INTRODUCTION: As populations age globally and the burden of chronic illnesses increases, valid measures of disability are needed for assessment in the older adult population. The aim of the current analysis was to explore the psychometric properties and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in an epidemiological survey of older adults in Singapore. METHODS: The study comprised secondary data analysis of the Well-being of the Singapore Elderly study. Inclusion criteria for the study were Singapore residents (Singapore citizens and permanent residents) aged 60 years and above. The 12-item interviewer-administered version of the WHODAS 2.0 was used to assess disability in the study. Data on cognition, health status and sociodemographic information were collected. Depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy. RESULTS: The study found a one-factor model solution for WHODAS 2.0 with a high internal consistency of all items. The internal consistency for the overall scale was 0.92. The WHODAS 2.0 score positively correlated with multimorbidity, perceived overall health status, depression and subsyndromal depression. There was a significant inverse association between the WHODAS 2.0 score and the cognitive status. After adjustment for all sociodemographic variables in the multiple linear regression analysis, these measures remained significantly associated with the WHODAS 2.0 score. CONCLUSION WHODAS 2.0 was found to be a valid measure of disability among older adults. However, further research is required to determine its usefulness as a responsive instrument that can detect change following interventions.

INTRODUCTION: The current study aimed to estimate the overall prevalence and sociodemographic correlates of successful ageing, as defined by Rowe and Kahn, among a national sample of multiethnic adults aged 60 years and older in Singapore. METHODS: Data from older adults who participated in the Well-being of the Singapore Elderly study was analysed. Successful ageing was defined with five indicators: no major diseases; no disability; high cognitive functioning; high physical functioning; and active engagement with life. RESULTS: The prevalence of successful ageing was 25.4% in this older population. Older adults aged 75-84 years and ≥ 85 years had 0.3 times and 0.1 times the odds of successful ageing, respectively, than those aged 60-74 years. Compared to older adults of Chinese ethnicity, those of Malay (odds ratio [OR] 0.6) and Indian (OR 0.5) ethnicities were less likely to be associated with successful ageing. Older adults with lower education levels, who had no formal education (OR 0.2), some schooling but did not complete primary education (OR 0.4) or only primary education (OR 0.5), had lower odds of ageing successfully than those with tertiary education. CONCLUSION Older adults in Singapore tend to have much more active engagement with life as compared to their counterparts from other countries. Further research into this population is needed, both in terms of qualitative research to gain a better understanding of successful ageing from the older adult's perspective, as well as longitudinal studies that explore behavioural determinants of successful ageing.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging ; Cognition ; Cross-Sectional Studies ; Disabled Persons ; Ethnic Groups ; Female ; Health Services for the Aged ; Health Status ; Humans ; Independent Living ; Male ; Middle Aged ; Prevalence ; Singapore ; Social Class ; Surveys and Questionnaires

INTRODUCTIONFunctioning and quality of life (QOL) are negatively impacted as a result of mental illness. This study aimed to determine the: i) socio-demographic and clinical correlates of functioning and; ii) associations between functioning and QOL in a multiethnic sample of psychiatric outpatients.

MATERIALS AND METHODSThis was a cross-sectional study of outpatients receiving treatment from a tertiary psychiatric hospital. Functioning was assessed using the Global Assessment of Functioning (GAF) scale, while QOL was measured using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) which comprises 4 domains: physical health, psychological health, social relationships and environment.

RESULTSVarious socio-demographic and clinical correlates were associated with functioning including employment and marital status, education and diagnosis. Depression was the only clinical characteristic which negatively correlated with functioning (= 0.035). Amongst the whole sample, multiple linear regressions revealed that functioning was positively associated with all 4 QOL domains (physical health [<0.001], psychological health [<0.001], social relationships [<0.001] and environment [<0.001]). Further analysis of each diagnostic group revealed that functioning was positively associated with all 4 QOL domains in the anxiety, depression and obsessive compulsive disorder subsamples, while in the schizophrenia subsample, functioning was only significantly associated with all environment domain.

CONCLUSIONFunctional impairments were associated with different socio-demographic and clinical characteristics, which should be addressed when planning tailored treatment and interventions. Given that functioning is significantly associated with QOL, it is crucial to regularly assess and monitor them (in addition to symptomatic outcomes and adopting a more holistic and biopsychosocial approach).

