IntroductionQuality of Life and its associated factors among Patient with Dementia Caregivers: A Cross-Sectional Study in Geriatric Clinic, Hospital Kuala Lumpur, Malaysia.

IntroductionQuality of Life and its associated factors among Patient with Dementia Caregivers: A Cross-Sectional Study in Geriatric Clinic, Hospital Kuala Lumpur, Malaysia. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article IntroductionQuality of Life and its associated factors among Patient with Dementia Caregivers: A Cross-Sectional Study in Geriatric Clinic, Hospital Kuala Lumpur, Malaysia. Mohd Rizal Abdul Manaf, Misra Helma Firdaus, Nur Fairuz Md Teridi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5318883/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Dementia is major cause of disability and dependency in patients around the world. The studies report a high level of burden in caring for patient with dementia (PWD), especially in the Malaysian culture-norm. This study aimed to assess the four domains of Quality of Life (QoL) of caregivers for PWDs in Kuala Lumpur. Methods A cross-sectional survey was conducted among 202 dementia caregivers recruited from the Geriatric Memory Clinic at Hospital Kuala Lumpur. The WHO QoL -BREF Malay version was used to assess the participants' QoL. Multivariate regression models were conducted to establish predictors of caregivers QoL, including caregivers’ sociodemographic characteristics. Results Male caregivers, working, and had stable monthly income had better median QoL scores in all three domains physical 69.00 (25.00), psychological 69.00 (32.00), social 72.00 (44.00), and environment 69.00 (44.00) with p-value (< 0.005). Caregivers in the public and private sectors are a major predictor of QoL score, with an adjusted coefficient of ‘high score’ ranging from 0.24 to 0.25 for environmental QoL and ‘lower score’ for the Chinese race, with an adjusted coefficient of -0.22 for environmental QoL. Caregivers such as female, spouses, lower education, provided care for a longer period and unemployed experienced a higher level of physical, emotional, social, and environmental distress leads to a lower QoL. Conclusions The current study provides important insights into the QoL of caregivers for PWDs in Malaysia. Factors positively influencing the four domains of QoL include being male, having a relative relationship with the patient, working in the private sector, and collaborating with a spouse in caregiving responsibilities. Conversely, being female, serving as a spouse caregiver, identifying as Chinese or Hindu, and providing care for a longer duration are associated with a decrease in QoL. In the context of Malaysia's unique cultural and social landscape, it is essential to recognize and address the challenges faced by caregivers. Supporting caregivers through educational programs and resources that enhance their physical, psychological, social, and environmental well-being is critical for improving QOL outcomes associated with caregiving for individuals with dementia. Quality of Life Caregivers Dementia Geriatric WHOQOL-BREF Introduction Dementia is a major global health challenge, particularly among older adults, as it involves progressive cognitive decline that increases disability and dependency. In Malaysia, the prevalence of dementia is rising. According to the National Health and Morbidity Survey (2018), the incidence was reported at 8.5% (95% CI: 6.97–10.22), with life expectancy in 2017 at 72.7 years for men and 77.4 years for women ( 10 , 13 , 32 ). Dementia in Malaysia primarily stems from a mix of neurodegenerative conditions, with Alzheimer's disease being the most common, followed by vascular dementia. Additional contributing factors include chronic diseases such as hypertension, diabetes, and hypercholesterolemia, alongside lifestyle risks like smoking and physical inactivity. Social factors, such as stress and limited access to early interventions, further complicate dementia management in the country ( 9 , 21 , 22 ). The increasing prevalence of dementia places a significant burden on caregivers, most of whom are family members. They are a source of informal care. Informal caregivers are an important element of the Community Care Program in most countries including Malaysia. They are individuals such as partners, spouses, parents, children, and siblings who feel some emotional and/or obligatory bond with the person they are caring for ( 6 , 10 ). These caregivers are responsible for providing essential care to patients and face various challenges, including physical, emotional, financial, and social pressures. The patient’s condition, the caregiver's capacity, and the patient’s overall functioning and QoL all influence these caregiving burdens ( 3 , 10 , 19 , 32 ). Malaysian cultural norms emphasize familial responsibility, often placing additional strain on family caregivers, particularly women, who frequently assume the role of primary caregiver. Studies, both global and local, have examined the relationship between sociodemographic factors like age, gender, education level, income, marital status, living arrangements, and social support with QoL in older adults [8–11]. Health-related factors, including depression [12], non-communicable diseases (NCDs) [10], functional limitations [9], and nutritional status [13], have also been linked to QoL. However, most studies have analyzed either social or health aspects in isolation. In Malaysia, research on older adults’ QoL often emphasizes social dimensions [12,14,16]. Although many studies have explored the health-related aspects of informal caregiving, fewer have holistically assessed the total impact of caregiving on caregivers’ QoL. Due to the multidimensional nature of QoL, consensus on its definition and measurement in the context of informal caregiving remains elusive. Some research highlights physical and mental well-being as markers of health-related QoL (e.g., [24,25]). However, the World Health Organization (WHO) emphasizes that health encompasses not only physical and mental well-being but also social well-being and environmental support [26]. Consequently, it is essential to consider physical, psychological, social, economic, and familial interactions when discussing an individual’s QoL [25,27]. The Quality of Life (QoL) is a crucial component of health assessment, reflecting an individual’s perception of their position in life concerning their goals, expectations, and cultural context ( 14 , 27 , 37 ). While caregiving burdens have been widely studied, there is limited research that delves deeply into the four key QoL domains; physical, psychological, social, and environmental. Instead, most studies have focused on general health outcomes. Despite growing research on caregiving for dementia patients, the unique challenges faced by Malaysian caregivers remain underexplored. This study addresses this gap by employing the WHOQOL-BREF tool, which allows for the cross-cultural assessment of QoL, comparison across subgroups, and measurement of changes over time based on life circumstances. The findings from this study will offer valuable insights for policy formulation and support services. Specifically, the study aims to assess the QoL of dementia caregivers and identify key factors influencing their QoL among those attending the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia Material and methods Participation and setting This was a cross-sectional study conducted between September 2020 and February 2021 at the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia. Study population The inclusion criteria based on DSM 5 for Major Neurocognitive Disorder were as follows: (i) a spouse, partner, or other adult family member living in the same house or in contact with a PWD; (ii) taking care of a patient for at least six months; (iii) the care recipient required assistance with personal needs, household chores, financial assistance, and transportation when necessary; and (iv) The caregiver must have a comprehensive understanding of the patient’s typical behaviors and needs, which is essential for providing effective care and support. The exclusion criteria were as follows: (i) had taken care of more than one critically ill or highly dependent patient, (ii) could