Biomedical subjects

S C Ho

Publications and source records attributed to S C Ho.

At least 37 records · Page 2Linked to original sources

PubMed2001

Longitudinal changes in body mass index and body composition over 3 years and relationship to health outcomes in Hong Kong Chinese age 70 and older.

OBJECTIVES: To determine longitudinal changes in body mass index (BMI) and body composition with age and the relationship between these changes with mortality, morbidity, functional capacity, and other health outcome measures. DESIGN: A 3-year longitudinal study of a random sample of community-living subjects. SETTING: Older Chinese in the Hong Kong Special Administrative Region of China. PARTICIPANTS: Two thousand and thirty-two Chinese subjects age 70 and older recruited territory-wide by proportional random sampling. MEASUREMENTS: Baseline information collected included medical history, self-perceived health, Barthel Index, Geriatric Depression Score, time taken to complete a 16-foot walk, height, weight, mid-arm circumference, arm skin-fold thickness, and waist/hip ratio. Body composition was calculated from prediction equation. Outcome measures included mortality, development of new diseases, Barthel Index, time taken for 16-foot walk, self-perceived health, and Geriatric Depression Score. RESULTS: All parameters, with the exception of triceps skin-fold thickness in men, decreased, regardless of presence or absence of disease. The decrease in arm circumference, triceps skin-fold thickness, and total body fat (TBF) was greater in women than in men, whereas men had a greater decrease in fat-free mass (FFM). Even in the absence of disease, three times as many subjects lost > or =5kg in weight as gained > or =5kg (15% vs. 5%), and only age could be identified as a contributing factor to this weight loss. In the absence of disease, lower anthropometric indices were associated with greater mortality, development of new disease (in women only), dependency, and poor performance measure. Waist-hip ratio was not associated with mortality or any other health outcomes. Decrease in both FFM and TBF were associated with worse outcomes, the effect being more marked in women. CONCLUSION: In the older population, changes in weight and body composition occur even in the absence of disease and are associated with mortality and physical functioning level. Weight loss rather than weight gain appears to be more important in this population, and promotion of life-style interventions targeted at weight maintenance would be important.

Activities of Daily Living↗

PubMed2001

A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort.

BACKGROUND: Longitudinal data on the older population in the Asian setting are limited. This paper reports the factors associated with the development of cognitive impairment (CI) in a cohort of Chinese elderly aged > or =70 years. METHODS: The study cohort comprising 2030 subjects aged > or =70 years was assembled in 1991-1992 and followed for 36 months. Baseline information on cognitive function, as well as a number of social and health variables were obtained through face-to-face interview at the respondent's place of residence. The outcome variable was the development of CI among 988 cohort members who were initially free from CI, and who could be contacted at the 36-month follow-up. The instrument used to assess CI was based on the information/orientation part of the Clifton Assessment Procedure for the elderly (CAPE), using a cut-off point of 7. RESULTS: Of the men, 6.7%, but 22.2% of women had CI at 3-year follow-up. The age-adjusted annual incidence of CI was 1.52% in men, and 6.37% in women. Multivariate logistic regression analysis showed that women had a 2.5-fold increased risk of having CI, compared with men. The risk increased by about 1.5-fold with every 5-year increase in age. Slow gait time, as assessed by the 16-foot walk, was a predictor of CI in both sexes (odds ratio [OR] = 1.03 per second increase, 95% CI : 1.0-1.07). Men residing in institutions had a 4.4-fold increased risk of having CI (95% CI : 1.7-11.1) compared with those residing in community, while the OR among women was 2.5 (95% CI : 1.3-4.9). Among women, no formal education increased the risk of having CI by 3.2-fold (95% CI : 1.8-5.5). Income dependency also increased the risk of CI by about fourfold, and no exercise at baseline was associated with a twofold increased risk of CI. Incident stroke during follow-up also increased the risk of CI (OR = 8.4, 95% CI : 1.2-59.4). CONCLUSIONS: Older age and female sex were independent factors associated with CI. No formal education, slow gait time and institutionalization increased the risk of CI in both sexes. While education had a stronger effect in women, institutionalization had a stronger effect in men. Financial dependency, lack of exercise and incident stroke played a significant role in women.

