Athena W L Hong

The University of Hong Kong, Hong Kong, Hong Kong

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Publications (14)49.81 Total impact

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    ABSTRACT: To examine the oral health status of Chinese hospitalised geriatric patients and identify its impacts on their oral health-related quality of life (OHRQoL). Cross-sectional correlational study. Geriatric wards of a regional hospital in Hong Kong. A consecutive sample of Chinese hospitalised geriatric patients (N = 155) aged >or= 65 years who were communicable. The Brief Oral Health Status Examination (BOHSE) was used to evaluate oral status. The General Oral Health Assessment Index (GOHAI) was used to assess OHRQoL. The oral health status of the Chinese hospitalised geriatric patients was fair, with the more prominent problems being decayed teeth, lack of occluded teeth, coated tongue, excessive tartar, dry and rough red oral tissue and diseased gum. The GOHAI score indicated their compromised OHRQoL. By using hierarchical regression analysis, fewer than eight pairs of occluding teeth (beta = -0.33, P < 0.001), unhealthy gum (beta = -0.26, P = 0.03) and perceived oral dryness (beta = -0.18, P = 0.04) significantly accounted for 17% of variance in the OHRQoL of Chinese hospitalised geriatric patients. This study suggests that routine screening for dental and gum problems, providing adequate adaptation of denture prosthesis and reducing oral dryness of geriatric patients may be important care to optimise the OHRQoL of Chinese hospitalised geriatric patients. The study needs to be replicated in larger-scale multicentre settings and incorporate the use of more-comprehensive oral assessment indices.
    Quality of Life Research 04/2008; 17(3):397-405. · 2.86 Impact Factor
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    ABSTRACT: Results from previous epidemiological studies on the relationship between depression and peripheral arterial diseases (PADs) were mixed. Therefore, a study was conducted to investigate this relationship in a large Chinese elderly sample. Cross-sectional data from the baseline examination of a large cohort study on Chinese elderly were used in this current study. A stratified convenience sample of 3985 Hong Kong men and women aged 65 to 92 were recruited from the community. Clinically relevant depressive symptoms were assessed by the use of a validated screening instrument for depression: the Chinese version of the Short Form of Geriatric Depression Scale. PAD was assessed by the ankle-brachial index, with an index of <0.9 indicating the presence of PAD. Multiple logistic regression was used to compare the presence of PAD in depressed and nondepressed subjects, controlling for confounding variables for the relationship. In the total subject population, more severe peripheral atherosclerosis was associated with a higher prevalence of depressive disorders. The presence of peripheral atherosclerosis was associated with an adjusted odds ratio of 1.46 (95% confidence interval=1.01-2.10) of having clinically relevant depressive symptoms. We showed that depressive symptoms were associated with peripheral atherosclerosis in the Asian elderly after adjusting for stroke and cardiovascular diseases. Prospective studies are needed to provide conclusive evidence on the causality of the relationship between peripheral atherosclerosis and depressive symptoms.
    Journal of Psychosomatic Research 11/2007; 63(5):471-6. · 3.27 Impact Factor
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    Jean Woo, Athena Hong, Edith Lau, Henry Lynn
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    ABSTRACT: The beneficial role of exercise in improving bone mineral density, muscle strength and balance, has been documented predominantly in younger populations. These findings may not apply to elderly populations with limited ability to perform exercises of high intensity. To examine the effects of Tai Chi (TC) and resistance exercise (RTE) on bone mineral density (BMD), muscle strength, balance and flexibility in community living elderly people. Randomised controlled trial, using blocked randomization with stratification by sex. A community in the New Territories Region of Hong Kong, China. One hundred eighty subjects (90 men, 90 women) aged 65-74, were recruited through advertisements in community centres. Subjects were assigned to participate in TC, RTE three times a week, or no intervention (C) for 12 months. Measurements were carried out at baseline, 6 and 12 months. Analyses of covariance (ANCOVA) adjusted for age, and baseline values of variables that were significantly different between groups: i.e. smoking and flexibility for men; quadriceps strength for women. Compliance was high (TC 81%, RTE 76%). In women, both TC and RTE groups had less BMD loss at total hip compared with controls. No effect was observed in men. No difference in either balance, flexibility or the number of falls was observed between either intervention or controls after 12 months. The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes.
