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12 results on '"Siriwardhana, Dhammika Deepani"'

1. The epidemiology of frailty and its association with disability and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka

Author

Siriwardhana, Dhammika Deepani

Subjects
362.19897
Abstract

Background and aim: Frailty is an important age related medical condition that predicts numerous adverse health outcomes. Many low-and middle-income countries (LMICs) are ageing rapidly but we know little about the epidemiology of frailty in these countries. This thesis describes the epidemiology of frailty and its association with disability and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka. Methods: Part A) A systematic review and meta-analysis on prevalence of frailty and pre-frailty among community-dwelling older adults in LMICs. Part B) A population-based cross-sectional study conducted in 2016 to i) estimate the prevalence of frailty, ii) describe factors associated with frailty, and iii) evaluate the association of frailty with disability and quality of life among rural community-dwelling older adults in Kegalle district. A three stage probability sampling was used to recruit 746 older adults aged ≥60 years. Frailty was assessed using the Fried phenotype. Results: Part A) Limited evidence was found on the prevalence of frailty in low-income and lower middle-income countries. The random-effects pooled prevalence of frailty and pre-frailty in community-dwelling older adults in LMICs was 17.4% (95% CI: 14.4%, 20.7%) and 49.3% (95% CI: 46.4%, 52.2%) respectively. Part B) The prevalence of frailty and pre-frailty among rural community-dwelling older adults aged ≥60 years in Kegalle district of Sri Lanka was estimated as 15.2% (95% CI: 12.3%, 18.6%) and 48.5% (95% CI: 43.8%, 53.2%) respectively. The prevalence of limitations in instrumental activities of daily living (≥1 IADL) assessed with Lawton IADL scale was high (84.4%) in frail older adults. The prevalence of basic activities of daily living (≥1 BADL) assessed with Barthel index was 38.7% in frail older adults. Being frail lowered the odds of having no IADL limitations and was associated with a four times higher count of IADL limitations compared with non-frail counterparts. Frailty was associated with a small but significant lower quality of life in this rural Sri Lankan population. Conclusions: The prevalence of frailty appears higher in rural community-dwelling older adults in Sri Lanka compared with upper middle-income and high-income countries with a significant impact on IADL limitations but with lower than anticipated impact on BADL limitations and quality of life.

Published
2019

4. Telehealth services for children with neuro‐developmental disabilities in the Asia‐Pacific region: A systematic review.

Author

Devagiri, Bhagya, Ariyasena, Akila Dinethra K., Siriwardhana, Dhammika Deepani, and Sumanasena, Samanmali

Subjects
CEREBRAL palsy treatment, TREATMENT of autism, TREATMENT of hearing disorders, PSYCHOLOGY information storage & retrieval systems, CINAHL database, NEUROLOGICAL disorders, MEDICAL information storage & retrieval systems, SYSTEMATIC reviews, DOWN syndrome, DEVELOPMENTAL disabilities, CLEFT palate, CLEFT lip, TREATMENT effectiveness, MEDLINE, TELEMEDICINE, CHILD development deviations
Abstract

Background: In recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID‐19 pandemic. Aim: We synthesized available evidence on telehealth for managing children with NDDs in the Asia‐Pacific region with the aim of identifying successful methods. Methodology: We systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database‐specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690. Results: We harvested 30,823 records; 17,563 duplicates were removed, and 196 full‐text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent‐led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect. Conclusions: According to published evidence telehealth for children with NDDs is an evolving, evidence‐based service facilitation modality in the Asia‐Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study

Author

Siriwardhana, Dhammika Deepani, Weerasinghe, Manuj Chrishantha, Rait, Greta, Falcaro, Milena, Scholes, Shaun, and Walters, Kate R

Subjects
Male, Rural Population, Frail Elderly, Global Health, Age Distribution, Risk Factors, Prevalence, Humans, Sex Distribution, Geriatric Assessment, health care economics and organizations, Aged, Sri Lanka, Aged, 80 and over, Frailty, geriatric medicine, Research, public health, Middle Aged, Cross-Sectional Studies, Logistic Models, epidemiology, Female, Independent Living
Abstract

