Author Reply : The relationship between alcohol intake and falls

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Could obesity be linked to falls in older adults?

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Ethnic-specific Sociodemographic Factors as Determinants of Cognitive Performance : Cross-sectional Analysis of the Malaysian Elders Longitudinal Research (MELoR) Study Article

Acknowledgement We are grateful to Prof Dr Chin Ai Vyrn and Prof Dr Shahrul Bahyah Kamaruzzaman from Faculty of Medicine, University of Malaya for their help in MELoR study. We also thank members of the Ageing and Age-Associated Disorders Research Group for helping with patient recruitment and data collectionPeer reviewedPostprin

Informing policy makers in developing countries: practices and limitations of geriatric home medication review in Malaysia-a qualitative inquiry

Objective: To explore existing practices and challenges in the delivery of geriatric home medication review (HMR). The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR. Methods: This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals. The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR. Results: Based on the emerging themes from the qualitative data, the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits, encompassing a diverse patient population with various healthcare needs. However, it faces challenges such as the lack of outcome monitoring, formal training, and workforce constraints. Despite these hurdles, there is a pressing need for the expansion of this service to better serve the community, and collaboration with community pharmacists holds potential to broaden its scope. Ultimately, the findings suggest that pharmacistled HMR is both warranted and feasible within the Malaysian healthcare context. In order to optimize medicine-use among older people living in the community, approaches for expanding geriatric HMR services in Malaysia must be developed. Conclusions: This study holds profound implications as it attempts to illuminate policy makers in developing countries, enabling them to formulate effective HMR plans. By considering the challenges highlighted within this research, policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population

Blood pressure variability and cognitive function : A scoping review

Acknowledgements The Malaysian Elders Longitudinal Research (MELoR) study is now part of the Transforming Cognitive Frailty into Later Life Self-Sufficiency (AGELESS) longitudinal cohort study, currently funded by the Ministry of Higher Education Long Term Research Grant Scheme (LRGS/1/2019/UM/01/1). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.Peer reviewedPostprin

The experience of Malaysian occupational therapists in conducting home assessments and home visits with older clients

Introduction: Home visits are complex processes for clients and occupational therapists. Despite the benefits of home visits, the numbers of home visits being conducted are decreasing in international settings due to service constraints or client reluctance. Published international studies may not be applicable to Malaysia due to cultural and geo-demographic differences relating to the home context. This study aimed to explore the experience of occupational therapists in Malaysia in conducting home visits. Materials and Methods: A focus group discussion was conducted with seven occupational therapists in one teaching hospital in Kuala Lumpur. The group session was audio-recorded, transcribed, summarised and analysed using thematic analysis. Results: Themes developed were: i) client factors inhibiting effective service provision, ii) uninformed policies and guidelines, and iii) professional identity and growth. Conclusions: Our study has revealed major challenges for Malaysian occupational therapists with regards to conducting home visits. Future studies should now evaluate factors underlying reluctance to participate in home visits and effective strategies to overcome these difficulties

Orientation and verbal fluency in the English Longitudinal Study of Ageing: modifiable risk factors for falls?

Objectives:To determine the relationship between falls and deficits in specific cognitive domains in older adults.Design:An analysis of the English Longitudinal Study of Ageing (ELSA) cohort.Setting:United Kingdom community-based.Participants:5197 community-dwelling older adults recruited to a prospective longitudinal cohort study.Measurements:Data on the occurrence of falls and number of falls, which occurred during a 12-month follow-up period, were assessed against the specific cognitive domains of memory, numeracy skills, and executive function. Binomial logistic regression was performed to evaluate the association between each cognitive domain and the dichotomous outcome of falls in the preceding 12 months using unadjusted and adjusted models.Results:Of the 5197 participants included in the analysis, 1308 (25%) reported a fall in the preceding 12 months. There was no significant association between the occurrence of a fall and specific forms of cognitive dysfunction after adjusting for self-reported hearing, self-reported eyesight, and functional performance. After adjustment, only orientation (odds ratio [OR]: 0.80; 95% confidence intervals [CI]: 0.65-0.98, p = 0.03) and verbal fluency (adjusted OR: 0.98; 95% CI: 0.96-1.00; p = 0.05) remained significant for predicting recurrent falls.Conclusions:The cognitive phenotype rather than cognitive impairment per se may predict future falls in those presenting with more than one fall

The Relationship between Alcohol Intake and Falls Hospitalization : Results from the EPIC-Norfolk

Acknowledgements The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) hasreceived funding from the Medical Research Council (MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK(C864/A14136). We are grateful to all the participants who have been part of the project and to the many members of the study teams at the University of Cambridge who have enabled this researchPeer reviewedPostprin

Increased beat-to-beat blood pressure variability is associated with impaired cognitive function

ACKNOWLEDGEMENTS We are grateful to Prof Dr Chin Ai Vyrn and Prof Dr Shahrul Bahyah Kamaruzzaman from Faculty of Medicine, University of Malaya for their help in MELoR study. Ageing and Age Associated Disorders Research Group for helping with patient recruitment and data collection. SOURCE OF FUNDING The Malaysian Elders Longitudinal Research (MELoR) study is now part of the Transforming Cognitive Frailty into Later Life Self-Sufficiency (AGELESS) longitudinal cohort study, currently funded by the Ministry of Higher Education Long Term Research Grant Scheme (LRGS/1/2019/UM/01/1).Peer reviewedPostprin

The Dementia Health Literacy Intervention For Informal Caregivers: A Systematic Review Protocol

This review will systematically examine the effectiveness of educational interventions on dementia health literacy (DHL) among informal caregivers (ICs) in 42 Asia Pacific countries/territories. Methods: A systematic literature search will be performed in nine databases. No date nor language restriction will be applied. The quality of studies will be assessed using existing appraisal tools (i.e. Joanna Briggs Institute’s Checklists) and an inductive narrative synthesis technique will be used to analyse the extracted data. Randomized Controlled Trial (RCT) and non-RCT interventions will be full-reviewed but only RCT studies will be pooled in a meta-analysis. Heterogeneity, publication bias, and sensitivity will also be assessed. Results: The results will be reported following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement. The standardized procedure and reporting will ensure the review’s quality and could be used by the stakeholders in the region for planning DHL-related programs and significantly contribute to dementia caregiving and caregiver literature and programs. Conclusion: This protocol of the planned systematic review and meta-analysis of the effectiveness of educational interventions on DHL for ICs in the Asia Pacific countries/territories will set the foundation for its further progress.   Keywords: Aging, Alzheimer’s, Caregiving, Gerontology, Global Sout