Sen Tyng Chai

Loneliness as a Risk Factor for Hypertension in Later Life

Objective: The present study aims to determine the impact of loneliness on hypertension in later life. Method: Data for this study are derived from a sample of 1,880 older Malaysians via a cross-sectional survey entitled “Patterns of Social Relationships and Psychological Well-Being Among Older Persons in Peninsular Malaysia.” Loneliness is assessed by the PGCMS item, “How much do you feel lonely?” Data analysis is carried out using the Statistical Package for Social Sciences (SPSS) version 19.0. Results: Nearly one third of respondents report high level of loneliness. The overall prevalence of hypertension is 39% (95% CI = 36.9-41.3). Logistic regression, controlling for sociodemographic factors and several chronic medical conditions, shows that loneliness significantly increases likelihood of hypertension in later life (OR = 1.31, p ≤ .05, 95% CI = 1.04-1.66). Discussion: The results show loneliness as a major risk factor for hypertension and call for health care professionals to be aware of the negative physiological effects of loneliness in old age.

Moderating effect of religiosity on the relationship between social isolation and psychological well-being

It is known that social isolation is negatively associated to psychological well-being. Hence, it is imperative to identify factors that may moderate this association. This study aimed to examine the moderating effect of religiosity on the relationship between social isolation and psychological well-being among a sample of 1415 community-dwelling older Malay Muslims age 60 years and over. The data for this study came from a national survey entitled Patterns of Social Relationship and Psychological Well Being among Older Persons in Peninsular Malaysia, which was conducted using a cross-sectional research design. Three scales namely WHO-5 Well being Index, Revised Intrinsic Extrinsic Religiosity Scale, and Lubben Social Network Scale were utilised to measure psychological well-being, religiosity, and social isolation, respectively. A four-step moderated hierarchical regression analysis using SPSS (version-13) was employed to test moderating effect of religiosity. The results of this study demonstrated that religiosity significantly moderates relationship between social isolation and psychological well-being, after controlling for age, sex, marital status, level of education, employment status, household income, and place of residence. Based on the findings from this study, the possible educational and therapeutic implications are discussed.

Assessment of factors influencing morale in the elderly.

Background We examined the relationship between morale measured by the Philadelphia Geriatric Morale Scale (PGC) and disability, social support, religiosity, and personality traits. Instruments predicting morale were then tested against PGC domains. Methods The study utilized a cross-sectional survey with a multistage cluster sampling design. Instruments used were disability (disease burden; WHO Disability Score-II, WHODAS-II), social support (Duke Social Support Scale, DUSOCS; Lubben Social Network Scale, LSNS-6; Medical Outcomes Study Social Support Survey, MOS-SSS), religiosity (Revised Intrinsic-Extrinsic Religious Orientation Scale, I/E-R), and personality (Ten-Item Personality Inventory, TIPI). These were plotted as bar charts against PGC, resolved with one-way ANOVA and Kruskal-Wallis tests, then corrected for multiple comparisons. This process was repeated with PGC domains. Contribution of factors was modeled using population attributable risk (PAR) and odds ratios. Effect of confounders such as gender, age, and ethnicity were checked using binary logistic regression. Results All instruments showed clear relationships with PGC, with WHODAS-II and DUSOCS performing well (ANOVA p<0.001). For PGC domains, attitude toward aging and lonely dissatisfaction trended together, while agitation did not. PAR, odds ratios, and Exp(β) were disability (WHODAS-II: 28.5%, 3.8, 2.8), social support (DUSOCS: 28.0%, 3.4, 2.2), religiosity (I/E-R: 21.6%, 3.2, 2.1), and personality (TIPI: 27.9%, 3.6, 2.4). Combined PAR was 70.9%. Conclusions Disability, social support, religiosity, and personality strongly influence morale in the elderly. WHODAS-II and DUSOCS perform best in measuring disability and social support respectively.

Smoking and Cognitive Impairment Among Older Persons in Malaysia

Introduction: Previous studies have shown conflicting results on the association between smoking and cognitive function. This study aims to examine the relationship of smoking with cognitive function. Methodology: Data for the study, consisting of 2553 older adults aged 60 years and older, were drawn from a nationwide household survey entitled “Determinants of Wellness among Older Malaysians: A Health Promotion Perspective” conducted in 2010. Results: Current smokers had lower rates of cognitive impairment compared to never smokers (17.4% vs 25.9%), while cognitive function in former or ex-smokers was almost similar to that of the never smokers. Findings from multiple logistic regression analysis showed that current smokers were 37% less likely to be cognitively impaired, compared to the never smokers (odds ratio [OR] = .63; 95% confidence interval [CI]: .46-.86) while controlling for potential confounders. No difference in cognitive function was observed between former smokers and never smokers (OR = .94; 95% CI: .71-1.25). Conclusion: Although the findings indicated a negative association between cigarette smoking and cognitive impairment, we are unable to conclude whether this relationship is causal or affected by other unmeasured confounding factors, especially survival bias.