    Age and Ageing 06/2007; 36(3):262-8. · 3.82 Impact Factor
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    ABSTRACT: To study, in a large prospective cohort study of 2000 Chinese men 65 to 92 years of age in Hong Kong, the role of lifestyle and medical risk factors for moderate to severe lower urinary tract symptoms (LUTS). Previous epidemiologic studies evaluating the risk factors for LUTS were mainly conducted in non-Chinese populations. After excluding men with prostate or bladder cancer or surgery and those who took alpha-blockers and antiandrogens, 1739 subjects provided responses to a structured interviewer-administered questionnaire and physical examination. A clustered case-control analysis was performed, comparing subjects with moderate to severe LUTS with those with mild or no LUTS. A total of 38.2% of subjects had moderate to severe LUTS. On multiple logistic regression analysis, a history of heart disease was independently associated with an increased risk of moderate to severe LUTS (odds ratio 1.50, 95% confidence interval 1.13 to 1.98). Physical activity was independently associated with reduced risk of moderate to severe LUTS (odds ratio 0.66, 95% confidence interval 0.48 to 0.90). A mild increase in the body mass index (23 to 24.9 kg/m2) was associated with a reduced risk of LUTS (odds ratio 0.72, 95% confidence interval 0.56 to 0.93). These results have shown that LUTS are a significant health problem in Chinese men and that, similar to results from previous studies, LUTS are associated with medical and lifestyle factors in the Chinese.
    Urology 12/2006; 68(5):1009-14. · 2.42 Impact Factor
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    ABSTRACT: To evaluate the impact of moderate to severe lower urinary tract symptoms (LUTS) on clinically significant depressive symptoms in elderly Chinese men aged 65 and above. In a large prospective cohort of 2000 Chinese men aged 65 to 92 years of age in Hong Kong, the association between moderate to severe lower urinary tract symptoms and clinically relevant depressive symptoms was studied. After excluding men with prostate or bladder cancer or surgery, 1980 subjects provided response to a structured interviewer-administered questionnaire and physical examination. A case-control analysis was performed, comparing subjects with clinically relevant depressive symptoms (cases) to those without depressive symptoms (controls). In multiple analyses adjusting for all factors that were shown to be significantly associated with having clinically relevant depressive symptoms in the initial bivariate analyses, being widowed, divorced or single were associated with increased risk of having clinically relevant depressive symptoms. Having a history of cardiac disease, being a current smoker and the use of corticosteroid were also associated with increased risk. Having moderate to severe LUTS was significantly associated with increased odds of having clinically relevant depressive symptoms (OR: 2.40; CI: 1.68-3.43) even after adjustment. This study was cross-sectional and there were no clinician-based diagnostic interviews that were conducted to diagnose clinical depression and thus only clinically relevant depressive symptoms were assessed. In elderly men, moderate to severe LUTS are important public health problems that are associated with increased risk of having clinically relevant depressive symptoms. These findings suggest that physicians who deal with patients with moderate to severe LUTS should consider the psychological health of their patients as this population is at risk of having clinically relevant depressive symptoms.
    Journal of Affective Disorders 12/2006; 96(1-2):83-8. · 3.30 Impact Factor
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    ABSTRACT: The purpose of this investigation was to study the prevalence of and risk factors for androgen deficiency in middle-aged men in Hong Kong. A community-based, cross-sectional household survey was performed in Hong Kong on men aged 45 to 64 years. Demographics, lifestyle information (cigarette smoking, alcohol consumption, and physical activity), and symptoms previously defined for identifying those with androgen deficiency were measured by using standardized questionnaires. Blood samples were collected in the morning, and total, free, and bioavailable testosterone levels were assessed. Data on androgen deficiency were available for 252 men aged 45 to 64 years. Crude prevalence of androgen deficiency was 9.52%. Prevalence increased significantly with age. For risk factors, having a lower personal income and having a history of hypertension were independently associated with increased risk of having androgen deficiency (odds ratio, 3.72; confidence interval, 1.01-13.61; and odds ratio, 2.89; confidence interval, 1.06-7.91, respectively). The prevalence of androgen deficiency in Hong Kong Chinese is similar to that found in Caucasians by using a similar definition. From this age-specific prevalence cross-sectional data, it is estimated that there are approximately 68,775 Hong Kong Chinese men aged 45-64 years with androgen deficiency. Future studies with large sample size are needed to evaluate the risk factors for androgen deficiency in men.
