A Narrative Review on Biopsychosocial Predictors of Cognitive Impairment among Multiple Sclerosis Patients: Directions for Malaysia Studies (Satu Tinjauan Naratif Mengenai Peramal Biopsikososial Kemerosotan Kognitif dalam Kalangan Pesakit Sklerosis Berbilang: Halatuju Arah Kajian di Malaysia) / Jurnal Sains Kesihatan Malaysia

@#Cognitive impairment is the most disabling symptoms of Multiple Sclerosis (MS). Researchers have been studying factors that could predict cognitive impairment among MS patients hoping to alleviate its consequences and gather indicators of the disease progression. However, there were limited up-to-date articles that review the predictors of cognitive impairment among MS patients. In Malaysia, the topic about cognitive functioning in MS was absent. This review aims to identify and synthesize the research evidence concerning biopsychosocial variables on cognitive impairment among this population for future directions in Malaysia researches. A narrative review was performed by identifying research articles from year 2004 to 2019 through PubMed, EBSCOhost, Scopus and Google Scholar. Fulltext articles meeting the selection criteria were included for qualitative synthesis. A total of 12 studies were included. Studies included in this paper found that age, course of disease and anxiety predicts cognitive functioning. Mixed results were found among variables such as gender, disability, fatigue, burden of lesion, depression and educational level. Stress was correlated with cognitive functioning but it was not a significant predictor. Although many factors were found to affect cognitive functioning among MS patients, evidence provided from this review indicates that their relationships might not be linear and direct.

Prevalence of Poor Mental Health and Cognitive Status among Middle-Aged Adults and Its Predictors in Relation to Polyphenols Intake

@#Background: Decline in mental health and cognitive status starts to show its sign during middle-age and is affected by dietary factors, namely the polyphenols intake. Polyphenols have received attention in improving health issues related to aging, including decline in mental health and cognitive. The aim of this study is to determine the prevalence of poor mental health and cognitive status among middle-aged adults and its predictors in relation to polyphenols intake. Methods: Subjects’ food intakes were calculated by using dietary history questionnaire and food frequency questionnaire for polyphenols. The subjects’ mental health and cognitive status were measured by general health questionnaire-28 (GHQ-28) and Rey’s auditory verbal learning test (RAVLT). Results: More than 40% of middle-aged adults were identified as having signs of poor mental health. A total of 67.9% of the subjects had poor cognitive status according to RAVLT immediate recall. Hierarchical binary logistic regression indicated that fat intake was associated with somatic symptoms for both men [adjusted odds ratio (AOR) = 1.04; P < 0.05] and women (AOR = 1.06; P < 0.05). Intake of lignan (AOR = 1.071; P < 0.05) was associated with better RAVLT immediate recall among women. Additionally, high cholesterol (AOR = 3.14; P < 0.05) was associated with poor score of RAVLT delayed recall for women. Conclusions: Early detection of poor mental health and cognitive is crucial to prevent Alzheimer’s disease in old age.

Neuropsychology of Epilepsy in Malaysia: A Narrative Review / Jurnal Sains Kesihatan Malaysia

@#The aim of this study is to describe the development of neuropsychological research among epilepsy patients in Malaysia so far, the current trend and the focus of future research endeavour. The research in epilepsy grows concurrently with the interest in the field of neuropsychology in Malaysia. Beginning with the presurgical evaluation of epilepsy patients as part of the epilepsy protocols, research areas expanded further into neuropsychological profiling. The current trend in Malaysia is determining the factors influencing neuropsychological outcomes as well as the risk factors associated with low quality of life among epilepsy patients. The future neuropsychological research should emphasize on the effectiveness of neurorehabilitation of epilepsy patients as well as psychosocial and cultural issues particularly on social stigma and employability in line with the research priorities set by the Research Task Force of the ILAE Commission on Asian and Oceanian Affairs for people with epilepsy in Asia-Oceanic region.

Identification of dietary patterns associated with characteristics of successful aging

@# Introduction: This study aimed to identify dietary patterns (DPs) and their association with successful aging (SA). Methods: A comparative cross-sectional study was conducted among 579 elderly subjects recruited from four states in Malaysia through a multistage random sampling method. SA was defined as having no chronic illnesses, no functional limitation, normal global function, no depression, a good quality of life and good self-perceived health. Information on dietary intake was obtained using a diet history questionnaire. Cognitive functions were assessed using the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric Depression Score-15 items (GDS-15) and a question regarding their perceived health and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to determine functional status. DPs were obtained using the principal component analysis (PCA) approach. An ordinal logistic regression model was used to examine associations between DP scores and SA. Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and ‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished when the model was adjusted for education level. Further analysis indicated that this DP increased the chance of SA among those with secondary education and above [Adjusted OR=2.43 (95% CI: 1.09–5.42)]. Conclusion: Tropical fruits-oats’ DP is associated with SA among elderly with secondary education and above. There is a need to investigate DPs among those with lower education.

