Reduced muscle strength and quality of life (QoL) has an impact on adults at risk of osteoporotic fractures. Muscle strength and QoL among Malaysian adults at risk of osteoporotic fractures is not known. The aim of our study was to examine muscle strength and QoL status and its relationship among adults at low and moderate to high risk of osteoporotic fractures. In this cross-sectional study, we recruited 27 men and 78 women with mean age 69.3 ± 8.5 years from Orthopaedic Clinic, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia. A 10-year probability of major osteoporotic fractures were calculated according to WHO fracture risk assessment tool (FRAX) with femoral neck BMD (cut-point 10%). Participants were categorized as low and moderate to high risk of osteoporotic fractures based on FRAX results. Back extensor muscle strength (BES) and dominant hand grip strength (HGS) was measured using a load cell system and a hand dynamometer respectively. European QoL questionnaire (EQ5Dvas) was used to measure QoL. Multiple linear regression was performed with QoL as a dependent variable and back extensor muscle strength and hand grip strength as the independent variables. Approximate 40% of adults were categorized into moderate to high risk of osteoporotic fractures. The mean values among the low and moderate to high risk of osteoporotic fractures for QoL was 80.5 ± 13.2 and 76.9 ± 16.9 (p = 0.77); hand grip strength was 25.7 ± 17.3 and 20.6 ± 5.5 kg (p < 0.001) and back extensor strength was 25.0 ± 7.0 and 18.9 ± 9.5 Newton (p < 0.01) respectively. Hand grip muscle strength appeared to be a determinant of QoL and accounted for 5.8% of the total variance. Improved muscle strength may lead in better QoL among adults at risk of osteoporotic fractures.

Optimum physical health is important in maintaining independence among older adults. There is limited information regarding physical health status among older adults attending primary care clinics in the local population. The aim of this study was to examine physical health among older adults attending Primary Care Clinic at Cheras, Malaysia. A cross-sectional study was conducted at Primary Care Clinic at Cheras, Malaysia with a total 106 participants (mean age of 68 ± 6.3 years). Participants performed a battery of physical function tests. The results showed that the percentages of participants who performed below recommended norms for the 30secs Chair Stand Test (lower limb strength), Chair Sit and Reach Test (lower limb flexibility), Back Scratch Test (upper limb flexibility), Timed Up and Go (TUG) (functional mobility), Single Leg Stance Test (balance) and 2 mins Walk Test (2MWT) (aerobic endurance) were 32%, 18%, 21%, 29%, 22% and 78% respectively. The results suggest that the majority of older adults visiting primary health care clinics had inadequate physical function in relation to aerobic endurance. Older adults attending primary health care clinics should be encouraged to improve their physical health status, especially aerobic endurance, to optimise their physical independence.

Falls is a global health issue among older adults. Identifying measuring tools that can predict falls risk among older adults can assist in early falls risk detection and prevention. Best measuring tools that can predict falls risk among Malaysian community dwelling older adults is not known. The objective of our study was to determine if Timed Up and Go (TUG) test and Activities-Specific Balance Confidence (ABC) scale could be used as a falls risk predictor tools among Malaysian community dwelling older adults. Hundred and six (n = 106) community dwelling older adults who were attending Klinik Kesihatan Cheras participated in this cross sectional study. Falls incidence in the past one year was obtained from the participants. TUG test was performed and ABC scale was administered. Data was analysed using binomial logistic regression and receiver operating curves (ROC). The cut off values identified for TUG test and ABC scale were 9.02 seconds (area under the curve, AUC was 0.711; 95% CI 0.577-0.844) and 82.81% (area under the curve, AUC was 0.682; 95% CI 0.562-0.802) respectively. Hence, older adults with a score of above 9.02 seconds for TUG test and a score of below 82.81% for ABC scale were noted to have a higher risk of falls. Results of this study demonstrated that both TUG test (p < 0.001) and ABC scale (p < 0.01) were significant predictors of falls risk. Our study results indicated that both mobility (TUG test) and fear of falls (ABC scale) measuring tools, with the present cut off values can be used to identify community dwelling older adults who are at a higher risk of falls. Identifying older adults with higher risk of falls can assist the health professionals to optimise falls prevention and management approaches.