    Metabolism 12/2006; 55(11):1488-94. · 3.10 Impact Factor
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    ABSTRACT: To evaluate the correlates of erectile dysfunction (ED) in Hong Kong middle-aged Chinese men aged 45-64 years. A community-based cross-sectional household survey was performed in Hong Kong. The Chinese abridged version of the International Index of Erectile Function (IIEF-5) was used to measure erectile function. The International Prostate Symptom Score (IPSS) was used to measure lower urinary tract symptoms (LUTS) and depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D). Demographic and lifestyle data were also collected. The association between ED and its correlates was analyzed using bivariate and multivariate analyses. Of the 545 subjects who agreed to participate in the survey, 75 refused to answer questions about their sexual activities and function. Out of those who responded, 118 (22%) subjects were not sexually active (not sexually active over the past 4 weeks). Out of 352 subjects, 60.3% suffered from some degree of ED. Age, presence of depression defined by CES-D and moderate LUTS were associated with increased odds of having ED. In multivariate analysis, depressive symptoms identified by CES-D (OR = 2.3, CI: 1.2-4.6) and moderate LUTS (OR = 3.7, CI: 1.6-8.3) were independently associated with increased odds of having ED. ED is an important public health problem in Chinese middle-aged men, with more than half suffering from some degree of ED. Depression and LUTS were significant and important risk factors associated with ED.
    International Journal of Urology 11/2006; 13(10):1304-10. · 1.73 Impact Factor
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    ABSTRACT: This study examines the prevalence of atherosclerosis (using ankle-brachial index (ABI) value <0.9) and associated socioeconomic and lifestyle factors in elderly Chinese, adjusting for presence of cardiovascular diseases and body mass index, in a cross-sectional survey of 1999 men and 1999 women aged 65 years and over living in the community. A questionnaire containing information regarding socioeconomic status, medical history and lifestyle factors was administered. Measurement included height, weight, percentage body fat using dual-energy X-ray absorptiometry and ABI. The Hong Kong population (2000) age adjusted prevalence of ABI <0.9 was 5.3% for men and 11.0% for women. In multivariate analysis, old age, female gender, presence of cardiovascular diseases, cognitive impairment, prolonged 6 m walk, smoking habit and alcohol intake were positively associated with ABI <0.9, while negative associations were observed with Vitamin C intake >100 mg per day, with the lowest OR for the range 141-190 mg (OR 0.4). Physical activity level, and self rated higher social standing in the community, while significant in univariate analysis, were not included as independent significant factors in the multivariate model. Lifestyle factors and the female gender were independent risk factors for atherosclerosis in the elderly Chinese population.
    Atherosclerosis 06/2006; 186(2):360-6. · 3.71 Impact Factor
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    ABSTRACT: Ageing promotes increases in the prevalence of components of the metabolic syndrome, which obesity often underlies. We report the relationship between ageing, obesity and other cardiovascular risk factors in 694 community-based Chinese subjects in gender-specific groups of three age ranges: 20.0-39.9 (young), 40.0-59.9 (middle-aged) and 60.0-79.9 (old-aged) years. Body mass index (BMI) values were similar in males in each age group, but waist and percentage body fat increased (6.6, and 39.5%, both p < 0.001, respectively), from young to old-age groups, as did blood pressure and glycated haemoglobin levels (all p < 0.001). In the females, increases (all p < 0.001) in percentage body fat (29.3%) were accompanied by greater increases in BMI (10.3%) and waist (19.2%) than the males. Blood pressure, glycated haemoglobin, total and LDL-cholesterol and triglyceride levels increased linearly with age (all p < 0.001). Age-related increases in central adiposity and percentage body fat were associated with increasingly adverse cardiovascular risk factor profiles.
