Sharifah Azizah Haron

Dyadic effects of attitude toward aging on psychological well-being of older Malaysian couples: an actor–partner interdependence model

Background There is a growing body of literature indicating that attitudes toward aging significantly affect older adults’ psychological well-being. However, there is a paucity of scientific investigations examining the role of older adults’ attitudes toward aging on their spouses’ psychological well-being. Therefore, the present study aimed to examine the dyadic effects of attitude toward aging on the psychological well-being of older couples. Methods Data for the present study, consisting of 300 couples aged 50 years and older, were drawn from a community-based survey entitled “Poverty among Elderly Women: Case Study of Amanah Ikhtiar” conducted in Peninsular Malaysia. An actor–partner interdependence model using AMOS version 20 (Europress Software, Cheshire, UK) was used to analyze the dyadic data. Results The mean ages of the husbands and wives in this sample were 60.37 years (±6.55) and 56.33 years (±5.32), respectively. Interdependence analyses revealed significant association between older adults’ attitudes toward aging and the attitudes of their spouses (intraclass correlation =0.59; P<0.001), and similar interdependence was found for psychological well-being (intraclass correlation =0.57; P<0.001). The findings from AMOS revealed that the proposed model fits the data (CMIN/degrees of freedom =3.23; goodness-of-fit index =0.90; confirmatory fit index =0.91; root mean square error of approximation =0.08). Results of the actor–partner independence model indicated that older adults’ psychological well-being is significantly predicted by their spouses’ attitudes toward aging, both among older men (critical ratio =2.92; P<0.01) and women (critical ratio =2.70; P<0.01). Husbands’ and wives’ own reports of their attitudes toward aging were significantly correlated with their own and their spouses’ psychological well-being. Conclusion The findings from this study supported the proposed Spousal Attitude–Well-Being Model, where older adults’ attitudes toward aging significantly affected their own and their spouses’ psychological well-being. The theoretical and practical implications of the findings are discussed.

Are older people more vulnerable to long-term impacts of disasters?

Background Despite the growing interest in the study of disasters, there is limited research addressing the elderly population that lead to prejudiced beliefs that older adults are more vulnerable to disasters than younger adults. This study aimed to compare positive mental health between elderly and young earthquake survivors. Method Data for this study, consisting of 324 earthquake survivors, were obtained from a population-based cross-sectional survey conducted in Iran, 2015. The long-term effect of earthquake was assessed using the Mental Health Continuum-Short Form questionnaire. A one-way multivariate analysis of covariance (MANCOVA) using SPSS (version 22) was used in data analysis. Results Older adults scored significantly a higher level of overall positive mental health (mean [M]=34.31, standard deviation [SD]=10.52) than younger age group (M=27.48, SD=10.56, t=−4.41; P<0.001). Results of MANCOVA revealed a statistically significant difference between older and young adults on the combined positive mental health subscales (F(3,317)=6.95; P<0.001), after controlling for marital status, sex, and employment status. Conclusion The present findings showing a higher level of positive mental health among elderly earthquake survivors compared with their younger counterparts in the wake of natural disasters suggest that advancing age per se does not contribute to increasing vulnerability.

Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach

ABSTRACT Objectives: The aim of this study was to identify the predictors of elderlys cognitive function based on biopsychosocial and cognitive reserve perspectives. Method: The study included 2322 community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, biomarkers, psychosocial status, disability, and cognitive function. A biopsychosocial model of cognitive function was developed to test variables’ predictive power on cognitive function. Statistical analyses were performed using SPSS (version 15.0) in conjunction with Analysis of Moment Structures Graphics (AMOS 7.0). Results: The estimated theoretical model fitted the data well. Psychosocial stress and metabolic syndrome (MetS) negatively predicted cognitive function and psychosocial stress appeared as a main predictor. Socio-demographic characteristics, except gender, also had significant effects on cognitive function. However, disability failed to predict cognitive function. Conclusion: Several factors together may predict cognitive function in the Malaysian elderly population, and the variance accounted for it is large enough to be considered substantial. Key factor associated with the elderlys cognitive function seems to be psychosocial well-being. Thus, psychosocial well-being should be included in the elderly assessment, apart from medical conditions, both in clinical and community setting.

Social embeddedness as a mechanism for linking social cohesion to well-being among older adults: moderating effect of gender.

Background The positive effect of social cohesion on well-being in older adults has been well documented. However, relatively few studies have attempted to understand the mechanisms by which social cohesion influences well-being. The main aim of the current study is to identify social pathways in which social cohesion may contribute to well-being. Methods The data for this study (taken from 1,880 older adults, aged 60 years and older) were drawn from a national survey conducted during 2008–2009. The survey employed a two-stage stratified sampling process for data collection. Structural equation modeling was used to test mediating and moderating analyses. Results The proposed model documented a good fit to the data (GFI =98; CFI =0.99; RMSEA =0.04). The findings from bootstrap analysis and the Sobel test revealed that the impact of social cohesion on well-being is significantly mediated by social embeddedness (Z=5.62; P<0.001). Finally, the results of a multigroup analysis test showed that social cohesion influences well-being through the social embeddedness mechanism somewhat differently for older men than women. Conclusion The findings of this study, in addition to supporting the importance of neighborhood social cohesion for the well-being of older adults, also provide evidence that the impact of social cohesion towards well-being is mediated through the mechanism of social embeddedness.

