title: Predicting cognitive function of the Malaysian elderly: a structural equation modelling approach.
abstract: OBJECTIVE
  The aim of this study was to identify the predictors of elderly's cognitive function based on biopsychosocial and cognitive reserve perspectives.
  
  
  METHODS
  The study included 2322 community-dwelling elderly in Malaysia, randomly selected through a multi-stage proportional cluster random sampling from Peninsular Malaysia. The elderly were surveyed on socio-demographic information, biomarkers, psychosocial status, disability, and cognitive function. A biopsychosocial model of cognitive function was developed to test variables' predictive power on cognitive function. Statistical analyses were performed using SPSS (version 15.0) in conjunction with Analysis of Moment Structures Graphics (AMOS 7.0).
  
  
  RESULTS
  The estimated theoretical model fitted the data well. Psychosocial stress and metabolic syndrome (MetS) negatively predicted cognitive function and psychosocial stress appeared as a main predictor. Socio-demographic characteristics, except gender, also had significant effects on cognitive function. However, disability failed to predict cognitive function.
  
  
  CONCLUSIONS
  Several factors together may predict cognitive function in the Malaysian elderly population, and the variance accounted for it is large enough to be considered substantial. Key factor associated with the elderly's cognitive function seems to be psychosocial well-being. Thus, psychosocial well-being should be included in the elderly assessment, apart from medical conditions, both in clinical and community setting.
authors.affiliation: a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.
authors.forename: Hui Foh
authors.identifier: http://orcid.org/0000-0002-3198-4212
authors.initials: HF
authors.lastname: Foong
authors.affiliation: a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.|b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia.
authors.forename: Tengku Aizan
authors.initials: TA
authors.lastname: Hamid
authors.affiliation: a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.|b Department of Human Development and Family Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia.
authors.forename: Rahimah
authors.initials: R
authors.lastname: Ibrahim
authors.affiliation: a Malaysian Research Institute on Aging (MyAging), Universiti Putra Malaysia , Serdang , Malaysia.|c Department of Resource Management and Consumer Studies, Faculty of Human Ecology , Universiti Putra Malaysia , Serdang , Malaysia.
authors.forename: Sharifah Azizah
authors.initials: SA
authors.lastname: Haron
authors.affiliation: d Dietetic Programme, School of Healthcare Sciences, Faculty of Health Sciences , Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia.
authors.forename: Suzana
authors.identifier: http://orcid.org/0000-0002-7191-9212
authors.initials: S
authors.lastname: Shahar
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D058245:Cognitive Reserve / Q000502:physiology*; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D008962:Models, Theoretical; D010549:Personal Satisfaction; D013315:Stress, Psychological / Q000453:epidemiology*
keywords: Cognitive function; biopsychosocial model; metabolic syndrome; psychosocial stress; structural equation modelling