    Diabetes/Metabolism Research and Reviews 01/2006; 22(1):72-8. · 2.97 Impact Factor
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    ABSTRACT: Tai Chi is rapidly gaining in popularity, worldwide. This study was performed to assess its impact on cardiovascular risk factors in comparison with resistance training exercises in elderly Chinese subjects. A total of 207 healthy elderly participants (65-74 years, 113/207 (55%) men) were randomly assigned to one of three intervention groups: (1) Tai Chi, three times/week for 1 h/session (n = 64); (2) resistance training exercise, three times/week for 1 h/session (n = 65); (3) usual level of physical activity control group (n = 78). Anthropometric measures, dual X-ray densitometry body composition, blood pressure, lipids, glycaemic and insulin sensitivity indices were measured at baseline and 12 months. Repeated-measures analysis of variance (anova) was used to assess the between-group changes using a last-observation-carried-forward intention-to-treat approach. A total of 180 (87.0%) subjects completed the study. No significant changes were identified in the Tai Chi group compared to the resistance training or control group. Of the primary outcomes, only the improvement in the insulin sensitivity index differed, being significantly greater in the resistance training than in the control group [mean difference 0.018 (95% confidence interval ( CI) 0.000-0.037) mmol glucose/min, P = 0.02), and tending to be greater than in the Tai Chi group (mean difference 0.019 (95% CI 0.000-0.038) mmol glucose/min, P < 0.06). Tai Chi had no significant effect on any measure compared to the controls, whereas resistance training improved the insulin sensitivity index in this 12-month study.
    Clinical Endocrinology 12/2005; 63(6):663-9. · 3.40 Impact Factor
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    ABSTRACT: To prospectively use hydrogen 1 (1H) magnetic resonance (MR) spectroscopy and dynamic contrast material-enhanced MR imaging to measure vertebral body marrow fat content and bone marrow perfusion in older men with varying bone mineral densities as documented with dual x-ray absorptiometry (DXA). This study had institutional review board approval, and all participants provided informed consent. DXA, 1H MR spectroscopy, and dynamic contrast-enhanced MR imaging of the lumbar spine were performed in 90 men (mean age, 73 years; range, 67-101 years). Vertebral marrow fat content and perfusion (maximum enhancement and enhancement slope) were compared for subject groups with differing bone densities (normal, osteopenic, and osteoporotic). The t test was used for comparisons between groups, and the Pearson test was used to determine correlation between marrow fat content and perfusion indexes. Eight subjects were excluded, yielding a final cohort of 82 subjects (mean age, 73 years; range, 67-101 years) that included 42 subjects with normal bone density (mean T score, 0.8 +/- 1.1 [standard deviation]), 23 subjects with osteopenia (mean T score, -1.6 +/- 0.4), and 17 subjects with osteoporosis (mean T score, -3.2 +/- 0.5). Vertebral marrow fat content was significantly increased in subjects with osteoporosis (mean fat content, 58.23% +/- 7.8) (P = .002) or osteopenia (mean fat content, 55.68% +/- 10.2) (P = .034) compared with that in subjects with normal bone density (50.45% +/- 8.7). Vertebral marrow perfusion indexes were significantly decreased in osteoporotic subjects (mean enhancement slope, 0.78%/sec +/- 0.3) compared with those in osteopenic subjects (mean enhancement slope, 1.15%/sec +/- 0.6) (P = .007) and those in subjects with normal bone density (mean enhancement slope, 1.48%/sec +/- 0.7) (P < .001). Subjects with osteoporosis have decreased vertebral marrow perfusion and increased marrow fat compared with these parameters in subjects with osteopenia. Similarly, subjects with osteopenia have decreased vertebral marrow perfusion and increased marrow fat compared with these parameters in subjects with normal bone density.
