Nurul Hidayah Md Fadzil

@ukm.my

Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia
Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia

Nurul Hidayah Md Fadzil


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EDUCATION

Universiti Kebangsaan Malaysia

RESEARCH, TEACHING, or OTHER INTERESTS

Nutrition and Dietetics, Geriatrics and Gerontology
5

Scopus Publications

208

Scholar Citations

6

Scholar h-index

5

Scholar i10-index

Scopus Publications

  • Multidomain Intervention for the Reversal of Cognitive Frailty Using a Personalized Approach (AGELESS Trial): Recruitment and Baseline Characteristics of Participants
    A.M. Ibrahim, D.K.A. Singh, A.F.M. Ludin, P. Subramaniam, C. Ai-Vyrn, N. Ibrahim, H. Haron, A.M. Safien, N.M. Khalid, P. Ponvel, N.H.M. Fadzil, J.M. Hanipah, F. Mangialasche, M. Kivipelto, Suzana Shahar
    Journal of Prevention of Alzheimer S Disease, 2024
    BACKGROUND Reversal of cognitive frailty through a multidomain intervention is desirable to prevent dementia. AGELESS Trial was conducted to determine the effectiveness of a comprehensive, multidomain intervention on older adults with cognitive frailty in Malaysia. However, conducting a clinical trial, particularly during and after Covid-19, posed unique challenges. OBJECTIVE We aimed to investigate the recruitment process and baseline characteristics of the AGELESS Trial participants to better understand an at-risk population and those who agree to participate in an intervention. DESIGN/SETTING 24-month, randomized controlled trial. PARTICIPANTS Community-dwelling older adults with independent mobility, aged ≥ 60 years, with a mini mental state examination score of 19-25, a clinical dementia rating of 0.5 ≥ 1 Fried's physical frailty criteria, and < 22 Beck depression inventory. INTERVENTION Participants were randomized 1:1 to a structured multidomain intervention consisting of vascular management, diet, exercise, cognitive and psychosocial stimulation, or to the arm, including routine care and general health consultation. MEASUREMENT We analyzed the group differences between (1) cognitive frailty and non- cognitive frailty screened subjects, (2) recruited and non-recruited participants, (3) baseline characteristics of participants by arm, (4) adherence to AGELESS intervention at 12 months, and (5) preliminary findings on the effectiveness of the intervention at 12 months. RESULTS A total of 957 older adults from two locations, i.e., urban (n = 764) and rural (n = 193) areas, were screened, of whom 38.9% had cognitive frailty and were eligible to participate. Those with cognitive frailty had fewer years of education (B = -0.08; 95%CI = 0.88-0.97; p = 0.002), and lower functioning cognition (B = -0.24; 95%CI = 0.74-0.84; p < 0.001). Among those from urban areas, only 33.1% (n = 106) agreed to participate, particularly those with multimorbidity (B = 0.86; 95%CI = 1.31-4.30; p = 0.01), higher physical activity (B = -1.02; 95%CI = 0.19-0.69; p = 0.002), slower walking speed (B = 1.26; 95%CI = 1.62-7.61; p = 0.001), and higher systolic blood pressure (B = 0.02; 95%CI = 1.00-1.03; p = 0.03). At baseline, participants' mean age was 68.1±5.6, years of education was 8.3±3.9, body mass index was 27.5±5.3 kg/m2, and mini mental state examination score was 22.7±4.0. Generally, there were no significant differences between the intervention and control groups for the main outcomes, except those in the intervention group had higher body mass index, mid-upper-arm circumference, and waist circumference (p < 0.05 for all parameters). Overall intervention adherence at 12 months was 52.8%, ranging from 52.8%-90.6% for each of the modules. Preliminary analysis of the effectiveness of the intervention at 12 months was positive on most of the cognitive domains, some of the nutrient intake and food groups, physical function, and vascular outcomes (p < 0.05 for all parameters). CONCLUSION Despite the challenges posed by the pandemic, screening, recruitment, and 12-month intervention delivery were achieved in a Malaysian multidomain preventive randomized controlled trial in older adults at risk of dementia, with a satisfactory adherence rate and cognitive benefits at 12 months.
  • What stops us and what motivates us? A scoping review and bibliometric analysis of barriers and facilitators to physical activity
    Azliyana Azizan, Nurul Hidayah Md Fadzil
    Ageing Research Reviews, 2024
  • Development and Evaluation of Content Validity and Acceptance of a Multidomain Intervention Module for Reversal of Cognitive Frailty Among Older Adults
