Boon Yiang Chua

Prevalence of Dementia in People Aged 60 Years and Above: Results from the WiSE Study

BACKGROUND The challenge of an aging population with its expected attendant problem of an increase in the number of people with dementia is a growing concern across the world. OBJECTIVE The aims of this study were to establish the prevalence and risk factors of dementia in Singapore among the elderly resident population (aged 60 years and above). METHODS The WiSE study was a comprehensive single phase, cross-sectional, epidemiological survey that adapted the 10/66 protocol to establish the 10/66 and the Diagnostic and Statistical Manual of mental disorders -fourth edition (DSM-IV) diagnosis of dementia. 10/66 and DSM-IV dementia diagnosis as established by the survey questionnaires was validated by comparing against a gold standard of clinical assessment. RESULTS A total of 2,565 respondents completed the study giving a response rate of 65.6%. The validity of 10/66 dementia was higher (sensitivity = 95.6%, specificity = 81.8%) than that of DSM-IV dementia (sensitivity = 75.6%, specificity = 88.6%) when compared against the clinical gold standard. The study found that the prevalence of 10/66 dementia was 10% in the older adult population while the prevalence of DSM-IV dementia was 4.6%. Older age (75 years and above); no formal education, or completed primary education (versus higher education); homemaker and retired status (versus employed); and a history of stroke were associated with a higher risk of 10/66 dementia. CONCLUSION The establishment of accurate data on the number of people with dementia is essential in the planning of services and initiatives.

The positive mental health instrument: development and validation of a culturally relevant scale in a multi-ethnic asian population

BackgroundInstruments to measure mental health and well-being are largely developed and often used within Western populations and this compromises their validity in other cultures. A previous qualitative study in Singapore demonstrated the relevance of spiritual and religious practices to mental health, a dimension currently not included in exiting multi-dimensional measures. The objective of this study was to develop a self-administered measure that covers all key and culturally appropriate domains of mental health, which can be applied to compare levels of mental health across different age, gender and ethnic groups. We present the item reduction and validation of the Positive Mental Health (PMH) instrument in a community-based adult sample in Singapore.MethodsSurveys were conducted among adult (21-65 years) residents belonging to Chinese, Malay and Indian ethnicities. Exploratory and confirmatory factor analysis (EFA, CFA) were conducted and items were reduced using item response theory tests (IRT). The final version of the PMH instrument was tested for internal consistency and criterion validity. Items were tested for differential item functioning (DIF) to check if items functioned in the same way across all subgroups. Results: EFA and CFA identified six first-order factor structure (General coping, Personal growth and autonomy, Spirituality, Interpersonal skills, Emotional support, and Global affect) under one higher-order dimension of Positive Mental Health (RMSEA = 0.05, CFI = 0.96, TLI = 0.96). A 47-item self-administered multi-dimensional instrument with a six-point Likert response scale was constructed. The slope estimates and strength of the relation to the theta for all items in each six PMH subscales were high (range:1.39 to 5.69), suggesting good discrimination properties. The threshold estimates for the instrument ranged from -3.45 to 1.61 indicating that the instrument covers entire spectrums for the six dimensions. The instrument demonstrated high internal consistency and had significant and expected correlations with other well-being measures. Results confirmed absence of DIF.ConclusionsThe PMH instrument is a reliable and valid instrument that can be used to measure and compare level of mental health across different age, gender and ethnic groups in Singapore.

Care participation and burden among informal caregivers of older adults with care needs and associations with dementia.

Background: Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers’ care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers’ burden. Methods: Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, and their informal caregivers, who were aged 21 to 88 years, closely involved in their care and “knew the older resident best,” and were interviewed during a cross-sectional national survey, were used. Clinical characteristics of older adults, including behavioral and psychological symptoms of dementia (BPSD) and dementia diagnosis, care needs, and socio-demographic characteristics of participants were obtained. Care burden was assessed with the Zarit Burden Interview. Results: Informal caregivers’ participation was highest in activities related to communication (35.1%), feeding (32%), and bathing (21.1%). Among the older adults with any care need, 356 (51.4%) had dementia. Care burden was significantly associated with married caregivers (odds ratio (OR) 2.4 vs. never married), when their relative belonged to a younger cohort (OR 2.5 vs. >84 years), needed care much of the time (OR 2.5 vs. no care needed), exhibited BPSD (OR 3.5 vs. no BPSD), and had dementia (OR 2.52 vs. no dementia). Conclusions: Factors related to older adults – more care needs, presence of BPSD, and dementia – were significant contributors to informal caregivers’ burden, and these should be considered while planning interventions to alleviate care burden.

Attitudes Toward Seeking Professional Psychological Help: Factor Structure and Socio-Demographic Predictors

Attitudes toward seeking professional psychological help (ATSPPH) are complex. Help seeking preferences are influenced by various attitudinal and socio-demographic factors and can often result in unmet needs, treatment gaps, and delays in help-seeking. The aims of the current study were to explore the factor structure of the ATSPPH short form (-SF) scale and determine whether any significant socio-demographic differences exist in terms of help-seeking attitudes. Data were extracted from a population-based survey conducted among Singapore residents aged 18–65 years. Respondents provided socio-demographic information and were administered the ATSPPH-SF. Weighted mean and standard error of the mean were calculated for continuous variables, and frequencies and percentages for categorical variables. Confirmatory factor analysis and exploratory factor analysis were performed to establish the validity of the factor structure of the ATSPPH-SF scale. Multivariable linear regressions were conducted to examine predictors of each of the ATSPPH-SF factors. The factor analysis revealed that the ATSPPH-SF formed three distinct dimensions: “Openness to seeking professional help,” “Value in seeking professional help,” and “Preference to cope on ones own.” Multiple linear regression analyses showed that age, ethnicity, marital status, education, and income were significantly associated with the ATSPPH-SF factors. Population subgroups that were less open to or saw less value in seeking psychological help should be targeted via culturally appropriate education campaigns and tailored and supportive interventions.

Prevalence of frailty and its association with sociodemographic and clinical characteristics, and resource utilization in a population of Singaporean older adults.

The present study examined the prevalence of frailty and its association with sociodemographic, clinical and social characteristics, and service utilization in a representative general population sample of Singaporean older adults.

The Societal Cost of Dementia in Singapore: Results from the WiSE Study.

BACKGROUND There is currently limited evidence on the economic burden that dementia exerts on multi-ethnic Asian populations. OBJECTIVE The present study aimed to estimate the economic cost of dementia in Singapore. METHODS We used data from the Well-being of the Singapore Elderly study, a nationally representative survey of the older Singapore Resident population aged 60 years and above. Generalized linear modeling was used to estimate factors associated with costs. RESULTS The total cost of dementia in 2013 was estimated at S

Prevalence and Correlates of Pain in People Aged 60 Years and above in Singapore: Results from the WiSE Study

532 million (95% CI, S

Prevalence, correlates and outcomes of insomnia in patients with first episode psychosis from a tertiary psychiatric institution in Singapore

361 million to S

Clinicians’ perceptions of pharmacogenomics use in psychiatry

701 million) while the annual cost per person was estimated at S

Recognition of mental disorders: findings from a cross-sectional study among medical students in Singapore

10,245 per year (95% CI, S