not comprehend Bahasa Malaysia or English, (iii) had a physical and/or mental disability diagnosed by a medical officer, and (iv) refused to participate in this study. Sample methods and Ethical approval Based on the population prevalence estimation formula N = Z 2 P (1 – P)/d 2 by Evan et al. (2023), a total of 194 was chosen as the minimum sample size, based on a 95% CI (1.96) with an estimated ratio of 88–20% dropout. A total of 202 respondents were selected using a simple random method during the six-month period. Patients were given explanations about the study, and written informed consent was obtained. This study was conducted at the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia, and received ethical approval from the Universiti Kebangsaan Malaysia (UKM) Medical Research and Ethics Committee (MREC) under the approval number UKMPP1/111/8/JEP-2021-306. The study was also registered with the National Medical Research Register (NMRR) with the registration number NMRR-21-492-58143 (IIR), KKM. Written informed consent was obtained from all study participants prior to their inclusion in the research. Study tool The validated WHOQOL-BREF (Bahasa Malaysia version) questionnaire by Hasanah et al. (2013) was used in this study. The scale has 26 items and uses a five-point Likert scale that measures general health (2 items), physical health (7 items), psychological health (6 items), social relationships (3 items), and the environment (8 items) to assess overall QoL. Domain scores are scaled in a positive direction (i.e., higher scores denote higher quality of life). The scores are presented as the mean and standard deviation or median and interquartile range based on the normality of the data. The questionnaire is divided into three ( 3 ) sections: the first section on caregiver sociodemographic information, the second section on patient demographic profiles and the third component of the WHOQOL-BREF questionnaire. In this study, a trained individual collected the data to reduce different types of bias that could affect the integrity of the research findings. Potential biases included interviewer bias, response bias, selection bias, and measurement bias. The training ensured consistent administration of the data collection instruments, thereby improving the reliability of the measurements obtained. Statistical analysis SPSS Software version 26 was used for the data analysis. As dependent variables, the four domains of the WHOQOL-BREF questionnaire (physical, psychological, social relationship, and environmental) were examined. Descriptive statistics, tables, and cross-tabulations were used to present the data. Normality was determined using histograms, Kolmogorov‒Shapiro tests, and skewness and kurtosis measurements. Spearman's correlations were used to investigate relationships between QoL domains, while the Mann‒Whitney and Kruskal‒Wallis tests were used to compare group scores. Significant variables were included in multivariate linear regression models with a p value cutoff of 0.05. In this study, variables with p-values less than 0.25 were included in regression models using either forward or backward selection methods. This approach was chosen because of the exploratory nature of the analysis, which allows for the inclusion of variables with weaker associations but may still provide insights into the predictors of quality of life among dementia caregivers. The statistical literature supports using a higher p-value threshold in the early stages of model development because it can help identify potential predictors for further investigation ( 15 , 23 , 38 ). After identifying these variables, the model was finalised using a stricter criterion of p < 0.05, ensuring that only statistically significant predictors were retained. Results The demographic characteristics of the respondents and PWDs are summarized in Table 1 . Sociodemographic characteristics of the caregivers The median age of the caregivers was 49 years. Most of the caregivers were female (64.9%) and married (70.8%). Most of them were Chinese (43.1%), followed by Malay (37.1%), Indian (16.8%), and others (3.0%), which demonstrated good representation of the country’s ethnic distribution. Almost half of them were either Muslim (37.1%) or Buddhist (36.1%), followed by Hindu (16.8%), Christian (11.4%), and others (3.5%). A total of 48.5% had a tertiary education. The majority of the respondents lived in urban areas (96%), had been caregiving for more than 4 years, and had a median household income of RM4000. Approximately one-third of them had underlying medical conditions (26.7%). Most of them were children (73.8%), followed by spouses (16.3%). The spouse caregivers were mostly patients' husbands, and the majority of caregivers (73.3%) had no formal assistants to assist them in dealing with PWDs. Patient (care-receivers) characteristics The majority of PWDs (61.4%) were female, with a median age of 75 years, and half (53.5%) of the patients were married. Among the participants, 43.6% were Chinese, 36.1% were Malay, 17.3% were Indian, and 3.0% were others. Almost half were Buddhist (39.1%), Muslim (37.1%), Hindu (12.4%), Christian (8.9%), or other (2.5%). The majority of PWDs had completed 35.1% of primary and secondary schools, 40.6% had a moderate type of dementia, and the average duration of illness was three ( 3 ) years. Table 1 Demographic characteristics of the respondents and PWDs (n = 202) Variable Caregivers Patients n (%) Median (IQR) n (%) Median (IQR) Age (year) 49.00 (20.00) 75.00 (12.00) Gender • Male • Female 71 (35.1) 131 (64.9) 78 (38.6) 124 (61.4) Marital status • Single • Married • Widowed • Divorced 52 (25.7) 143 (70.8) 4 (2.0) 3 (1.5) 7 (3.5) 108 (53.5) 83 (41.1) 4 (2.0) Race • Malay • Chinese • India • Others 75 (37.1) 87 (43.1) 34 (16.8) 6 (3.0) 73 (36.1) 88 (43.6) 35 (17.3) 6 (3.0) Religion • Muslim • Buddhist • Hindu • Christian • Others 75 (37.1) 73 (36.1) 24 (16.8) 23 (11.4) 7 (3.5) 75 (37.1) 79 (39.1) 25 (12.4) 18 (8.9) 5 (2.5) Education • No formal education • Primary • Secondary • Tertiary 1 (0.5) 9 (4.5) 94 (46.5) 98 (48.5 ) 51 (25.2) 71 (35.1) 71 (35.1) 9 (4.5) Localities • Urban • Rural 194 (96.0) 8 (4.0) Comorbidity • Yes • No 54 (26.7) 148 (73.3) 188 (93.1) 14 (6.9) Relationship with patient • Spouse • Son or daughter • Relative • Other 33 (16.3) 149 (73.8) 11 (5.4) 9 (4.5) Duration of caregiving (year) N = 201 4.00 (3.00) Formal Assistant • Yes • No 54 (26.7%) 148 (73.3%) Severity of dementia • Very mild • Mild • Moderate • Moderately severe • Severe 4 (2.0) 63 (31.2) 82 (40.6) 37 (18.3) 16 (7.9) Duration of dementia (year) 3.00 (2.00) Occupational • Unemployed • Government sector • Private sector • Housewife • Others 25 (12.4) 20 (9.9) 107 (53.0 ) 31 (15.3) 19 (9.4) Spouse Occupation • Unemployed • Government sector • Private sector • Housewife • Others 44 (21.8) 24 (11.9) 82 (40.6) 4 (2.0) 48 (23.8) Monthly Household Income (MYR) 4000.00 (2500.00) Quality of Life Table 2 shows the median score and Spearman's correlation coefficient for the differences between the four ( 4 ) domains. The highest median score for the respondents was in the social relationship domain (72.00), but the remaining domain scores for the physical, psychological and environmental aspects were the same (69.00). Spearman’s rank order correlation showed that there was a positive correlation between all four ( 4 ) domains, physical, psychological, social relationship, and environmental. The highest correlation score was found between the physical and social relationship domains (r 2 = 0.925, n = 202 p < 0.001), indicating a very strong positive correlation, and the lowest correlation score was found between the psychological and environmental domains (r 2 = 0.722, n = 200, p < 0.001), indicating a fair positive correlation. Table 2 Scores of the overall QoL and 4 domains of QoL and their Spearman’s correlation (n = 202) Variable Domain Score Physical Psychological Social Relationship Environment Overall QOL Median (IQR) Min Max Physical 69.00 (25.00) 19.00 100.00 1.000 0.919* 0.925* 0.916* 0.901* Psychological 69.00 (32.00) 19.00 100.00 1.000 0.830* 0.722* 0.770* Social Relationship 72.00 (44.00) 00.00 100.00 1.000 0.787* 0.839* Environmental 69.00 (44.00) 25.00 100.00 1.000 