Biomedical subjects

Tze-Pin Ng

Publications and source records attributed to Tze-Pin Ng.

9 recordsLinked to original sources

PubMed2007

Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life.

BACKGROUND: Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD), but depression's impact on COPD outcomes has not been fully investigated. We evaluated the impact of comorbid depression on mortality, hospital readmission, smoking behavior, respiratory symptom burden, and physical and social functioning in patients with COPD. METHODS: In this prospective cohort study, 376 consecutive patients with COPD hospitalized for acute exacerbation were followed up for 1 year. The independent associations of baseline comorbid depression (designated as a Hospital Anxiety and Depression Scale score of > or =8) with mortality, hospital readmission, length of stay, persistent smoking, and quality of life (determined by responses to the St George Respiratory Questionnaire) were evaluated after adjusting for potential confounders. RESULTS: The prevalence of depression at admission was 44.4%. The median follow-up duration was 369 days, during which 57 patients (15.2%) died, and 202 (53.7%) were readmitted at least once. Multivariate analyses showed that depression was significantly associated with mortality (hazard ratio, 1.93; 95% confidence interval, 1.04-3.58), longer index stay (mean, 1.1 more days; P = .02) and total stay (mean, 3.0 more days; P = .047), persistent smoking at 6 months (odds ratio, 2.30; 95% confidence interval, 1.17-4.52), and 12% to 37% worse symptoms, activities, and impact subscale scores and total score on the St George Respiratory Questionnaire at the index hospitalization and 1 year later, even after controlling for chronicity and severity of COPD, comorbidities, and behavioral, psychosocial, and socioeconomic variables. CONCLUSIONS: Comorbid depressive symptoms in patients with COPD are associated with poorer survival, longer hospitalization stay, persistent smoking, increased symptom burden, and poorer physical and social functioning. Interventions that reduce depressive symptoms may potentially affect COPD outcomes.

Aged↗

PubMed2007

Mental disorders and asthma in the elderly: a population-based study.

BACKGROUND: Clinical studies have mostly linked anxiety disorders with asthma in young patients, but the data are inconsistent for depression. Few population-based studies have investigated the co-morbid diagnoses of mental disorders with asthma in older adults. METHOD: Cross-sectional study of a population sample of older adults aged 60 and above (n = 1092). The diagnoses of recent depression and anxiety were made using the Geriatric Mental State (GMS) Schedule. The presence of asthma was ascertained by self-reports of physician-diagnosed asthma. RESULTS: Asthma was associated with a higher prevalence of depressive disorders, with odds ratio of 2.45 (95% CI, 1.06-5.69) when compared against non-asthmatic controls; and 2.42 (95% CI, 1.04-5.64) when compared against controls with other chronic illnesses, after adjusting for psychosocial factors, physical co-morbidity and use of depression-causing drugs. Odds ratios were elevated but statistically insignificant for anxiety disorders and dementia. CONCLUSION: We observed that asthma in the elderly was more evidently associated co-morbidly with depression, rather than anxiety disorder. However, possible associations with anxiety and dementia are not excluded, and should be further investigated.

Aged↗

PubMed2006

Curry consumption and cognitive function in the elderly.

Curcumin, from the curry spice turmeric, has been shown to possess potent antioxidant and antiinflammatory properties and to reduce beta-amyloid and plaque burden in experimental studies, but epidemiologic evidence is lacking. The authors investigated the association between usual curry consumption level and cognitive function in elderly Asians. In a population-based cohort (n = 1,010) of nondemented elderly Asian subjects aged 60-93 years in 2003, the authors compared Mini-Mental State Examination (MMSE) scores for three categories of regular curry consumption, taking into account known sociodemographic, health, and behavioral correlates of MMSE performance. Those who consumed curry "occasionally" and "often or very often" had significantly better MMSE scores than did subjects who "never or rarely" consumed curry. The authors reported tentative evidence of better cognitive performance from curry consumption in nondemented elderly Asians, which should be confirmed in future studies.

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PubMed2006

Factors associated with acute health care use in a national adult asthma management program.

