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Background Poverty at old age is associated with poor dietary habit, nutritional status and higher rates of chronic diseases and psychosocial problems. However, there is limited information about this matter according to urban and rural settings. The aim of this study was to identify dietary, nutritional, physical and cognitive factors associated with poor socioeconomic status (SES) among older adults according to urban and rural settings in Malaysia. Methods An analysis was conducted among 2237 older adults who participated in a longitudinal study on aging (LRGS TUA). This study involved four states in Malaysia, with 49.4% from urban areas. Respondents were divided into three categories of SES based on percentile, stratified according to urban and rural settings. SES was measured using household income. Results The prevalence of low SES was higher among older adults in the rural area (50.6%) as compared to the urban area (49.4%). Factors associated with low SES among older adults in an urban setting were low dietary fibre intake (Adj OR:0.91),longer time for the Timed up and Go Test (Adj OR:1.09), greater disability (Adj OR:1.02), less frequent practice of caloric restriction (Adj OR:1.65), lower cognitive processing speed score (Adj OR:0.94) and lower protein intake (Adj OR:0.94). Whilst, among respondents from rural area, the factors associated with low SES were lack of dietary fibre intake (Adj OR:0.79), lower calf circumference (Adj OR: 0.91), lesser fresh fruits intake (Adj OR:0.91), greater disability (Adj OR:1.02) and having lower score in instrumental activities of daily living (Adj OR: 0.92). Conclusion Lower SES ismore prevalent in rural areas. Poor dietary intake, lower fitness and disability were common factors associated with low in SES, regardless of settings. Factors associated with low SES identifiedin both the urban and rural areas in our study may be useful inplanning strategies to combat low SES and its related problems among older adults.

Background Probable sarcopenia is a condition related to low muscle strength which increases the risk of sarcopenia. Both probable sarcopenia and sarcopenia increases the risk of dementia. The aim of this study is to investigate the factors associated with dementia among probable sarcopenia and sarcopenia older adults. It was hypothesized that comorbidities among probable sarcopenia and sarcopenia subjects may elevate the risk of dementia. Methodology This study involved 194 older adults with probable sarcopenia and sarcopenia aged 60 years and above. Sarcopenia was assessed using the Asian Working Group of Sarcopenia (AWGS) 2019. Among the parameters investigated in this study were sociodemographic, medical history, anthropometry, body composition, physical fitness, subjective cognitive decline, depressive symptoms, cognitive function and functional status. Dementia risk was assessed using the Montreal Cognitive Assessment (MoCA) tool. Adjusted binary logistic regression was employed to identify the factors associated with dementia among probable sarcopenia and sarcopenia older adults. Results Probable sarcopenia subjects with dementia were older (68.5(7.8) years old) as compared to those without dementia (66.0(6.0) years old). Among the probable sarcopenia, 66.1% of the subjects with dementia had hypertension, while 64.3% of the sarcopenia subjects had hypertension. Fat mass was significantly higher among dementia subjects with probable sarcopenia (33.0(6.5) %) as compared to non-dementia subjects (30.4(6.8) %). Multivariate analysis revealed that hypertension (OR: 4.049; 95% CI: 1.510; 10.855, p  = 0.005) was the only factor associated with dementia risk among older adults with probable sarcopenia and sarcopenia. Conclusion Hypertension is the only factors associated with risk of dementia after adjusting for potential confounders among older adults with probable sarcopenia and sarcopenia. Good control of blood pressure is essential among sarcopenia patients for lowering risk of dementia. Well-designed clinical trials are essential to investigate optimizing blood pressure level to reduce risk of dementia among patients with sarcopenia and probable sarcopenia.

BACKGROUND:Covid-19 lockdown had caused lifestyle changes especially in sleep, physical activity, and body weight. Thus, this study aimed to determine the weight changes before and after the lockdown period and further assessed the association between sleep quality, physical activity, and body mass index (BMI).MATERIAL AND METHODS:This was a retrospective cross-sectional study involving 107 undergraduate students in Universiti Sains Malaysia. Subjects recalled information during the first lockdown implemented in Malaysia from early March 2020 to July 2020. The questionnaire consisted of socio-demography, anthropometry, and physical activity using International Physical Activity Questionnaire and sleep quality using Pittsburgh Sleep Quality Index. Chi-square analysis was used to determine the association between the variables using Statistical Package for Social Sciences software version 26.0.RESULTS:There was a significant increase of 1.8 kg in weight before and after the lockdown period. The majority of respondents had poor sleep quality (80.4%) and low physical activity (60.2%), respectively. Almost 29% of the subjects had sleep latency of more than 30 min while 69.1% of them had sleep duration of <7 h. There was no significant association between sleep quality and BMI as well as physical activity and BMI.CONCLUSION:Our study demonstrated that the prevalence of poor sleep quality and low physical activity among university students was high during Covid-19 confinement. Moreover, youths have a significant increase in body weight during the lockdown period. Thus, university students may adopt exciting leisure activities to keep themselves active such as doing meditation or joining online exercise classes.