0.805* * Correlations are significant at the p < 0.01 level (2-tailed); physical and social (r 2 = 0.855) and psychological and environmental (r 2 = 0.521) As shown in Table 3 , there were significant differences in age, sex, race, religion, education level, comorbidities, relationship with patient, duration of caregiving occupation, spouse's occupation, and monthly income according to the QoL domain. The men had longer median physical and psychological QoL (p < 0.05) than did the women. Malays and Muslims had greater environmental QoL than did individuals of other races and religions (p < 0.05). The caregivers who worked in government and had a monthly income had a greater median QoL in all domains than did the other variables (p < 0.05). Being a relative to a PWD and having a tertiary education improve physical and environmental QoL (p < 0.05). Table 3 Bivariate analysis of factors associated with the QoL of caregivers of PWDs. Factors Variable Physical Psychological Social Relationship Environment Median (IQR) Z stat/ Corr. X 2 stat p value/ adj. p* Median (IQR) Z stat/ Corr. X 2 stat p value/ adj. p* Median (IQR) Z stat/ Corr. X 2 stat P value/adj. p* Median (IQR) Z stat/ Corr. X 2 stat p value/ adj. p* Age (year) -0.20 c 0.005 -0.15 c 0.039 -0.11 c 0.107 0.16 c 0.019 Gender - Male - Female 81.00(31.00) 63.00(25.00) -3.37 a 0.001 75.00(44.00) 69.00(25.00) -2.99 a 0.003 69.00(50.00) 75.00(31.00) -1.33 a 0.184 69.00(44.00) 69.00(31.00) -2.60 a 0.009 Marital status - Single - Married - Widowed - Divorced 100.00(37.0) 69.00(25.00) 75.00(25.00) 56.00(32.25) 0.88 b 0.831 69.00(30.25) 69.00(32.00) 59.50(11.50) 63.00(0.00) 2.34 b 0.504 69.00(37.00) 75.00(44.00) 62.50(22.00) 75.00(0.00) 2.87 b 0.412 69.00(36.50) 69.00(44.00) 63.00(9.75) 69.00(0.00) 1.53 b 0.675 Race - Malay - Chinese - India - Others *Chinese-Malay 69.00(25.00) 69.00(18.00) 63.00(32.75) 72.00(23.75) 1.56 0.669 75.00(25.00) 69.00(31.00) 63.00(39.50) 72.00(21.50) 4.84 b 0.184 75.00(38.00) 69.00(44.00) 56.00(32.50) 78.00(28.25) 7.02 b 0.071 75.00(31.00) 63.00(25.00) 63.00(39.50) 66.00(35.75) 11.26 b 0.010 0.014* Religion - Muslim - Buddhist - Hindu - Christian - Others *Muslim-Hindu 69.00(25.00) 69.00(25.00) 56.00(31.00) 69.00(18.00) 69.00(32.00) 3.48 b 0.481 75.00(25.00) 69.00(31.00) 56.00(19.00) 69.00(32.00) 69.00(44.00) 6.08 b 0.194 75.00(38.00) 69.00(44.00) 50.00(45.25) 69.00(44.00) 75.00(37.00) 8.16 b 0.086 75.00(31.00) 63.00(38.00) 63.00(31.00) 69.00(44.00) 63.00(13.00) 12.06 b 0.017 0.040* Education - Primary - Secondary - Tertiary - No formal education *primary-tertiary 56.00(25.00)* 69.00(25.00) 75.00(31.00)* - 11.26 b 0.010 0.053 56.00(37.00) 69.00(26.50) 69.00(38.00) - 7.17 b 0.067 56.00(22.00) 69.00(31.00) 75.00(45.50) - 7.78 b 0.051 44.00(43.50) 63.00(38.00) 69.00(31.00) - 10.28 b 0.016 Place of living - Urban - Rural 69.00(25.00) 62.50(28.00) -1.02 a 0.307 69.00(32.00) 69.00(18.75) -0.49 a 0.623 72.00(44.00) 72.00(29.50) -0.50 a 0.615 69.00(44.00) 66.00(21.75) -0.29 a 0.775 Comorbidity - No - Yes 69.00(25.00) 75.00(28.50) -2.25 a 0.025 69.00(25.00) 62.50(38.00) -1.26 a 0.208 75.00(31.00) 69.00(50.00) -0.17 a 0.867 69.00(38.00) 69.00(44.00) -0.93 a 0.352 Relationship with patient - Spouse - Son or daughter - Relative - Other *spouse-relative 63.00(19.00)* 69.00(25.00) 81.00(31.00) 69.00(34.50)* 9.13 b 0.028 0.019* 63.00(31.00) 69.00(32.00) 94.00(31.00) 69.00(59.00) 6.83 b 0.077 56.00(31.00) 69.00(44.00 81.00(44.00) 75.00(40.50) 3.04 b 0.386 69.00(50.00) 69.00(38.00) 94.00(31.00) 63.00(31.00) 8.56 b 0.036 Duration of caregiving (year) N = 201` -0.19 c 0.006 -0.20 c 0.004 -0.13 c 0.071 -0.22 c 0.002 Occupational - Unemployed - Government sector - Private sector - Housewife - Others *unemployed-private *unemployed-government *housewife-government *housewife-private 63.00(28.00) 72.00(25.00) 81.00(31.00) 69.00(31.00) 69.00(18.00) 19.10 b 0.001 0.007* 0.009* 56.00(31.00) 75.00(25.00) 69.00(38.00) 69.00(31.00) 69.00(25.00) 13.62 b 0.031* 0.009 50.00(44.00) 87.50(25.00) 75.00(50.00) 56.00(25.00) 69.00(25.00) 17.15 b 0.002 0.018* 0.002* 63.00(25.00) 88.00(29.50) 69.00(44.00) 63.00(37.00) 69.00(12.00) 15.34 b 0.004 0.014* 0.018* Spouse Occupation - Unemployed - Government sector - Private sector - Housewife - Others *unemployed-government *others-government 69.00(25.00) 75.00(28.50) 75.00(26.75) 66.00(39.00) 69.00(25.00) 4.26 b 0.372 66.00(31.00) 81.00(29.50) 69.00(38.00) 59.50(51.25) 69.00(25.00) 9.62 b 0.047 0.052 56.00(31.00) 81.00(25.00) 75.00(50.00) 37.50(76.75) 69.00(34.00) 16.10 b 0.003 0.027* 0.008* 63.00(34.00) 91.00(34.00) 69.00(39.50) 53.00(39.00) 69.00(31.00) 13.69 b 0.008 0.006* Formal Assistant : - Yes - No 69.00(26.75) 69.00(25.00) -0.95 a 0.343 75.00(38.00) 69.00(25.00) -0.59 a 0.554 75.00(44.00) 69.00(40.75) -0.72 a 0.470 69.00(38.00) 69.00(38.00) -1.23 c 0.218 Monthly Household Income (MYR) 0.26 c < 0.001 0.28* < 0.001 0.35 c < 0.001 0.33 c 2 categorical data. c Using the Spearman coefficient correlation. *Post hoc test for significant variable p < 0.05; a significant value was adjusted by the Bonferroni correction for multiple tests (pair wire comparison). Table 4 presents the factors that influence caregivers' quality of life (QoL) for people with dementia. The study focusses on four major aspects of QoL: physical, psychological, social relationships, and environmental. The findings are derived from a multivariate linear regression model, which examines the various sociodemographic factors on caregivers' well-being. The model found a significant linear relationship between factors associated with a caregiver's sociodemographic status and all four domains of QoL. There is a significant positive relationship among male gender, relative relationships with dementia patients, caregivers working in the private and public sectors, and spouse caregivers working in the government sector. However, there is a negative relationship between the four domains of QoL and Chinese ethnicity, Hinduism, spouses working as housewives, unemployed caregivers, and monthly income. Male caregivers reported significantly higher QoL across all domains than female caregivers. Males experienced a 7.15-point increase in psychological QoL (95% CI: 1.67, 12.62; p = 0.011). Caregivers of Chinese descent experienced a significant decrease in environmental quality of life, with a reduction of 9.01 points compared to caregivers of other races (95% CI: -14.61, -3.40; p = 0.002). Single caregivers had a lower social relationship QoL than divorced caregivers, by 10.09 points (95% CI: -17.72, 2.67; p = 0.008). Hindu caregivers reported significantly lower social relationships and environmental quality of life (QOL) than caregivers of other religions, indicating a negative impact on their overall well-being. Furthermore, caregivers in government positions reported improved social relationships, with a 20.33 point increase (95% CI: 8.71, 31.96; p = 0.001). In contrast, unemployed caregivers had a 10.62 point decrease in psychological QOL (95% CI: -18.53, -2.71; p = 0.009). The caregiver's spouse's occupation had a significant impact on their psychological health. Spouses in government roles increased psychological QOL by 9.60 points (95% CI: 1.56, 17.65; p = 0.020). Caregivers with a housewife, on the other hand, reported a significant decrease in social relationship quality of life by 28.11 points (95% CI: -51.64, -4.60; p = 0.019). Every additional year of caregiving was associated with a slight decrease in physical activity (-0.23 points, 95% CI: -1.39, -0.18; p = 0.012) and psychological QoL (-0.75 points, 95% CI: -1.40, -0.09; p = 0.026). Income also influences QoL. For example, higher monthly income was positively correlated with environmental QoL, with an increase of 0.001 points for each additional MYR (95% CI: 0.000, 0.002; p = 0.016). This study's analysis shown three interactions. There is a significant interaction effect between male caregivers and spouses working in government positions in terms of psychological QoL. Male caregivers whose spouses work in government report an increase in psychological QoL of 17.47 points (95% CI: 1.30, 33.65; p = 0.034). Caregivers in the government sector with housewife spouses improve their social relationship QoL by 20.33 points (95% CI: 8.71, 31.96; p = 0.001). Similarly, caregivers