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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]

Resilience increases the ability of an individual to overcome adversity. It has not yet been determined how resilience is linked to quality of life among individuals experiencing knee osteoarthritis symptoms. To explore the inter-relationships of psychological distress, resilience and quality of life among older individuals with knee osteoarthritis. The study examined older adults in Kuala Lumpur and Selangor, identifying osteoarthritis through verified physician diagnosis. Various factors, including resilience, psychological status, and quality of life, were measured. In the study with 338 older adults, 50.9% had knee osteoarthritis. Higher resilience was linked to lower depression, anxiety, and stress, and better quality of life in both groups with and without knee osteoarthritis. Psychological factors consistently mediated the link between resilience and quality of life even after controlling potential confounders. Analysis showed that depression, anxiety, and stress mediate the relationship between resilience and quality of life, indicating a significant influence even when considering various factors. Resilience appears to influence psychological well-being and quality of life among older adult with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the community. Methods: A comprehensive literature search was conducted in nine databases (PubMed, MEDLINE, CINAHL, Embase, Emcare, Web of Science (WOS), Scopus, PsycINFO and Cochrane Library. The search was undertaken between March 15 and 31, 2022 with subsequent updates performed on October 15, 2023 and April 10, 2024. This review also included grey literature sourced via Google, Google Scholar and backward citation searches. Results: Out of 5,621 records, 20 articles were found to meet the inclusion criteria with a total of 8,035 participants involved and the mean age ranged from 74.0 to 84.4 years. Using McMaster Critical Review Form for Quantitative Studies, we ascertained that the studies included in our analysis had moderate to high levels of quality. In addition to health-related outcomes, PHV interventions were also conducted to evaluate psychological effects (16 studies) and social outcomes (seven studies). Five studies conducted financial assessment to evaluate the costs of health and social care utilisation during PHV interventions. Regarding the results of the review, seven studies showed favourable outcomes, five indicated no effect and eight had equivocal findings. Only one study assessed resilience and determined that PHV had no effect on the resilience of the subjects. Conclusion: This review found that the effectiveness of PHV interventions was uncertain and inconclusive. PHV interventions often prioritise health-related objectives. The incorporation of a holistic approach involving psychosocial health into PHV interventions is relatively uncommon. Due to the paucity of research on resilience as PHV outcome, we are unable to draw a conclusion on the effectiveness of PHV on resilience. Resilience should be prioritised as a psychological assessment in the future development of comprehensive PHV interventions, as it enables older adults to adapt, manage, and respond positively to adversities that may arise with age. Performing financial analysis such as costs and benefits analysis to incorporate the return on investment of PHV interventions is an added value for future research on this topic. Clinical trial registration: PROSPERO registration number: CRD42022296919. [ABSTRACT FROM AUTHOR]

Educational videos and other multimedia materials are frequently employed to enhance clinical undergraduate learning. The acceptability and use of a fall prevention training videos by Malaysian clinical students are examined in this study. The use of multimedia in the classroom offers numerous advantages, but it is important to understand the needs, preferences, and feedback of the students regarding its usefulness and efficacy. Therefore, the objective of this study is to evaluate the acceptability and usability of the fall prevention instructional videos among clinical undergraduates in Malaysia through quantitative and qualitative study methods. This study looks at the acceptability and usage of fall prevention videos among clinical undergraduates in Malaysia. A quantitative and qualitative study of 53 clinical undergraduate students in Malaysia was conducted. The System Usability Scale (SUS) was adapted for our study to incorporate two open-ended questions regarding educational video continuity and practicality, feedback sections, and closed-ended questions addressing video flaws. The educational video on fall prevention has an excellent usability score of 73.26 ± 13.32. Most of the feedback suggested trimming the videos because 15 participants (28 %) felt it was too long. Many participants said that the educational videos were essential for practical sessions and future learning. The consensus was that educational videos should be kept up to date for future learning and usefulness, but more improvements are required to make the learning process better for the students. [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]

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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]

Several cardiometabolic factors such as diabetes, hypertension and dyslipidemia which are prevalent in older adults with increased body mass index (BMI) may play an important role in sarcopenia development.[[2], [7]] Excess fat mass interrupts the blood glucose pathway and triggers insulin resistance which may then further enhance the development of sarcopenia. Hospitalization rates over 5 years among individuals with BMI >= 30 kg/m SP 2 sp compared to those with normal BMI following adjustments in Model 2 and remained significant with slight attenuation after differences in diabetes status were accounted for [RR (95%CI): 1.90 (1.11-3.28), Model 3]. The direct effect of BMI categories on the risk of all outcomes (Y1, Y2, Y3) was significant for BMI >= 30 kg/m SP 2 sp but not BMI < 18.5 or BMI: 25-29.9 kg/m SP 2 sp compared to those the BMI: 18.5-25 kg/m SP 2 sp group, suggesting the potential mediating role of FBG (Figure 2A-C). [Extracted from the article]

BACKGROUND Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over. METHODS Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment. RESULTS Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62–3.24)] and [OR (95% CI) = 1.80 (1.32–2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03–1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18–0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34–0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34–0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57–1.17)], compared to normal aging with similar adjustments. CONCLUSION Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline. [ABSTRACT FROM AUTHOR]