Introduction Fear of falling has serious implications for health and is an important threat to autonomy. The purpose of this cross-sectional study was to investigate risk factors for fear of falling among Palestinian older adults in Hebron district. Methods A cross-sectional study was conducted among Palestinians > 60 years living in Hebron, West Bank. The Falls Efficacy Scale-International was used to predict falls among Palestinian older adults. Moreover, socio-demographic data, medical history, lifestyle habits, body composition, nutritional status, cognitive status (using the Montreal cognitive assessment tool), and functional status (using activities of daily living and instrumental activities of daily living scale), the presence of depressive symptoms (using geriatric depression scale), and physical fitness performance (using senior fitness test) were collected through an interview-based questionnaire. Data were analyzed using univariate and multivariate approach. Results A total of 200 participants were included in the study; 137 (68.5%) females and 63 (31.5%) males. Mean age was 70.5 ± 5.7 years, ranged from 65 to 98 years old. Fear of falling was significantly higher among older adults with advanced aged, living in villages or camps, low educational level, and being married (p < 0.05). Functional status (ADL and IADL), physical fitness status (timed up and go), and depression symptoms were significantly related to fear of falling (p < 0.05). Conclusion High concern of falling is significantly associated with advanced age, low education level, being married, and living in villages or camps. ADLs were among the factors that had a significant relationship with increased fear of falling. Predictors of fear of falling among Palestinian older adults were IADL scores, body fat percentage, rapid gait speed, timed up and go test. Future studies could investigate further correlates of fear of falling among older adults.

Background and Objectives: Bariatric surgery becomes the final option for managing severe obesity. This study aims to identify the complications, changes in anthropometry, adherence to dietary recommendations, and psychological well-being of post-bariatric surgery patients. Methods and Study Design: An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery. The participants were assessed for the complications experienced, current comorbidities, anthropometric changes, dietary intake, and psychological well-being. A three-day, 24-hour diet recall was done to assess the dietary intake of the patients. The mean macronutrient and micronutrient intakes were compared to several available recommendations. The DASS-21 questionnaire was administered to determine the psychological well-being of the participants. Results: The most common complications experienced by patients after bariatric surgery were hair loss (50.8%), gastroesophageal reflux disease (GERD) (49.2%), and vomiting (41.3%). There were significant differences in mean weight before (129.5 (33.0) kg/m2) and after (85.0 (32.0) kg/m2) bariatric surgery (p<0.001). The prevalence of clinically severe obesity declined by 55%. Overall, patients had insufficient intake of some nutrients such as protein, fat, calcium, and iron. Majority of the patients experienced a normal level of stress, anxiety, and depression, but some had mild (3.2%), moderate (4.8%), and severe anxiety (1.6%). Conclusions: There were drastic improvements in patients' weight following bariatric surgery. However, there were several complications including nutrient deficiencies. Due to the anatomical changes in the gastrointestinal tract, patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional. A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.

BackgroundA significant lack of systematic data exists regarding the relationship between nutrition and dialysis, despite the recognized impact of poor nutrition on extended hospital stays and high mortality rates, especially in developing countries. To address this gap and stimulate further research, a comprehensive bibliometric analysis is crucial. This study aims to map the connections between dialysis and nutrition by examining citations, regional distributions, and research trends, ultimately identifying key areas of focus and providing an overview of current research in this field.MethodsA comprehensive literature review on the relationship between nutritional status and dialysis therapy was conducted, and the Scopus database was used to identify relevant publications from 1952 to 2022. The selected articles met the preestablished inclusion criteria. VOSviewer software (version 1.6.20) was employed to analyse publication trends and key research areas within this body of literature.ResultsThe study encompassed a total of 2,545 publications, reflecting a steady increase in published materials. Among these records, the United States emerged as the top contributor with 22.99%, followed by Japan at 6.95% and Italy at 6.29%. The primary funding source was NIDDK, accounting for 3.73%, with NIH ranking second at 2.48%. Before 2012, investigations in this field centred mainly on how nutritional parameters and anthropometric measurements affect dialysis outcomes; in the past decade, attention has broadened to encompass inflammation-related mortality in dialysis care and, more recently, dietary intake patterns, adherence, and patient behaviour.ConclusionsThis study presents a pioneering bibliometric analysis aimed at tracing the evolution of knowledge and trends in nutrition and dialysis therapy over the past seven decades. The findings offer a comprehensive overview, delineating the forefront of research on nutrition and end-stage renal disease, and providing valuable insights for scholars in this field. The study highlights a growing research emphasis on integrating inflammatory biomarkers, dynamic body composition monitoring, and multidisciplinary dietary interventions to enhance outcomes for dialysis patients.