Aged↗

PubMed2001

Effects of mutations involving the highly conserved S281HCC motif in the extracellular domain of the thyrotropin (TSH) receptor on TSH binding and constitutive activity.

A model has been proposed in which, in the absence of TSH, the extracellular domain of the TSH receptor would exert a silencing effect on the serpentine domain involved in activation of the G(alpha)(s) protein. Mutation of S281 in the ectodomain is supposed to release this constraint, thereby causing receptor activation. This defines S281 and its neighbors as a segment important in intramolecular signal transduction. The functional importance of this segment was explored by site-directed mutagenesis experiments involving S281, as well as the two cysteine residues (C283, C284) present immediately downstream. S281 was mutated to N, T, G, and A in this study, and the functional characteristics of the mutants were compared. We found that S281N, S281T, and S281G display stronger constitutive activity than S281A mutant, suggesting that increase in constitutive activity is related to the extent of disruption of the local structure of the ectodomain. C283 and C284, the two consecutive cysteines that are highly conserved in glycoprotein hormone receptors, were mutated to serine, either alone (S281HSC or S281HCS) or in combination (S281HSS) and were studied in two different TSH receptor backgrounds. The mutated cysteine ectodomains were either linked to a glycosylphosphatidylinositol anchor or the serpentine domain of the wild-type holoreceptor. Glycosylphosphatidylinositol-anchored ectodomain receptors showed good cell surface expression in CHO cells, but only S281HCS was able to bind TSH specifically, illustrating the importance of C283, or the putative disulphide bond, in maintaining the conformation of the ligand binding site. In contrast, cysteine mutants on an extracellular domain-holoreceptor background displayed severely impaired membrane targeting and were poorly expressed in COS cells. However, basal cAMP production, normalized to expression at the plasma membrane, indicated significant increase in constitutive activity of all three mutants, compared with the wild-type receptor. Altogether, these findings support a model in which the ectodomain would act as a silencer of the basal activity of the serpentine portion of the receptor.

Amino Acid Sequence↗

PubMed2001

Soy intake and the maintenance of peak bone mass in Hong Kong Chinese women.

Our previous study on bone health among premenopausal women showed that bone mass consolidation is attained by the early 30s, and small loss of spinal bone mineral density (SBMD) occurs soon after peak bone mass attainment. Recent interest has been shown in the potential beneficial effects of phytoestrogens on bone health. However, data are lacking, particularly in Asian women. This study aims to investigate the effect of soy isoflavones intake on the maintenance of peak bone mass in a cohort of 132 women aged 30-40 years who were followed up for 3 years. Baseline measurements of SBMD (L2-L4) were obtained using dual-energy X-ray densitometry, and dietary intake of soy foods and other key nutrients, including dietary calcium, were obtained through a quantitative food frequency method. Information on body measurements; physical activity (PA), weight-bearing activity in particular; age of menarche; and number of pregnancies were obtained at baseline. Repeated measurements of SBMD were obtained yearly for a further 3 years with an average follow-up time of 38 months. Analyses were performed on 116 subjects with at least three SBMD measurements (at baseline, 3-year follow-up, and at least one measurement during follow-up). The individual SBMD regression slope was computed for each of the subjects. Soy isoflavones consumption was categorized as quartiles of intake. We observed a significant difference in the SBMD individual regression slopes between women belonging to the fourth and first soy isoflavones intake quartiles. The positive effect of soy isoflavones on SBMD remained after adjusting for age and body size (height, weight, and bone area). Multiple linear regression analysis including the other known covariates (lean body mass, PA, energy adjusted calcium, and follow-up time) showed that soy isoflavones, together with these variables, accounted for 24% of the variances of the SBMD individual regression slope. This longitudinal study shows that soy intake had a significant effect on the maintenance of SBMD in women aged 30-40 years. The effects of phytoestrogens on bone health should be explored further in a population with habitual dietary soy but low calcium intake.

Absorptiometry, Photon↗

PubMed2001

Relationship between six-minute walking test and pulmonary function and ventilatory drive in patients with airflow limitation.

