Tengku Aizan Hamid

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.

Sociodemographic risk factors and correlates of dementia in older Malaysians.

Objective: The rapid expansion of the aged population in Malaysia is expected to greatly increase the number of persons with dementia in the country. However, data on dementia prevalence at the national level is lacking, and little is known about the sociodemographic risk factors and correlates of dementia. This paper describes a nationwide study of dementia prevalence and its sociodemographic risk factors and health correlates among older Malaysians. Methods: In the nationwide study, the Mental Health and Quality of Life of Older Malaysians, AGECAT-GMS was used to diagnose dementia in a nationally representative sample of 2,980 persons aged 60 and above. Results: The prevalence rate of dementia was 14.3%. Higher dementia prevalences were found in oldest age (26.3%), women (19.7%), no formal education (24.1%), Bumiputeras (32.2%), unmarried (19.4%), unemployed (31.3%) and very poor on self-rated health (33.3%). Multivariate logistic regression analyses showed that older age, female gender, no formal education, ethnicity and very poor self-rated health were independent risk factors and correlates of dementia. Conclusions: Relatively higher prevalence rates of dementia in older Malaysians were accounted for by greater proportions without education, Malay and Bumiputera ethnicity, and other unknown factors which should be further investigated.

Predictors and Prevalence of Successful Aging among Older Malaysians

Background: Successful aging is an important and worldwide concept in gerontology. However, until recently, there has been very little known about successful aging in Malaysia. This study was designed to describe the prevalence and correlates of successful aging among older Malaysians. Methods: Data for this study were obtained from the national survey ‘The Mental Health and Quality of Life of Older Malaysians’. For this study, successful aging was defined based on a multidimensional model, encompassing the avoidance of chronic disease and physical functioning difficulty, and maintenance of good psychocognitive functioning. Results: The prevalence of successful aging among older Malaysians was calculated at 13.8% (CI: 12.6–15.1). Results of multiple logistic regression analysis showed that age, educational attainment, household income, and ethnicity were significantly associated with successful aging. Conclusion: Results of this study show that successful agers were more likely to be among the younger age, ethnic Chinese, and those with a higher education level and household income, after adjusting for all other variables in the model.

Sociodemographic predictors of elderly's psychological well-being in Malaysia.

Background and objective: Psychological well-being as one of the most important indicators of successful aging has received substantial attention in the gerontological literature. Prior studies show that sociodemographic factors influencing elderlys psychological well-being are multiple and differ across cultures. The aim of this study was to identify significant sociodemographic predictors of psychological well-being among Malay elders. Methodology: The study included 1415 older Malays (60–100 years, 722 women), randomly selected through a multistage stratified random method from Peninsular Malaysia. WHO-Five well-being index was used to measure psychological well-being. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 13.0. Results: Using multiple regression analysis a significant model emerged (F(7, 1407) = 20.14, p ≤ 0.001), where age, sex, marital status, and household income were significant predictor variables of psychological well-being among Malay elders. However, level of education, employment status, and place of residence failed to predict psychological well-being. Conclusion: This study showed that the oldest old, elderly women, unmarried, and the poor elderly people are at risk for experiencing low psychological well-being. Therefore, they need special attention from family, policy makers, and those who work with elderly people.

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.

Moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well-being among elderly Malays.

Background:  Research has found that physical health decline in later life is associated with poor psychological well‐being. This study aimed to examine the possible moderating effect of Islamic religiosity on the relationship between chronic medical conditions and psychological well‐being.

Unmet needs among disabled elderly Malaysians

Unmet need as a significant factor affecting quality of life in later life has recently received considerable attention in gerontological research. The main aim of this study was to identify the prevalence, predicting factors, and negative consequence of unmet need among older Malaysians. The findings may be useful to reduce unmet need and the burden of its adverse consequence. The sample for this study consists of 400 functionally disabled elderly people aged 60 and over was obtained from a large national survey. Unmet need was operationally defined based on Mantons (1989) criteria. The findings from the present study showed about 18.0% of functionally disabled older Malaysians suffer from unmet need. Logistic regression revealed that gender (being male) and chronic health conditions are statistically associated with increased odds of unmet need after adjusting for other possible risk factors. Further results indicated that unmet need statistically increases odds of fall as a negative consequence of unmet need. The high prevalence rates of unmet need among disabled elderly men and chronically ill older persons suggest that policy makers should pay more attention to this vulnerable group to achieve good quality of life. The implications and limitations of the present study are discussed.

Living Arrangement and Life Satisfaction in Older Malaysians: The Mediating Role of Social Support Function

Background This cross-sectional and correlational survey examines the association between different types of living arrangements and life satisfaction in older Malaysians, while taking into account the mediating effects of social support function. Methodology and Findings A total of 1880 of older adults were selected by multistage stratified sampling. Life satisfaction and social support were measured with the Philadelphia Geriatric Center Morale Scale and Medical Outcomes Study Social Support Survey. The result shows living with children as the commonest type of living arrangement for older adults in peninsular Malaysia. Compared to living alone, living only with a spouse especially and then co-residency with children were both associated with better life satisfaction (p<.01) and social support function (p<.01). The mediating effect of social support function enhanced the relation between living arrangements and life satisfaction. Conclusion This study revealed that types of living arrangement directly, and indirectly through social support function, play an important role in predicting life satisfaction for older adults in Malaysia. This study makes remarkable contributions to the Convoy model in older Malaysians.

Mediating Effects of Social and Personal Religiosity on the Psychological Well Being of Widowed Elderly People

Spousal death is one the most stressful life events that seriously affects the psychological well being of widowed. This study examined the mediating effects of social and personal religiosity on the psychological well being of widowed elderly people. The sample for this study was comprised of 1367 widowed and married elderly Muslims from Malaysia. Psychological well being, religiosity, and physical health were measured using WHO-5 Well being Index, Intrinsic Extrinsic religiosity scale, and a checklist of 16 physical health problems, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (version-13). As expected, bivariate correlation analysis revealed that widowhood is statistically and negatively associated with psychological well being. Results of multiple hierarchical regression analyses and Sobel test showed that only the indirect effect of widowhood through personal religiosity was statistically significant (Sobel = −2.79, p < .01). Sobel test for social religiosity was not significant (Sobel = −1.54, p > .05). The results of this study confirmed earlier studies, which found that widowhood negatively affects psychological well being of elderly people. Overall, the findings show that the potential solace provided by religiosity can decrease the negative effects of widowhood on the psychological well being of widowed elderly people.