The Development And Feasibility Evaluation Of A Module In Improving Functioning Of Children With Autism Spectrum Disorder (Asd)

@#Children with Autism Spectrum Disorder (ASD) have significant challenges in their daily life including social communication and interaction, emotional awareness and management, as well as behavioural issues. Many interventions are conducted based on theoretical backgrounds and past literature. There is lack of research study that interview and explore the real psychological needs of children with ASD in Malaysia. It is a significant component as their needs may vary depending on the cultural background, lifestyle, and social norms. Besides, there is a need to develop standardised intervention module to enhance intervention fidelity and replication of future study. The current study aims to scrutinise the psychological needs of children with ASD in Malaysia, develop a standardised group intervention module based on the identified needs, and then examine the feasibility of the developed module. Nine children with moderate to high functioning of ASD (7 to 12 years old) and their parents from Kuala Lumpur and Sarawak participated in the study. Result from the focus group interview suggests that children with ASD have three major psychological needs which are sociocommunication, awareness of danger, and emotions. The group intervention module was designed to fulfil these needs. The feasibility result shows that the designed module is practical, useful, and understandable for the participants. In view of this, future study may explore the effectiveness of the module. Once the module is proven effective, it can be patented and utilised to improve the psychological functioning of children with ASD in Malaysia.

Phonological Awareness And Global Visual Spatial Ability Among Malay Speaking Children With Specific Learning Disorder With Dyslexia

@#Children with Specific Learning Disorder (SLD) faces challenges in academic areas and are often negatively labelled. The learning problems in SLD children were mainly due to poor phonological skill but not much was known about the contribution of visuospatial difficulties. Therefore, this study aims to determine the relationship between phonological awareness skills and global visual-spatial abilities among Malay speaking children with SLD, and to compare children with SLD and typical readers on intellectual functioning, phonological awareness and global visual-spatial ability. An equal number of typical readers (n = 36) and children with SLD were recruited. Data were coded and analysed using Kendall’s Tau-b, independent samples t-test and Mann-Whitney U test. Results showed phonological skills have strong negative correlation with global visual-spatial ability (r = .55). The typical readers have significantly higher IQ and better phonological skills and better global visual-spatial skills as compared to the group with SLD. However, there is no conclusive evidence due to specificity of more than one area measured by the assessment tools. Nevertheless, it provides a direction for future research to look into global visual-spatial aspects of SLD to aid in educational instruction in the future, in addition to the long-standing phonology deficit theory.

A Review On Phonological Awareness And Visual-Spatial Ability Among Children With Dyslexia / Jurnal Sains Kesihatan Malaysia

This review aims to present an overview of current research findings on the possible relationship between phonologicalawareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles wereobtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholarwhich included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from theyear 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide abetter understanding of the relationship between them among individuals with dyslexia. Although it is evident that thereis a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficitand strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatialabilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia isdependent on the area of visual ability measured.

The predicting roles of reasons for living and social support on depression, anxiety and stress among young people in Malaysia

Introduction: This research examined the predicting roles of reasons for living and social support on depression, anxiety and stress in Malaysia. Method: This research was carried out on a sample of 263 participants (age range 12-24 years old), from Klang Valley, Selangor. The survey package comprises demographic information, a measure of reasons for living, social support, depression, anxiety and stress. To analyse the data, correlation analysis and a series of linear multiple regression analysis were carried out. Results: Findings showed that there were low negative relationships between all subdomains and the total score of reasons for living and depression. There were also low negative relationships between domain-specific of social support (family and friends) and total social support and depression. In terms of the family alliance, self-acceptance and total score of reasons for living, they were negatively associated with anxiety, whereas family social support was negatively associated with stress. The linear regression analysis showed that only future optimism and family social support found to be the significant predictors for depression. Family alliance and total reasons for living were significant in predicting anxiety, whereas family social support was significant in predicting stress. Conclusion: These findings have the potential to promote awareness related to depression, anxiety, and stress among youth in Malaysia.

