0.85, I2 = 0%). Tai Chi = 0.7597 (95% CI: 0.5130–1.2043, P<=0.0014, P for heterogeneity = 0.26, I2 = 0%) and aerobic exercises = 0.6880 (95% CI: 0.5704–1.302, P < 0.00001, P for heterogeneity = 0.71, I2 = 0%). While pooled results for falls risk outcomes in, strength training, Tai chi and aerobics also showed a significant reduction in reduced risk of falls significantly with pooled result 0.55 (95% CI: 0.41–0.68, P < 0.00001, P for heterogeneity = 0.39, I2 = 6%).Conclusion: strength training, Tai Chi and aerobics exercises improved balance and falls risk in older individuals with knee OA, while water-based exercises and light treatment did not significantly improve balance outcomes. Strength training, Tai Chi and aerobics exercises can therefore be recommended as falls prevention strategies for individuals with OA. However, a large randomised controlled study using actual falls outcomes is recommended to determine the appropriate dosage and to measure the potential benefits in falls reduction. [ABSTRACT FROM PUBLISHER]

• The world falls guidelines risk stratification algorithm was successfully adapted within the Malaysian population. • Individuals in the intermediate- and high-risk groups had a significantly higher incidence of falls at two-year follow-up. • The algorithm has high specificity and low sensitivity in predicting falls. • The algorithm's sensitivity decreases over time. The World Falls Guidelines (WFG) Task Force published a falls risk stratification algorithm in 2022. However, its adaptability is uncertain in low- and middle-income settings such as Malaysia due to different risk factors and limited resources. We evaluated the effectiveness of the WFG risk stratification algorithm in predicting falls among community-dwelling older adults in Malaysia. Data from the Malaysian Elders Longitudinal Research subset of the Transforming Cognitive Frailty into Later-Life Self-Sufficiency cohort study was utilized. From 2013–2015, participants aged ≥55 years were selected from the electoral rolls of three parliamentary constituencies in Klang Valley. Risk categorisation was performed using baseline data. Falls prediction values were determined using follow-up data from wave 2 (2015–2016), wave 3 (2019) and wave 4 (2020–2022). Of 1,548 individuals recruited, 737 were interviewed at wave 2, 858 at wave 3, and 742 at wave 4. Falls were reported by 13.4 %, 29.8 % and 42.9 % of the low-, intermediate- and high-risk groups at wave 2, 19.4 %, 25.5 % and 32.8 % at wave 3, and 25.8 %, 27.7 % and 27.0 % at wave 4, respectively. At wave 2, the algorithm generated a sensitivity of 51.3 % (95 %CI, 43.1–59.2) and specificity of 80.1 % (95 %CI, 76.6–83.2). At wave 3, sensitivity was 29.4 % (95 %CI, 23.1–36.6) and specificity was 81.6 % (95 %CI, 78.5–84.5). At wave 4, sensitivity was 26.0 % (95 %CI, 20.2–32.8) and specificity was 78.4 % (95 %CI, 74.7–81.8). The algorithm has high specificity and low sensitivity in predicting falls, with decreasing sensitivity over time. Therefore, regular reassessments should be made to identify individuals at risk of falling. [ABSTRACT FROM AUTHOR]