A number of longitudinal studies on aging have been designed to determine the predictors of healthy longevity, including the neuroprotective factors, however, relatively few studies included a wide range of factors and highlighted the challenges faced during data collection. Thus, the longitudinal study on neuroprotective model for healthy longevity (LRGS TUA) has been designed to prospectively investigate the magnitude of cognitive decline and its risk factors through a comprehensive multidimensional assessment comprising of biophysical health, auditory and visual function, nutrition and dietary pattern and psychosocial aspects. At baseline, subjects were interviewed for their status on sociodemographic, health, neuropsychological test, psychosocial and dietary intake. Subjects were also measured for anthropometric and physical function and fitness. Biospecimens including blood, buccal swap, hair and toenail were collected, processed and stored. A subsample was assessed for sensory function, i.e., vision and auditory. During follow-up, at 18 and 36 months, most of the measurements, along with morbidity and mortality outcomes will be collected. The description of mild cognitive impairment, successful aging and usual aging process is presented here. A total 2322 respondents were recruited in the data analysis at baseline. Most of the respondents were categorized as experiencing usual aging (73 %), followed by successful aging (11 %) and mild cognitive impairment (16 %). The LRGS TUA study is the most comprehensive longitudinal study on aging in Malaysia, and will contribute to the understanding of the aging process and factors associated with healthy aging and mental well-being of a multiethnic population in Malaysia.

Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

Background Chronic kidney disease (CKD) is seen as a diverse disease and a primary contributor to global mortality. Malnutrition arises within chronic illness, which involves protein energy depletion and inadequate levels of essential nutrients. These factors increase the likelihood of death and the overall impact of the disease on affected individuals. Consequently, this study aims to utilize bibliometric and visual analysis to assess the current state of research, the latest advances and emerging patterns in the fields of CKD and malnutrition. Methods Extensive research was conducted using the Scopus database, which is the most authoritative database of research publications and citations, to focus on CKD research between 2003 and 2022, as indicated by title and author keywords. Then, within this vast collection of academic publications, a notable subset of articles was exclusively dedicated to investigating the relationship between CKD and malnutrition. Finally, we performed bibliometric analysis and visualization using VOSviewer 1.6.19 and Microsoft Excel 2013. Results Large global research between 2003 and 2022 resulted in 50,588 documents focused on CKD, as indicated by title and author keywords. In this extensive collection of scientific publications, a staggering portion of 823 articles is devoted exclusively to investigating the link between CKD and malnutrition. Further analysis reveals that this body of work consists of 565 articles (68.65%), 221 reviews (26.85%), and 37 miscellaneous entries (4.50%), which encompass letters and editorials. The USA was found to be the most productive country ( n  = 173; 21.02%), followed by Italy ( n  = 83; 10.09%), Sweden ( n  = 56; 6.80%), Brazil ( n  = 54; 6.56%) and China ( n  = 51; 6.20%). The most common terms on the map include those related to the topic of (a) malnutrition in hemodialysis patients and predicting factors; terms associated with the (b) impact of malnutrition on cardiovascular risk and complications in CKD patients; and terms related to the (c) dietary protein intake and malnutrition in CKD. Conclusions This study is the first of its kind to analyze CKD and malnutrition research using data from Scopus for visualization and network mapping. Recent trends indicate an increasing focus on protein-energy wasting/malnutrition in hemodialysis patients and predicting factors, dietary protein intake, and malnutrition in CKD. These topics have gained significant attention and reflect the latest scientific advances. Intervention studies are crucial to examining diet therapy's impact on patients with stages 1 to 5 CKD. We hope this study will offer researchers, dietitians and nephrologists valuable information.

Objective The research aimed to study digital divide by determining the usage of digital technology among older adults with cognitive frailty (CF) in Malaysia. Methods The dataset was obtained from the AGELESS trial screening phase conducted from October 2021 to March 2022, involving 476 community-dwelling Malaysian older adults (67.7 years old ± 6.1). Digital technology usage was assessed and CF was determined using Fried's criteria and Clinical Dementia Rating. A binary logistic regression was used to determine the sociodemographic factors associated with digital technology use among older adults with CF. Results The findings suggest a digital divide between older adults with CF and robust in Malaysia. CF individuals (72.1%) were less likely to utilise digital technology, mainly smartphone than robust older adults (89.6%). More than 70% of older people owned social media on their smartphones, namely, WhatsApp. The most frequent online activities in both groups were family interaction and obtaining current news. CF older adults were less likely to play games on their smart devices. Usage of digital technology was more common among male, younger age, attained formal education more than 6 years, had a higher monthly household income, and robust participants. Conclusions The usage of digital technology was inversely related to CF status. CF older adults were less likely to integrate digital technology into their daily living compared to robust even though they were familiar with it. The use of digital technology should be reinforced among female, advanced age, widowers/divorcees without formal education and those from lower- or middle-income statuses, and cognitively frail older people.