The Association of Parent Education and Family Monthly Income on Intelligence Quotient (IQ) among Students with Special Needs in Kelantan, Malaysia / Jurnal Sains Kesihatan Malaysia

This paper investigate the effect of parents’ education background and family monthly income on the Intelligence Quotient (IQ) of students with special needs in Kelantan, Malaysia. This cross-sectional method study was employed multistage random sampling to obtain information drawn from 130 participants from 10 selected school in Kelantan, Malaysia. Questionnaire was used to obtain parents’ education background, family monthly income and demographic variables. Students IQ were assessed using Comprehensive Test for Non-Verbal Intelligence (CTONI 2nd Edition). Data analysis involve independent sample t-test, one-way between group ANOVA, Pearson’s correlation and multiple linear regression. From analysis of IQ score, 63.8% of the special needs students scored very poor IQ, 12.3% scored below average and only 1.5% score average IQ. Significant mean difference were revealed between age group (p = 0.002), parents’ education (p = 0.018) and family monthly income (p < 0.05) on special needs students IQ. Post-hoc tukey shows significance between parents who never went to school, went to secondary school (p = 0.037) and university/college (p = 0.021). In term of family monthly income, significance difference were found between family with low and high monthly income (p < 0.05). Family monthly income (r = 0.393, p < 0.01) showed positive moderate correlation on special needs students IQ. After being forwarded by multiple linear regression, it was found that family monthly income (B = 3.605, p < 0.05) and age group of special needs students (B = 0.879, p = 0.002) were significant predictor for IQ score and explained 22.5% of the variance (R2 = 0.225, F (5,124) = 83.94, p < 0.05. Overally, majority of special needs students in current study have very poor IQ score. Further explanation are discussed on the paper.

Perceived Stress and Coping Styles among Malay Caregivers of Children with Learning Disabilities in Kelantan

Background: Caregivers of children with learning disabilities have been shown to experience increased stress and greater negative caregiving consequences than those with typically developing children. There remains a lack of studies focusing on stress and coping mechanisms among caregivers of a wider age group and diagnosis of individuals with disabilities in Asian countries. The current study examines levels of perceived stress and associated child and caregiver factors among caregivers of children with learning disabilities in the Malaysian context. An additional aim was to determine whether caregiver coping styles may be predictors of perceived stress. Methods: The Malay version of the Perceived Stress Scale with 10 items and the Brief COPE Scale were administered to a sample of 190 Malay caregivers of children with learning disabilities registered with community-based rehabilitation centres in Kelantan, a state in Peninsular Malaysia. Multiple linear regression analysis was applied to determine the predictors of perceived stress. Results: The mean total perceived stress score of caregivers was 16.96 (SD = 4.66). The most frequently used coping styles found among caregivers included religion, acceptance and positive reframing, while substance use and behavioural disengagement were least frequently used. Higher perceived stress was significantly predicted among caregivers with fewer children, frequent use of instrumental support and behavioural disengagement coping, and lack of emotional support and religious coping. Conclusion: Findings indicate that the perceived stress levels among caregivers were significantly predicted by different coping styles. It is vital to help the caregivers improve their good coping styles in order to reduce their stress levels.

Perceived Stress among Malay Caregivers of Children with Learning Disabilities in Kelantan / Jurnal Sains Kesihatan Malaysia

Parents or caregivers of children with learning disabilities have been shown to experience increases in stress and greater negative caregiving consequences than those with typically developing children. The current study sought to assess the perceived stress among Malay caregivers of children with learning disabilities in Kelantan. The Malay version of Perceived Stress Scale 10 items was administered to a sample of 40 caregivers of children with learning disabilities who were registered to five Pusat Pemulihan Dalam Komuniti (PDK) in Kelantan. Higher scores indicate higher levels of stress. The caregivers had mean age of 47.68 (SD = 9.18) years old, of whom 90% were fathers or mothers. Ninety percent of them were married, majority were unemployed or housewives and had secondary school education. The majority of children with learning disabilities were males and half of them were Down Syndrome children. The mean total Perceived Stress Scale score of the caregivers was 16.77 (SD = 5.74). There were no significant associations between total perceived stress score and any of the independent variables. The mean total perceived stress score showed that the perceived stress level was in the category of slightly higher than average and health concern level was high, while the average stress level was between score of 12 to 15. In conclusion, this result indicated that the caregivers had slightly higher levels of stress than the average score, and might increase susceptibility to stress-induced illness.

Relationship between Demographic and Clinical Factors with Physical Functioning of Stroke Patients / Jurnal Sains Kesihatan Malaysia

Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation (r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.

Cognitive Profiles in Parkinson’s Disease and their Correlation with Dementia, Anxiety and Depression: A Preliminary Study

A cross-sectional study was carried out at a medical centre to determine the cognitive profiles of 30 Parkinson’s disease patients with age of 69.76 ± 7.39 years. Thirty-seven percent of the patients were found to be at risk for dementia. The scores on subscales of working memory and alternating verbal fluency were significantly lower in Parkinson’s disease patients who were older than 77 years old. The scores on a subtest of working memory on the Parkinson’s Disease Cognitive Rating Scale (PDCRS) were significantly lower in Parkinson’s disease patients with a duration of illness of more than 10 years. In cognitive measurement, the subtests of verbal memory, delayed free recall and verbal fluency on the PD¬CRS were significantly lower in patients with less than six years of education. The patients who had difficulty with sustained attention, working memory and movement had significant anxiety and depression symptoms. In conclusion, multiple patterns in cognitive profiles influence the quality of life of patients with Parkinson’s disease in multi-dimensional ways.

