Living arrangement has been reported to have a significant influence on several mental health statuses of older adults, but their social network may confound this association. This study is aimed at examining the interactive effect of living arrangements and social network on the mental health status among older adults in Malaysia. A total of 2,188 Malaysian older adults living nationwide were included in this cross-sectional study. Participants were classified into four groups according to their living arrangements (living alone or not living alone) and social network size (assessed using Lubben's Social Network Scale-6). Poor social network was defined as the lowest quartile (fourth quartile) of the score. Mental health statuses, which include flourishing in life, life satisfaction, cognitive functions, loneliness, depression, and perceived stress, were measured. Multiple linear regression models, adjusted for age, gender, education, and comorbidities, revealed that a good social network was significantly associated with an increase on the flourishing scale scores, regardless of living arrangements. Not living alone and having good social network was significantly associated with increased Montreal Cognitive Assessment scores and decreased loneliness scores. This study found that living arrangements are not always a risk factor for the mental health status of older adults. However, it may be confounded by the level of their social networks. The results suggested that the effects of social network may exceed the impact of living arrangements. It is recommended that health professionals pay more attention to the social networks of older Malaysians to harness its benefits in improving their mental health status.

Malaysia is experiencing population ageing and expects to be an aged nation by 2030. Depression is one of the common disorder among elderly worldwide and the prevalence of depression in Malaysia is expected to increase as a result of population ageing. The association of depression and sexual satisfaction was unclear, particularly among the elderly. Therefore, this study aimed to examine the association between depression and sexual satisfaction among the Malay elderly population. One hundred and nine married community-dwelling elderly (Mean age = 63.23 years old) participated in this cross-sectional study. Hierarchical logistics regression was used to examine the association of depression on sexual satisfaction while controlling for potential confounders. Prevalence of depression and sexual dissatisfaction were 26.6% and 20.2%, respectively. Depression was significantly associated with sexual satisfaction (P = 0.002; OR = 0.19, 95% CI = 0.06, 0.66). Depressed participants were 81% less likely to experience sexual satisfaction compared to those without depression. Cross-sectional study design assessing the association between depression and sexual satisfaction. Findings from this study suggest that attention should be given to the prevention and treatment of depression among the elderly as a mechanism to improve sexual health.

Objective. This study is aimed at translating the Home Falls and Accidents Screening Tool (HOME FAST) into the three main languages spoken in Malaysia and investigating its reliability through an alternative technology-based evaluation. Methods. Translation into three languages and cross-cultural adaptation of the HOME FAST was conducted via the five steps adopted from the Mapi Institute. For interrater reliability, occupational therapists who attended a face-to-face home hazard workshop were recruited. Each therapist rated the HOME FAST by using the provided combination of videos and photographs of stroke survivors manoeuvring in their home. For test-retest reliability, the same occupational therapists were invited to rate the same combination of photographs and videos again. Reliability was analysed using Gwet’s and Bland and Altman’s plot to describe agreement. Results. The translation challenges were minimal and rectifiable. A Bahasa Melayu, Mandarin, and Tamil versions of the HOME FAST were developed. Overall interrater reliability for both video ( ) and photograph ( ) were good. The test-retest reliability yielded similar outcome (video: overall and photograph: overall ). Conclusion. Using alternative technology (video and photograph) to do a home hazard assessment was feasible. However, the asynchronous nature of these methods has limitations in clarifying certain aspects in the home. Moving forward, potential investigation on other technologies such as telehealth for synchronous and real-time interaction is warranted.

Background: This is a phase II randomised, double-blind, sham-controlled trial to evaluate the effectiveness and tolerability of repetitive transcranial magnetic stimulation for preventive treatment of episodic migraine amongst migraine subjects.Methods: Subjects age 18 to 60 years will undergo a baseline evaluation to establish the diagnosis of migraine based on the International Classification of Headache Disorder 3rd Edition (ICHD-3). Those who fulfil the ICHD-3 criteria for episodic migraine and compliant to the headache diary during a month run-in period will be enrolled. A total of 76 subjects will be randomised to receive either transcranial magnetic stimulation or sham stimulation for 5 sessions within 2 weeks duration. Follow-up sessions will be conducted monthly for three consecutive months. Prior to treatment, subjects will be required to fill up questionnaires and undergo few procedures such as electroencephalography, transcranial Doppler ultrasound and biochemical analysis for serum serotonin, serum calcitonin gene-related peptide and serum beta-endorphin. These procedures will be repeated at month 3 after receiving the last treatment. The primary outcome measure of this study is the difference in mean monthly migraine days at baseline and at months 1, 2 and 3 after treatment sessions.Discussion: Following evidence from previous studies showing restoration of dorsolateral prefrontal cortex (DLPFC) activation to almost normal level, the rTMS intervention will target left DLPFC in this study. An intermediate duration of treatment sessions is selected for this study. It is set to five treatment sessions given within 2 weeks duration.Trial registration: ClinicalTrials.govNCT03556722. Registered on 14 June 2018