BACKGROUND: We studied the correlation between exercise tolerance and pulmonary function, arterial blood gases, and ventilatory drive in patients with airflow limitation (AFL). METHODS: Forty-one patients (36 men, 5 women, mean age 63.6 +/- 10.3 years) with forced expiratory volume in one second (FEV1) < 75% and FEV1/forced vital capacity (FVC) < 75% were enrolled. All patients were clinically stable with no impairment of the lower extremities. On the first day of the study, pulmonary function test (PF), including FVC, FEV1, diffusion capacity (DLCO), and residual volume (RV)/total lung capacity (TLC) was measured by plethysmography. On the next day, ventilatory drive P0.1 were measured before drawing blood gases. Then, a 6-minute walking test with pulse-oxymetry and end tidal CO2 monitoring was performed. Ventilation efficiency (O2SATp & ETCO2) was recorded every 6 seconds during exercise. RESULTS: The walking distance (WD) was significantly correlated to PF: FVC%, FEV1%, DLCO%, and RV/TLC. There was also a significant correlation between resting arterial blood gases (PaO2, PaCO2, SatO2) and PF (FVC%, FEV1%, DLCO% and RV/TLC). The SatO2 at the end of exercise was highly correlated to PF (FVC%, FEV1%, DLCO% and RV/TLC). Gas exchange parameters: PaO2, PaCO2, O2SATa, O2SATp at rest, and O2SATp at the end of exercise were also significantly related to WD. CONCLUSION: The magnitude of exercise intolerance in patients with AFL was not only significantly correlated to the impairment of pulmonary function, but also closely related to gas exchange during exercise. Therefore, limitation of ventilation could be identified earlier using an exercise test.

Aged↗

PubMed2001

In the absence of dietary surveillance, chitosan does not reduce plasma lipids or obesity in hypercholesterolaemic obese Asian subjects.

OBJECTIVE: To investigate the effects of Absorbitol on body weight, anthropometry, body composition, blood pressures and lipid profiles in obese, hypercholesterolaemic subjects without dietary restriction. DESIGN: A randomised, double blind. Placebo-controlled study. SUBJECTS: Normal volunteers with no history of chronic illnesses (n=88) who were obese (body fat percentage > 20% in males and > 30% in females) and hypercholesterolaemic (total cholesterol > 5.20 mmol/L). Sixty-eight (72.3%) subjects completed the study. INTERVENTION: After a 4 week run in phase, 4 placebo/Absorbitol (250 mg) capsules were prescribed 3 times a day before meals. Subjects received written information on healthy lifestyle but there was no dietary restriction or monitoring. MAIN OUTCOME MEASURES: Weight, body mass index, lean body mass, waist, hip, blood pressure, fasting lipids and insulin levels were taken at baseline, 4th and 16th week of the study. STATISTICAL ANALYSIS PERFORMED: Analyses were on an intention-to-treat basis. Comparisons between groups were made using Student's t and Mann-Whitney tests for parametric and non-parametric data respectively. RESULTS: There was no significant change in the measured parameters in Absorbitol treated subjects compared to those on placebo, with exception of HDL-cholesterol which increased in the absorbitol group and decreased in the placebo group (p=0.048). The side effects of Absorbitol were also comparable to that of placebo. CONCLUSIONS: In the absence of dietary surveillance, Absorbitol does not bring about improvement in weight, anthropometry, body composition, blood pressure or lipid profile.

Adult↗

PubMed2001

Dietary habit of smokers in a Chinese population.

The objective of this study is to determine whether smokers have unhealthy dietary habits with respect to cardiovascular diseases and cancer. An age and sex stratified random sample of the Hong Kong Chinese population aged 25 to 74 years (500 men, 510 women) was recruited. A dietary assessment using a food frequency method over a 7 day period, together with a lifestyle questionnaire was administered by a trained interviewer. Approximately half the men were smokers, while only 19/510 women smoked. Smoking was related to lower education level. Male smokers had a lower mean daily consumption of fruits, lower carbohydrate and carbohydrate percentage calorie intake, higher fat and fat percentage calorie intake, and higher vitamin D intake compared with non-smokers. However, the differences were small compared with reported differences in Caucasian populations. No difference in dietary pattern was noted between female smokers and non-smokers. Although there is a tendency for male smokers to have an unhealthy dietary pattern with respect to cardiovascular disease and cancer, the differences between smokers and non-smokers are small, and together with the favourable health features of the Chinese diet, this difference is unlikely to add to the risk of these diseases in smokers or be a confounding factor in examining the aetiology of smoke-related diseases in this population.

