exudates and Cognition-Disorders

Depression, as one of the most disabling diseases around the world, had caught the global concern with its rising prevalence rate. There is a growing need of detecting depression, particularly in the old age population which is often left being overlooked.. We conducted a cross-sectional community-based study which included 150 Chinese elderly aged 60 and above within Klang Valley area. We obtained the sociodemographic profiles and assessed the status of well-being, depression, and cognitive function of the participants with the help of instruments: WHO Five-Item Well-Being Index, Major (ICD-10) Depression Inventory, and 6-Item Cognitive Impairment Test.. We found that the prevalence of depression among the Chinese elderly within Klang Valley region was 10.7%. With multiple logistic regression, decision to consult doctor on depressed mood or memory problem and presence of cognitive impairment were shown to be significantly associated with unipolar major depression, whereas wellbeing status was also found to be statistically correlated with depression in univariate analysis.. The prevalence of unipolar depression among Chinese elderly within Klang Valley, Malaysia presented that there was an increased trend compared to the previous studies.

Topics: Age Factors; Aged; Aged, 80 and over; Asian People; Cognition Disorders; Cross-Sectional Studies; Depressive Disorder; Female; Humans; Malaysia; Male; Memory Disorders; Middle Aged; Prevalence

It has long been postulated that the relative abundance of specific nutrients can affect cognitive processes and emotions. Newly described influences of dietary factors on neuronal function and synaptic plasticity have revealed some of the vital mechanisms that could be responsible for the action of diet on brain health and cognitive function. Here, through a double-blind, randomized, placebo-controlled trial, we asked if the newly discovered chicken meat ingredient-168 (CMI-168) could be beneficial to the cognitive function in healthy adults.. Normal, healthy subjects were supplemented with either placebo or CMI-168 for 6 weeks. The subjects were given a series of cognitive tests to examine their levels of cognitive functioning at the beginning and end of supplementation, as well as two weeks after termination of supplementation. The combination of these tests, namely Digit Span Backwards, Letter-Number Sequencing, and the Rey Auditory Verbal Learning Test (RAVLT), was used to assess the subjects' attention and working memory. For all comparisons, the probability level of p < 0.05 was taken as statistically significant using repeated measure 2-way ANOVA followed by Bonferroni post-hoc test.. Overall, subjects supplemented with CMI-168 showed significantly (p < 0.01) better performance in all cognitive tests after 6 weeks' supplementation compared to control and such superior performance was maintained even 2 weeks after termination of supplementation.. The present study reveals the cognition-enhancing properties of a recently developed chicken meat ingredient, likely arising from the promotion of attention and prefrontal cortex functions.

Topics: Adult; Animals; Attention; Chickens; Cognition; Cognition Disorders; Dietary Supplements; Double-Blind Method; Female; Humans; Hydrolysis; Malaysia; Male; Meat; Memory, Short-Term; Middle Aged; Nootropic Agents; Performance-Enhancing Substances; Pilot Projects; Tissue Extracts; Verbal Learning

Although diabetes through several possible mechanisms such as increased microvascular pathology and inefficiency of glucose utilization during cognitive tasks can be associated with cognitive impairment, there is inconclusive evidence that shows elderly diabetic patients under therapy have higher cognitive function compared to their non-diabetics counterparts. The present study was conducted to elucidate the association between diabetes and cognitive function in later life.. Data for this study, consisting of 2202 older adults aged 60 years and above, were taken from a population-based survey entitled "Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly. Data analysis was conducted using the IBM SPSS Version 23.0.. The mean of MMSE was found to be 22.67 (SD = 4.93). The overall prevalence of selfreported diabetes was found to be 23.6% (CI95%: 21.8% - 25.4%). The result of independent t-test showed diabetic subjects had a higher mean score of MMSE (M = 23.05, SD =4 .55) than their counterparts without diabetes (M = 22.55, SD = 5.04) (t = -2.13 p<.05). The results of multiple linear regression analysis showed that diabetes was not significantly associated with cognitive function, after controlling the possible confounding factors.. The findings from the current study revealed that diabetes is not associated with cognitive decline. This study supports the findings that long-term treatment of diabetes may reduce the risk of cognitive decline. This finding may provide new opportunities for the prevention and management of cognitive decline.

