Nutritional and Non-Communicable Disease (NCD) Status Association with Fall among Older Persons in Malaysia: Findings from National Health and Morbidity Survey (NHMS) Malaysia 2018

ntroduction Fall is a health problem for older persons. This study investigates the potential factors of concern: the nutritional status of the elderly and non-communicable disease association with incidents of falls. Methods and Materials This study used data from NHMS 2018, a cross-sectional design, applied two-stage stratified cluster sampling. Descriptive statistics such as the percentage of each variable were done. Factors associated with falls were determined at both univariate and multivariable levels using simple logistic regression and multiple logistic regression. The data were presented as standard values for each analysis and adjusted odds ratios with 95% CI with p values (<0.05). Results A total of 3,867 from 3,977 elderly (mean age 68.2+ 6.85) were recruited with the response rate of 97.2%. Factors associated with fall were 70 years old and above (AOR= 1.34, 95% CI: 1.09, 1.64), obesity (AOR=1.55, 95% CI: 1.21, 1.98), undernutrition (AOR=1.59, 95% CI: 1.30, 1.94), persons with 2 NCDs (AOR=1.49, 95% CI: 1.15, 1.92) and persons with 3 NCDs (AOR=1.63, 95% CI: 1.23, 2.16). Discussion and Conclusion Advanced age, malnutrition, obesity, and having two or more NCD are associated with falls in the NHMS 2018 study. In conclusion, falls are prevalent among older persons. There is an urgent need for public health strategies to decrease the incidence and early identification of those at risk. Implementation of fall preventive programs can also significantly reduce falls among the elderly.

Sodium intake assessed by 24-h urine excretion and its relationship with anthropometric measurements in Malaysian adults

BACKGROUND

Sodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia.

METHODS

A cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents' 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0.

RESULTS

Of 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl.

CONCLUSION

Our study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

Prevalence and factors associated with physical fighting among Malaysian adolescents

Physical fighting among adolescents is one manifestation of interpersonal violence that is an important issue globally, but attention to this problem in Malaysia has been limited. We analyzed data available from the Malaysia Global School-Based Health Survey conducted in 2012. Of the 25 507 respondents, 27.4% reported having been in a physical fight in the past 12 months. Being bullied (adjusted odds ratio [aOR] = 3.01; 95% confidence interval [CI] = 2.67-3.39) was significantly and highly associated with involvement in physical fighting. Smoking (aOR = 2.56; 95% CI = 2.20-2.97), males (aOR = 1.77; 95% CI = 1.62-1.93), using drugs (aOR = 1.73; 95% CI = 1.09-2.15), and drinking alcohol (aOR = 1.42; 95% CI = 1.24-1.63) were other factors associated with physical fighting. Parental supervision showed no significant association with physical fighting. These findings indicate that more attention needs to be given to bullying at school by school authorities and parents.