Displaying publications 21 - 34 of 34 in total

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  1. Vanoh D, Shahar S, Yahya HM, Che Din N, Mat Ludin AF, Ajit Singh DK, et al.
    Clin Interv Aging, 2021;16:161-175.
    PMID: 33531799 DOI: 10.2147/CIA.S266587
    Purpose: Use of dietary supplements by older adults has been increasing for improving micronutrient deficiencies, cognitive function, and overall health status. Thus, the objective of this secondary investigation is to explore the longitudinal association of baseline supplement intake in improving cognitive function, biochemical parameters, anthropometric variables and physical fitness among older adults.

    Methods: Towards Useful Aging (TUA) is a three-year longitudinal study conducted at baseline (2013-2014) and at follow-up (2015-2017) surveys. The number of participants dropped from 2322 during baseline study to 1787 and 1560 during the 18th and 36th month follow-up, respectively. Data on socio-demography, use of dietary supplement, biochemical indices, anthropometry, cognitive function, physical fitness and depressive symptoms were obtained. Longitudinal associations were done using the linear mixed model analysis among 1285 subjects with complete data.

    Results: The most common vitamin and mineral supplementations consumed were multivitamin, B-complex, and calcium. Meanwhile, the herbal supplements consumed by participants were Eurycoma longifolia, Morinda citrifolia and Orthosiphon aristatus. Longitudinal analysis adjusted for multiple covariates showed improvement in both supplement users and non-users for global cognitive function, working memory, visual memory, 2-minute step test, chair stand test, chair sit and reach and time up and go test, waist circumference and hip circumference in both the supplement users and non-users.

    Conclusion: Our findings indicated that dietary supplement intake is not associated with cognitive function, physical fitness, nutritional status, depressive symptoms or biochemical indices since improvement in the parameters was observed among both supplement users and non-users.

