OBJECTIVES: To determine the prevalence of fear of falling (FOF) and fear-related activity restriction (FAR) and their association with frailty, sarcopenia, gait speed and grip strength, cognitive impairment, depression, social isolation, self-perceived health, and vision. DESIGN: Observational cross-sectional study. SETTING: Community. PARTICIPANTS: A total of 493 community-dwelling older adults, 60 years and older. MEASURES: FOF and FAR were assessed using validated single closed-ended questions. Questionnaire was administered to evaluate frailty (FRAIL scale-Fatigue, Resistance, Aerobic, Illness, and Loss of Weight), sarcopenia (SARC-F-lifting and carrying 10 pounds, walking across a room, transferring from bed/chair, climbing a flight of 10 stairs, and frequency of falls in the past 1 year), social isolation (six-item Lubben Social Network Scale), depression (Even Briefer Assessment Scale), cognition (Chinese Mini-Mental State Examination), and perceived general health and pain (The EuroQol-5 Dimension (EQ-5D) and EQ visual analogue scale (EQ VAS)). Binary logistic regression was performed to determine the influence of sociodemographic, medical, functional, and cognitive variables on FOF with/without FAR. RESULTS: Prevalence of FOF was 69.2%, and among them, 38.4% had FAR. Prevalence of FOF with or without FAR in those with sarcopenia was 93.3% and in prefrail/frail was 76.6%. FOF was significantly associated with prefrail/frail (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.26-3.73), depression (OR = 4.90; 95% CI = 1.06-22.67), number of medications (OR = 1.28; 95% CI = 1.03-1.59), and female sex (OR = 3.54; 95% CI = 1.82-6.90). FOF + FAR was associated with depression (OR = 5.17; 95% CI = 1.84-14.54) and sarcopenia (OR = 8.13; 95% CI = 1.52-43.41). CONCLUSION: FOF with/without FAR is highly prevalent among community-dwelling older adults, especially in those with sarcopenia, prefrailty, and frailty, with significant negative impact on function, quality of life, social network, and mental health. Further research is needed to investigate the value of population-level screening, causal relationship, and efficacy of comprehensive intervention strategies.
Assessing habitual food consumption is challenging in multi-ethnic cosmopolitan settings. We systematically developed a semi-quantitative food frequency questionnaire (FFQ) in a multi-ethnic population in Singapore, using data from two 24-h dietary recalls from a nationally representative sample of 805 Singapore residents of Chinese, Malay and Indian ethnicity aged 18–79 years. Key steps included combining reported items on 24-h recalls into standardized food groups, developing a food list for the FFQ, pilot testing of different question formats, and cognitive interviews. Percentage contribution analysis and stepwise regression analysis were used to identify foods contributing cumulatively ≥90% to intakes and individually ≥1% to intake variance of key nutrients, for the total study population and for each ethnic group separately. Differences between ethnic groups were observed in proportions of consumers of certain foods (e.g., lentil stews, 1%–47%; and pork dishes, 0%–50%). The number of foods needed to explain variability in nutrient intakes differed substantially by ethnic groups and was substantially larger for the total population than for separate ethnic groups. A 163-item FFQ covered >95% of total population intake for all key nutrients. The methodological insights provided in this paper may be useful in developing similar FFQs in other multi-ethnic settings.