Topics: Aged; Aged, 80 and over; Aging; Cognition; Cognition Disorders; Comorbidity; Diabetes Mellitus, Type 2; Female; Humans; Independent Living; Linear Models; Malaysia; Male; Middle Aged; Multivariate Analysis; Neuropsychological Tests; Prevalence; Risk Assessment; Socioeconomic Factors; Surveys and Questionnaires

Motoric cognitive risk (MCR) syndrome is characterized by slow gait and memory complaints that could be used to predict an increased risk of dementia. This study aims to determine the MCR syndrome and its risk factors among low-income (B40) older adults in Malaysia.. Data from TUA cohort study involving 1366 older adults (aged 60 years and above) categorized as low-income were analysed, for risk of MCR syndrome based on defined criteria. Chi-square analysis and independent t test were employed to examine differences in socioeconomic, demographic, chronic diseases and lifestyle factors between MCR and non-MCR groups. Risk factors of MCR syndrome were determined using hierarchical logistic regression.. A total of 3.4% of participants fulfilled the criteria of MCR syndrome. Majority of them were female (74.5%, p = 0.001), single/widow/widower/divorced (55.3%, p = 0.002), living in rural area (72.3%, p = 0.011), older age (72.74 ± 7.08 year old, p <  0.001) and had lower years of education (3.26 ± 2.91 years, p = 0.001) than non-MCR group. After adjustment for age, gender and years of education, participants living in rural area (Adjusted OR = 2.19, 95% CI = 1.10-4.35, p = 0.026), with obesity (Adjusted OR = 3.82, 95% CI = 1.70-8.57, p = 0.001), diabetes (Adjusted OR = 2.04, 95% CI = 1.01-4.11, p = 0.046), heart disease (Adjusted OR = 2.50, 95% CI = 1.00-6.20, p = 0.049) and cancer (Adjusted OR = 6.57, 95% CI = 1.18-36.65, p = 0.032) were associated with increased risk of MCR syndrome.. Only 3.4% of older adults from low-income group were identified as having MCR syndrome. Women, those living in rural areas, had obesity, diabetes, heart disease and cancer were more likely to have MCR syndrome. Further investigation on MCR as a predementia syndrome will help in development of preventive strategies and interventions to reduce the growing burden of dementia, especially among individuals with low socioeconomic status.

Topics: Aged; Cognition Disorders; Cohort Studies; Dementia; Female; Humans; Malaysia; Male; Middle Aged; Poverty; Risk Factors; Syndrome

Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children.. A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference.. Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)].. Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

Topics: Body Mass Index; Child; Child Development; Child, Preschool; Cognition; Cognition Disorders; Female; Humans; Income; Intelligence Tests; Malaysia; Male; Nutrition Surveys; Nutritional Status; Obesity, Morbid; Parents; Poverty; Prevalence; Social Class; Surveys and Questionnaires

The link between psychosocial stress and cognitive function is complex, and previous studies have indicated that it may be mediated by processing speed. Therefore, the main aim of this study was to examine whether processing speed mediates the association between psychosocial stress and global cognition in older adults. Moreover, the moderating role of gender in this model is examined as well.. The study included 2322 community-dwelling older adults in Malaysia who were randomly selected through a multistage proportional cluster random sampling technique. Global cognition construct was measured by the Mini-Mental State Examination and Montreal Cognitive Assessment; psychosocial stress construct was measured by perceived stress, depression, loneliness, and neuroticism; and processing speed was assessed by the Digit Symbol Substitution Test. Structural equation modelling was used to analyze the mediation and moderation tests.. Processing speed was found to partially mediate the relationship between psychosocial stress and global cognition (β in the direct model = -0.15, P < 0.001; β in the full mediation model = -0.11, P < 0.001). Moreover, the relationship between psychosocial stress and global cognition was found to be significant in men only, whereas the association between processing speed and global cognition was significant in men and women.. Psychosocial stress may increase the likelihood that older adults will experience poor processing capacity, which could reduce their higher level cognition. Results indicate that there is a need to develop processing capacity intervention programmes for psychologically distressed older adults to prevent them from suffering cognitive decline.