  2. Mohd Safien A, Ibrahim N, Subramaniam P, Shahar S, Din NC, Ismail A, et al.
    Gerontol Geriatr Med, 2021 08 11;7:23337214211025167.
    PMID: 34395815 DOI: 10.1177/23337214211025167
    Aim: The goal is to explore available evidence and provide greater clarity to what is described as psychosocial intervention to improve cognitive function among older population with MCI as well as identifying areas for future research. Methods: An electronic literature search of PubMed, Cochrane, Ebscohost, Medline, Scopus, and gray resource was conducted to find articles published in English language between 2010 and September 2020. This review focused on research undertaken using randomized clinical trials study design. We extracted information regarding the publication date, geographical location, study setting, intervention mechanism, type of cognitive measurement used, and outcome of the studies. References of this literature were also reviewed to ensure comprehensive search. Result: Out of 240 potential records found, a total of 27 articles were identified following the first round of screening and deletion of duplicates. Full-text article reviews and analysis in the second round of screening narrowed the selection down to four articles. Another three relevant articles obtained from references were also included making a total of seven articles in the final analysis. Findings: Psychosocial intervention strategies for improvement of cognitive function, done in various setting all over the globe, covered a range of approaches including art therapy, visual art therapy, therapeutic writing therapy, reminiscence activity, and cognitive behavioral approach. Most were conducted in weekly basis within 1-to-2-hour duration of session. Cognitive function of older adult in psychosocial intervention group was significantly improved in two studies. Three studies showed no significant improvement at all in the cognitive function, and another one reported success in improving cognitive function over time in the intervention group than in control group. One study did not describe the interaction effect. Different types of cognitive measurement also were used to quantify different domains of cognitive function in the reviewed studies. Conclusion: The idea of using psychosocial intervention for improving cognitive function has begun to increasingly accepted recently. Findings from the limited studies are encouraging, although the outcome of the cognitive function was mixed. Large-scale and longer duration of psychosocial intervention with bigger sample size is warranted for future studies.
  3. Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Ban AY, et al.
    Chronobiol Int, 2021 05;38(5):659-665.
    PMID: 33733959 DOI: 10.1080/07420528.2021.1887209
    The Munich Chronotype Questionnaire (MCTQ) has been widely validated among various types of populations. However, determination of chronotype among individuals who have a split sleep pattern with short intervals between the first and second sleep bouts on free days has not yet been reported. This study aimed to validate the MCTQ modified for this purpose by assessing the actual sleep-wake timing against the Morningness-Eveningness Questionnaire (MEQ). The modified calculation for the midpoint of sleep on free days (MSF) of the split sleep pattern considers the second sleep bout as the total sleep duration on free days. We recruited 161 participants (mean age: 38.7 ± 7.8 years; 73% females, 29% with split sleep pattern) were recruited to administer the modified version of the MCTQ and MEQ. All of the MCTQ original parameters: midpoint of sleep on work days (MSW, r = -0.575), midpoint of sleep on free days (MSF, r = -0.568), and midpoint of sleep on free days corrected for sleep debt (MSFsc,r = -0.566) were significantly correlated with MEQ. The MEQ was further tested against MSF in four conditions of the split sleep pattern. The MSF modified for split sleep within 60 minutes after the first awakening showed highest correlation (r = -0.576) against MEQ score. The results demonstrate the modified version of MCTQ is valid to determine the chronotype in participants who practice consolidated and split sleep patterns.
  4. Joseph DK, Mat Ludin AF, Ibrahim FW, Ahmadazam A, Che Roos NA, Shahar S, et al.
    Front Physiol, 2023;14:1287170.
    PMID: 37817985 DOI: 10.3389/fphys.2023.1287170
    [This corrects the article DOI: 10.3389/fphys.2023.1216948.].
  5. Joseph DK, Mat Ludin AF, Ibrahim FW, Ahmadazam A, Che Roos NA, Shahar S, et al.
    Front Physiol, 2023;14:1216948.
    PMID: 37664425 DOI: 10.3389/fphys.2023.1216948
    Introduction: Studies have shown that exercise increases angiogenesis and perfusion in the hippocampus, activates neurogenesis in the dentate gyrus and increases synaptic plasticity, as well as increases the complexity and number of dendritic spines, all of which promote memory function and protect against cognitive decline. Flavonoids are gaining attention as antioxidants in health promotion due to their rich phenolic content, particularly for their modulating role in the treatment of neurodegenerative diseases. Despite this, there has been no comprehensive review of cognitive improvement supplemented with flavonoid and prescribed with exercise or a combination of the two interventions has been conducted. The purpose of this review is to determine whether a combined intervention produces better results when given together than when given separately. Methods: Relevant articles assessing the effect of physical exercise, flavonoid or in combination on cognitive related biomarkers and neurobehavioral assessments within the timeline of January 2011 until June 2023 were searched using three databases; PubMed, PROQUEST and SCOPUS. Results: A total of 705 articles were retrieved and screened, resulting in 108 studies which are in line with the objective of the current study were included in the analysis. Discussion: The selected studies have shown significant desired effect on the chosen biomarkers and neurobehavioral assessments. Systematic Review Registration: identifier: [CRD42021271001].
  6. Othman MS, Mat Ludin AF, Chen LL, Hossain H, Abdul Halim II, Sameeha MJ, et al.
    PLoS One, 2022;17(2):e0264158.
    PMID: 35226684 DOI: 10.1371/journal.pone.0264158
    INTRODUCTION: The decreasing level of physical activity among female undergraduates is worrying as it is associated with the increased risk of non-communicable diseases. Thus, this study aimed to identify the motivations, barriers and preferences towards exercise among female undergraduates in Malaysia.

    METHODS: A non-probability purposive sampling was used for the recruitment process. The inclusion criteria of the participants were registered female undergraduates and aged between 18-30 years old. A semi-structured in-depth interview was used to collect topic-related information from the participants and signed consents were obtained prior to the interview. The interview questions were on respondents' understanding of exercise, motivation and barriers to exercise, and exercise preferences. The recruitment process was conducted until the data was saturated. All interviews were audio recorded and manually transcribed verbatim. NVivo 11 was used to conduct the inductive analysis of the data to develop themes for motivation and barriers to exercise. For exercise preferences, four predetermined themes were used.

    FINDINGS: A total of 26 respondents participated in this study. Eight themes were found for motivation to exercise, with the most common themes being maintaining or improving appearance, health benefits and togetherness. For barriers of exercising, five themes were found, and the most common ones were disliking exercise and no motivation. For exercise preferences, most respondents preferred a structured exercise program with flexibility in terms of when and where the exercise could be conducted. Light or moderate intensity exercise for 10-30 minutes with a frequency of 1-2 times a week was desired the most among the respondents.

    CONCLUSION: In conclusion, personal and environmental factors play important roles in motivating or hampering female undergraduates to exercise, and a structured program was the preferred mode of exercise of these respondents. A new exercise module was designed based on this needs assessment with a 70% acceptance rate among the participants. These findings can help the future development of more exercise modules tailored to female university students.

