Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study.

BACKGROUND AND PURPOSE:Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia. METHODS:It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed. RESULTS:The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress. CONCLUSIONS:Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made

Multiple logistic regression analysis of respondents’ characteristics and anxiety.

<p>Multiple logistic regression analysis of respondents’ characteristics and anxiety.</p

Level and Determinants of Knowledge of Symptomatic Knee Osteoarthritis among Railway Workers in Malaysia

Background. Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention. Purpose. This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers. Methods. A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA. Results. Mean (±SD) age of the respondents was 41.4 (±10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores. Conclusion. The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care

Respondents’ characteristics by depression, anxiety and stress status.

<p>Respondents’ characteristics by depression, anxiety and stress status.</p

Multiple logistic regression analysis of respondents’ characteristics and stress.

<p>Multiple logistic regression analysis of respondents’ characteristics and stress.</p

Mental health status of the elderly respondents: scores of Dass-21 subscales.

<p>Mental health status of the elderly respondents: scores of Dass-21 subscales.</p

Eradication of <i>Helicobacter pylori</i> Infection Improves Levodopa Action, Clinical Symptoms and Quality of Life in Patients with Parkinson's Disease

<div><p>Background</p><p>Previous studies have demonstrated a higher prevalence of <i>Helicobacter pylori (H. pylori)</i> infection in patients with Parkinson's disease (PD) compared to controls. <i>H. pylori</i> infection affects levodopa absorption and its eradication significantly improves clinical response to levodopa. Here, we studied the prevalence of <i>H. pylori</i> infection and its eradication effects among our PD patients.</p><p>Methods</p><p>A prospective study involving idiopathic PD patients on levodopa therapy. ¹³C-urea breath test (UBT) was used to detect <i>H. pylori</i>. UBT-positive patients were given standard eradication therapy and followed up at 6 and 12 weeks in an open label single arm design. Repeat UBT was performed at 12 weeks. The UPDRS, PD NMQ, PD NMSS and PDQ-39 were administered at baseline and post-eradication (6 and 12 weeks). Levodopa ‘onset’ time and ON-duration were recorded.</p><p>Results</p><p>Of 82 patients recruited, 27 (32.9%) had positive UBT. <i>H. pylori</i>-positive patients had significantly poorer total UPDRS (p = 0.005) and PDQ39 (p<0.0001) scores compared to <i>H. pylori</i>-negative patients. At 12 weeks post-eradication, the mean levodopa onset time shortened by 14 minutes (p = 0.011). The mean ON duration time increased by 56 minutes at week 6 (p = 0.041) and 38 minutes at week 12 (p = 0.035). The total UPDRS scores (p<0.0001), scores for parts II (p = 0.001), III (p<0.0001) and IV (p = 0.009) were significantly better. The total PDQ-39 scores (p = 0.001) and subdomains mobility (p = 0.002), ADL (p = 0.001), emotional well being (p = 0.026) and stigma (p = 0.034) significantly improved. The PD NMSQ did not show significant improvement.</p><p>Conclusions</p><p><i>H. pylori</i> eradication improved levodopa onset time, ON duration, motor severity and quality of life parameters. Screening and eradication of <i>H. pylori</i> is inexpensive and should be recommended in PD patients, particularly those with erratic response to levodopa.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02112812" target="_blank">NCT02112812</a></p></div

Study Flow Chart.

<p>Study Flow Chart.</p

Clinical Effects at baseline and following <i>H. pylori</i> eradication therapy (n = 21).

<p>All analyses were performed using ANOVA.</p><p>Clinical Effects at baseline and following <i>H. pylori</i> eradication therapy (n = 21).</p