Malaysia is ageing. The number of Malaysians aged 65 years and over will rise from 6.8 per cent in 2020 to 14 per cent by 2044.
According to the Department of Statistics 2020 census, 6.8 per cent (2.2 million) of Malaysia’s 32.4 million population are elderly people (65 years and over), 24.0 per cent are between 0 and 14 years old, and 69.3 per cent between 15 and 64 years old.
The highest proportion of elderly people by state is Perak (8.9 per cent), Perlis and Kedah (7.9 per cent), and Sarawak (7.5 per cent). Three districts in Sarawak recorded the highest composition of elderly people, namely Lubok Antu (13.5 per cent), Song (12.4 per cent), and Sri Aman (11.9 per cent).
A 2017 study on the epidemiology of dementia in Singapore found that among Singaporean Malays above 60, the overall age-standardised prevalence of any cognitive impairment was 25.5 per cent, including 2 per cent with dementia.
The cognitive impairment prevalence of 14.9 per cent in the 60 to 64 age group increased to 40.2 per cent in those above 80. This prevalence is higher in women.
Dementia
It is estimated that 8.5 per cent of older adults in Malaysia (roughly 260,000) are living with dementia, according to the World Health Organization statistics for 2022.
Stroke
About 130 people suffer from stroke every day in Malaysia. There were 47,911 stroke incidences in 2019, according to the National Stroke Registry.
The Global Burden of Disease Stroke Statistics Worldwide Survey in 2016 estimated that one in four Malaysians will suffer a stroke by 2040 if no preventive action is taken.
Stroke patients are also getting younger. One in four strokes now occur in persons under the age of 50.
Traumatic Brain (TBI) And Spinal Cord Injuries (SCI)
Very little has been published on the epidemiological patterns of SCI in Malaysia. Available studies show that most persons with SCI are males, aged below 40, and have paraplegia.
The incidence peaks in the 25 to 34 and 55 to 64 age groups. The most common cause was motor vehicle accidents, followed by falls from heights.
Tumour-related cases made up 40 per cent of non-traumatic causes. No local data is available on the mortality and life expectancy of persons with SCI.
In Malaysia, TBI is one of the top three common causes of admission to intensive care units. Incidence rate and statistics on TBI remain under-reported, especially for non-road accident cases such as falls or abuse.
Visual Impairment
1.2 per cent of the population experience some kind of visual impairment. One in 10 children have undiagnosed vision conditions that lead to visual impairment if diagnosed late or not treated.
According to the Department of Social Welfare, as of July 2024, there are 61,112 registered visually impaired individuals in Malaysia.
Hearing Impairment
The deaf community forms approximately 7.4 per cent of the Malaysian population, including 52,000 children and teenagers who were born deaf.
Neurodiversity
People with learning disabilities recorded the highest registration at 265,503 persons.
5 to 10 per cent of Malaysian children have dyslexia (worldwide prevalence is 5 to 17 per cent). There are currently no accurate statistics on dyslexic children in Malaysia.
An estimated 200,000 and 400,000 school students are dyslexic, and are struggling with reading, writing, spelling, and comprehension.
The International Dyslexia Association estimates that dyslexia affects 15 to 20 per cent of the population. Roughly one in five individuals have some form of dyslexia with boys more likely to be diagnosed.
Autism Spectrum Disorder (ASD)
Autism Spectrum Disorder (ASD) affects 10.5 per cent of children and 6.0 per cent of adults worldwide.
The reported prevalence in Malaysia is 3.9 per cent. In children, the rate of ADHD is higher in boys (8 to 10 per cent) than in girls (4 per cent). In a study of Malaysian working adults, 30 per cent have been identified as having ADHD symptoms
Cerebral Palsy
Cerebral palsy is the second most common disability in Malaysia after Down syndrome. The prevalence in Malaysia is 2.6 per 1,000 live births.
Down Syndrome
The Down syndrome incidence in Malaysia has been reported as one for every 950 life births, with Malays at 1:981, Chinese 1:940, and Indians1:860. The American College of Obstetrics and Gynaecology estimates that about one in 150 babies is born with a chromosomal abnormality.
Mental Health
The National Health Morbidity Survey (2022) revealed that one in four adolescents is battling depression. One in ten has reported a suicide attempt.
Suicide
Per 100,000 population, Malaysia’s rate of 5.8 is lower than the 9.0 recorded worldwide. Since 2021, there have been almost 1,000 suicide cases each year, with 609 (2019), 621 (2020), 1,142 (2021), 981 (2022), and 1,087 (2023). Male to female ratio is 4.6 to 1.
The Chinese have the highest rates followed by non-Malaysians, Indians, and Malays. Hanging is the most common method (50 per cent) followed by jumping from heights.
Drug Abuse
103,760 drug abusers were registered in Malaysia between January and March 2023 by the National Anti-Drugs Agency (NADA).
The prevalence of drug addiction is highest in Malays (80.4 per cent), Chinese (6.4 per cent), and Indians (6.0 per cent). Opiates, methamphetamines, and amphetamine-type stimulants (ATS) were among the major types of drugs abused in Malaysia (NADA, 2021).
22.4 per cent of the participants admitted to taking drugs and substances (alcohol, tobacco, and cigarettes) during their lifetimes and 12.9 per cent have been reported as being current users
19.9 per cent have used tobacco products (cigarettes, chewing tobacco, cigars, and others) in their lifetime, and 11.5 per cent are current tobacco users.
4.9 per cent have consumed alcoholic beverages (beer, wine, liquor, and others) during their lifetimes, and 3.5 per cent were current drinkers.
5.5 per cent had used drugs during their lifetimes and 3.5 per cent are current users
Adverse Childhood Experiences
Adverse childhood experiences (ACEs) are precursors to adult ill-health, including depression, cardiovascular disease, cancer, diabetes, and premature death. Research suggests ACEs is associated with long-term changes in the nervous, endocrine, and immune systems.
ACEs data in Malaysia is limited. The reported examples of maltreatment among undergraduates in Universiti Sains Malaysia was emotional abuse (30.2 per cent), emotional neglect (29.2 per cent), physical abuse (28.7 per cent), physical neglect (9.1 per cent), and sexual abuse among both males and females (6.1 per cent). The most commonly reported household dysfunction was parental divorce/separation (5.5 per cent).
Can we train teachers to identify children with ACEs from preschool for early intervention? Can we develop training modules for them to help or refer these kids early?
The high rates of childhood adverse experiences may be the underlying cause of the mental issues affecting one in three Malaysians, reported by the National Health and Morbidity Survey in 2015.
Dr Tan Poh Tin is a paediatrician and public health specialist working with a network of specialists in brain-related specialities in Sarawak to raise awareness about brain care in health and disease.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