  7. Ahmad NA, Mat Ludin AF, Vanoh D, Tohit NM, Manaf ZA, Mohd Noah SA, et al.
    Digit Health, 2024;10:20552076241297213.
    PMID: 39600385 DOI: 10.1177/20552076241297213
    BACKGROUND: Technology advancement along with the increase in the older adults' population leads to the creation of health applications. The combination of exercise, nutrition, and cognition should be studied carefully in improving older adults' health.

    OBJECTIVE: The purpose of this study is to develop a health application, WeFit contains these three components and to determine its content validity, acceptability, and usability.

    METHODOLOGY: This study is a design and development study involving three phases. The first phase is the need analysis involving a review on 16 mobile applications available in Google play and iTunes App store as well as a review of six articles for identifying the perception of older adults in using mobile applications. Second phase is mobile application development and content validity. The content validity was determined using the Content Validity Index for Individual Items (I-CVI). Phase 3 evaluated the acceptance of the WeFit mobile application among older adults and health practitioners.

    RESULTS: Phase 1 indicated that half of the applications reviewed (50.0%) had physical activity component and the other half (50.0%) had a cognitive component, and none on nutrition. No application is reported to have all three components. In Phase 2, WeFit health application containing the three components was developed where users can view exercise and food recommendations and play cognitive games. WeFit had an I-CVI value of 0.98. With respect to acceptability, majority of the study participants (93.3%) understood the WeFit's content and the graphics used were appropriate. The usability study found that the majority of the older adults were satisfied with the interface and content. All health practitioners (100%) agreed WeFit is easy to use and agreed that it can guide them in giving medical advices.

    CONCLUSION: WeFit mobile app has been successfully developed, validated, and tested for acceptance among the older adults and health practitioners.

  8. Ooi TC, Mat Ludin AF, Loke SC, Fiatarone Singh MA, Wong TW, Vytialingam N, et al.
    Gerontol Geriatr Med, 2021 08 12;7:23337214211038789.
    PMID: 34409130 DOI: 10.1177/23337214211038789
    Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention (n = 35) and control (n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (-1.34% point, p < 0.001), fasting blood glucose (-1.30 mmol/L, p < 0.001), and systolic blood pressure (-1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle-brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.
  9. Malek Rivan NF, Shahar S, Singh DKA, Ibrahim N, Mat Ludin AF, Yahya HM, et al.
    Aging Ment Health, 2021 Sep 06.
    PMID: 34486885 DOI: 10.1080/13607863.2021.1972281
    OBJECTIVE: In this study, we aim to assess general psychological health, associated factors, and the potential of coping strategies as a mediator for middle-aged and older Malaysian adults during the COVID-19 pandemic.

    METHODS: A total of 535 individuals aged 52 years and above from the previous cohort and interventional studies in Peninsular Malaysia were contacted during the Movement Control Order (MCO) issued during the COVID-19 pandemic. Telephonic interviews were conducted to obtain participant information concerning socio-demography, physical activity, subjective well-being (SWB) as assessed using flourishing scale, coping strategies, and general psychological health (GHQ-12). Simple linear regression (SLR) and multiple linear regression (MLR) analyses were performed to identify the factors associated with GHQ-12. The associated factors were further analysed using mediation analysis to determine the potential of coping strategies as a mediator.

    RESULTS: It was observed that participants had a low mean GHQ-12 score (M = 0.80, SD = 2.19), indicating good psychological health. Living arrangement, physical activity, and flourishing scale were associated with psychological health (R2 = 0.412, p 