The Ability of Recovery Locus of Control Scale (RLOC) and Post-traumatic Stress Symptoms (PTSS) to Predict the Physical Functioning of Stroke Patients

Background: The aim of this study was to address the ability of the recovery locus of control scale (RLOC) and post-traumatic stress symptoms (PTSS) to predict physical functioning among stroke patients. In addition, the best predictors within the subdomains of the RLOC and PTSS were also investigated. Methods: A total of 147 stroke patients aged 33–85 years who had intact cognitive functioning were involved in the study. The Recovery Locus of Control Scale (RLOC), the Impact of Event Scale- Revised (IES-R), and the Barthel Index (ADL) were administered to respondents six weeks after stroke. Results: The results showed that the RLOC and PTSS were significant predictors and were capable of predicting 31% of the physical functioning of stroke patients (adjusted R2 = 0.31; P < 0.001). Furthermore, with respect to clinical factors, the affected lesion side contributed to predicting 7% of the physical functioning (R2 = 0.07; P < 0.001). A hierarchical regression analysis found that the internal recovery locus of control (IRLOC) was a predictor capable of explaining 18% of the predicted physical functioning (adjusted R2 = 0.18; P < 0.001). Meanwhile, avoidance was the most influential significant predictor among PTSS, contributing to 24% of the predicting physical functioning (adjusted R2 = 0.24; P < 0.001). Conclusion: In conclusion, the RLOC and PTSS were capable of predicting physical functioning among stroke patients.

Dietary Polyphenols Consumption and Its Relation with Cognitive and Mental Health in Aging: A Review / Jurnal Sains Kesihatan Malaysia

Literature review suggests that polyphenols in particular fl avonoids, are benefi cial for mental health during aging process. This review examines the effect of consumption of all polyphenols groups on mental health and cognitive status during aging process. The keywords searched were “mental health,” “depression,” “anxiety,” “stress” and “cognitive” combined with “dietary,” and “polyphenols.” The databases including PubMed, Web of Science and CAB Abstracts were searched for a period of 10 years. A total of 11 studies were identifi ed to fulfi ll the inclusion criteria. From this review, polyphenols may confer benefi cial effects towards mental health, in particular the decline in cognitive functions during aging process, however, some studies showed contradictory results. Polyphenols have been proven to improve language and verbal ability, which is among the main vulnerable aspects in cognitive decline in pathological brain aging. In contrast, polyphenols intake did not seem to affect executive functioning. The effects of polyphenols towards cognitive status were more prominent among the elderly as compared to young and middle-aged adults. This review also shows that fl avonoids is the main type of polyphenols that confer positive effects towards cognitive status during aging. This review provides evidence that consumption of polyphenols may lead to cognitive and mental health benefi ts. Further clinical trials involving human subjects are required with carefully designed methodology to elucidate the potential mechanisms underlying the relationship between polyphenols consumption and improvement in cognitive and mental health status

The prevalence and factors influencing posttraumatic stress disorders (PTSD) among help-seeking women experiencing domestic violencein Malaysia

Objective: The aim of the study is to examine the prevalence and factors influencing PTSD among a sample of help-seeking women experiencing domestic violence. Methods: This was a cross-sectional survey study of 40 women in two shelters in Malaysia from 2007 to 2008. Measures include the Detailed Assessment of Posttraumatic Stress; the Measure of Wife Abuse; the Posttraumatic Cognitions Inventory; the Coping Scale for Adults; and the Provision of Social Relations. Results: Results showed that 60% of subjects exhibited patterns of symptoms consistent with the diagnosis of PTSD. The most prominent posttraumatic symptoms reported were re-experience, avoidance, dissociative responses, and symptoms of increased arousal. Both negative appraisals about themselves and self blame for the abusive situations were positively associated with increased tendency to develop PTSD. The greater use of optimism coping style and the higher quality social support appeared to lead to a significantly reduced tendency of developing PTSD. Negative appraisals about themselves were found to be the strongest positive predictor of PTSD [R² = 0.32, F(1,38)=17.67, p<0.001]. However, type of intensity of abuse did not indicate any significant relationship with PTSD. The findings highlighted the need for service providers to screen and educate survivors of domestic violence with respect to PTSD. The study also emphasized the importance of negative appraisals as a factor that contribute to the maintenance or persistence of PTSD. Conclusion: The current findings suggest that service providers should continue to assist the survivors in developing positive coping skills and improve their social support networks. Cognitive-behavioural treatment approaches seem to be particularly relevant for the cognitive distortions commonly presence in survivors of domestic Keywords: Domestic violence, negative appraisal, social support, coping styles, PTSD violence.