Food Variety and Dietary Diversity Scores to Understand the Food-Intake Pattern among Selected Malaysian Households

Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0–7 and 0–6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.

Spousal Death Anxiety in Old Age Gender Perspective

Anxiety toward one’s own death has been extensively studied and conceptualized. However, the fear of death of others particularly of spouse in later life, which may be worse than individual’s death anxiety, has not been investigated. The present research aims to study spousal death anxiety among Malaysian middle-aged and older couples. The study subjects, consisting of 300 couples aged 50 years and older, were obtained from a national cross-sectional survey entitled “Poverty among Elderly Women: Case Study of Amanah Ikhtiar” conducted in Peninsular Malaysia. Women reported significantly higher levels of spousal death anxiety than their partners t(299) = 2.48, p < .05. About 45% of older men and 52% of their spouses reported high spousal death anxiety. The results of two separate stepwise regression analyses yielded a two-variable model for men and a four-variable model for women. The most important concern of older men that may increase spousal death anxiety was caregiving issues. For older women, financial security following widowhood was most important factor toward spousal death anxiety. The findings suggest that the majority of the older couples are prone to death anxiety of their spouse and factors contributing to the fear of death of spouse are different for men and women.

Moderating effect of intrinsic religiosity on the relationship between depression and cognitive function among community-dwelling older adults

ABSTRACT Objectives: Research has found that depression in later life is associated with cognitive impairment. Thus, the mechanism to reduce the effect of depression on cognitive function is warranted. In this paper, we intend to examine whether intrinsic religiosity mediates the association between depression and cognitive function. Method: The study included 2322 nationally representative community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, cognitive function, depression and intrinsic religiosity. A four-step moderated hierarchical regression analysis was employed to test the moderating effect. Statistical analyses were performed using SPSS (version 15.0). Results: Bivariate analyses showed that both depression and intrinsic religiosity had significant relationships with cognitive function. In addition, four-step moderated hierarchical regression analysis revealed that the intrinsic religiosity moderated the association between depression and cognitive function, after controlling for selected socio-demographic characteristics. Conclusion: Intrinsic religiosity might reduce the negative effect of depression on cognitive function. Professionals who are working with depressed older adults should seek ways to improve their intrinsic religiosity as one of the strategies to prevent cognitive impairment.

Prevalence of hypotension and its association with cognitive function among older adults.

ABSTRACT Background and Objective: The negative effect of hypertension has overshadowed possible health problems associated with hypotension. The purposes of this study were to describe the prevalence of hypotension in older adults and to determine the association between hypotension and cognitive function, after adjusting for possible covariates. Methodology: The data for the study consisting of 1067 community-dwelling older adults were obtained from a national survey entitled “Identifying Psychosocial and Identifying Economic Risk Factor of Cognitive Impairment among Elderly”, conducted in Malaysia. The hypotension was considered as blood pressure <120/75 mm Hg, measuring by standard mercury manometer. Data analysis was performed using the SPSS Version 22.0. Results: The mean age of the respondents was 68.27 (SD = 5.93). Mean score of cognitive function as measured by MMSE was 22.70 (SD = 4.95). The prevalence of hypotension was 29.3%. The prevalence of cognitive impairment for hypotension group was 25.6%. Results of multiple linear regression analysis revealed that hypotension is negatively associated with cognitive function (Beta = −0.11, p<.01), after adjusting for age, gender, education, marital status, employment status, diabetes, heart disease, stroke and gastritis. Conclusion: The study showing hypotension is significantly associated with decreased cognitive function in later life, implies more attention to low blood pressure in old age.

Does food insufficiency in childhood contribute to dementia in later life

Background Despite several studies attempting to identify the risk factors for dementia, little is known about the impact of childhood living conditions on cognitive function in later life. The present study aims to examine the unique contribution of food insufficiency in childhood to dementia in old age. Methods Data for this study of 2,745 older Malaysians aged 60 years and older was obtained from a national survey entitled “Mental Health and Quality of Life of Older Malaysians” conducted from 2003 through 2005 using a cross-sectional design. The Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy was used to measure dementia. A multiple binary logistic regression using Statistical Package for Social Sciences version 21 was conducted to assess the unique effect of food insufficiency in childhood on developing dementia in old age. Results A notably higher prevalence of dementia was found in respondents who indicated they had experienced food insufficiency in childhood than in their food-sufficient counterparts (23.5% versus 14.3%). The findings from multiple logistic regression analysis revealed that food insufficiency in childhood would independently increase the risk of developing dementia in old age by 81%, after adjusting for sociodemographic factors (odds ratio =1.81, 95% confidence interval 1.13–2.92, P<0.01). Conclusion Findings from the present study showing that food insufficiency in early life significantly contributes to dementia in later life highlight the importance of childhood living conditions in maintaining cognitive function in old age. It is, therefore, suggested that older adults with childhood food insufficiency might be targeted for programs designed to prevent dementia.

Information processing speed as a mediator between psychosocial stress and global cognition in older adults

The link between psychosocial stress and cognitive function is complex, and previous studies have indicated that it may be mediated by processing speed. Therefore, the main aim of this study was to examine whether processing speed mediates the association between psychosocial stress and global cognition in older adults. Moreover, the moderating role of gender in this model is examined as well.