  10. Jamil NA, Shahudin NN, Abdul Aziz NS, Jia Qi C, Wan Aminuddin WAA, Mat Ludin AF, et al.
    PMID: 31783521 DOI: 10.3390/ijerph16234735
    This study assessed knowledge, attitude and practice (KAP) related to vitamin D and its relationship with vitamin D status among Malay female office workers. A total of 147 women aged between 20 and 55 years were recruited from a university in Kuala Lumpur. They answered questionnaires related to KAP on vitamin D, sun exposure, dietary vitamin D intake and physical activity. Serum 25-hydroxyvitamin D (25OHD) was analysed using an enzyme-linked immunoassay. Nearly half (45%) of the subjects had good knowledge but moderate attitude (76%) and practice (84%) towards sunlight exposure and dietary vitamin D intake. Median serum 25OHD was 34.1 nmol/L with the majority (91%) had vitamin D insufficiency (25OHD < 50 nmol/L). Knowledge was weakly associated with attitude (r = 0.29, p < 0.001) but no association was found between knowledge and practice (r = 0.08, p = 0.355) nor attitude and practice (r = -0.001, p = 0.994). Serum 25OHD was positively associated with sunlight exposure (r = 0.22, p = 0.008) and dietary vitamin D intake (r = 0.37, p < 0.001). It can be implied that this group is at increased risk of low bone health status, which highlights the needs of public health campaigns to improve their vitamin D status.
  11. Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Hazwari NDD, et al.
    Nutrients, 2021 Nov 17;13(11).
    PMID: 34836375 DOI: 10.3390/nu13114121
    This study examined whether the temporal patterns of energy and macronutrient intake in early and late eating windows were associated with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) among non-shift workers. A total of 299 overweight/obese non-shift workers (Age: 40.3 ± 6.9 years; 73.6% women; BMI: 31.7 ± 5.0 kg/m2) were recruited in the Klang Valley area of Malaysia. The biochemical parameters were determined from fasting blood samples, whereas information on dietary intake and timing was obtained from a 7-day diet history questionnaire. The midpoint of eating was used to determine the early and late windows. Compared to MHO non-shift workers (n = 173), MUO non-shift workers (n = 126) had lower energy intake from carbohydrates and protein during the early window. In contrast, MUO participants had greater energy intake from carbohydrates and fat during the late window. Participants with unhealthy metabolic status (regardless of their chronotypes) had similar temporal patterns of energy intake characterized by smaller energy intake during the early window and greater energy intake during the late window compared with participants with healthier metabolic status. Overall, the lowest percentile of energy intake during the early window was associated with an increased risk of MUO, after adjustment for potential confounders [odds ratio (OR) = 4.30, 95% confidence interval (CI) 1.41-13.11]. The greater the energy intake during the late window, the greater the risk of MUO (OR = 2.38, 95% CI 1.11-5.13) (OR = 2.33, 95% CI 1.03-5.32) (OR = 4.45, 95% CI 1.71-11.56). In summary, consuming less energy earlier in the day and more energy and carbohydrate later in the day was associated with a greater risk of MUO. Thus, a prospective study is needed to explore the potential role of chrono-nutrition practices in modifying risk factors to delay the transition of MHO to MUO.
  12. Mohd Rosnu NS, Ishak WS, Abd Rahman MH, Shahar S, Musselwhite C, Mat Ludin AF, et al.
    Front Public Health, 2023;11:1153822.
    PMID: 37275505 DOI: 10.3389/fpubh.2023.1153822
    INTRODUCTION: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults.

    METHODS: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking).

    RESULTS: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs.

    DISCUSSION: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p 

  13. Malek Rivan NF, Yahya HM, Shahar S, Ajit Singh DK, Ibrahim N, Mat Ludin AF, et al.
    Nutrients, 2021 Jan 25;13(2).
    PMID: 33503860 DOI: 10.3390/nu13020353
    This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.
  14. Mustafa Khalid N, Ponvel P, Ibrahim AM, Mohd Safien A, Md Fadzil NH, Singh DKA, et al.
    Clin Interv Aging, 2024;19:1189-1202.
    PMID: 38974508 DOI: 10.2147/CIA.S458600
    PURPOSE: There is a limited availability of multidomain interventions that target cognitive frailty. Thus, the aim of the present study was to develop and evaluate the content validity and acceptance of the multidomain intervention module to reverse cognitive frailty among older adults (iAGELESS).

    PATIENTS AND METHODS: This study was conducted in two phases: Phase I included the development of the multidomain intervention module iAGELESS and evaluation of content validity, while Phase II consisted of evaluating the acceptance of the module among 18 healthcare and social care providers, 13 older adults with cognitive frailty, and 13 caregivers. Content validity index (CVI) was used to quantify the content validity. Respondents completed a questionnaire which consisted of information on sociodemographic, followed by module acceptance evaluation with respect to content, terminologies, and graphics. The data was then analyzed descriptively.

    RESULTS: A multidomain intervention module, iAGELESS was developed. The module was found to have appropriate content validity (overall CVI = 0.83). All the caregivers, 92% of older adults with cognitive frailty and 83% of healthcare and social care providers were satisfied with the overall content of the module. More than 50% of those who accepted the module had satisfactory consensus on the ease of the terminologies, length of sentences, pictures, information, color, and font size included in the module.

    CONCLUSION: The iAGELESS module demonstrated good content validity and was well accepted, thus warranting its utilization in future studies to determine its effectiveness in reversing cognitive frailty among older adults.

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