Adult↗

PubMed2001

Critical role of functional decline in delayed discharge from an acute geriatric unit.

INTRODUCTION: Delayed hospital discharge of elderly patients after an acute illness poses significant problems, including bed-blockade, iatrogenesis, and increase in morbidity, dependency and social isolation. The aim of this study was to determine the factors associated with delayed discharge from an acute geriatric unit. MATERIALS AND METHODS: This was a prospective cohort study involving 172 consecutive non-institutionalised patients, 65 years and older, admitted to an acute geriatric unit. The medical, functional, psychological and social variables of each subject were documented and any decline in functional status recorded. Based on the discharge status, patients were dichotomised into the "delayed" and "non-delayed" groups. Initial bivariate analyses of the variables were performed to select those associated with the "delayed discharge" group at the P < 0.05 levels. These variables were in turn entered into a multivariate logistic regression model to identify factors significantly associated with delayed discharge. RESULTS: Forty-eight patients (27.9%) had their discharge from the acute geriatric care unit delayed despite clinically fit to be so. Variables significantly associated with delayed discharge in the multivariate model were: 1) decline in basic activities of daily living (ADL) status [P < 0.001; adjusted odds ratio (AOR), 3.63; 95% confidence interval (CI), 1.33 to 9.86] and 2) need for skilled nursing [P = 0.012; AOR, 4.57; 95% CI, 1.88 to 11.14]. CONCLUSIONS: The study demonstrates the central importance of effectively identifying elderly patients who are at risk of delayed discharge after acute hospitalisation through a multidisciplinary focus on illness-induced functional decline. It is likely therefore that proactive approaches to rehabilitation and caregiver training, and adequate community-based services, may facilitate early and effective return of these patients to their homes, thereby reducing inappropriate use of acute beds.

Activities of Daily Living↗

PubMed2000

Accelerated proteasomal degradation of membrane Ig heavy chains.

Membrane IgG H chains turn over considerably more rapidly than secretory Ig H chains in the 18-81 A2 pre-B cell line. This rapid degradation occurs in proteasomes. N-Glycosylated membrane Ig H chains accumulate in the endoplasmic reticulum in the presence of proteasomal inhibitors, suggesting that retrotranslocation and proteasomal degradation of membrane Ig H chains may be closely coupled processes. Accelerated proteasomal degradation of membrane Ig H chains was also observed in transfected nonlymphoid cells. At steady state, the membrane form of the H chain associates more readily with Bip and calnexin than its secretory counterpart. The preferential recognition of membrane, as opposed to secretory, Ig H chains by some endoplasmic reticulum chaperones, may provide an explanation for the accelerated proteasomal degradation of the former.

Amino Acid Sequence↗

PubMed2000

Body fat distribution and cardiovascular risk in normal weight women. Associations with insulin resistance, lipids and plasma leptin.

OBJECTIVE: To systematically examine the correlations between insulin resistance, plasma leptin concentration, obesity and the distribution of fat assessed by anthropometry and magnetic resonance imaging in Asian women. DESIGN: A cross sectional study of non-diabetic, normal weight women. SUBJECTS: Twenty-one healthy women aged 38.8 y (s.d. 11.7) and BMI 22.6 kg/m2 (s.d. 2.3). MEASUREMENTS: Intraperitoneal, retroperitoneal and subcutaneous abdominal fat volume was assessed by magnetic resonance imaging. Anthropometric data were collected. Total fat mass was assessed by bioelectric impedance analysis. Fasting serum lipids, insulin and plasma leptin were assayed. RESULTS: Generalized obesity correlated with subcutaneous abdominal fat mass (r=0.83, P<0.001), but not with intra-abdominal fat mass. Both intraperitoneal fat mass and retroperitoneal fat mass increased with age (r=0.58, P=0.005 and r=0. 612, P=0.003, respectively). Abdominal subcutaneous fat mass was the most important determinant of insulin resistance and plasma leptin. Of the serum lipids, only fasting triglyceride correlated significantly with the waist-to-hip ratio. CONCLUSIONS: It is possible that the large size of the subcutaneous depot compared to the intra-abdominal depot overwhelms any metabolic differences between adipose tissue from these two sites, resulting in the stronger correlation between insulin resistance and subcutaneous abdominal fat mass rather than intra-abdominal fat mass. On the other hand, the distribution of fat between subcutaneous fat depots may be important in the metabolic syndrome given the correlation of fasting triglyceride with waist to hip ratio but not with abdominal fat. However, the study population was small, younger and leaner compared to previous studies and we may not be able to generalize these results to all segments of the population. We confirm that subcutaneous fat mass is the major determinant of plasma leptin.