    Norhayati Mustafa Khalid, Pavapriya Ponvel, Azianah Ibrahim, A'isyah Mohd Safien, Nurul Hidayah Md Fadzil, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Norhayati Ibrahim, Ponnusamy Subramaniam, Hasnah Haron, Roslee Rajikan, Divya Vanoh, Suzana Shahar
    Clinical Interventions in Aging, 2024
    Purpose There is a limited availability of multidomain interventions that target cognitive frailty. Thus, the aim of the present study was to develop and evaluate the content validity and acceptance of the multidomain intervention module to reverse cognitive frailty among older adults (iAGELESS). Patients and Methods This study was conducted in two phases: Phase I included the development of the multidomain intervention module iAGELESS and evaluation of content validity, while Phase II consisted of evaluating the acceptance of the module among 18 healthcare and social care providers, 13 older adults with cognitive frailty, and 13 caregivers. Content validity index (CVI) was used to quantify the content validity. Respondents completed a questionnaire which consisted of information on sociodemographic, followed by module acceptance evaluation with respect to content, terminologies, and graphics. The data was then analyzed descriptively. Results A multidomain intervention module, iAGELESS was developed. The module was found to have appropriate content validity (overall CVI = 0.83). All the caregivers, 92% of older adults with cognitive frailty and 83% of healthcare and social care providers were satisfied with the overall content of the module. More than 50% of those who accepted the module had satisfactory consensus on the ease of the terminologies, length of sentences, pictures, information, color, and font size included in the module. Conclusion The iAGELESS module demonstrated good content validity and was well accepted, thus warranting its utilization in future studies to determine its effectiveness in reversing cognitive frailty among older adults.
  • A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty
    Nurul Hidayah Md Fadzil, Suzana Shahar, Roslee Rajikan, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Ponnusamy Subramaniam, Norhayati Ibrahim, Divya Vanoh, Nazlena Mohamad Ali
    International Journal of Environmental Research and Public Health, 2022
    Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants’ existing knowledge towards telerehabilitation to achieve its target.
  • Multidomain Intervention for Reversal of Cognitive Frailty, towards a Personalized Approach (AGELESS Trial): Study Design
    Pavapriya Ponvel, Suzana Shahar, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Roslee Rajikan, Nor Fadilah Rajab, Chin Ai-Vyrn, Normah Che Din, Norhayati Ibrahim, Ponnusamy Subramaniam, Hasnah Haron, Aniza Ismail, Razinah Sharif, Kalavathy Ramasamy, Abu Bakar Abdul Majeed, Nazlena Mohamad Ali, Mazlyfarina Mohamad, Shahrul Azman Mohd Noah, Azianah Mohd Ibrahim, Aisyah Mohd Safien, Norhayati Mustafa Khalid, Nurul Hidayah Md Fadzil, Francesca Mangialasche, Miia Kivipelto
    Journal of Alzheimer S Disease, 2021
    Background: Cognitive frailty (CF) is identified as one of the main precursors of dementia. Multidomain intervention has been found to delay or prevent the onset of CF. Objective: The aim of our present study is to determine the effectiveness of a comprehensive, multidomain intervention on CF; to evaluate its cost effectiveness and the factors influencing adherence toward this intensive intervention. Methods: A total of 1,000 community dwelling older adults, aged 60 years and above will be screened for CF. This randomized controlled trial involves recruitment of 330 older adults with CF from urban, semi-urban, and rural areas in Malaysia. Multidomain intervention comprised of physical, nutritional, cognitive, and psychosocial aspects will be provided to participants in the experimental group (n = 165). The control group (n = 165) will continue their usual care with their physician. Primary outcomes include CF status, physical function, psychosocial and nutritional status as well as cognitive performance. Vascular health and gut microbiome will be assessed using blood and stool samples. A 24-month intensive intervention will be prescribed to the participants and its sustainability will be assessed for the following 12 months. The effective intervention strategies will be integrated as a personalized telerehabilitation package for the reversal of CF for future use. Results: The multidomain intervention developed from this trial is expected to be cost effective compared to usual care as well as able is to reverse CF. Conclusion: This project will be part of the World-Wide FINGERS (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) Network, of which common identifiable data will be shared and harmonized among the consortia.

