Cross-validation of a non-exercise measure for cardiorespiratory fitness in Singaporean adults.

INTRODUCTION: Cardiorespiratory fitness (CRF) is an independent predictor of voluminous health outcomes and can be measured using non-exercise fitness assessment (NEFA) equations. However, the accuracy of such equations in Asian populations is unknown. The objective of this study was to cross-validate the NEFA equation, developed by Jurca et al in 2005, in the adult Singaporean population. METHODS: A total of 100 participants (57 men, 43 women; aged 18-65 years) were recruited, and their maximal oxygen consumption (VO2 max) was measured in the laboratory by indirect calorimetry. The participants also completed the NEFA questionnaire, which helps to predict VO2 max with the NEFA equation. The relationship between NEFA-predicted and laboratory-measured VO2 max values was analysed. RESULTS: Overall, our study demonstrated a high correlation between the NEFA-predicted and laboratory-measured VO2 max values (r = 0.83). The Pearson's correlation coefficient values for the men and women in the study were 0.61 and 0.77, respectively. To improve the accuracy of the predictive equation, we transformed the original equation developed by Jurca et al into new equations that would allow estimation of VO2 max with and without resting heart rate as a variable. CONCLUSION: The modified NEFA equations accurately estimated CRF and may be applied to the majority of adult Singaporeans. With this, health practitioners and researchers are now able to assess CRF levels at both the individual and population levels in either the primary care, fitness or research setting.

Myopia and cognitive dysfunction: the singapore malay eye study.

PURPOSE: To investigate a possible relationship between refractive error and cognitive function. METHODS: This population-based, cross-sectional study included 1032 persons aged 60 to 79 who participated in the Singapore Malay Eye Study. Refraction (sphere, cylinder, and axis) was measured using an autorefractor, and spherical equivalent was defined as sphere plus half negative cylinder. Refractive errors were defined as myopia (spherical equivalent < -0.5), emmetropia (-0.5 diopter [D] ≤ spherical equivalent ≤ 0.5 D), and hyperopia (spherical equivalent > 0.5 D). Visual acuity was measured with a logMAR chart. Cognitive dysfunction, assessed using the Abbreviated Mental Test, was defined based on education-specific cutoff values. RESULTS: Compared with individuals with emmetropia, persons with myopia were almost twice as likely to have cognitive dysfunction (odds ratio 1.82; 95% confidence interval 1.05-3.15), after adjusting for age, sex, body mass index, income, education, and hours of reading and writing per day. Hyperopia was not associated with cognitive dysfunction. The association remained significant after further adjustment for uncorrected refractive errors or best-corrected visual acuity. CONCLUSIONS: Our results provide evidence on a novel association between myopia and cognitive dysfunction.

The use of point-of-decision prompts to increase stair climbing in Singapore.

Physical inactivity is a significant contributor to worldwide mortality and morbidity associated with non-communicable diseases. An excellent avenue to incorporate lifestyle physical activity into regular routine is to encourage the use of stairs during daily commutes. We evaluated the effectiveness of point-of-decision prompts (PODPs) in promoting the use of stairs instead of the escalators in a Singapore Mass Rapid Transit (MRT) station. We measured the number of stair climbers before the PODPs were put up, during the 4 weeks that they were in use, and 2 weeks after they were removed. Measurements at a no intervention control site were additionally taken. The use of stair-riser banners was associated with an increase in the number of people using the stairs by a factor of 1.49 (95% CI 1.34-1.64). After the banners were removed, the number of stair climbers at the experimental station dropped to slightly below baseline levels. The Singapore MRT serves a diverse multi-ethnic population with an average daily ridership of over 2 million and 88 stations island-wide. An increase of physical activity among these MRT commuters would have a large impact at the population level. Our findings can be translated into part of the national strategy to encourage an active lifestyle in Singaporeans.

Visual impairment, age-related eye diseases, and cognitive function: the Singapore Malay Eye study.

OBJECTIVE: To describe the associations of visual impairment and major age-related eye diseases with cognitive function in an older Asian population. METHODS: A population-based, cross-sectional study of 1179 participants aged 60 to 80 years from the Singapore Malay Eye study was conducted. Visual acuity was measured using the logMAR vision chart. Cataract and age-related macular degeneration were graded using the Wisconsin Cataract Grading System and the Wisconsin Age-Related Maculopathy Grading System, respectively. Glaucoma was diagnosed using the International Society Geographical and Epidemiological Ophthalmology criteria. Diabetic retinopathy was graded using the modified Airlie House classification system. Cognitive dysfunction was defined as a locally validated Abbreviated Mental Test using education-based cutoff scores. RESULTS: After adjusting for age, sex, education level, income, and type of housing, persons with visual impairment before refractive correction (odds ratio [OR]=2.59; 95% CI, 1.89-3.56) or after refractive correction (OR=1.96; 95% CI, 1.27-3.02) and those with visual impairment due to cataract (OR=2.75; 95% CI, 1.35-5.63) were more likely to have cognitive dysfunction. Only moderate to severe diabetic retinopathy was independently associated with cognitive dysfunction (OR=5.57; 95% CI, 1.56-19.91) after controlling for concurrent age-related eye diseases. No significant independent associations were observed between cataract, age-related macular degeneration, or glaucoma and cognitive dysfunction. CONCLUSIONS: Older persons with visual impairment, particularly those with visual impairment due to cataract, were more likely to have cognitive dysfunction. Furthermore, among the major age-related eye diseases, only diabetic retinopathy was associated with cognitive dysfunction.