BACKGROUND: The use of acute health care resources for asthma is considerable. Disease severity is an established risk factor, but ethnicity and health care factors are less well studied. OBJECTIVE: To investigate the independent associations of ethnicity and health care factors with acute resource use for asthma. METHODS: Longitudinal data from a national adult asthma management program providing universal access to care were analyzed. Outcome measures were unscheduled physician visits with urgent nebulization, emergency department (ED) visits, and hospitalizations. RESULTS: In multivariate analyses, markers of disease severity were found to be significantly associated with all acute resource use. After controlling for disease severity, ethnicity was associated with increased risk of all acute resource use; Indian (vs Chinese) ethnicity was associated with increased risk of unscheduled physician visits (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.03-1.70), ED visits (HR, 1.61; 95% CI, 1.12-2.32), and hospitalizations (HR, 1.49; 95% CI, 1.03-2.16). Malay ethnicity was associated with unscheduled physician visits (HR, 1.30; 95% CI, 1.01-1.68) and ED visits (HR, 1.55; 95% CI, 1.09-2.19). Default of follow-up appointments was associated with unscheduled physician visits (HR, 1.47; 95% CI, 1.08-2.00), ED visits (HR, 2.35; 95% CI, 1.59-3.45), and hospitalizations (HR, 1.74; 95% CI, 1.09-2.76). Poor inhaler technique was associated with ED visits (HR, 1.86; 95% CI, 1.05-3.30) and smoking with unscheduled physician visits (HR, 1.38; 95% CI, 1.09-1.76). CONCLUSIONS: In addition to markers of asthma severity, ethnicity, smoking, discontinuity of care, and self-care behavior are risk factors for acute resource utilization and represent target groups and elements of asthma intervention for improving asthma outcomes.

Adult↗

PubMed2006

Homocysteine, folate, and vitamin B-12 and cognitive performance in older Chinese adults: findings from the Singapore Longitudinal Ageing Study.

BACKGROUND: The relations of elevated homocysteine, low folate, and vitamin B-12 with cognitive performance in nondemented elderly are not well established. Limited research data suggest differential effects of homocysteine and folate on specific cognitive domains. OBJECTIVE: The aim was to examine the independent associations of homocysteine, folate, and vitamin B-12 with cognitive performance in high-functioning elderly Chinese. DESIGN: Homocysteine, folate, and vitamin B-12 concentrations were measured in fasting blood samples of 451 Chinese aged >or=55 y with Mini-Mental State Examination scores >or=24 and who were considered fully independent based on Activities of Daily Living score. Cognitive functions were assessed by a neuropsychological test battery. Independent associations (standardized beta) were determined in multiple linear regression models that simultaneously controlled for potential confounders. RESULTS: Log-transformed homocysteine was inversely associated with performance on Block Design (beta = -0.319, P = 0.006) and the written Symbol Digit Modality Test (beta = -0.129, P = 0.031). Log-transformed folate was significantly associated with Rey Auditory Verbal Learning Test delayed recall (beta = 0.139, P = 0.010), verbal learning (beta = 0.112, P = 0.038), percentage of forgetting (beta = -0.139, P = 0.013), and the Categorical Verbal Fluency test (beta = 0.104, P = 0.042). Vitamin B-12 was not significantly associated with any cognitive test score. CONCLUSIONS: In this high-functioning elderly Chinese population, elevated homocysteine is associated with deficits in constructional ability and processing speed and folate is associated with measures of episodic memory and language. Our results provide support for differential effects of homocysteine and folate on specific cognitive functions.

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PubMed2006

Physical and cognitive domains of the Instrumental Activities of Daily Living: validation in a multiethnic population of Asian older adults.

BACKGROUND: We sought to assess the validity of the physical and cognitive domains of Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale and its cross-cultural applicability across ethnic groups in an Asian population of community-living older adults. METHODS: Using data from a random population sample of noninstitutionalized Chinese, Malay, and Indian older adults 60 years old and older in Singapore (N = 1072), we modeled the dimensional structure of the 8-item IADL Scale using exploratory and confirmatory factor analyses, and assessed its convergent and divergent validity using known group differences and strengths of association. RESULTS: Factor analyses yielded two strong and reliable factors representing underlying physical and cognitive dimensions of IADL. The validity of the model was supported by the pattern of associations of the IADL with age, gender, education, self-reported health status, hospitalization, physical comorbidities, dementia and depression, and Mini-Mental State Examination (MMSE) scores. Notably, cognitive IADL showed a greater total effect on MMSE cognitive performance score than did physical IADL, with the effect of physical IADL on MMSE score mostly explained by cognitive IADL. Reasonably good cross-cultural validity was demonstrated among Chinese, Malays, and Indians, with strongest validity for Indians. CONCLUSION: The eight-item IADL Scale has physical and cognitive domains and is cross-culturally applicable. The cognitive IADL domain taps a set of activities directly related to cognitive functioning.

