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Fulltext Prevalence and Factors Associated with Self-Reported Vision Disability among the Elderly in Malaysia: Findings from National Health and Morbidity Survey (NHMS) 2018

Rezali MS, Ab Wahab NA, Sahril N, Ramli MHT, Shahein NA, Chan YY, et al.

J Ophthalmol, 2021;2021:7564827.
PMID: 34007483 DOI: 10.1155/2021/7564827

Introduction: Disability has adverse effects on health, wellbeing, and life quality. Vision disorder is one of the top-ranked causes of disability in the elderly population. This study aims to determine the prevalence and factors associated with vision disability among the elderly in Malaysia. Methodology. Data collection from National Health and Morbidity Survey (NHMS) 2018 was obtained. This survey focused on elderly health by using two-stage stratified cluster sampling design. The Washington Group Extended Question Set on Functioning (WG ES-F) was used to determine the vision disability. The data were analyzed using SPSS version 21.0 utilizing a complex sample design with multivariable logistic regression analysis to determine the prevalence and associated factors to vision disability.
Results: A total of 3,977 elderly completed the vision disability questionnaire. The overall prevalence of vision disability among those who were 60 years old and above was 4.5%. Multiple logistic regression revealed that no formal education (AOR: 6.69, 95% CI: 1.52, 29.49), only primary education (AOR: 4.26, 95% CI: 1.01, 18.03), unemployed/retiree or homemaker (AOR: 3.25, 95% CI: 1.79, 5.89), hypertension (AOR: 1.45, 95% CI: 1.00, 2.09), and malnourished elderly (AOR: 2.84, 95% CI: 1.76, 461) had higher odds for having vision disability.
Conclusion: The findings suggest that a low education level, unemployment, hypertension, and malnourishment are significant risk factors for VD among Malaysia's elderly. Strengthening awareness campaigns to increase VD awareness and provide high-quality rehabilitation services must target specific groups, such as the elderly with a low level of education and the unemployed. Empower primary healthcare providers with the knowledge and skills necessary to improve the quality of eye care delivery and expand eye screening in settling VD issues nationally.

Matched MeSH terms: Disabled Persons
Classification of lower limb body shapes of paralysed female wheelchair users in Hebei, China: analysis of anthropometric data using clustering approach

Xing L, Zakaria N, Ruznan WS

Ergonomics, 2024 Sep;67(9):1190-1197.
PMID: 38044671 DOI: 10.1080/00140139.2023.2289855

Lower limb body shape is important in the design of functional pants. The skin, muscles, and body shapes of the lower limbs of wheelchair users may differ from healthy people because of the different shapes of their legs and the prolonged seating position. This study aimed to classify the shapes of the lower limbs of adult female wheelchair users. The lower body measurement of 384 female wheelchair users was obtained. The principal component analysis and two-step cluster analysis were used to categorise the body shapes into three different types and five different size standards. Based on the study findings, female wheelchairs have larger waist, belly, and hip circumferences than healthy individuals, with 89.3% of them having prominent hips. Therefore, the design and production of trousers for wheelchair users should take into consideration the classification of lower limb shapes and sizes reported in this study.Practitioner summary: This work initiated the investigation of human body size assessment of clothes for handicapped persons in China, allowing paraplegic female wheelchair users to wear adapted trousers.

Matched MeSH terms: Disabled Persons
Physical Disability and Diabetes Mellitus; Qualitative Exploration of Patients' Perception and Behavior

Gillani SW, Syed Sulaiman SA, Abdul MIM, Saad SY

Curr Diabetes Rev, 2018;14(5):472-480.
PMID: 28699483 DOI: 10.2174/1573399813666170710183736

BACKGROUND: Disability is a key indicator implicating both overall morbidity and success of public health efforts to compress the period of morbidity among geriatrics for the overall population. Disabilities are more prevalent among diabetics than among those without diabetes.
OBJECTIVE: This study aimed to determine self-monitoring practices, awareness to dietary modifications and barriers to medication adherence among physically disabled type 2 diabetes mellitus patients.
METHODS: Interview sessions were conducted at diabetes clinic - Penang general hospital. The invited participants represented three major ethnic groups of Malaysia (Malay, Chinese & Indians). An openended approach was used to elicit answers from participants. Interview questions were related to participant's perception towards self-monitoring blood glucose practices, Awareness towards diet management, behaviour to diabetes medication and cues of action.
RESULTS: A total of twenty-one diabetes patients between the ages 35 - 67 years with physical disability (P1-P21) were interviewed. The cohort of participants was dominated by Males (n=12) and also distribution pattern showed that majority of participants were Malay (n=10), followed by Chinese (n=7) and rest Indians (n=4). When the participants were asked in their opinion what was the preferred method of recording blood glucose tests, several participants from low socioeconomic status and either divorced or widowed denied to adapt telemontoring instead preferred to record manually. There were mixed responses about the barriers to control diet/calories. Even patients with high economic status, middle age 35-50 and diabetes history of 5-10 years were influenced towards alternative treatments.
CONCLUSION: Study concluded that patients with physical disability required extensive care and effective strategies to control glucose metabolism.