Abdomen↗

PubMed2000

Graves' ophthalmopathy in the absence of elevated free thyroxine and triiodothyronine levels: prevalence, natural history, and thyrotropin receptor antibody levels.

The aims of this study were to (a) determine the prevalence of patients without elevated thyroid hormone levels in Graves' ophthalmopathy (GO) using current generation free thyroid hormone assays, (b) measure the prevalence of thyrotropin receptor antibodies (TRAb) in these cases, and (c) identify possible predictors of hyperthyroidism. Over a 30-month period, 1020 cases of thyroid eye disease were evaluated, of which only 19 (1.9%) met the diagnostic criteria. Ten (1%) had subclinical thyrotoxicosis, 7 (0.7%) were euthyroid, and 2 (0.2%) were hypothyroid as determined by a third-generation thyrotropin (TSH) assay. TRAb levels were measured in 16 of these 19 patients. The prevalence of TRAb varied according to the assay used. Polyethylene glycol-extracted thyroid-stimulating immunoglobulin (PEG-TSI), unfractionated thyroid-stimulating immunoglobulin (uTSI), first-generation porcine TSH-binding inhibitory immunoglobulin (pTBII), and second-generation human TSH-binding inhibitory immunoglobulin (hTBII) assays were positive in 93.8%, 50%, 18.8%, and 81.3% of patients, respectively. TRAb was detected by at least one method in all patients. Patients were followed up for 15 to 45 months. Hyperthyroidism developed in 4 patients (25%). Suppressed TSH levels and elevated TBII were predictors of hyperthyroidism. When sensitive assays are used, the prevalence of GO patients without elevated thyroid hormone levels is extremely low. The sensitivities of assays for TRAb detection differ substantially in these cases. PEG extraction improves the detection rate of TSI (p = 0.02), and hTBII assays improve the detection of TBII in these patients (p = 0.002). The high prevalence of TRAb in such cases supports a role for these antibodies in the pathogenesis of thyroid-associated eye disease.

Adolescent↗

PubMed2000

An estimate of long-term care needs and identification of risk factors for institutionalization among Hong Kong Chinese aged 70 years and over.

BACKGROUND: The goal of this study is to estimate the long-term care needs of the Hong Kong Chinese population age 70 years and older, and to identify risk factors for institutionalization. METHODS: A three-year prospective follow-up study was carried out in Hong Kong Special Administrative Region, China. 2,032 subjects aged 70 years and older were recruited territory-wide by stratified random sampling of the Old Age and Disability Allowance register, covering over 90% of the elderly population. A questionnaire was administered at baseline to obtain information on social, functional, physical, and mental health status, and place of residence. A repeat interview was carried out at 36 months. The number of subjects moving from home to institution or vice versa, and the number who had died, were noted. Univariate analysis was performed to determine risk factors for institutionalization, and backward stepwise multiple logistic regression was used to identify independent factors predisposing to institutionalization. RESULTS: The institutionalization rate per year is estimated to be 0.7% for the 70-79 age group, and 1.5% for the 80+ age group. Using population figures projected by the Hong Kong Census, the corresponding number of places required will be 24,150 and 42,000, respectively, for the two age groups by 2005, whereas the number of government subvented places projected to be available is unlikely to be more than 40,000 for the whole population. Age, being a woman, being single, not having a formal education, cognitive impairment, physical dependency, and the presence of depressive symptoms were factors predisposing to institutionalization. In multivariate analysis, age, marital status, and dependency were identified as independent factors. CONCLUSION: The requirement for institutional places is unlikely to be met by government, the shortfall likely to be met by the private sector. Maintenance of functional independence, good social support network, engagement in social activities, and good informal carer support may reduce demand for institutional care.