RECENT SCHOLAR PUBLICATIONS

  • The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive …
    P Ponvel, S Shahar, DKA Singh, AFM Ludin, P Subramaniam, N Ibrahim, ...
    Alzheimer's research & therapy 17 (1), 101 , 2025
    2025
    Citations: 16
  • Development and evaluation of content validity and acceptance of a multidomain intervention module for reversal of cognitive frailty among older adults
    N Mustafa Khalid, P Ponvel, AM Ibrahim, A Mohd Safien, NH Md Fadzil, ...
    Clinical Interventions in Aging, 1189-1202 , 2024
    2024
    Citations: 8
  • Multidomain intervention for the reversal of cognitive frailty using a personalized approach (AGELESS Trial): recruitment and baseline characteristics of participants
    AM Ibrahim, DKA Singh, AFM Ludin, P Subramaniam, C Ai-Vyrn, ...
    The Journal of Prevention of Alzheimer's Disease 11 (5), 1291-1306 , 2024
    2024
    Citations: 5
  • What stops us and what motivates us? A scoping review and bibliometric analysis of barriers and facilitators to physical activity
    A Azizan, NHM Fadzil
    Ageing Research Reviews 99, 102384 , 2024
    2024
    Citations: 34
  • Mapping the landscape: A bibliometric analysis of information and communication technology adoption by older adults with cognitive frailty or impairment
    NH Md Fadzil, S Shahar, DKA Singh, R Rajikan, D Vanoh, ...
    Geriatrics & Gerontology International 24 (3), 251-262 , 2024
    2024
    Citations: 3
  • Multidomain intervention for reversal of cognitive frailty, towards a personalised approach (AGELESS Trial): Recruitment and baseline characteristics of participants
    AM Ibrahim, DKA Singh, AFM Ludin, P Subramaniam, C Ai-Vyrn, ...
    2023
  • Digital Technology Usage Among Older Adults with Cognitive Frailty: A Survey During COVID-19 Pandemic
    NHM Fadzil, S Shahar, DKAS Singh, R Rajikan, D Vanoh, N Mohamad Ali, ...
    Digital Health 9, 1-14 , 2023
    2023
    Citations: 29
  • Dietary Inflammatory and Its Association with Cognitive Frailty Among Community-Dwelling Older Adults in Klang Valley
    FBJ Fae, RA Rahman, NHM Fadzil, S Shahar
    Malaysian Journal of Medicine and Health Sciences 19 (4), 273-281 , 2023
    2023
  • Association Between Internet Accessibility and Health Literacy among Community-Dwelling Older Adults with Cognitive Frailty (CF) from Lower Socioeconomic Status (LES) group: A …
    NHM Fadzil
    Alzheimer's Association International Conference , 2023
    2023
  • Need assessment of ICT literacy for development of multi‐domain telehealth intervention among cognitive frail (CF) older adults: A preliminary study
    NHM Fadzil
    Alzheimer's & Dementia 19, e063029 , 2023
    2023
  • A scoping review for usage of telerehabilitation among older adults with mild cognitive impairment or cognitive frailty
    NH Md Fadzil, S Shahar, R Rajikan, DKA Singh, AF Mat Ludin, ...
    International Journal of Environmental Research and Public Health 19 (7), 4000 , 2022
    2022
    Citations: 73
  • Multidomain intervention for reversal of cognitive frailty, towards a personalized approach (AGELESS Trial): study design
    P Ponvel, S Shahar, DKA Singh, AFM Ludin, R Rajikan, NF Rajab, ...
    Journal of Alzheimer’s Disease 82 (2), 673-687 , 2021
    2021
    Citations: 40