Objective: Electronic cigarettes (e-cigarettes) are increasingly used globally and the implications of their smoking are being debated. The aim of this study is to identify awareness, use and perceptions of e-cigarettes among young smokers and parents of youths in Singapore. Methods: A total of 12 focus group discussions (FGDs) were conducted among youths (aged 15-29 years) who smoke and parents of youths, from diverse social contexts. Participants were recruited using a mix of network and purposive sampling. Youth FGDs were conducted in English language while the parent FGDs were conducted in Chinese and English language. FGDs were audio recorded and transcribed verbatim. The data were analysed using qualitative content analysis. Results: Awareness about e-cigarettes was perceived more among youth as compared to parents in terms of structure, mechanism and use of the device. Parents considered e-cigarettes to be a healthy substitute for conventional smoking. However, youth expressed the failure of e-cigarettes to provide satiety level same as conventional cigarette smoking. Participants endorsed e-cigarettes as a tool for smoking cessation. Conclusion: It was evident from the study that though there was knowledge of e-cigarettes, both parents and youths were ill- informed about them, owing to varied and inconsistent information on e-cigarettes along with its legal implications in Singapore. Future research is required to assess safety and efficacy of e-cigarettes as well as the association of their use with smoking cessation.

INTRODUCTIONMajor depressive disorder (MDD) is one of the most common psychiatric disorders worldwide and has been associated with various sociodemographic risk factors, including age, gender and ethnicity. The present study aimed to establish whether gender-specific differences relating to the prevalence and correlates of MDD exist in the Singapore adult resident population.

METHODSThe Singapore Mental Health Study was a population-based, cross-sectional epidemiological study among Singapore citizens and permanent residents aged 18 years and above. Face-to-face interviews were completed with 6,616 respondents between December 2009 and December 2010. Psychiatric conditions were established using version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI). In addition, data relating to chronic medical conditions was captured using a modified version of the CIDI checklist for chronic medical conditions.

RESULTSThe lifetime prevalence of MDD was higher among women (7.2%) than men (4.3%). MDD was more prevalent among men and women who were divorced/separated and widowed women, as compared to those who were single. Among men, MDD was more prevalent among Indian and other ethnicities as compared to Chinese. Of the 417 respondents with MDD, women had significantly higher odds of having generalised anxiety disorder but lower odds of having high blood pressure, as compared to men.

CONCLUSIONThe study highlighted key gender-specific correlates of MDD. Given the comorbidities associated with MDD and other psychiatric disorders and/or physical illnesses, these correlates pose additional challenges for care providers.

INTRODUCTIONThe objectives of this current study were to: 1) examine the prevalence and correlates of diabetes mellitus (DM) among older adults (aged 60 years and above) in a multi-ethnic population; 2) examine the prevalence and correlates of comorbid DM and depression among them; and 3) assess the effect of comorbid depression on disability, cognition and healthcare utilisation.

MATERIALS AND METHODSData for the current study came from the Well-being of the Singapore Elderly (WiSE) study; a single phase, cross-sectional survey conducted among Singapore residents aged 60 years and above. A total of 2565 respondents completed the survey; depression was assessed using the Automated Geriatric Examination for Computer Assisted Taxonomy (AGECAT) while a diagnosis of DM was considered if respondents stated that a doctor had diagnosed them with DM.

RESULTSDM was reported by 25.5% of the population. The prevalence of depression was significantly higher in those diagnosed with DM than those without DM (6% vs 3%). After adjusting for sociodemographic correlates, smoking and other chronic conditions, DM remained significantly associated with depression and subsyndromal depression. However, after including measures of functioning and cognitive impairment as covariates, DM was not significantly related to depression and subsyndromal depression. Those with comorbid DM and depression were more likely to be of Indian and Malay ethnicity, aged 75 to 84 years (versus 60 to 74 years) and widowed.

CONCLUSIONGiven the significant association of certain sociodemographic groups with comorbid depression among those with DM, targeted interventions for prevention and early diagnosis in these groups should be considered.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; statistics & numerical data ; Comorbidity ; Cross-Sectional Studies ; Depression ; epidemiology ; Depressive Disorder ; epidemiology ; Diabetes Mellitus ; epidemiology ; Ethnic Groups ; statistics & numerical data ; Female ; Health Services ; utilization ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Male ; Middle Aged ; Prevalence ; Severity of Illness Index ; Singapore ; epidemiology ; Surveys and Questionnaires

INTRODUCTIONCurrently very little is known about the prevalence or magnitude of caregiver dependence in Singapore and thus, there is a need to fill this gap in this multiethnic ageing population. This study aims to determine the prevalence and risk factors of caregiver dependence among older adults in Singapore.

MATERIALS AND METHODSData were used from the Well-being of the Singapore Elderly (WiSE) study, a nationally representative, cross-sectional survey among Singapore residents aged 60 years and above. Caregiver dependence was ascertained by asking the informant (the person who knows the older person best) a series of open-ended questions about the older person's care needs.

RESULTSThe older adult sample comprised 57.1% females and the majority were aged 60 to 74 years (74.8%), while 19.5% were 75 to 84 years, and 5.7% were 85 years and above. The prevalence of caregiver dependence was 17.2% among older adults. Significant sociodemographic risk factors of caregiver dependence included older age (75 to 84 years, and 85 years and above,<0.001), Malay and Indian ethnicity (<0.001), those who have never been married (= 0.048) or have no education (= 0.035), as well as being homemakers or retired (<0.001). After adjusting for sociodemographic variables and all health conditions in multiple logistic regression analyses, dementia (<0.001), depression (= 0.011), stroke (= 0.002), eyesight problems (= 0.003), persistent cough (= 0.016), paralysis (<0.001), asthma (= 0.016) and cancer (= 0.026) were significantly associated with caregiver dependence.