Activities of Daily Living↗

PubMed2000

Intake of soy products is associated with better plasma lipid profiles in the Hong Kong Chinese population.

We describe the pattern of soy intake and its association with blood lipid concentrations in the Hong Kong Chinese population. Subjects were contacted by random telephone survey and invited to a hospital for a physical examination and blood tests. A total of 500 men and 510 women with an age range of 24-74 y completed the dietary intake study. The dietary assessment was based on a semiquantitative food frequency questionnaire that included 10 commonly consumed soy items. Many (88%) of the study population had consumed some soy products during the previous week. About 80% of the soy protein or isoflavones were obtained from different forms of tofu, and an additional 9% was obtained from soy milk. The mean weekly isoflavone intake was 102 +/- 107 mg in men and 77 +/- 90 mg in women. In men, soy intake and total plasma cholesterol were negatively correlated (r = -0.09, P: = 0.04), as were soy intake and LDL cholesterol (r = -0.11, P: = 0.02). The respective values in women <50 y old were r = -0.11, P: = 0.04 and r = -0.11, P: = 0.05. Soy protein remained significantly associated with these two lipid concentrations after adjustment for other social and dietary confounders. Higher soy intake seemed to be related to a better plasma lipid profile in men and in younger women, but more epidemiological studies and controlled clinical trials in this setting would help to confirm the optimal amount required for the prevention and treatment of hyperlipidemia.

Adult↗

PubMed2000

The effect of incentive spirometry on chest expansion and breathing work in patients with chronic obstructive airway diseases: comparison of two methods.

BACKGROUND: Chronic obstructive airway diseases (COAD), characterized by mucus hypersecretion, lead to exercise intolerance. Incentive spirometry has been used to prevent postoperative pulmonary atelectasis. METHODS: To compare the efficacy of two incentive spirometers, Coach (volume-oriented) and Triflo (flow-oriented), in the work of breathing in COAD patients, 22 patients were randomized in this study: 12 patients (Triflo-II group) initially used Triflo-II for 10 minutes and then Coach for the same period. In contrast, the Coach group, including 10 patients, started with Coach followed by Triflo-II. After receiving incentive spirometry, lung expansion and work of breathing were assessed. RESULTS: Patients in the Coach group significantly increased chest wall expansion (p = 0.041), as compared with patients using Triflo-II. Similarly, there was also a significantly increased abdominal wall expansion in the Coach group (p = 0.0056), compared with that in the Triflo-II group. The need of accessory muscle assistance for breathing in the Coach group was significantly less than in the Triflo-II group (p = 0.047). It was easier for patients in the Coach group to start a breath (p = 0.0058) than for those in the Triflo-II group. For the entire group, 17 patients (77.3%) preferred Coach to assist their breathing, and only 4 patients (18.2%) favored Triflo-II. CONCLUSION: COAD patients achieved a larger expansion of the chest and abdomen with a Coach device. Our data provide a good rationale for an outcome study on the use of incentive spirometer in COAD patients.

Adult↗

PubMed2000

A man with osteoblastic metastasis and hypocalcaemia.

We report a case of an 80-year-old man with osteoblastic metastases from advanced carcinoma of the prostate presenting with a grand mal seizure resulting from severe hypocalcaemia. He had low serum phosphate and ionised calcium levels, elevated serum skeletal alkaline phosphatase and intact parathormone levels. 99mTc radioisotope bone scan revealed a "super bone scan" suggestive of osteomalacia. The serum 1, 25-dihydroxycholecalciferol level was unexpectedly elevated. The biochemical abnormalities persisted despite high dose calcium replacement, but improved with supraphysiological doses of 1,25 (OH)2 vitamin D3 (Rocaltrol) therapy. We hypothesise that the hypocalcaemia in this patient was due to vitamin D resistance secondary to a humoral factor secreted by the tumour.

Aged↗

PubMed2000

Epidemiology of health changes in older women in Hong Kong.