Topics: Aged; Aged, 80 and over; Cognition; Cognition Disorders; Cognitive Dysfunction; Depression; Female; Humans; Independent Living; Loneliness; Malaysia; Male; Mental Processes; Stress, Psychological

A cross sectional study was conducted in a group of 317 subjects older than 60 in Malaysia, aimed to determine risk factors associated with cognitive impairment in older adults, focusing on trace elements and DNA damage.. Cognitive decline was determined by Montreal Cognitive Assessment (MoCA). Oxidative stress markers (malondialdehyde-MDA and superoxide dismutase-SOD) were determined and DNA damage was assayed using Alkaline Comet Assay. Toenail samples were taken and analyzed using ICP-MS to determine trace element levels.. A total of 62.1 % of subjects had cognitive impairment. Subjects with cognitive impairment had significantly higher levels of MDA and DNA damage as compared to the group with normal cognitive function; MDA (2.07 ± 0.05 nmol/L vs 1.85 ± 0.06 nmol/L) (p<0.05) and DNA damage (% Tail Density, 14.52 ± 0.32 vs 10.31 ± 0.42; Tail Moment, 1.79 ± 0.06 vs 1.28 ± 0.06) (p<0.05 for all parameters). However, the level of SOD among subjects with cognitive impairment (6.67 ± 0.33 u.e/min/mg protein) was lower than the level among those with normal cognitive functions (11.36 ± 0.65 u.e/min/mg protein) (p<0.05). Multiple logistic regression revealed the predictors for cognitive impairment among the subjects were DNA damage (Adjusted odd ratio [OR], 1.37; 95% confidence interval [CI], 1.18-1.59), level of trace elements in toenails namely, lead (OR, 2.471; CI, 1.535-3.980) and copper (OR, 1.275; CI, 1.047-1.552) (p<0.05).. High levels of lead and copper can lead to increase in oxidative stress levels and are associated with DNA damage that eventually could be associated with cognitive decline.

Topics: Aged; Biomarkers; Cognition; Cognition Disorders; Cognitive Dysfunction; Comet Assay; Copper; Cross-Sectional Studies; DNA Damage; Female; Humans; Lead; Logistic Models; Malaysia; Male; Malondialdehyde; Middle Aged; Nails; Odds Ratio; Oxidative Stress; Risk Factors; Superoxide Dismutase; Trace Elements

To compare the extent of persistent neuropsychological impairment in patients with complicated mild traumatic brain injury (mTBI) and those with uncomplicated mTBI.. Sixty-one patients with mTBI (Glasgow Coma Scale score 13-15) were recruited prospectively, categorized according to baseline computed tomography findings, and subjected to neuropsychological assessment at initial admission (n = 61) as well as at a 6-month follow-up (n = 30). The paired t test, Cohen's d effect size calculation, and repeated-measures analysis of variance were used to establish the differences between the 2 groups in terms of neuropsychological performance.. A trend toward poorer neuropsychological performance among the patients with complicated mTBI was observed during admission; however, performance in this group improved over time. In contrast, the uncomplicated mTBI group showed slower recovery, especially in tasks of memory, visuospatial processing, and executive functions, at follow-up.. Our findings suggest that despite the broad umbrella designation of mTBI, the current classification schemes of injury severity for mild neurotrauma should be revisited. They also raise questions about the clinical relevance of both traumatic focal lesions and the absence of visible traumatic lesions on brain imaging studies in patients with milder forms of head trauma.