Matched MeSH terms: Disabled Persons/psychology*
Fulltext Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Global Burden of Disease Study 2013 Collaborators

Lancet, 2015 Aug 22;386(9995):743-800.
PMID: 26063472 DOI: 10.1016/S0140-6736(15)60692-4

BACKGROUND: Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013.
METHODS: Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries.
FINDINGS: Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2·4 billion and 1·6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537·6 million in 1990 to 764·8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114·87 per 1000 people to 110·31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21·1% in 1990 to 31·2% in 2013.
INTERPRETATION: Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
FUNDING: Bill & Melinda Gates Foundation.
Malaysian collaborators: Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lampur, Malaysia (Prof N Mohamed Ibrahim MBBch); Universiti Kebangsaan Malaysia Medical Centre, Bangi, Selangor, Malaysia (R Sahathevan PhD); Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Selangor, Malaysia (C T Sreeramareddy MD); WorldFish, Penang, Malaysia (A L Thorne-Lyman ScD); TCM Medical TK SDN BHD TCM, Nusajaya, Johor Bahru, Malaysia (K Yun Kin PhD)

Matched MeSH terms: Disabled Persons/statistics & numerical data*
Cross-cultural adaptation of the Oral Health Impact Profile (OHIP) for the Malaysian adult population

Saub R, Locker D, Allison P, Disman M

Community Dent Health, 2007 Sep;24(3):166-75.
PMID: 17958078

The aim of this project was to develop an oral health related-quality of life measure for the Malaysian adult population aged 18 and above by the cross-cultural adaption the Oral Health Impact Profile (OHIP).

Matched MeSH terms: Disabled Persons
Fulltext Acute disseminated encephalomyelitis: a report of six cases

Thomas GST, Hussain IHMI

Med J Malaysia, 2004 Aug;59(3):342-51.
PMID: 15727380 MyJurnal

Six children with Acute Disseminated Encephalomyelitis (ADEM) were seen at the Penang Hospital over a two year period (July 1999-June 2001). Diagnosis was based upon typical clinical features and characteristic findings on neuroimaging. Cerebrospinal fluid examination and other investigations were done, where appropriate, to rule out other causes of central nervous system disease. Three children had a prodromal illness. The most common presenting symptoms were fever, seizures, ataxia, focal neurological deficits and labile mood. Two children presented with status epilepticus. All children had an abnormal neurological examination. Brain magnetic resonance imaging revealed hyperintense signals on T2-weighted and FLAIR sequences in the subcortical and deep white matter regions of the frontal, parietal, and temporal lobes, as well as in the thalami, cerebellum and brainstem. One child had multiphasic disseminated encephalomyelitis (three episodes). The child with multiphasic disease had only one treated episode, and has suffered mild disability. Three children were treated with either methylprednisolone or immunoglobulins, and remain well. One child received both treatments but expired as a result of severe gastrointestinal bleeding from the use of methylprednisolone. The child who was not treated has severe disability.

Matched MeSH terms: Disabled Persons
The impact of sensory impairment on cognitive performance, quality of life, depression, and loneliness in older adults

Harithasan D, Mukari SZS, Ishak WS, Shahar S, Yeong WL

Int J Geriatr Psychiatry, 2020 04;35(4):358-364.
PMID: 31736109 DOI: 10.1002/gps.5237

OBJECTIVES: The objective of this study was to evaluate the relationship between sensory impairment (hearing loss only, vision loss only, and dual sensory impairment [DSI]) and depression, loneliness, quality of life, and cognitive performance in older adults.
METHODS: A total of 229 community-dwelling older adults aged 60 years or older participated in this study. Variables were measured using the Geriatric Depression Scale (GDS-15), Revised University of California at Los Angeles Loneliness Scale (R-UCLA), Satisfaction with Life Scale (SWLS), and Mini-Mental State Examination (MMSE).
RESULTS: There was an independent association between DSI and quality of life (P < .05) and between DSI and hearing loss alone and cognitive function (P < .05) in older adults. In addition, higher education was associated with better quality of life and cognitive function.
CONCLUSIONS: DSI is a significant factor affecting the quality of life and cognitive function in older adults. Sociodemographic factors such as education play an important role in improving quality of life and cognitive function. Thus, increasing the awareness of this disability is important to ensure that older adults receive the necessary support services and rehabilitation to improve their level of independence.

Matched MeSH terms: Disabled Persons