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Introduction: Sarcopenia is characterised by a progressive and generalised loss of skeletal muscle mass, strength and/or performance. It is associated with adverse health outcomes such as increased morbidity, functional decline and death. Early detection of sarcopenia in community-dwelling older adults is important to prevent these outcomes. Our scoping review evaluates validated screening tools that are used to identify community-dwelling older individuals at risk of sarcopenia and appraises their performance against international consensus definitions. Materials and Methods: A systematic search on MEDLINE, PubMed and EMBASE was performed for articles that evaluated the predictive validity measures of screening tools and validated them against at least 1 internationally recognised diagnostic criterion for sarcopenia. Results: Of the 17 articles identified in our search, 8 used questionnaires as screening tool, 2 utilised anthropometric measurements, 3 used a combination of questionnaire and anthropometric measures and 1 used a physical performance measure (chair stand test). The questionnaire Strength, Assistance with walking, Rising from chair, Climbing stairs and Falls (SARC-F) has the highest specificity (94.4-98.7%) but low sensitivity (4.2-9.9%), with the 5-item questionnaire outperforming the 3-item version. When SARC-F is combined with calf circumference, its sensitivity is enhanced with improvement in overall diagnostic performance. Although equation-based anthropometric screening tools performed well, they warrant external validation. Conclusion: Our scoping review identified 6 candidate tools to screen for sarcopenia. Direct comparison studies in the community would help to provide insights into their comparative performance as screening tools. More studies are needed to reach a consensus on the best screening tool(s) to be used in clinical practice. Key words: Low muscle function, Low muscle mass, Older adults, Sensitivity, Specificity

Falls are prominent health issues among older adults. Among hypertensive older adults, falls may have a detrimental effect on their health and wellbeing. The purpose of this study is to determine the prevalence of falls among hypertensive older adults and to identify the associated factors that contribute to their falls. This was a cross-sectional study conducted among two hundred and sixty-nine hypertensive older adults who were selected via systematic random sampling in two primary health clinics in Kuala Terengganu, Malaysia. Data on their socio-demographic details, their history of falls, medication history and clinical characteristics were collected. Balance and gait were assessed using the Performance Oriented Mobility Assessment (POMA). It was found that 32.2% of participants reported falls within a year. Polypharmacy (adjusted OR 2.513, 95% CI 1.339, 4.718) and diuretics (adjusted OR 2.803, 95% CI 1.418, 5.544) were associated with an increased risk of falls. Meanwhile, a higher POMA score (adjusted OR 0.940, 95% CI 0.886, 0.996) and the number of antihypertensives (adjusted OR 0.473, 95% CI 0.319, 0.700) were associated with a low incidence of falling among hypertensive older adults. Falls are common among hypertensive older adults. Older adults who are taking diuretics and have a polypharmacy treatment plan have a higher incidence of falls. However, older adults taking a higher number of anti-hypertensive medications specifically were not associated with an increased prevalence of falls.

Background There is no specific recommendation regarding the type of anaesthesia in hip fracture surgery. Objectives This study sought to examine the current local anaesthetic practice (general anaesthesia versus regional anaesthesia (RA)) in hip fracture surgery and to analyse their associations with perioperative outcomes. Methodology A retrospective observational study of hip fracture patients from April to December 2017 was undertaken. Patient characteristics and perioperative outcomes were analysed against the types of anaesthesia using multiple logistic regression. Results One hundred and twelve out of 154 patients (72.7%) had a general anaesthesia. Patients from residential care facilities were more likely to receive general anaesthesia (OR = 2.9, 95% CI: 1.1, 7.4; P = 0.03). There was no significant association between type of anaesthesia and specific postoperative outcomes; however, patients with postoperative delirium and hypotension were more likely to have received general anaesthesia [OR = 1.7, 95% CI: 0.68, 4.38; P = 0.25] and [OR = 1.6, 95% CI: 0.67, 4.04; P = 0.27] respectively). Subgroup analysis showed increased length of stay with patients who underwent general anaesthesia (OR = 1.26, 95% CI:1.04, 1.54; P = 0.02). Conclusion Regional anaesthesia may be considered in patients without contraindications in view of increased risk of postoperative delirium and hypotension, and longer length of stay with general anaesthesia. A larger prospective study is needed to confirm these findings.