Topics: Adult; Brain Concussion; Causality; Cognition Disorders; Comorbidity; Female; Humans; Incidence; Malaysia; Male; Nervous System Diseases; Risk Factors; Trauma Severity Indices; Treatment Outcome

A number of longitudinal studies on aging have been designed to determine the predictors of healthy longevity, including the neuroprotective factors, however, relatively few studies included a wide range of factors and highlighted the challenges faced during data collection. Thus, the longitudinal study on neuroprotective model for healthy longevity (LRGS TUA) has been designed to prospectively investigate the magnitude of cognitive decline and its risk factors through a comprehensive multidimensional assessment comprising of biophysical health, auditory and visual function, nutrition and dietary pattern and psychosocial aspects. At baseline, subjects were interviewed for their status on sociodemographic, health, neuropsychological test, psychosocial and dietary intake. Subjects were also measured for anthropometric and physical function and fitness. Biospecimens including blood, buccal swap, hair and toenail were collected, processed and stored. A subsample was assessed for sensory function, i.e., vision and auditory. During follow-up, at 18 and 36 months, most of the measurements, along with morbidity and mortality outcomes will be collected. The description of mild cognitive impairment, successful aging and usual aging process is presented here. A total 2322 respondents were recruited in the data analysis at baseline. Most of the respondents were categorized as experiencing usual aging (73 %), followed by successful aging (11 %) and mild cognitive impairment (16 %). The LRGS TUA study is the most comprehensive longitudinal study on aging in Malaysia, and will contribute to the understanding of the aging process and factors associated with healthy aging and mental well-being of a multiethnic population in Malaysia.

Topics: Aged; Aging; Cognition Disorders; Female; Geriatric Assessment; Humans; Longevity; Longitudinal Studies; Malaysia; Male; Neuroprotection; Neuropsychological Tests; Nutrition Assessment; Protective Factors; Psychomotor Performance; Risk Factors

The present study aimed to identify dietary patterns and determine the relationship between dietary patterns and cognitive ability among 12- to 13 year-old Malay adolescents in the urban areas of Gombak district in Selangor, Malaysia.. Data on sociodemographic background were obtained from parents. Height and weight were measured and BMI-for-age was determined. Adolescents were interviewed on their habitual dietary intakes using a semi-quantitative FFQ. Cognitive ability was assessed using the Wechsler Nonverbal Scale of Ability in a one-to-one manner. Dietary patterns were constructed using principal component analysis based on thirty-eight food groups of the semi-quantitative FFQ.. Urban secondary public schools in the district of Gombak in Selangor, Malaysia.. Malay adolescents aged 12 to 13 years (n 416).. The mean general cognitive ability score was 101·8 (sd 12·4). Four major dietary patterns were identified and labelled as 'refined-grain pattern', 'snack-food pattern', 'plant-based food pattern' and 'high-energy food pattern'. These dietary patterns explained 39·1 % of the variance in the habitual dietary intakes of the adolescents. The refined-grain pattern was negatively associated with processing speed, which is a construct of general cognitive ability. The high-energy food pattern was negatively associated with general cognitive ability, perceptual reasoning and processing speed. Monthly household income and parents' educational attainment were positively associated with all of the cognitive measures. In multivariate analysis, only the high-energy food pattern was found to contribute significantly towards general cognitive ability after controlling for socio-economic status.. Consumption of foods in the high-energy food pattern contributed towards general cognitive ability after controlling for socio-economic status. However, the contribution was small.

Topics: Adolescent; Adolescent Development; Adolescent Nutritional Physiological Phenomena; Body Mass Index; Child; Child Nutritional Physiological Phenomena; Cognition; Cognition Disorders; Diet; Energy Intake; Feeding Behavior; Female; Humans; Malaysia; Male; Nutrition Policy; Overweight; Patient Compliance; Pediatric Obesity; Prevalence; Principal Component Analysis; Urban Health

Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function.. Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010.. Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25).. Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias.

Topics: Aged; Aged, 80 and over; Cognition Disorders; Comorbidity; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Smoking

Many stroke research trials do not include assessment of cognitive function. A Very Early Rehabilitation Trial (AVERT) is an international multicenter study that includes the Montreal Cognitive Assessment (MoCA) as an outcome. At the Malaysian AVERT site, completion of the MoCA has been limited by low English proficiency in some participants. We aimed to develop a Bahasa Malaysia (BM) version of the MoCA and to validate it in a stroke population.. The original English version of the MoCA was translated into BM and then back-translated to ensure accuracy. Feasibility testing in a group of stroke patients prompted minor changes to the BM MoCA. In the validation phase, a larger group of bilingual stroke patients completed both the original English MoCA and the finalized BM MoCA, with presentation order counter-balanced.. Forty stroke patients participated, with a mean age of 57.2 (SD = 10.3). Agreement between BM MoCA and English MoCA was strong (intra-class correlation coefficient = 0.81, 95% CI 0.68-0.90). Scores on BM MoCA were slightly higher than scores on English MoCA (median absolute difference = 2.0, IQR 0-3.5), and this difference was present regardless of which version was completed first.. The existence of a validated BM version of the MoCA will be of major benefit to clinicians and researchers in Malaysia and the wider South-east Asian region, where the Malay language is used by over 200 million people.

