Self-management education program (SMEP) is essential in the knee osteoarthritis (OA) management. While the benefits of tailored SMEP have been highlighted in the literature, evidence on the effects of tailored knee OA SMEP for multiethnic populations, such as in Malaysia, remains limited. Therefore, the aim of this study was to conduct an intervention study on a tailored SMEP among Malaysian older adults who aged 60 years and above with knee OA. Participants aged 60 years and over with a diagnosis of knee OA were recruited. The intervention comprised four weekly structured group SMEP which was developed specifically for the multicultural population in Malaysia. Symptom’s severity and functional performance were assessed at baseline and six-week follow-up using the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS), 30 seconds sit to stand (30sST), time up and go (TUG), chair sit and reach (CSR), back stretch (BS), handgrip strength (HGS) and two-minute walk (2MW) tests. Of the 32 individuals recruited, 30 participants, mean age of 66.77 (±6.42) years, completed the post-intervention assessment. Improvements in mean KOOS domains scores were observed by between 1.3% - 8.6% from baseline to follow-up. Significant differences between baseline and followup scores were identified for 30sST (p < 0.05), TUG ( p < 0.001) and 2MW (p < 0.001) tests. A 4-week tailored SMEP delivered face to face by a physiotherapist, improved lower limb muscle strength, mobility, balance and endurance. Larger randomized controlled trials regarding the long-term effects of SMEP for older adults with OA is warranted.

The aim of this study was to detemine the effectiveness of Customized vestibular rehabilitation (CVR) in addition to the standard Canalith repositioning maneuver (CRM) on static balance among adults with posterior canal Benign Paroxysmal Positional Vertigo (BPPV). In this randomised controlled trial, 28 adults with idiopathic unilateral posterior canal BPPV were randomized to either the control or experimental group. The experimental group (n=14, mean age: 50.71±9.88 years) received CVR in addition to CRM, and the control group (n=14, mean age: 54.36±8.55 years) received only CRM for 6 weeks. Measurements of static balance (postural sway) using a portable kinematic sensor were performed at baseline, four and six weeks after treatment for both groups while standing on firm and foam surface with eyes open (EO) and closed (EC). Only standing on foam surface with EC was observed to have a significant interaction effect, F (2, 52) =5.28, p<0.05. This suggest that the groups were affected differently by the intervention and greater improvement was demonstrated in the experimental group. Post hoc test showed that a significant difference (p<0.05) in static balance was shown between baseline and 6th week after intervention. The results of our study indicate that CVR in addition to CRM improved static balance in adults with UPC BPPV at 6th week after intervention for persons with BPPV.

In this study, we aimed to determine gender specific age-related decline in anthropometry status, physical performance (PP) and physical activity (PA) in older persons with and without mild cognitive impairment (MCI) prospectively over 3 years. Within-group changes across three time points (baseline-Wave 1, 18 months-Wave 2, 36 months-Wave 3) based on gender and cognitive status were determined. Data was collected at Wave 3 of a longitudinal study: “Neuroprotective Model for Health Longevity among Elderly”. Secondary data from Wave 1 and 2 was obtained for analysis. Older persons with MCI were categorised to have subjective memory problems (answered ‘yes’ on item 10 of Geriatric Depression Scale), scored at least 1.5 SD below mean average on Rey Auditory Verbal Learning Test and Digit Span, no dementia, no problems with activities in daily living, intact global cognition (>19/30: Mini Mental State Examination) and without depression (Geriatric Depression Scale 15-items,≤4). Anthropometry measurements and a battery of PP tests were performed. PA was measured using Physical Activity Scale for the Elderly questionnaire. Data from 779 older persons (67.7 ± 5.3 years) consisting of 372 men (68.0 ± 5.2 years) and 407 women (67.4 ± 5.4) who completed all tests from Wave 1 to Wave 3 were analysed. There was a decline in PP (-0.7% to -14.1% per year), PA levels (-0.7% to -14.1% per year) and anthropometry status (-0.1% to -6.3% per year), except for percentage body fat (+9.9% per year) with advancing age. Within-group changes over the three years showed significant differences (p<0.05) in height and PA in non-MCI and MCI men and lower body flexibility in non-MCI and MCI women. Specifically, tailored physical and nutritional health prevention and promotion strategies for older persons based on gender and cognitive status may be beneficial to support person-centered care.