MOST CITED SCHOLAR PUBLICATIONS

  • A scoping review for usage of telerehabilitation among older adults with mild cognitive impairment or cognitive frailty
    NH Md Fadzil, S Shahar, R Rajikan, DKA Singh, AF Mat Ludin, ...
    International Journal of Environmental Research and Public Health 19 (7), 4000 , 2022
    2022
    Citations: 73
  • Multidomain intervention for reversal of cognitive frailty, towards a personalized approach (AGELESS Trial): study design
    P Ponvel, S Shahar, DKA Singh, AFM Ludin, R Rajikan, NF Rajab, ...
    Journal of Alzheimer’s Disease 82 (2), 673-687 , 2021
    2021
    Citations: 40
  • What stops us and what motivates us? A scoping review and bibliometric analysis of barriers and facilitators to physical activity
    A Azizan, NHM Fadzil
    Ageing Research Reviews 99, 102384 , 2024
    2024
    Citations: 34
  • Digital Technology Usage Among Older Adults with Cognitive Frailty: A Survey During COVID-19 Pandemic
    NHM Fadzil, S Shahar, DKAS Singh, R Rajikan, D Vanoh, N Mohamad Ali, ...
    Digital Health 9, 1-14 , 2023
    2023
    Citations: 29
  • The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive …
    P Ponvel, S Shahar, DKA Singh, AFM Ludin, P Subramaniam, N Ibrahim, ...
    Alzheimer's research & therapy 17 (1), 101 , 2025
    2025
    Citations: 16
  • Development and evaluation of content validity and acceptance of a multidomain intervention module for reversal of cognitive frailty among older adults
    N Mustafa Khalid, P Ponvel, AM Ibrahim, A Mohd Safien, NH Md Fadzil, ...
    Clinical Interventions in Aging, 1189-1202 , 2024
    2024
    Citations: 8
  • Multidomain intervention for the reversal of cognitive frailty using a personalized approach (AGELESS Trial): recruitment and baseline characteristics of participants
    AM Ibrahim, DKA Singh, AFM Ludin, P Subramaniam, C Ai-Vyrn, ...
    The Journal of Prevention of Alzheimer's Disease 11 (5), 1291-1306 , 2024
    2024
    Citations: 5
  • Mapping the landscape: A bibliometric analysis of information and communication technology adoption by older adults with cognitive frailty or impairment
    NH Md Fadzil, S Shahar, DKA Singh, R Rajikan, D Vanoh, ...
    Geriatrics & Gerontology International 24 (3), 251-262 , 2024
    2024
    Citations: 3
  • Multidomain intervention for reversal of cognitive frailty, towards a personalised approach (AGELESS Trial): Recruitment and baseline characteristics of participants
    AM Ibrahim, DKA Singh, AFM Ludin, P Subramaniam, C Ai-Vyrn, ...
    2023
  • Dietary Inflammatory and Its Association with Cognitive Frailty Among Community-Dwelling Older Adults in Klang Valley
    FBJ Fae, RA Rahman, NHM Fadzil, S Shahar
    Malaysian Journal of Medicine and Health Sciences 19 (4), 273-281 , 2023
    2023
  • Association Between Internet Accessibility and Health Literacy among Community-Dwelling Older Adults with Cognitive Frailty (CF) from Lower Socioeconomic Status (LES) group: A …
    NHM Fadzil
    Alzheimer's Association International Conference , 2023
    2023
  • Need assessment of ICT literacy for development of multi‐domain telehealth intervention among cognitive frail (CF) older adults: A preliminary study
    NHM Fadzil
    Alzheimer's & Dementia 19, e063029 , 2023
    2023