Topics: Cognition; Cognition Disorders; Female; Humans; Intelligence Tests; Malaysia; Male; Mental Status Schedule; Middle Aged; Neuropsychological Tests; Reproducibility of Results; Stroke; Translations

None of the quantitative scales for public attitudes toward epilepsy had been translated to Malay language. This study aimed to translate and test the validity and reliability of a Malay version of the Public Attitudes Toward Epilepsy (PATE) scale.. The translation was performed according to standard principles and tested in 140 Malay-speaking adults aged more than 18 years for psychometric validation.. The items in each domain had similar standard deviations (equal item variance), ranging from 0.90 to 1.00 in the personal domain and from 0.87 to 1.23 in the general domain. The correlation between an item and its domain was 0.4 and above for all items and was higher than the correlation with the other domain. Multitrait analysis showed that the Malay PATE had a similar variance, floor and ceiling effects, and relative relationship between the domains as the original PATE. The Malay PATE scale showed a similar correlation with almost all demographic variables except age. Item means were generally clustered in the factor analysis as the hypothesized domains, except those for items 1 and 2. The Cronbach's α values were within acceptable range (0.757 and 0.716 for the general and personal domains, respectively).. The Malay PATE scale is a validated and reliable translated version for measuring public attitudes toward epilepsy.

Topics: Adult; Cognition Disorders; Epilepsy; Female; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Psychometrics; Public Opinion; Reproducibility of Results; Translating

Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.. A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.. Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.

Topics: Activities of Daily Living; Aged; Appetite; Cognition Disorders; Comorbidity; Cross-Sectional Studies; Depressive Disorder; Female; Geriatric Assessment; Health Status; Humans; Loneliness; Malaysia; Male; Malnutrition; Middle Aged; Nutrition Assessment; Nutritional Status; Risk Factors; Rural Health; Rural Population; Social Behavior; Surveys and Questionnaires

Cognitive impairment is a common psychiatric problem among the elderly. The objective of the study was to determine the prevalence of cognitive impairment among the elderly Malays living in a rural community in north Malaysia. A cross sectional study was conducted among the elderly population of 22 villages in north Malaysia. Elderly cognitive assessment questionnaire was used to determine the cognition status. Analysis was done using SPSS version 13. The prevalence of cognitive impairment among the older adults in these villages was 11% (n=46). There was an increasing prevalence of cognitive impairment with increasing age (p < 0.05). Being unmarried (OR 2.31), unemployed (OR 2.74) and living alone (OR 2.32) were significantly associated with the risk of being cognitively impairment. Being unemployed (OR 2.29) was a significant predictor variable for cognitive impairment. Similar to other studies conducted in Malaysia the prevalence of cognitive impairment was high.

Topics: Age Factors; Aged; Aged, 80 and over; Cognition Disorders; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Prevalence; Risk Factors; Rural Population; Surveys and Questionnaires

Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment.. A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale.. Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness.. Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.

Topics: Activities of Daily Living; Adult; Age of Onset; Aged; Aged, 80 and over; Antiparkinson Agents; Caregivers; Cognition Disorders; Cross-Sectional Studies; Educational Status; Ethnicity; Female; Follow-Up Studies; Humans; Levodopa; Malaysia; Male; Middle Aged; Neuropsychological Tests; Parkinson Disease; Risk Factors; Severity of Illness Index; Surveys and Questionnaires; Urban Population