Knee osteoarthritis (KOA) is a major cause of disability and significantly reduce quality of life (QOL). There is limited information about knee associated problems and functional mobility among Malaysian adults with KOA. The aim of our study was to examine knee associated problems and functional mobility among this population. Forty-five (45) adults with KOA with mean age of 65.02 ± 8.083 were recruited from Hospital Canselor Tuanku Muhriz, UKM. Knee associated problems and functional mobility were measured using Knee injury and Osteoarthritis Outcome Scores (KOOS) and Timed-Up and Go (TUG) test respectively. The mean score and standard deviation for TUG test was 11.44 ± 2.69. Median scores (with interquartile ranges [IQR]) for the KOOS subscale domains were; Symptoms: 80.56, (69.44 to 91.67); Pain: 71.43 (50 to 78.57); Functional Activities of Daily Living: 82.3 (67.65 to 86.76); Sports and Recreation Function: 30 (20 to 60); and Knee-Related Quality of Life: 50 (25 to 75). Generally, participants’ TUG test performance showed that time taken to complete the test was higher than the reference values (7.14 to 8.43 seconds) identified among Malaysian community dwelling older adults with low to high risk of falls. The KOOS scores in adults with KOA in our study is similar to previous reports with Sport and Recreation Function and QOL domains been the most affected. It is important to improve functional mobility and balance in order to decrease falls risk and optimise sport and recreation function and QOL among adults with KOA.

Ageing is associated with changes in body balance mechanism. The gold standard assessment for body balance is posturography. However, because of the high cost constraints, not many health centers are equipped with the equipment. Nintendo Wii balance board (WBB) has been reported as a potential tool to be used to assess body balance and sway. Also, because WBB is more economical and portable, it has greater potential to be used in primary health centers and community settings. The objective of this study was to compare balance measures using BRU™ and WBB among young and older healthy adults during quiet standing. Thirty three young (26.9±5.6 years) and 33 older adults (65.6±4.4 years) were randomly tested on both equipments. Subjects performed 30sec trial for each of the four testing conditions: quiet standing on a firm or compliant surface (foam) with eyes-open and closed. The results showed significant differences in balance measurements between all four testing conditions and age groups using both equipments.This study also found significant positive correlations between the COPand sway velocity, SV (of the BRU™) and COB (of the WBB) in all test conditions. These results indicated that WBB coupled with its commercially available software could potentially be used as a screening tool for balance assessment in primary health centres.
Wii balance board (WBB), Balance Rehabilitation Unit (BRU&trade ; ), centre of pressure (COP), centre of base (COB), sway velocity (SV)

Falls in older adults is a major health issue globally. Falls prevalence reports vary based on the study settings. The importance of a fast, easy self-assessment tool to identify falls risk has been emphasised in numerous studies. The aim of our study was to pool information on the prevalence of falls and its risk assessment tools based on a scoping review. This information will be beneficial to inform current falls prevalence and to decide on the best falls risk assessment tool to be used among Malaysian community-dwelling older adults. Articles referred were based on the following electronic databases (MEDLINE Complete, CINAHL, Rehabilitation & Sports Medicine Source and SPORTDiscus) via EBSCOHOST, Science Direct, PubMed, Cochrane Library, Embase® and Google Scholar. Twelve studies were identified to meet the inclusion and exclusion criteria. Our review findings showed that current falls prevalence (between 4.2% and 61%) among Malaysian community dwelling older adults was consistent with the findings in Asia. Falls risk assessment tools used were similar to the ones used in other countries, taking the multiple falls risk factors in consideration.

n this review weaimed to determine the prevalence of urinary incontinence (UI)and its association with declined cognitive and physical function among community dwelling older adults. Literature review was performed using multiple online databases includingMEDLINE, Science Direct andWiley Online Library from June 2000 to April 2017. Hand searching ofbibliographies of relevant studies was also carried out. The studies included ofthose conducted from within the last 17years; assessed and compared according to population characteristics, definition of urinary incontinence, prevalence and its association with cognitive and physical functionaldecline. Nine studies met the eligibility criteria of this review. Prevalence rates of UI among community dwelling older adults ranged from10% to 53% (median 32%).Physical functionaldecline in termsof mobility, locomotion and activities of daily living interruptions werefound to be correlated with UI. Although limited, the existing evidence also showed an association between declined cognitive function and UI.