working in the private sector with housewife spouses report an increase in social relationship QoL of 11.89 points (95% CI: 4.79, 18.98; p = 0.001). The model accounts for 13.8% of the variation in psychological QoL (R²=0.138), 14.4% in social relationship QoL (R²=0.144), and 14.2% in environmental QOL (R²=0.142) in the study sample. Table 4 Multivariate linear analysis of factors associated with the 4 QoL domains of caregivers of PWDs. Factors Variable Multiple Linear Regression Physical Psychological Social Relationship Environmental Beta 95% CI p value Beta 95% CI p value Beta 95% CI p value Beta 95% CI p value Gender - Female (references) Male 5.96 0.61,11.02 0.029 7.15 1.67,12.62 0.011 6.76 1.27,12.47 0.016 Male*Spouse (government) interaction 17.47 1.30,33.65 0.034 Race - Others (References) Chinese -9.01 -14.61, -3.40 0.002 Marital status - Divorced (References) Single -10.09 -17.72,2.67 0.008 Religion - Others (references) Hindu -12.48 -22.52, -2.43 0.015 -10.26 -18.87, -1.64 0.020 Relationship with patient - Others ( references) Relative 12.41 3.55,24.96 0.009 12.13 0.69,23.67 0.038 Occupational - Others (references) Unemployed -10.62 -18.53, -2.71 0.009 Government 8.12 2.89,12.91 0.002 20.33 8.71,31.96 0.001 Private sector 11.89 4.79,18.98 0.001 Government*Housewife(spouse) interaction 20.33 8.71,31.96 0.001 Private* Housewife(spouse) interaction 11.89 4.79,18.98 0.001 Spouse Occupation - Others (References) Government 9.60 1.56,17.65 0.020 Housewife -28.11 -51.64, -4.60 0.019 Duration of caregiving (year) -0.23 -1.39, -0.18 0.012 -0.75 -1.40, -0.09 0.026 Monthly Income (MYR) 0.001 0.000,0.002 0.016 R 2 0.138 0.172 0.144 0.142 Backward multiple linear regression was applied. Multivariate linear regression model (enter) for significant (p < 0.05) variables during univariate analysis. The mean (SD) domain scores were 70.91 (± 18.45), 70.05 (± 19.89), 68.25 (± 24.79), and 70.12 (± 20.13). *One two-way interaction was detected for the Male*Spouse (Government) interaction in the Psychological Domain and for the Single, Private, and Government caregiver*Spouse (Housewife) interactions in the Social Relationships domain. However, for the Chinese religion, the interaction of the Hindu religion occurs in the environmental domain. No multicollinearity was detected (VIF < 10). Model assumptions are met. Discussion Caregiver factors The majority of PWD caregivers were women (64.9%), 70.8% were married, 43.1% were Chinese, and 96% lived in cities indicating that Hospital Kuala Lumpur is located in an urban setting and most likely serves a Chinese population. In general, women's longer life expectancy indirectly contributes to their role as caregivers aligning with broader Asian cultural practices, and social norms emphasize familial responsibility in caring for older people compared to men ( 6 , 8 , 11 , 14 , 24 – 25 , 27 , 29 , 33 ). Among the caregivers, 48.5% had a tertiary education, 73.3% had not received formal assistance and had no comorbidities. A total of 53% of the caregivers worked in the private sector, 40.6% of their spouses also worked in a similar sector and earned an average income of RM 4000 per month. Well-informed caregivers demonstrate greater comprehension, acceptance, awareness, and adaptability, which results in better patient care. This study focused on the importance of education, stable employment, and financial assistance in caregivers’ roles, as in previous studies ( 4 , 8 , 21 , 30 ). Similarly, additional earnings from employment may help alleviate financial constraints and duration of care ( 21 , 30 ). Patient Factors The demographic characteristics of the PWDs in this study reveal significant insights into the factors influencing caregiver dynamics. The finding that 61.4% of patients are female aligns with existing literature, indicating a higher prevalence of dementia among women. This pattern reflects broader trends observed in both Western and Asian contexts, where females typically exhibit longer life expectancies, leading to a higher incidence of age-related conditions, including dementia ( 9 , 35 ). Understanding the gender distribution of PWDs can guide targeted interventions and support mechanisms for caregivers, especially given the additional burdens faced by female caregivers. Furthermore, the significant representation of Chinese patients (43.6%) raises important cultural considerations. Previous studies have indicated that cultural background can influence caregiving practices and perceptions of dementia, with Chinese families often adhering to strong familial obligations and cultural expectations ( 8 , 21 , 30 ). This cultural context may impact the caregivers' stress levels and coping mechanisms, highlighting the need for culturally sensitive support programs tailored to the unique challenges faced by caregivers in these communities. The marital status of patients also offers valuable insights into the dynamics of caregiving. With half of the patients being married, the role of spouses as primary caregivers is emphasized. This finding is crucial, as spousal caregivers often face intense emotional and physical strain, leading to higher levels of caregiver burden and stress ( 29 ). The caregiving relationship, especially between spouses, can significantly affect the QolL for both parties, suggesting that interventions should include strategies to support spousal caregivers specifically. Moreover, the presence of a religious affiliation, particularly among the Buddhist and Chinese patients, may shape both the caregivers' and patients' experiences with dementia. Previous research suggests that religious beliefs can provide a framework for coping with chronic illnesses, offering emotional support and a sense of purpose ( 9 , 27 ). However, the challenges associated with caregiving within these cultural and religious contexts can also create unique stressors, reinforcing the need for holistic support that addresses both emotional and practical caregiving needs. In terms of quality of life (QoL), the median scores reported in this study were consistent with findings from other Asian countries, indicating a common experience among caregivers across these regions. However, the reported scores also highlight the disparities that exist within different demographic groups. For instance, the relatively low environmental QoL reported by Chinese and Hindu caregivers suggests that these groups may face specific challenges related to their living conditions and social support systems. Addressing these challenges through targeted community interventions may be vital in enhancing their overall well-being and caregiving efficacy ( 22 , 37 ) By understanding patient factors is crucial for informing the development of effective caregiver support strategies. Recognizing the interplay between gender, cultural background, marital status, and religious beliefs can lead to more tailored interventions that enhance the QoL of both caregivers and PWDs. Future research should continue to explore these dynamics to develop comprehensive support systems that recognize and address the multifaceted challenges faced by caregivers in different contexts. QOL in the Four Domains This study aimed to explore the associations between sociodemographic factors and the four domains of QoL; physical, psychological, social relationships, and environmental among caregivers of PWDs in Malaysia. The findings from the multivariate linear regression analysis provide important insights into how these factors influence caregivers’ QoL. The median score for the four QoL domains was the same as that reported in studies from China (87.2), Taiwan (87.6), and Hong Kong (79.6) (Guan et al. 2016; Wong et al. 2012). These parallels have been linked to culture, caregivers’ perceptions of their own well-being, and expectations for multiple stakeholders to take responsibility for reducing the burden of dementia care on society ( 16 , 35 ). Physical Domain Our results indicate that male caregivers, particularly those in a spousal relationship and employed in government positions, reported significantly higher physical QoL scores. This may reflect the traditional role of men as primary providers in Malaysian culture, which could lead to better access to resources and support