Background: While adiposity has been found to be protective against adverse outcomes in older adults, the role of muscle in this association remains underexplored. This study sought to evaluate sex-specific mortality associated with available adiposity indices in older adults and the potential role of muscle strength in this relationship. Methods: Individuals aged ≥55 years were recruited from 2013 to 2015. Adiposity indices obtained were body mass index (BMI), percentage body fat (%BF), waist-to-hip ratio (WHR), and waist circumference (WC). Vital status up to June 2022 was determined through the National Registry Department. Results: Of the 1,347 included participants, mean age of 68.45±7.21 years, 57.1% female, and 11.2% deaths were recorded. Male who were underweight had increased mortality compared to male with normal BMI (hazard ratio [HR]=3.17, 95% confidence interval [CI] 1.35–7.47). Mortality was greater in male with %BF within the highest quartile (Q4) compared to the lowest quartile (Q1) (HR=4.72, 95% CI 2.07–10.78). Increased mortality in both male and female in Q4 for WHR compared to Q1 was influenced by age, as was increased mortality in female in Q4 for %BF. WC did not predict mortality in male or female. Increased mortality risk was present in male with normal muscle strength and increased %BF, and reduced muscle strength in male with low BMI. Conclusions Adiposity measured with BMI, WHR and WC had limited value in determining mortality risk at 9-year follow-up among individuals aged ≥55 years. Increased mortality was, however, observed in male with higher %BF but this could not be attributed to muscle strength.

Background: Noise-induced hearing loss (NIHL) is one of the most prevalent occupational disease globally. The objective of this study was to determine the effectiveness of a training and education program in increasing knowledge, attitude and practice (KAP) towards NIHL prevention among vector control workers. Methods: This is a cluster-randomized controlled trial design involving 183 vector control workers from nine district health offices in the state of Perak, Malaysia. Both groups were followed-up for a period of 3 months. Changes in KAP score towards NIHL was measured at intervals of 1 month and 3 months post-intervention. Data was analyzed according to Per-Protocol (PP) principles. Results: Both intervention and control groups showed increase in mean scores for all three domains (knowledge, attitude and practice) after 1 month but a larger improvement was seen in the intervention group for the attitude and practice domain in comparison to the control group. For the practice domain, the intergroup mean difference was 0.35% with 95% CI of -5.2 to 4.5. The greatest improvement was seen in attitude domain where the intergroup mean difference was 0.9% (95% CI -4.1, 2.3). At 3 months post-intervention, a greater improvement was observed in the intervention group compared to the control group for all 3 domains. The largest improvement was seen in the practice domain where the intergroup mean difference was -4.2 (95% CI -9.1, 0.7). Conclusion The training and education program was effective in maintaining the existing knowledge, attitude and practice of vector controls towards noise-induced hearing loss (NIHL). Continuous training and education is needed to cultivate good safety behaviour at workplace.
Health Education

Introduction: COVID-19 survivors with mental health issues are more likely to have a lower quality of life, reduced work productivity, social troubles, and other health issues. However, information on the mental health of COVID-19 survivors is scarce. Therefore, we aimed to determine the COVID-19 survivors’ mental health status in the form of depression and its associated factors. Methods: This cross-sectional study was conducted in Malaysia, during the nationwide lockdown. Data were collected using an online questionnaire. Socio-demographic variables, comorbidities, self-perception of health, information on the person’s acute condition during COVID-19 infection, symptoms and duration of symptoms postCOVID, and state of depression were gathered. The Patient Health Questionnaire 9 was used to assess depression. Factors associated with mild to severe depression were analysed using multivariable logistic regression analyses. Results: A total of 732 COVID-19 survivors responded to the survey. The respondents were mainly females and of younger age (in their 20s and 30s). One-third of the participants perceived themselves as having poor health. One in five participants reported having Long COVID. Slightly less than half (47.3%) of the respondents had mild to severe depression (total PHQ-9 score of 5-27). In the multivariable analysis, being female (aOR: 1.68; 95% CI: 1.08,2.62), of younger age (20s – aOR: 3.26; 95% CI: 1.47, 7.25; 30s – aOR: 2.08; 95% CI: 1.05, 4.15; and 40s – aOR: 2.43; 95% CI: 1.20, 4.90; compared to those in their 50s and above), being overweight/obese (aOR: 1.83; 95% CI: 1.18, 2.83), having Long COVID (aOR: 2.45; 95% CI: 1.45, 4.16) and perceived poorer health (aOR: 4.54; 95% CI: 2.89, 7.13) Conclusion Females, younger age groups, being overweight/obese, having Long COVID and perceiving themselves to be in poor health were factors associated with higher odds of mild to severe depression.
COVID-19

Background: Metabolic syndrome (MS) is a major public health challenge worldwide. The risks of MS and chronic diseases are further escalated with the increasing burden of psychological health. This was a cross-sectional study aimed to investigate the relationship between socio-demographic, lifestyle and psychological factors and MS, as well as the independent relationship between social support and MS among school teachers in Malaysia. Methodology: Multi-stage sampling was used to recruit participants from the state of Malacca, Malaysia. Data on socio-demographics, lifestyle factors and psychological health were obtained using self-administered questionnaires, including Short-form International Physical Activity Questionnaire (IPAQ), Depression, Anxiety and Stress Scale (DASS-21), Job content questionnaire (JCQ) and the revised 8-item Malay version of the Multidimensional Scale Perceived Social Support (MSPSS-M). Anthropometric measurements and metabolic risk assessment were conducted. Univariate analysis followed by multiple logistic regressions was conducted using complex sample logistic regression analysis. Results: Of 1511 participants, the prevalence of MS was 23.3% (95% CI: 20.7, 26.1). MS was significantly associated with increasing age, male gender, Indian ethnicity, usage of saturated fats, lesser sleeping duration, job strain, iso-strain, and lower perceived social support. After adjusting for potential confounders, higher perceived social support from family, friends or both were significantly associated with the lower likelihood of MS by 4% (OR 0.96; 95% CI: 0.93, 0.98), 10% (OR 0.90; 95% CI: 0.85, 0.96) and 4% (OR 0.96; 95% CI: 0.94, 0.98), respectively. Conclusion Metabolic syndrome was associated with increasing age, male gender, Indian ethnicity, usage of saturated fats and lesser sleeping duration in our population. Psychological health such as job strain, iso strain as well as low social support may be modifiable risk factors for MS.
Malaysia