Introduction: Sarcopenia is one of the geriatric syndromes affecting the ability of older adults to lead an independent living. However, its risk factors among Malaysian older adults are yet to be determined. This study investigated the prevalence and risk factors of sarcopenia among community-dwelling older adults in Klang Valley. Methods: This cross-sectional study involved 393 Malaysians aged 60 and above, residing in urban areas of Klang Valley recruited through convenience sampling. Socio-demographic and food intake information were obtained using validated questionnaires. Cut-off points for sarcopenia screening were obtained from the Asian Working Group of Sarcopenia(AWGS) while body impedance analysis(BIA) was employed to determine skeletal muscle index. A handgrip dynamometer was used to assess dominant handgrip strength and a 6-meter gait speed test was used to determine walking speed. Binary logistic regression analysis was used to determine the risk factors of sarcopenia. Results: Prevalence of sarcopenia was 33.6% and women(35.9%) were more affected compared to men(30.1%). The mean age of women assessed to have sarcopenia(69.1±6.5 years old) was higher compared to men(68.3±5.8 years old) (p<0.05). After adjusting for confounding factors, older adults with one year increased in age and one mg decreased in habitual dietary iron intake were estimated to be 1.08 times and 0.93 times the chances to have sarcopenia respectively. Conclusion: Approximately one-third of community-dwelling older adults in Klang Valley were assessed to have sarcopenia. Older adults aged 60 years and above and those with low dietary iron intake were at an increased risk of developing sarcopenia.

Online health information have a role in enhancing health in older adults. However, age-related physiological changes and non-senior friendly websites proved to be a challenge for older adults. Research investigating older adults’ preferences of features in health information websites is limited. Thus, in this review, we aim to summarize older adults’ preferences regarding the design and content of health websites. Medline, CINAHL, Cochrane Library, Scopus, Journal of Medical Internet Research (JMIR) and Google Scholar were searched for relevant articles in February 2018, using key words ‘older adults’, ‘Internet’, ‘health information’ and ‘usability’. The methodological quality of included studies was evaluated using the McMaster critical appraisal tools by two independent reviewers. Individual study design, participants’ characteristics, and identified preferences for health website features were extracted and summarized narratively. (PROSPERO registration number: CRD42018096281). Five studies (3 qualitative, 2 quantitative) were included in this review. The quality appraisal score ranged from 32% to 83%. The web feature preferences of older adults were grouped into three domains: web presentation factors, web navigation factors and health information preferences. The results highlight older adults have specific preferences when engaging with online content. This review suggests that readable text, simple design, consistent layout and straightforward web navigation are the preferred priorities for a health information website for older adults. Findings from this review may be useful to healthcare professionals and developers to understand older adults’ preferences pertaining to web design and contents in health websites specifically designed for this population.

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.

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.

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.

Falls is one of the main problems in older adults, which indirectly contributes to deterioration of quality of life, morbidityand mortality. The purpose of this study was to examine the difference in values between Timed Up and Go (TUG) andgait speed tests among community dwelling older adults with high and low risk of falls classified using PPA (PhysiologicalProfile Assessment). This cross-sectional study involved 278 older adults aged between 60 to 88 years, recruited fromsenior citizen club around Klang Valley. 40.6% older adults had high risk of falls and mostly were women (75%). Theresults of the study showed that there was a significant (p < 0.05) difference in TUG and Gait speed tests performancebetween older adults with high and low risk of falls. Declined mobility (longer time of TUG test) and increased age wereidentified as significant (p < 0.05) risk factors for falls in this study. The TUG test reference values obtained in this studymay be useful for early identification, prevention and management of falls among community dwelling older adults.

There is limited information regarding gender differences in spinal morphological attributes among healthy young adultsalthough alterations have been reported to influence postural changes, mainly with forward-bending and extensionpostures. The aim of this preliminary study was to examine gender differences in spinal morphological attributes oflumbar extensor muscles that includes its muscle fibre angles, thickness, endurance and thoracolumbar curvature amongyoung adults. Nineteen male and 26 female healthy young adults (aged 21-24 years) matched for age, body mass indexand physical activity levels participated in this preliminary study. Fibre angles and thickness of lumbar extensor muscleswere examined using ultrasonography. Lumbar extensor muscle endurance and thoracolumbar curvatures were assessedusing Sorenson’s test and a flexible ruler respectively. Paired t-test showed a significant mean difference (p < 0.01)between the right and left fibre angles. However, no significant mean difference (p = 0.50) was found between the rightand left muscle thickness. Results of independent t-test showed a significant difference (p < 0.01) in muscle thicknessbetween males and females. No significant differences were shown in right fibre angle (p = 0.12), left fibre angle (p =0.89), muscle endurance (p = 0.46), thoracic curvature (p = 0.76) and lumbar curvature (p = 0.06) between genders.There were no gender differences in spinal morphological attributes except for lumbar extensor muscle thickness inyoung adults age between 21 to 24. This study data may be useful as an initial reference norm of spinal morphologicalattributes among young adults. Further studies may be required to examine the factors that may influence changes inspinal morphological attributes among healthy adults.