CONCLUSIONVarious sociodemographic and health-related conditions were significantly associated with caregiver dependence. Dependent older adults will put greater demands on health and social services, resulting in greater healthcare expenditures. Hence, effective planning, services and support are crucial to meet the needs of dependent older adults and their caregivers.

Activities of Daily Living ; Age Factors ; Aged ; Aged, 80 and over ; Asthma ; epidemiology ; Caregivers ; Cough ; epidemiology ; Cross-Sectional Studies ; Dementia ; epidemiology ; Depression ; epidemiology ; Educational Status ; Ethnic Groups ; Female ; Humans ; India ; Logistic Models ; Malaysia ; Male ; Marital Status ; Middle Aged ; Multivariate Analysis ; Neoplasms ; epidemiology ; Occupations ; statistics & numerical data ; Paralysis ; epidemiology ; Prevalence ; Retirement ; statistics & numerical data ; Risk Factors ; Singapore ; epidemiology ; Stroke ; epidemiology ; Vision Disorders ; epidemiology

INTRODUCTIONGiven that past research on drinking problems has focused primarily on younger samples, the present study sought to examine the prevalence and correlates of alcohol use among the elderly in Singapore.

MATERIALS AND METHODSData were extracted from the Well-being of the Singapore Elderly (WiSE) study, a cross-sectional, epidemiological survey conducted among a nationally representative sample of Singapore residents (n = 2565) aged 60 years and above. Variables assessed include drinking problems, depression and anxiety symptoms, obesity, smoking status, chronic physical disorders and disability.

RESULTSThe weighted prevalence of drinking problems (CAGE score ≥2) in our sample was 4.2%. Male sex, Indian ethnicity, and being divorced or separated were associated with a significantly higher likelihood of drinking problems. Participants with drinking problems were also more likely to have subthreshold depression. There were no significant differences in disability among those with drinking problems, those without drinking problems and non-drinkers, after adjusting for demographic variables.

CONCLUSIONOur findings contribute to the body of research that indicates an association between drinking problems and depressive symptoms among the elderly. Thus, screening for depressive symptoms in the elderly with drinking problems may be useful in identifying such comorbidities in order to aid treatment planning.

Aged ; Aged, 80 and over ; Alcohol-Related Disorders ; diagnosis ; epidemiology ; psychology ; Alcoholism ; diagnosis ; epidemiology ; psychology ; Anxiety ; epidemiology ; psychology ; Chronic Disease ; Cross-Sectional Studies ; Depression ; epidemiology ; psychology ; Divorce ; statistics & numerical data ; Ethnic Groups ; Female ; Humans ; India ; Male ; Marital Status ; Mass Screening ; Middle Aged ; Obesity ; epidemiology ; Prevalence ; Risk Factors ; Sex Factors ; Singapore ; epidemiology ; Smoking ; epidemiology ; Surveys and Questionnaires

INTRODUCTIONDisability increases an individual's dependence and negatively impacts their physical, mental, and social functioning. The current study aims to establish the prevalence and risk factors of disability in Singapore's population.

MATERIALS AND METHODSData was extracted from the Well-being of the Singapore Elderly (WiSE) study. This cross-sectional study recruited participants aged 60 years and above (n = 2421) who were representative of Singapore's multiethnic population. We used the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 to assess the severity of disability in our sample while establishing its associations and correlations with cognitive levels, sociodemographic variables, and chronic illness.

RESULTSCognitive deficits, old age, female gender, Malay and Indian ethnicity, lack of education, retired or homemaker status, presence of chronic illness (specifically stroke, heart problems, depression, and dementia) were found to be significantly associated with disability in Singapore's elderly population. As hypothesised, participants with deficits in cognition were more likely to indicate higher WHODAS scores.

CONCLUSIONThe findings highlighted specific factors associated with disability in this multiethnic population. The identification of these factors would lead the way to the development of appropriate interventions.

Age Factors ; Aged ; Aged, 80 and over ; Chronic Disease ; Cognitive Dysfunction ; epidemiology ; Cross-Sectional Studies ; Dementia ; epidemiology ; Depression ; epidemiology ; Disabled Persons ; Educational Status ; Ethnic Groups ; statistics & numerical data ; Female ; Heart Diseases ; epidemiology ; Humans ; India ; Malassezia ; Male ; Middle Aged ; Occupations ; statistics & numerical data ; Prevalence ; Retirement ; statistics & numerical data ; Risk Factors ; Sex Factors ; Singapore ; epidemiology ; Stroke ; epidemiology