To compare the ability of methods based on skeletal muscle index (SMI) and another one by the European Working Group on Sarcopenia in Older People (EWGSOP) based on both muscle mass and physical function in identifying older adults with sarcopenia. Anthropometric measurements and physical performance (hand grip strength and gait speed) were performed. In order to determine the value of SMI, body impedance analysis was also carried out. A total of 426 older adults, mostly women (60.8%) with mean age of 68.4 ± 6.2 years participated in this study. Methods based on SMI and EWGSOP identified 50.5% and 32.2% older adults as sarcopenic respectively. Method based on SMI showed a significantly higher percentage of men (70.7%) were sarcopenic as compared to women (37.5%) (p < 0.05). No such difference was noted for EWGSOP method, with 28.7% of men were sarcopenic as compared to women (34.4%). Binary logistic regression indicated that aged 75 years and above (adjusted odds ratio: 3.3, 95% confidence interval: 1.9 – 5.6) and having arthritis (adjusted odds ratio: 2.5, confidence interval: 1.3 – 4.7) to be associated with sarcopenia as assessed using method recommended by EWGSOP. The lower prevalence of sarcopenia by EWGSOP as compared to SMI may be due to the more comprehensive method by EWGSOP. Further research regarding validation of these two screening methods against a gold standard of screening for sarcopenia is needed in order to identify the best method..

Negative attitudes towards ageing are reported to be associated with greater functional impairment in older adults.There is limited information regarding attitudes towards ageing and physical performance in regard to adults aged 55 to 64 years. The objective of our study was to examine the association of attitude towards ageing on physical performance which includes mobility, agility and falls risk. This cross sectional study was conducted at five senior citizen clubs around Klang Valley in Malaysia. A total of 154 community dwelling adults aged 55 and above (mean:65.8+6.82) participated in this study. Attitude towards ageing was measured using Kogan’s Attitude towards Older People Questionnaire (KAOP). Mobility and agility were measured using gait speed test and ten step test respectively. Risk of falls was assessed using physiological profile aproach (PPA). Approximately 75% of the participants had positive attitude towards ageing with high to very high risk of falls. A significant (p<0.05) correlation was demonstrated between attitude towards ageing, falls risk and gait speed.Regression analysis showed that attitudes toward ageing had a relationship with falls risk, explaining 6% of the variance, F (1, 152) =10.26, p<0.01.The results of this study suggest that there is some relationship between attitude towards ageing and falls risk measured using a combination of physical performance test. Positive attitude towards ageing should be promoted among adults in an earlier age for overall physical health among older adults.
attitudes towards ageing ; gait speed ; agility ; falls risk ; older adults

Physical Activity Scale for the Elderly (PASE) is a simple, valid and reliable questionnaire that can be administered to quantify older adults’ physical activity levels during daily living. However, PASE in Malay language for use among older population is not available. The objective of our current study was to evaluate the reliability and validity of the Malay translated Physical Activity Scale for Elderly (PASE-M) for the use among older adults. Objective results of physical activity were obtained by wearing continuously an accelerometer for one week among a population of older adults in Malaysia who speak Malay language. Participants completed PASE-M twice, on day-8 (PASE-M1) and day-15 (PASE-M2). Concurrent validity between PASE-M1 and accelerometer results was assessed using Spearman’s rank correlation coefficient. Test-retest reliability for one week interval of PASE-M was tested using Spearman’s rank correlation coefficient and Intra-class correlation coefficients (ICC). Forty-four community-dwelling older adults (12 men and 32 women; mean age ± SD= 66.95 ± 5.34) participated in this study. However, only 33 participants (8 men and 25 women; mean age ± SD= 66.64 ± 5.51) were able to achieve the minimum accelerometer wearing time and filled up the PASE-M questionnaire for two times with one weeks interval. The results showed the PASE-M score was significantly correlated with vector magnitude (VM) counts (r=0.54, p<0.01), time in moderate-to-vigorous physical activity (MVPA) (r =0.55, p<0.01), energy expenditure (r =0.53, p<0.01) and walking steps (r=0.39, p<0.05). A high reliability (ICC = 0.96) was demonstrated between first and the subsequent administration of PASE-M (p<0.01, 95% CI: 0.92-0.98). The PASE-M is a valid and reliable questionnaire to assess physical activity level for Malaysian community-dwelling older adults.
older adults, physical activity, questionnaire, accelerometer, validity, reliability