systems. Conversely, unemployed caregivers experienced a decrease in their physical QoL, highlighting the impact of economic status on caregivers' well-being ( 21 , 25 ) Psychological Domain The psychological QoL scores revealed that male caregivers in spousal roles also had significantly higher scores compared to their female counterparts. Additionally, caregivers of Chinese ethnicity demonstrated lower psychological well-being, potentially reflecting cultural stigma surrounding mental health. The significant interaction between gender and spousal occupation suggests that financial stability may contribute to psychological resilience among male caregivers ( 22 , 36 ) Social Relationships Domain The results underscore the critical role of the caregiver's relationship with the patient. Relatives of patients reported significantly higher social relationship scores, indicating that family ties may provide emotional support and reduce feelings of isolation. However, single caregivers experienced lower social relationship scores, suggesting that social networks are vital for emotional support, particularly in a collectivist society like Malaysia ( 22 – 24 ) Environmental Domain In the environmental domain, caregivers practicing Hinduism scored lower, possibly due to cultural and religious factors influencing access to supportive resources. The results also indicated that higher monthly income positively correlates with better environmental QoL reinforcing the notion that socioeconomic status significantly impacts caregivers’ living conditions and access to care services ( 2 , 5 , 11 , 24 ) Based on all QoL domain in multivariate regression analysis reveals that sociodemographic factors such as gender, ethnicity, marital status, occupation, and income significantly influence the QoL of caregivers in the physical, psychological, social relationship, and environmental domains. Specifically, male caregivers, those in spousal relationships, and those with higher incomes generally reported better QoL across all domains. Limitations The cross-sectional study design limits its ability to establish causal relationships. Another limitation is that this study was conducted in a single health facility; therefore, the results should be interpreted with caution. Some biases, such as comprehension and interpretation bias, may have an impact on self-reporting methods. A significant limitation not previously addressed is the lack of assessment regarding the presence or absence of collaborating persons in caregiving roles. For instance, if a primary caregiver, such as a wife, has the support of a cooperating spouse or other family members, this could reduce the caregiving burden and enhance the caregiver's quality of life. The absence of this variable in our study may limit our understanding of the full context surrounding caregiver experiences and quality of life. Additionally, some biases, such as comprehension and interpretation bias, may impact the accuracy of self-reported data. Participants' ability to understand and accurately express their experiences may vary, potentially influencing the validity of the findings. Conclusion The current study provides important insights into the QoL of caregivers for PWDs in Malaysia. Factors positively influencing the four domains of QoL include being male, having a relative relationship with the patient, working in the private sector, and collaborating with a spouse in caregiving responsibilities. Conversely, being female, serving as a spouse caregiver, identifying as Chinese or Hindu, and providing care for a longer duration are associated with a decrease in QoL. In the context of Malaysia's unique cultural and social landscape, it is essential to recognize and address the challenges faced by caregivers. Supporting caregivers through educational programs and resources that enhance their physical, psychological, social, and environmental well-being is critical for improving QOL outcomes associated with caregiving for individuals with dementia Abbreviations MOH; Ministry of Health, MREC; Medical Research and Ethical Committee, MYR; Malaysia Ringgit, QoL; Quality of Life, SD; Standard Deviation, UKM; Universiti Kebangsaan Malaysia, PWDs; Patient with Dementia Declarations Ethics approval This study included patient and caregiver data, and confidentiality was maintained at all times. Ethical approval was obtained from the Universiti Kebangsaan Malaysia (UKM) Medical Research and Ethics Committee (MREC) UKMPP1/111/8/JEP-2021-306; registration with the National Medical Research Register (NMRR-21-492-58143 (IIR), KKM); and approval from the director and the head of the geriatric unit, Hospital Kuala Lumpur. Consent for publication Not applicable Availability of data and materials The data used to support the findings of this study are available from the corresponding author upon request Competing interest The authors declare that they have no competing interests. Funding This is a self-funding study Authors’ contributions MRAM conceived and designed the study. NFT collected materials and data. MHF analysed the data and drafted the manuscript. MRAM and MHF contributed to interpret the results and critically reviewed the manuscript. All authors read and approved the final manuscript. All authors contributed equally to this work. Acknowledgments Appreciation was extended to the director of Kuala Lumpur Hospital Head of the Clinical Research Centre Kuala Lumpur Hospital, the Head of the Medical Department of Kuala Lumpur Hospital, the Head of the Geriatrics Unit at Kuala Lumpur Hospital, and Geriatric specialists at Kuala Lumpur Hospital, who were core searchers who helped a lot in making this study successful. References Ahman A. World Health Organization quality of life assessment: brief version in Bahasa Malaysia. Med J Malaysia. 2003;58(1):79–88. Abdul Manaf MR, Mustafa M, Abdul Rahman MR, Yusof KH, Abd Aziz NA. Factors influencing the prevalence of mental health problems among Malay older residing in a rural community: a cross-sectional study. PLoS ONE. 2016;11(6):e0156937. Ahmad Zubaidi ZS, Ariffin F, Oun CTC, Katiman D. Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross sectional study. BMC Palliat care. 2020;19(1):1–15. 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Burden of caring for Alzheimer’s disease or dementia patients in Japan, the US, and EU: results from the National Health and Wellness Survey: a cross-sectional survey [Article]. J Med Econ. 2021a;24(1):266–78. https://doi.org/10.1080/13696998.2021.1880801 . Ohno S, Chen Y, Sakamaki H, Matsumaru N, Yoshino M, Tsukamoto K. Humanistic burden among caregivers of patients with Alzheimer’s disease or dementia in Japan: a large-scale cross-sectional survey [Article]. J Med Econ. 2021b;24(1):181–92. https://doi.org/10.1080/13696998.2021.1877149 . Organization WH, editor. (2012). Programme on Mental health: WHOQOL User Manual . Division of Mental Health and Prevention Substance Abuse, World Health Organization. https://www.who.int/publications/i/item/WHO-HIS-HSI-Rev.2012-3 (World Health Organization). Rosdinom R, Norzarina M, Zanariah M, Ruzanna Z. Sociodemographic profiles of caregivers and their association with burden of care in dementia. Malaysian J Psychiatry. 2011;20(1):37–46. Santos RL, Neto JPS, Belfort T, Lacerda IB, Dourado MCN. Patterns of impairment in decision-making capacity in Alzheimer’s disease and its relationship with cognitive and clinical variables [Article]. Brazilian J Psychiatry. 2022;44(3):271–8. https://doi.org/10.1590/1516-4446-2021-2180 . Sarkar S. Impact of Caregiving Role in the Quality of Life of Family Caregivers for Persons with Alzheimer's Disease. Mankato: Minnesota State University; 2015. Suriawati G, Ayu Sulaini J, Aniza AA. Burden of caregivers of the older with chronic illnesses and their associated factors in an urban setting in Malaysia. Malaysian J Public Health Med. 2015;15(1):1–9. Vun IJ, Cheah W, Helmy H. (2020). Quality of Life and its associated factors among caregivers of patients with dementia–A crosssectional study in Kuching, Sarawak, Malaysia. Neurol Asia, 25 (2). Warren A. Preserved Consciousness in Alzheimer’s Disease and Other Dementias: Caregiver Awareness and Communication Strategies [Review]. Front Psychol. 