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Shamsul Azhar Shah,1 Nazarudin Safian,1 Saharuddin Ahmad,2 Siti Rohani Nurumal,1 Zulkefley Mohammad,1 Juliana Mansor,1 Wan Abdul Hannan Wan Ibadullah,1 Yugo Shobugawa,3 Megumi Rosenberg4 1Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; 2Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; 3Department of Active Aging, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4Centre for Health Development, World Health Organization, Kobe, JapanCorrespondence: Shamsul Azhar ShahDepartment of Community Health, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, 56000, MalaysiaTel +60 3-9145 8787Fax +60 3-91456670Email drsham@ppukm.ukm.edu.myPurpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia.Patients and Methods: This cross-sectional study used data collected during 2018– 2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs.Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life.Conclusion: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people’s knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.Keywords: healthcare needs, old age, Malaysia

Background Globally, and particularly in countries with rapidly ageing populations like Japan, there are growing concerns over the heavy burden of ill health borne by older people, and the capacity of the health system to ensure their access to quality care. Older people with dementia may face even greater barriers to appropriate care in acute care settings. Yet, studies about the care quality for older patients with dementia in acute care settings are still few. The objective of this study is to assess whether dementia status is associated with poorer treatment by examining the association of a patient’s dementia status with the probability of receiving surgery and the waiting time until surgery for a hip fracture in acute care hospitals in Japan. Methods All patients with closed hip fracture were extracted from the Diagnosis Procedure Combination (DPC) database between April 2014 and March 2018. After excluding complicated cases, we conducted regressions with multilevel models. We used two outcome measures: (i) whether the patient received a surgery or was treated by watchful waiting; and (ii) number of waiting days until surgery after admission. Results Two hundred fourteen thousand six hundred one patients discharged from 1328 hospitals were identified. Among them, 159,173 patients received surgery. Both 80–89 year-olds (OR 0.87; 95% CI, 0.84, 0.90) and those 90 years old and above (OR 0.67; 95% CI, 0.65, 0.70) had significantly lower odds ratios for receiving surgery compared to 65–79 year-olds. Those with severe dementia had a significantly greater likelihood of receiving surgery compared to those without dementia (OR 1.21; 95% CI, 1.16, 1.25). Patients aged 90 years old and above had shorter waiting time for surgery (Coef. -0.06; 95% CI, − 0.11, − 0.01). Mild dementia did not have a statistically significant impact on the number of waiting days until surgery (P = 0.34), whereas severe dementia was associated with shorter waiting days (Coef. -0.08; 95% CI, − 0.12, − 0.03). Conclusions These findings suggest physicians may be taking proactive measures to preserve physical function for those with severe dementia and to avoid prolonged hospitalization although there are no formal guidelines on prioritization for the aged and dementia patients.

Shah SA, Safian N, Ahmad S, et al. J Multidiscip Healthc. 2021;14:2931–2940. The authors have advised there was misuse of the word “elderly” in the title and some sentences within the main text. Additionally, the Ethics Approval and Funding sections have also been updated. The paper title should read from “Unmet Healthcare Needs Among Elderly Malaysians” to “Unmet Healthcare Needs Among Older Malaysians”. On page 2935, second paragraph from the right column, the first sentence should read from “This study found that overweight and obese elderly more likely to have unmet healthcare needs than the non-obese elderly.” to “This study found that overweight and obese older people are more likely to have unmet healthcare needs than the non-obese older people.” On page 2935, second paragraph from the right column, the last sentence should read from “Regardless, cautious interpretation of BMI in the elderly is necessary because lean body mass, fat mass, or fluid retention are not determinants of BMI,22,26 and aging is associated with progressive loss of muscle strength, mass, and increased fat mass.19,27” to “Regardless, cautious interpretation of BMI in older people is necessary because lean body mass, fat mass, or fluid retention are not determinants of BMI,22,26 and aging is associated with progressive loss of muscle strength, mass, and increased fat mass.19,27” On page 2937, last sentence on the left column should read from “The inability of the elderly to travel alone therefore needs attention in collaboration with the community or nearby nongovernmental agencies to provide these older people with transportation assistance to reach nearby health facilities.” to “The inability of older people to travel alone therefore needs attention in collaboration with the community or nearby nongovernmental agencies to provide these older people with transportation assistance to reach nearby health facilities.” On page 2938, in the Ethics Approval section, the last sentence should read from “This research was approved by the Research Ethics Committee of the National University of Malaysia (FF-2018-532;14 September 2018).” to “This research was approved by the Research Ethics Committee of the National University of Malaysia (FF-2018-532;14 September 2018) and the Research Ethics Review Committee of the World Health Organization (ERC.0003072; 17 September 2018).” On page 2939, in the Funding section, it should read from “This research was funded by the World Health Organization Centre for Health Development (WHO Kobe Centre-WKC) grant number 2018/863819-1. The funder had no role in the study’s design; in the data collection; analyses, or interpretation data; in the writing of the manuscript; or in the decision to publish the results.” to “This research was funded by the World Health Organization Centre for Health Development (WHO Kobe Centre-WKC:K18015). The funder had a role in the study’s design and in the decision to publish the results; it had no role in the data collection, analyses, or interpretation of data, nor in the writing of the manuscript. The views and opinions expressed in the document are solely the responsibility of the authors and do not necessarily represent the official views or positions of the World Health Organization.” The authors apologize for these errors. Read the original article

Frailty is a common clinical syndrome in older adults associated with an increased risk for poor health outcomes including disability, hospitalisation and mortality.[1][1] The global burden of frailty is increasing with the worldwide trend of population ageing.[2][2] Based on a recent meta-analysis

Global population aging is the result of successes in public health, enabling longer life expectancy in many countries. The Asia Pacific region is aging more rapidly than many other parts of the world. The implications will be profound for every sector of society, requiring policy makers to reframe their thinking about the design of health and social systems to enable older populations to thrive. With increasing demand for more and different kinds of services, an imperative is shifting resources toward primary care for the prevention and comprehensive care of people with chronic conditions, and establishing linkages with community support. Major innovations are underway that accelerate progress in attaining universal health coverage for older populations. The renewed commitments under the Sustainable Development Goals to achieve universal health coverage offer a unique opportunity to invest in the foundations of the health system of the future.