Objective Our main objective was to describe the prevalence and associated sociodemographic factors of frailty and pre-frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka. Design Community-based cross-sectional study. Setting The study was conducted in rural areas of Kegalle district in Sri Lanka. Participants A total of 746 community-dwelling older adults aged ≥60 years were included in the study. Results The prevalence of frailty and pre-frailty in rural Kegalle district was 15.2% (95% CI 12.3% to 18.6%) and 48.5% (95% CI 43.8% to 53.2%), respectively. We found a strong association between age and both frailty and pre-frailty. There were strong associations between longest-held occupation and frailty and education level and pre-frailty. Conclusions The prevalence of frailty in this rural Sri Lankan older population was high compared with high-income and upper middle-income countries. The profile of health and social care services in Sri Lanka needs to address frailty and its consequences.

Published
2019

10. Cross-cultural adaptation and psychometric evaluation of the Sinhala version of Lawton Instrumental Activities of Daily Living Scale

Author

Siriwardhana, Dhammika Deepani, Walters, Kate, Rait, Greta, Bazo-Alvarez, Juan Carlos, and Weerasinghe, Manuj Chrishantha

Subjects
Male, Aging, Asia, Psychometrics, Economics, Cognitive Neuroscience, Culture, lcsh:Medicine, Equipment, Social Sciences, Research and Analysis Methods, Geographical locations, Elderly, Mathematical and Statistical Techniques, Cognition, Sociology, Cross-Cultural Studies, Activities of Daily Living, Adaptation, Psychological, Medicine and Health Sciences, Psychology, Humans, Statistical Methods, lcsh:Science, Sri Lanka, Aged, Communication Equipment, Cognitive Impairment, Aged, 80 and over, Cognitive Neurology, lcsh:R, Biology and Life Sciences, Middle Aged, Telephones, Neurology, Age Groups, People and Places, Physical Sciences, Engineering and Technology, Cognitive Science, lcsh:Q, Population Groupings, Female, Factor Analysis, Mathematics, Statistics (Mathematics), Finance, Research Article, Neuroscience
Abstract

INTRODUCTION:Instrumental activities of daily living (IADL) are cognitively complex activities related to independent living in the community. Robust IADL scales are needed, however the psychometric properties of instruments have been little evaluated. There is no validated instrument for Sri Lankan older populations. Sri Lanka has the highest proportion of older people in South Asia with rapid population ageing. Therefore, it is essential to have standard instruments to assess activity limitations. We aimed to cross-culturally adapt the original Lawton Instrumental Activities of Daily Living Scale from English to Sinhala and evaluate the psychometric properties of the Sinhala version. METHODS:Cross-cultural adaptation of the instrument was performed. The instrument was validated in a sample of 702 community-dwelling older adults aged 60 years and above in Sri Lanka. Reliability (internal consistency and inter-rater reliability) was assessed. Construct validity of the scale was evaluated by performing exploratory and confirmatory factor analysis and testing convergent and divergent validity. RESULTS:The Lawton IADL scale was successfully adapted to Sri Lankan context. Internal consistency of the scale was very high (Cronbach's alpha = 0.91). Very good inter-rater reliability was observed with very good agreement for all items. Inter-class correlations for overall IADL score ranged from 0.57 to 0.91. Results of the exploratory and confirmatory factor analyses supported the unidimensionality of the scale. Goodness of fit indices in confirmatory factor analysis were in acceptable range (CFI = 0.98, SRMR = 0.06, NNFI = 0.97). Strength of associations were significant and in the expected direction. Results of the known group validity were also significant, confirming the convergent and divergent validity. CONCLUSION:The Lawton IADL scale was successfully translated and culturally adapted to Sinhala language. The Sinhala version demonstrated excellent reliability and construct validity. Given good psychometric properties, this scale would be recommended for use in future research.

Published
2018

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