In this work we explore the preparation of complex-shaped semiconductor nanostructures composed of different materials via a cationic exchange process in which the cations of the original semiconductor nanostructure are replaced by cations of different metals with preservation of the shape and the anionic framework of the nanocrystals. Utilizing this cation exchange method, we synthesized two new tetrapods for the first time: Cu2-xSe/Cu2-xS and PbSe/PbS, both prepared from CdSe/CdS tetrapods as 'templates'. We also fabricated near-infrared (NIR) photodetectors with a very simple architecture comprising a PbSe/PbS tetrapod layer between two Au electrodes on a glass substrate. When illuminated by a NIR laser, these devices are capable of achieving a responsivity of 11.9 A W(-1) without the use of ligand-exchange processes, thermal annealing or hybrid device architecture. Transient absorption spectroscopy was carried out on these PbSe/PbS tetrapods, the results of which suggest that the branched morphology contributes in part to device performance. Investigation of the charge dynamics of the PbSe/PbS tetrapods revealed an extremely long-lived exciton recombination lifetime of ∼17 ms, which can result in enhanced photoconductive gain. Overall, these heterostructured tetrapods showcase simultaneously the importance of nanoparticle shape, band structure, and surface chemistry in the attainment of NIR photodetection.
Objective: To determine the prevalence of metabolic syndrome (MetS) in older adults and assess the association of MetS and adverse outcomes with handgrip strength (HGS), HGS/ body weight (BWT), and HGS/body mass index (BMI). Methods: A cross-sectional population study in Singapore. Data were collected on demographics, HGS, Timed-Up and Go (TUG), fasting glucose, lipid profile, blood pressure, waist circumference, frailty status, and cognition in 722 older adults ≥65 years old. MetS was defined using the Modified ATP III for Asians where at least three of the following conditions must be fulfilled, central obesity, high blood glucose (or diagnosed diabetes mellitus), high blood pressure (or diagnosed hypertension), low high-density lipoprotein, and high triglycerides. The waist circumference in the Modified ATP III for Asians is ≥90 cm for males or ≥80 cm for females. HGS and HGS normalized by BWT or BMI were used for the association. Results: The prevalence of MetS in older adults was 41.0%, and those ≥85 years old 50.0%. The prevalence was higher in females ≥70 years old, with 8 in 10 females ≥85 years having MetS. After adjusting for age, years of education, physical exercise, as well as history of smoking and alcohol consumption, higher HGS normalized by BWT or BMI was significantly associated with lower odds of having MetS (OR: 0.51,95% CI 0.43-0.61, p<0.01) and (OR: 0.13, 95% CI 0.07-0.24, p<0.01). Conclusion: Almost 1 in 2 older adults had MetS, with the prevalence in females much higher than that in males over 70 years old. Our findings suggest that both HGS/BWT and HGS/BMI had a significant negative association with MetS, its components, and adverse effects. Further studies are needed to validate the association and to determine optimal cutoffs of HGS/BWT and HGS/BMI for MetS, and the effectiveness of interventions in averting the risk.
Purpose Social isolation in older adults is a major public health problem and associated with increased morbidity and mortality. There are limited data on the association between social isolation and physical function including gait speed. Hence, this study is to determine the prevalence of social isolation and its association with gait speed, frailty, cognition, depression and comorbidities amongst community-dwelling older adults. Methods Social isolation, depression, frailty and perceived general health were assessed using 6-item Lubben Social Network Scale (LSNS-6), Geriatric Depression Scale (GDS), FRAIL scale and EuroQol EQ-5D-5L questionnaire which includes EQ Visual Analogue Scale (EQ-VAS), respectively. Cognition was assessed using the Chinese Mini Mental State Examination (cMMSE), while physical performance test included gait speed and short physical performance battery test. Binary logistic regression was performed to determine the influence of socio-demographic, medical, functional and cognitive variables on social isolation. Results Out of 202 participants, 27.7% were robust, 66.8% of participants were pre-frail, and 5.4% of participants were frail. Almost half (45.5%, n = 92) of the participants were found to be at risk of social isolation. A poor social network was negatively associated with mean gait speed (OR = 0.674, CI 0.464-0.979, p = 0.039), EQ-VAS (OR = 0.561, CI 0.390-0.806, p < 0.01) and cMMSE (OR = 0.630, 95% CI 0.413-0.960, p = 0.032). Conclusion Almost half of older adults in the community are at risk of social isolation with a very significant association with gait speed, cMMSE and EQ-VAS scores.
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