2021;12., Article 790025. https://doi.org/10.3389/fpsyg.2021.790025 . Wiegelmann H, Wolf-Ostermann K, Brannath W, Arzideh F, Dreyer J, Thyrian R, Schirra-Weirich L, Verhaert L. Sociodemographic aspects and health care-related outcomes: a latent class analysis of informal dementia care dyads [Article]. BMC Health Serv Res. 2021;21(1). Article 727. https://doi.org/10.1186/s12913-021-06708-6 . Wong DFK, Lam AYK, Chan SK, Chan SF. Quality of life of caregivers with relatives suffering from mental illness in Hong Kong: roles of caregiver characteristics, caregiving burdens, and satisfaction with psychiatric services. Health Qual Life Outcomes. 2012;10(1):1–9. Wong FY, Yang L, Yuen JW, Chang KK, Wong FK. Assessing quality of life using WHOQOL-BREF: A cross-sectional study on the association between quality of life and neighborhood environmental satisfaction, and the mediating effect of health-related behaviors. BMC Public Health. 2018;18:1–14. Sykes AO. 1993. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5318883","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":372059979,"identity":"97a456ef-9f21-4bc5-b4db-ced01b516c3f","order_by":0,"name":"Mohd Rizal Abdul Manaf","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIiWNgGAWjYFACxgYGhgIbIIMNxEsAEQZEaDFII0kLWM1hErTozj7c/OGHwfk8c4m01A2MbWnRDOzN2yQYcw7j1GJ2LrHBsMfgdrHljLRjNxjbcnIbeI6VSTBuw6PlDGNDAo/B7cQNN9LbgFoqchskcswIajn4x+Ackhb5NwS1NDbzGBwAaoE5TIKHoJZmZhmD5GLLnmdpNxLOpeW28aQVWyRuS8ejhf3xxzcVdnnm7GlmNz6UJef2sx/eeOPjNmucWmAgARwXCQzw6GkmUgsSqCOoZRSMglEwCkYMAAD5PFkj1XTroQAAAABJRU5ErkJggg==","orcid":"","institution":"National University of Malaysia","correspondingAuthor":true,"prefix":"","firstName":"Mohd","middleName":"Rizal Abdul","lastName":"Manaf","suffix":""},{"id":372059980,"identity":"5ef7e377-8d58-47b8-8957-0ac1d9428813","order_by":1,"name":"Misra Helma Firdaus","email":"","orcid":"","institution":"National University of Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Misra","middleName":"Helma","lastName":"Firdaus","suffix":""},{"id":372059981,"identity":"8d8030cd-98b2-4375-b4ac-b23d679299e4","order_by":2,"name":"Nur Fairuz Md Teridi","email":"","orcid":"","institution":"National University of Malaysia","correspondingAuthor":false,"prefix":"","firstName":"Nur","middleName":"Fairuz Md","lastName":"Ter","suffix":"Md"}],"badges":[],"createdAt":"2024-10-23 12:23:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5318883/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5318883/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106093369,"identity":"ae49caad-8f57-4e07-97d1-980a85bbea84","added_by":"auto","created_at":"2026-04-03 11:37:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1832677,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5318883/v1/dbf7c032-f5de-4df0-898d-6e65adae1240.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"IntroductionQuality of Life and its associated factors among Patient with Dementia Caregivers: A Cross-Sectional Study in Geriatric Clinic, Hospital Kuala Lumpur, Malaysia.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDementia is a major global health challenge, particularly among older adults, as it involves progressive cognitive decline that increases disability and dependency. In Malaysia, the prevalence of dementia is rising. According to the National Health and Morbidity Survey (2018), the incidence was reported at 8.5% (95% CI: 6.97\u0026ndash;10.22), with life expectancy in 2017 at 72.7 years for men and 77.4 years for women (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Dementia in Malaysia primarily stems from a mix of neurodegenerative conditions, with Alzheimer's disease being the most common, followed by vascular dementia. Additional contributing factors include chronic diseases such as hypertension, diabetes, and hypercholesterolemia, alongside lifestyle risks like smoking and physical inactivity. Social factors, such as stress and limited access to early interventions, further complicate dementia management in the country (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe increasing prevalence of dementia places a significant burden on caregivers, most of whom are family members. They are a source of informal care. Informal caregivers are an important element of the Community Care Program in most countries including Malaysia. They are individuals such as partners, spouses, parents, children, and siblings who feel some emotional and/or obligatory bond with the person they are caring for (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). These caregivers are responsible for providing essential care to patients and face various challenges, including physical, emotional, financial, and social pressures. The patient\u0026rsquo;s condition, the caregiver's capacity, and the patient\u0026rsquo;s overall functioning and QoL all influence these caregiving burdens (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Malaysian cultural norms emphasize familial responsibility, often placing additional strain on family caregivers, particularly women, who frequently assume the role of primary caregiver.\u003c/p\u003e \u003cp\u003eStudies, both global and local, have examined the relationship between sociodemographic factors like age, gender, education level, income, marital status, living arrangements, and social support with QoL in older adults [8\u0026ndash;11]. Health-related factors, including depression [12], non-communicable diseases (NCDs) [10], functional limitations [9], and nutritional status [13], have also been linked to QoL. However, most studies have analyzed either social or health aspects in isolation. In Malaysia, research on older adults\u0026rsquo; QoL often emphasizes social dimensions [12,14,16].\u003c/p\u003e \u003cp\u003eAlthough many studies have explored the health-related aspects of informal caregiving, fewer have holistically assessed the total impact of caregiving on caregivers\u0026rsquo; QoL. Due to the multidimensional nature of QoL, consensus on its definition and measurement in the context of informal caregiving remains elusive. Some research highlights physical and mental well-being as markers of health-related QoL (e.g., [24,25]). However, the World Health Organization (WHO) emphasizes that health encompasses not only physical and mental well-being but also social well-being and environmental support [26]. Consequently, it is essential to consider physical, psychological, social, economic, and familial interactions when discussing an individual\u0026rsquo;s QoL [25,27].\u003c/p\u003e \u003cp\u003eThe Quality of Life (QoL) is a crucial component of health assessment, reflecting an individual\u0026rsquo;s perception of their position in life concerning their goals, expectations, and cultural context (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). While caregiving burdens have been widely studied, there is limited research that delves deeply into the four key QoL domains; physical, psychological, social, and environmental. Instead, most studies have focused on general health outcomes.\u003c/p\u003e \u003cp\u003eDespite growing research on caregiving for dementia patients, the unique challenges faced by Malaysian caregivers remain underexplored. This study addresses this gap by employing the WHOQOL-BREF tool, which allows for the cross-cultural assessment of QoL, comparison across subgroups, and measurement of changes over time based on life circumstances. The findings from this study will offer valuable insights for policy formulation and support services. Specifically, the study aims to assess the QoL of dementia caregivers and identify key factors influencing their QoL among those attending the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia\u003c/p\u003e"},{"header":"Material and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipation and setting\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional study conducted between September 2020 and February 2021 at the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe inclusion criteria based on DSM 5 for Major Neurocognitive Disorder were as follows: (i) a spouse, partner, or other adult family member living in the same house or in contact with a PWD; (ii) taking care of a patient for at least six months; (iii) the care recipient required assistance with personal needs, household chores, financial assistance, and transportation when necessary; and (iv) The caregiver must have a comprehensive understanding of the patient\u0026rsquo;s typical behaviors and needs, which is essential for providing effective care and support. The exclusion criteria were as follows: (i) had taken care of more than one critically ill or highly dependent patient, (ii) could not comprehend Bahasa Malaysia or English, (iii) had a physical and/or mental disability diagnosed by a medical officer, and (iv) refused to participate in this study.