The notion that dietary factors affect cognitive function and subsequently the risk of dementia has increased over the years from a global viewpoint. Because low folate intake has been described to impair cognitive function, we tested the hypothesis that low serum folate concentration is associated with cognitive impairment and an attenuated increase in DNA damage. We investigated the relationship between serum folate concentration, cognitive impairment, and DNA damage among elderly people attending health clinics in Klang Valley, an urban area in Malaysia. Two hundred thirty-two participants, composed of 115 men (49.6%) and 117 women (50.4%), were involved; none of the patients were diagnosed with neuropsychiatric problems, nor where they terminally ill. Sociodemography and health variables were assessed through face-to-face interview. Cognitive impairment review was conducted through an Elderly Cognitive Assessment Questionnaire. The estimation of dietary intake, serum folate concentration, and DNA damage was individually analyzed using validated Dietary History Questionnaires, immunoassay methods, and an Alkaline Comet Assay study (10 mL of peripheral venous blood), respectively. Results indicated that more men had cognitive impairment (33.0%) and DNA damage (27.0% for percentage DNA in tail, 22.6% tail moment) compared with women (25.6%, 15.4%, and 15.4%, respectively) (P < .05 for all parameters), recording an average folate deficiency value of 13.9% (0.2% higher than women). Multivariate binary logistic regression analysis outlined the association of cognitive impairment with older age (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.35-5.57), smoking habits (OR, 5.12; 95% CI, 2.48-10.57), poor serum folate concentration (OR, 3.46; 95% CI, 1.26-9.52), and DNA damage (percentage DNA in tail) (OR, 13.70; 95% CI, 1.36-138.29). In conclusion, this study highlighted the important role of serum folate concentration for cognitive function and provided a concise picture regarding the elevated levels of oxidative DNA damage in peripheral lymphocytes.

Topics: Age Factors; Aged; Avitaminosis; Cognition Disorders; Diet Surveys; DNA Damage; Folic Acid; Humans; Logistic Models; Lymphocytes; Malaysia; Male; Middle Aged; Prevalence; Sex Factors; Smoking

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Topics: Aged; Aged, 80 and over; Cognition Disorders; Cross-Sectional Studies; Depression; Female; Homes for the Aged; Humans; Malaysia; Male; Middle Aged; Prevalence

We sought to assess the validity of the physical and cognitive domains of Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale and its cross-cultural applicability across ethnic groups in an Asian population of community-living older adults.. Using data from a random population sample of noninstitutionalized Chinese, Malay, and Indian older adults 60 years old and older in Singapore (N = 1072), we modeled the dimensional structure of the 8-item IADL Scale using exploratory and confirmatory factor analyses, and assessed its convergent and divergent validity using known group differences and strengths of association.. Factor analyses yielded two strong and reliable factors representing underlying physical and cognitive dimensions of IADL. The validity of the model was supported by the pattern of associations of the IADL with age, gender, education, self-reported health status, hospitalization, physical comorbidities, dementia and depression, and Mini-Mental State Examination (MMSE) scores. Notably, cognitive IADL showed a greater total effect on MMSE cognitive performance score than did physical IADL, with the effect of physical IADL on MMSE score mostly explained by cognitive IADL. Reasonably good cross-cultural validity was demonstrated among Chinese, Malays, and Indians, with strongest validity for Indians.. The eight-item IADL Scale has physical and cognitive domains and is cross-culturally applicable. The cognitive IADL domain taps a set of activities directly related to cognitive functioning.

Topics: Activities of Daily Living; Aged; Chi-Square Distribution; China; Cognition Disorders; Cross-Cultural Comparison; Factor Analysis, Statistical; Female; Geriatric Assessment; Humans; India; Malaysia; Male; Singapore; Surveys and Questionnaires

To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.. Thirty-six paediatric patients who were referred for neurosurgical management for mild to severe head injuries were studied over a period of 2 years. No patients had orthopaedic or surgical trauma. Assessment of patients occurred at 3, 6 and 12 months, and patients were subjected to the Bender Gestalt Test, Weschler Intelligence Scale for Children--Revised and subtests from the Weschler Preschool and Primary Scale of Intelligence. None of the patients received professional rehabilitation due to a lack of facilities; only traditional treatment was given during this period.. There were no significant changes in any of the parameters, except for integration error, after a period of 1 year. Cognitive function improved in 30% of patients after 1 year of follow-up. Despite an increased relationship of the caregiver to the patient in the first year of trauma, there was no general improvement when compared to the Western literature.. A lack of modern resources in the community, a low general practitioner to patient ratio, and no inpatient or outpatient rehabilitation services do not lead to spontaneous improvement in the psychomotor condition of our patients despite good interfamily support. These are important findings for the future restructuring of the psychological service in Malaysia.