Activities of Daily Living↗

PubMed2006

Prevalence and correlates of functional disability in multiethnic elderly Singaporeans.

OBJECTIVES: To make comparative estimates of prevalence of late-life functional disability, examine sociodemographic and health correlates, investigate sex and ethnic differences, and estimate population attributable risk of modifiable risk factors. DESIGN: Population-based survey. SETTING: Multiethnic population of Singapore (3 million residents). PARTICIPANTS: Noninstitutionalized Chinese, Malay, and Indian people aged 60 and older (N=1,079) MEASUREMENTS: Functional disability was defined as needing help in at least one basic activity of daily living (ADL) task in the 10 items of the Barthel Index. Five basic ADLs (eating, bathing, dressing, transferring, toileting) were used to compare prevalence with those reported from other national surveys and with reported past prevalence within the country. RESULTS: The prevalence of disability in at least one of five ADL items (6.6% in those aged > or = 65) appeared lower than elsewhere, including China, but higher than reported past prevalence within the country. Functional disability on at least one of the 10 ADL items was independently associated with female sex, Indian ethnicity, older age, poor self-rated health, specific chronic diseases, cognitive impairment, sensory impairment, and living with others. The population attributable risks for leading modifiable factors were arthritis (12%) and cognitive impairment (14%). CONCLUSION: Lower prevalence of functional disability accompanies rapid aging and health transition in Singapore than in other countries but higher prevalence than reported past prevalence within the country. Associations with sociodemographic and health-related factors were consistent with Western studies, including unexplained sex and ethnic differences.

Activities of Daily Living↗

PubMed2003

Recent trends in elderly suicide rates in a multi-ethnic Asian city.

BACKGROUND: There are a few reports on the trends of elderly suicide rates in western countries but none from Asian countries. OBJECTIVES: To describe the trends of elderly suicide rates of Chinese, Malays and Indians in Singapore from 1991 to 2000. DESIGN: Data obtained from the National Department of Statistics were used in the analysis of sex- and age-standardized suicide rates and relative risks. RESULTS: Overall, the suicide rates for the elderly showed a decline from 40.1 per 100,000 in 1990 to 17.8 per 100,000 in 2000, with the most pronounced decline occurring from 1995 to 2000. The suicide rate for elderly Chinese was at a peak of 52 per 100,000 in 1995 and declined to 20 per 100,000 in 2000. The rates for elderly Malays were consistently low at 2.2 per 100,000 for the 10 years; for elderly Indians the rates were between the other two ethnic groups. CONCLUSION: In the 10-year period, the elderly suicide rates in Singapore declined markedly, especially for elderly Chinese.

Age Distribution↗

PubMed2003

Determinants of intraocular pressure and its association with glaucomatous optic neuropathy in Chinese Singaporeans: the Tanjong Pagar Study.

PURPOSE: To examine the relationship between intraocular pressure (IOP), anthropomorphic, demographic, socioeconomic, systemic, and ocular factors and glaucomatous optic neuropathy (GON) in Chinese people. METHODS: Chinese people (n = 2000), aged 40 to 79 years, were selected from the Singapore electoral register. Of the 1717 considered eligible for examination, 1232 participated, representing a response rate of 71.8%. IOP was estimated with Goldmann applanation tonometry. The drainage angle was assessed with static and dynamic gonioscopy. The optic nerve was examined at high magnification through a dilated pupil with a fundus contact lens or a +78-D lens. Static automated visual field testing was performed on subjects with suspected glaucoma. GON was diagnosed on the basis of structural and functional abnormalities of the optic nerve. RESULTS: The main independent determinants of higher IOP were higher systolic blood pressure (P < 0.001), quadrants of any peripheral anterior synechiae (PAS, P = 0.02) and width of the drainage angle (P = 0.049). A 100- micro m increase in corneal thickness was associated with an increase in mean IOP of 1.5 to 1.8 mm Hg (P < 0.001). Odds of GON increased 1.2 times per 1-mm Hg increase in screening IOP. A clear association between corneal thickness and GON was not identified. CONCLUSIONS: Clinical IOP estimates are related to systolic blood pressure and corneal thickness. Variation in IOP with angle width may suggest that trabecular compaction significantly contributes to causes of the increase in IOP, independent of angle-closure. GON is an IOP-related phenomenon among Chinese Singaporeans.

Adult↗