This paper aims to present the baseline social, mental and functional characteristics, the changes of these characteristics over a 36-month follow-up period, and the issues and implications related to these changes, particularly in older women. The cohort comprising 2030 subjects aged 70 and above has been assembled by stratified disproportional random sampling. Registrants with the Old Age Allowance Scheme, which has over 90 percent coverage of the Hong Kong elderly population, was used to define the accessible population. Face-to-face interviews were conducted at the respondents' place of residence. A number of social and health variables were collected at baseline. The surviving subjects had been followed up at 36 months and repeated measurements of the baseline variables were obtained. Older women were over-represented by low level education, financial dependency, as well as residence in institutions. Women had higher prevalence as well as incidence of musculoskeletal problems. While there was a general decline in health and social support in the elderly cohort, we observed a preponderance of older female subjects with mental and functional decline over the follow-up period. An overrepresentation of female subjects with depressive symptoms at baseline and follow-up was also noted. The descriptive data have revealed a host of social and health changes over a three-year follow-up period. Women aged 80 years and above formed a particularly disadvantaged group. The results will have direct implications for the shaping of social and health policy for strategic planning of priorities in social and health care services.

Activities of Daily Living↗

PubMed1999

Menopausal symptoms and symptom clustering in Chinese women.

OBJECTIVES: this paper aims to report the prevalence of symptoms in the Hong Kong Chinese perimenopausal women; to construct reported symptoms into symptom groupings; and to clarify whether the symptom groups are associated with menopausal status. METHODS: a random telephone survey of perimenopausal women aged 44-55 years was conducted in 1996. Eligible subjects were identified through telephone dialing of a random sample of the numbers listed in the residents' telephone directory. Standardized questionnaire, including a 22-item symptom check list, was administered over the telephone. The principal component analysis method followed by varimax rotation was used to examine the relations among the symptoms. RESULTS: differences in the prevalence of menstrual problems across the menopausal status were noted with perimenopausal women having the most complaints. Musculoskeletal conditions were the top complaints reported by the respondents, followed by headaches and psychological symptoms. About 10% of the women complained of hot flushes, and less than 5% of cold sweats. Five symptom clusters, namely psychological, musculoskeletal/gastrointestinal, non-specific somatic, respiratory, and vasomotor, have been identified. After adjustment for age, the analysis of variance showed that psychological, non-specific somatic and vasomotor symptoms were significantly associated with menopausal status, while musculoskeletal and respiratory were of borderline statistical significance. CONCLUSIONS: compared with pre- and post-menopausal women, perimenopausal women had the highest reports of symptom complaints. Musculoskeletal complaints were the most prevalent complaints, followed by psychological symptoms. While vasomotor symptoms were significantly associated with menopausal status, their prevalence was comparatively lower than that reported in Caucasian populations.

Adult↗

PubMed1999

The prevalence of osteoporosis in the Hong Kong Chinese female population.

OBJECTIVES: This paper aims to present population-based age-related bone mass values in the Hong Kong Chinese female population, and to assess the number and proportion of Chinese women considered osteoporotic according to the WHO diagnostic guidelines. METHODS: A total of 769 community-based female subjects were recruited. Social demographic characteristics of these subjects were similar to the Hong Kong general population. All bone mass measurements were performed by means of a dual energy X-ray densitometry (Norland XR 26) at two sites: lumbar vertebrae L2-L4 and left hip. These values were expressed as T-scores, with reference to the mean bone mineral density (BMD) values of the group aged 21-40 years. RESULTS: The study revealed that, in women aged 60 years and above, their mean BMD values are 30% lower than the young normal mean. The prevalence of osteoporosis at the spine increased dramatically from about 10% in the age group 50-59 to 45% in the group aged 60-69. In women aged 70 onwards, over half have osteoporosis at the hip. The prevalence of osteoporosis at the spine is relatively stable in the age groups above 60, while that for osteoporosis at the hip increased exponentially with age. CONCLUSIONS: The prevalence of osteoporosis in Hong Kong women is comparable to that found in Caucasian populations. Prevention of osteoporosis, involving both immediate and long-term measures, and targeting at different age groups, are required to combat this serious public health problem in Hong Kong.

Absorptiometry, Photon↗