\u003c/p\u003e\n\u003ch3\u003eSample methods and Ethical approval\u003c/h3\u003e\n\u003cp\u003eBased on the population prevalence estimation formula N\u0026thinsp;=\u0026thinsp;Z\u003csup\u003e2\u003c/sup\u003eP (1 \u0026ndash; P)/d\u003csup\u003e2\u003c/sup\u003e by Evan et al. (2023), a total of 194 was chosen as the minimum sample size, based on a 95% CI (1.96) with an estimated ratio of 88\u0026ndash;20% dropout. A total of 202 respondents were selected using a simple random method during the six-month period. Patients were given explanations about the study, and written informed consent was obtained. This study was conducted at the Geriatric Clinic at Hospital Kuala Lumpur, Malaysia, and received ethical approval from the Universiti Kebangsaan Malaysia (UKM) Medical Research and Ethics Committee (MREC) under the approval number UKMPP1/111/8/JEP-2021-306. The study was also registered with the National Medical Research Register (NMRR) with the registration number NMRR-21-492-58143 (IIR), KKM. Written informed consent was obtained from all study participants prior to their inclusion in the research.\u003c/p\u003e\n\u003ch3\u003eStudy tool\u003c/h3\u003e\n\u003cp\u003eThe validated WHOQOL-BREF (Bahasa Malaysia version) questionnaire by Hasanah et al. (2013) was used in this study. The scale has 26 items and uses a five-point Likert scale that measures general health (2 items), physical health (7 items), psychological health (6 items), social relationships (3 items), and the environment (8 items) to assess overall QoL. Domain scores are scaled in a positive direction (i.e., higher scores denote higher quality of life). The scores are presented as the mean and standard deviation or median and interquartile range based on the normality of the data. The questionnaire is divided into three (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) sections: the first section on caregiver sociodemographic information, the second section on patient demographic profiles and the third component of the WHOQOL-BREF questionnaire. In this study, a trained individual collected the data to reduce different types of bias that could affect the integrity of the research findings. Potential biases included interviewer bias, response bias, selection bias, and measurement bias. The training ensured consistent administration of the data collection instruments, thereby improving the reliability of the measurements obtained.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eSPSS Software version 26 was used for the data analysis. As dependent variables, the four domains of the WHOQOL-BREF questionnaire (physical, psychological, social relationship, and environmental) were examined. Descriptive statistics, tables, and cross-tabulations were used to present the data. Normality was determined using histograms, Kolmogorov‒Shapiro tests, and skewness and kurtosis measurements. Spearman's correlations were used to investigate relationships between QoL domains, while the Mann‒Whitney and Kruskal‒Wallis tests were used to compare group scores. Significant variables were included in multivariate linear regression models with a p value cutoff of 0.05. In this study, variables with p-values less than 0.25 were included in regression models using either forward or backward selection methods. This approach was chosen because of the exploratory nature of the analysis, which allows for the inclusion of variables with weaker associations but may still provide insights into the predictors of quality of life among dementia caregivers. The statistical literature supports using a higher p-value threshold in the early stages of model development because it can help identify potential predictors for further investigation (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). After identifying these variables, the model was finalised using a stricter criterion of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, ensuring that only statistically significant predictors were retained.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic characteristics of the respondents and PWDs are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003ch3\u003eSociodemographic characteristics of the caregivers\u003c/h3\u003e\n\u003cp\u003eThe median age of the caregivers was 49 years. Most of the caregivers were female (64.9%) and married (70.8%). Most of them were Chinese (43.1%), followed by Malay (37.1%), Indian (16.8%), and others (3.0%), which demonstrated good representation of the country\u0026rsquo;s ethnic distribution. Almost half of them were either Muslim (37.1%) or Buddhist (36.1%), followed by Hindu (16.8%), Christian (11.4%), and others (3.5%). A total of 48.5% had a tertiary education. The majority of the respondents lived in urban areas (96%), had been caregiving for more than 4 years, and had a median household income of RM4000. Approximately one-third of them had underlying medical conditions (26.7%). Most of them were children (73.8%), followed by spouses (16.3%). The spouse caregivers were mostly patients' husbands, and the majority of caregivers (73.3%) had no formal assistants to assist them in dealing with PWDs.\u003c/p\u003e\n\u003ch3\u003ePatient (care-receivers) characteristics\u003c/h3\u003e\n\u003cp\u003eThe majority of PWDs (61.4%) were female, with a median age of 75 years, and half (53.5%) of the patients were married. Among the participants, 43.6% were Chinese, 36.1% were Malay, 17.3% were Indian, and 3.0% were others. Almost half were Buddhist (39.1%), Muslim (37.1%), Hindu (12.4%), Christian (8.9%), or other (2.5%). The majority of PWDs had completed 35.1% of primary and secondary schools, 40.6% had a moderate type of dementia, and the average duration of illness was three (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) years.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of the respondents and PWDs (n\u0026thinsp;=\u0026thinsp;202)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eCaregivers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003ePatients\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMedian (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eMedian (IQR)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.00 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e75.00 (12.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003cp\u003e\u0026bull; Male\u003c/p\u003e \u003cp\u003e\u0026bull; Female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (35.1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e131 (64.9)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (38.6)\u003c/p\u003e \u003cp\u003e\u003cb\u003e124 (61.4)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003cp\u003e\u0026bull; Single\u003c/p\u003e \u003cp\u003e\u0026bull; Married\u003c/p\u003e \u003cp\u003e\u0026bull; Widowed\u003c/p\u003e \u003cp\u003e\u0026bull; Divorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (25.7)\u003c/p\u003e \u003cp\u003e\u003cb\u003e143 (70.8)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e4 (2.0)\u003c/p\u003e \u003cp\u003e3 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (3.5)\u003c/p\u003e \u003cp\u003e\u003cb\u003e108 (53.5)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e83 (41.1)\u003c/p\u003e \u003cp\u003e4 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace\u003c/p\u003e \u003cp\u003e\u0026bull; Malay\u003c/p\u003e \u003cp\u003e\u0026bull; Chinese\u003c/p\u003e \u003cp\u003e\u0026bull; India\u003c/p\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75 (37.1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e87 (43.