    Radiology 10/2005; 236(3):945-51. · 6.34 Impact Factor
  • H S Lynn, E M C Lau, S Y S Wong, A W L Hong
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    ABSTRACT: Several osteoporosis risk instruments have been proposed to select women for bone densitometry, but no validated instruments are currently available for men. This study aims to address this deficiency by developing and validating a Male Osteoporosis Screening Tool (MOST) for Chinese men. Two thousand ambulatory men, aged 65 and above, were recruited from the general community in Hong Kong, and a cohort of 1,970 men with valid total hip and lumbar spine dual-energy X-ray absorptiometry (DXA) measurements was included in the current analysis. A 60% random sample was selected as the training sample for developing the screening tool, and the remaining 40% constituted the validation sample. Logistic regression and receiver operating characteristic (ROC) analysis were used to identify the simplest combination of risk factors to be included in the screening tool for predicting osteoporosis at the femoral neck, total hip, or lumbar spine. Body weight and quantitative ultrasound index (QUI) were found to contribute significantly to the area under the ROC curve (AUC), yielding an AUC of 0.823 in the training sample. The resulting MOST had a sensitivity of 94% and a specificity of 46% when using a cutoff score of 3. MOST had an AUC of 0.839 in the validation sample. The risk of osteoporosis was 1% among those with MOST scores < or = 2, but 72% among those with MOST scores > 7. Using a cutoff of 3, the negative predictive value was 97.5% which suggests that the 42% with MOST scores < or = 3 may be accurately screened out as being without osteoporosis, thus saving two fifths of our DXA resources. The positive predictive value was 72% when using a cutoff of 7, implying that MOST cannot replace DXA for case-finding purposes. Nevertheless, for resource allocation and patient satisfaction, it is prudent and economical to offer DXA screening first to the 6% with MOST scores > 7.
    Osteoporosis International 07/2005; 16(7):829-34. · 4.04 Impact Factor
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    ABSTRACT: To investigate the impact of insulin resistance on cardiovascular risk factors in the elderly. A cross-sectional, community-based study of 225 older Chinese participants (65-74 years, 55.6% female) recruited from community centres for the elderly in Shatin. Anthropometric measures and DXA body fat, blood pressure, insulin sensitivity (fasting insulin, fasting insulin-glucose product, short insulin tolerance test (SITT)), glycaemic (fasting glucose, glycated haemoglobin A1c) and lipid (total, HDL-, and LDL-cholesterol, triglycerides) indices and albuminuria (24h albumin-to-creatinine ratio) were measured. There was a close correlation between the SITT and insulin-glucose product indices of insulin resistance. Decreasing tertiles of insulin sensitivity were associated with increasing indices of glycaemic control, and general and central obesity, including DXA lean and fat mass, albuminuria, and triglycerides, with decreasing HDL-cholesterol. There were no differences in blood pressure or electrolyte levels between these tertile groups. These subjects were more insulin resistant than a group of younger diabetics. Insulin resistance was associated with indices of obesity and an atherogenic lipid and hyperglycaemic profile and may in part contribute to the high frequency of metabolic syndrome components in these older Chinese subjects.
    Diabetes Research and Clinical Practice 06/2004; 64(2):123-8. · 2.74 Impact Factor
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    E M Lau, J Woo, V Lam, A Hong
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    ABSTRACT: The Chinese diet is low in calcium (less than 500 mg/day on average), and previous observational studies have suggested an association between a low calcium intake and risk of hip and vertebral fracture. In this study, we randomly assigned 200 postmenopausal Chinese women (age range, 55-59 years) to receive 50 g of milk powder containing 800 mg of calcium per day or to a control group. The following are the mean percentage changes (and SEs) in height and bone mineral density (BMD) over 24 months: for height, -0.1 +/- 0.2 cm in the milk supplementation group and -0.2 +/- 0.1 cm in the control group; for BMD at the total hip, -0.06 +/- 0.22% in the milk supplementation group and -0.88 +/- 0.26% in the control group; for BMD at the spine (L1-L4), -0.56 +/- 0.29% in the milk supplementation group and -1.5 +/- 0.29% in the control group; for total body BMD, -0.32 +/- 0.16% in the milk supplementation group and -1.2 +/- 0.19% in the control group (p < 0.05 by analysis of covariance [ANCOVA] for repeated measures for height and BMD at all sites). The milk supplementation group had less loss in terms of both height and BMD than the control group (p < 0.05 by ANCOVA for repeated measures). Serum parathyroid hormone (PTH) concentration was lower and serum 25-hyroxyvitamin D [25(OH)D] level was higher in the milk supplementation group than the control group at 12 months (p < 0.05 by paired t-test). We conclude that supplementing the diet of postmenopausal Chinese women with high calcium milk powder retards bone loss.
    Journal of Bone and Mineral Research 10/2001; 16(9):1704-9. · 6.13 Impact Factor