Topics: Age Factors; Analysis of Variance; Brain Injuries; Child; Cognition Disorders; Developing Countries; Female; Follow-Up Studies; Glasgow Coma Scale; Humans; Incidence; Injury Severity Score; Longitudinal Studies; Malaysia; Male; Multivariate Analysis; Neuropsychological Tests; Probability; Prospective Studies; Risk Assessment; Severity of Illness Index; Socioeconomic Factors; Time Factors; Treatment Outcome

Cognitive impairment is common in late life and may be due to the normal process of ageing or associated with physical or mental disorders. The aim of this study was to determine the prevalence of cognitive impairment among the elderly in a rural community setting. A cross sectional study design using stratified proportionate cluster sampling method was used in this study. A questionnaire similar to the Elderly Cognitive Assessment Questionnaire (ECAQ) was used as a screening instrument for cognitive impairment. The prevalence of cognitive impairment was 22.4% (50/223) among the elderly respondents. Cognitive impairment among the elderly was significantly associated with age, gender, ethnicity, marital status and level of education.

Topics: Aged; Aged, 80 and over; Chi-Square Distribution; Cognition Disorders; Female; Geriatric Assessment; Humans; Malaysia; Male; Middle Aged; Prevalence; Risk Factors; Rural Population; Surveys and Questionnaires

To compare the neurobehavioural outcome of children aged 6-12 years with severe closed head injury [sCHI] (coma > 24 h), mild-to-moderate head injury [mCHI] (coma < 6 h) and orthopaedic controls.. Twenty-nine children in each group, matched for age, sex and ethnicity, were assessed using the Glasgow outcome Scale (GOS), Weschler Intelligence Scale for Children (WISC-III), Movement Assessment Battery for Children (Movement ABC), Wide Range Assessment of Learning and Memory (WRAML) and a standardised neurological examination 6 months post-injury. Parental reporting of pre- and post-injury behaviour was documented using the Child Behaviour Checklist (CBCL).. Seven (24.1%) children with sCHI and three (10.3%) orthopaedic controls had residual motor deficits. Three (10.3%) children with sCHI and none in the other groups faced problems with independent ambulation. Twenty-seven (93.1%) of those with sCHI and all children in the other groups had GOS scores of good recovery or moderate disability. Twenty-two (81.5%) sCHI, five (18.5%) mCHI and one (3.7%) orthopaedic control reported a deterioration in school performance. MANOVAS identified a significant injury group effect for performance skills (P = 0.007), verbal skills (P = 0.002), memory and learning (P = 0.001) and motor skills (P = 0.001). Repeated measures ANOVA for pre- and post-injury CBCL scores showed significant differences related to somatic complaints (P = 0.004), problems of socialising (P = 0.003), delinquency (P = 0.004), aggressiveness (P = 0.010), thought (P < 0.001) and attention (P < 0.001). Post-hoc univariate analysis showed the significant differences were between that of the sCHI children and the other two groups.. Although most sCHI children seemed to have made good physical recovery, there were cognitive, motor, memory and learning difficulties and behavioural problems concomitant with a deterioration in school performance compared with those with lesser or no head injury. This highlights the need for better integrated rehabilitation services to enable a gradual return into mainstream school.

Topics: Achievement; Analysis of Variance; Case-Control Studies; Chi-Square Distribution; Child; Child Behavior Disorders; Child, Hospitalized; Cognition Disorders; Cost of Illness; Female; Glasgow Coma Scale; Head Injuries, Closed; Humans; Malaysia; Male; Movement Disorders; Neuropsychological Tests; Perceptual Disorders; Prospective Studies; Psychomotor Disorders; Treatment Outcome