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e34 (16.8)\u003c/p\u003e \u003cp\u003e6 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73 (36.1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e88 (43.6)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e35 (17.3)\u003c/p\u003e \u003cp\u003e6 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003cp\u003e\u0026bull; Muslim\u003c/p\u003e \u003cp\u003e\u0026bull; Buddhist\u003c/p\u003e \u003cp\u003e\u0026bull; Hindu\u003c/p\u003e \u003cp\u003e\u0026bull; Christian\u003c/p\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e75 (37.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e73 (36.1)\u003c/p\u003e \u003cp\u003e24 (16.8)\u003c/p\u003e \u003cp\u003e23 (11.4)\u003c/p\u003e \u003cp\u003e7 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75 (37.1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e79 (39.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e25 (12.4)\u003c/p\u003e \u003cp\u003e18 (8.9)\u003c/p\u003e \u003cp\u003e5 (2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003cp\u003e\u0026bull; No formal education\u003c/p\u003e \u003cp\u003e\u0026bull; Primary\u003c/p\u003e \u003cp\u003e\u0026bull; Secondary\u003c/p\u003e \u003cp\u003e\u0026bull; Tertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003cp\u003e9 (4.5)\u003c/p\u003e \u003cp\u003e94 (46.5)\u003c/p\u003e \u003cp\u003e\u003cb\u003e98 (48.5\u003c/b\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51 (25.2)\u003c/p\u003e \u003cp\u003e\u003cb\u003e71 (35.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e71 (35.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e9 (4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocalities\u003c/p\u003e \u003cp\u003e\u0026bull; Urban\u003c/p\u003e \u003cp\u003e\u0026bull; Rural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e194 (96.0)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e8 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComorbidity\u003c/p\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (26.7)\u003c/p\u003e \u003cp\u003e\u003cb\u003e148 (73.3)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e188 (93.1)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e14 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship with patient\u003c/p\u003e \u003cp\u003e\u0026bull; Spouse\u003c/p\u003e \u003cp\u003e\u0026bull; Son or daughter\u003c/p\u003e \u003cp\u003e\u0026bull; Relative\u003c/p\u003e \u003cp\u003e\u0026bull; Other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (16.3)\u003c/p\u003e \u003cp\u003e\u003cb\u003e149 (73.8)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e11 (5.4)\u003c/p\u003e \u003cp\u003e9 (4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of caregiving (year) N\u0026thinsp;=\u0026thinsp;201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.00 (3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormal Assistant\u003c/p\u003e \u003cp\u003e\u0026bull; Yes\u003c/p\u003e \u003cp\u003e\u0026bull; No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (26.7%)\u003c/p\u003e \u003cp\u003e\u003cb\u003e148 (73.3%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeverity of dementia\u003c/p\u003e \u003cp\u003e\u0026bull; Very mild\u003c/p\u003e \u003cp\u003e\u0026bull; Mild\u003c/p\u003e \u003cp\u003e\u0026bull; Moderate\u003c/p\u003e \u003cp\u003e\u0026bull; Moderately severe\u003c/p\u003e \u003cp\u003e\u0026bull; Severe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (2.0)\u003c/p\u003e \u003cp\u003e63 (31.2)\u003c/p\u003e \u003cp\u003e\u003cb\u003e82 (40.6)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e37 (18.3)\u003c/p\u003e \u003cp\u003e16 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of dementia (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.00 (2.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupational\u003c/p\u003e \u003cp\u003e\u0026bull; Unemployed\u003c/p\u003e \u003cp\u003e\u0026bull; Government sector\u003c/p\u003e \u003cp\u003e\u0026bull; Private sector\u003c/p\u003e \u003cp\u003e\u0026bull; Housewife\u003c/p\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (12.4)\u003c/p\u003e \u003cp\u003e20 (9.9)\u003c/p\u003e \u003cp\u003e\u003cb\u003e107 (53.0\u003c/b\u003e)\u003c/p\u003e \u003cp\u003e31 (15.3)\u003c/p\u003e \u003cp\u003e19 (9.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse Occupation\u003c/p\u003e \u003cp\u003e\u0026bull; Unemployed\u003c/p\u003e \u003cp\u003e\u0026bull; Government sector\u003c/p\u003e \u003cp\u003e\u0026bull; Private sector\u003c/p\u003e \u003cp\u003e\u0026bull; Housewife\u003c/p\u003e \u003cp\u003e\u0026bull; Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (21.8)\u003c/p\u003e \u003cp\u003e24 (11.9)\u003c/p\u003e \u003cp\u003e\u003cb\u003e82 (40.6)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e4 (2.0)\u003c/p\u003e \u003cp\u003e48 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly Household Income (MYR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4000.00 (2500.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eQuality of Life\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the median score and Spearman's correlation coefficient for the differences between the four (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) domains. The highest median score for the respondents was in the social relationship domain (72.00), but the remaining domain scores for the physical, psychological and environmental aspects were the same (69.00). Spearman\u0026rsquo;s rank order correlation showed that there was a positive correlation between all four (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) domains, physical, psychological, social relationship, and environmental. The highest correlation score was found between the physical and social relationship domains (r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.925, n\u0026thinsp;=\u0026thinsp;202 p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating a very strong positive correlation, and the lowest correlation score was found between the psychological and environmental domains (r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.722, n\u0026thinsp;=\u0026thinsp;200, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating a fair positive correlation.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eScores of the overall QoL and 4 domains of QoL and their Spearman\u0026rsquo;s correlation (n\u0026thinsp;=\u0026thinsp;202)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable Domain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eScore\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePsychological\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSocial Relationship\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eEnvironment\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eOverall QOL\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69.00 (25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.919*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.925*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.916*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.901*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychological\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69.00 (32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.830*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.722*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.770*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Relationship\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72.00 (44.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e00.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.787*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.839*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnvironmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69.00 (44.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e100.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.805*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e* Correlations are significant at the p\u0026thinsp;\u0026lt;\u0026thinsp;0.01 level (2-tailed); physical and social (r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.855) and psychological and environmental (r\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.521)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, there were significant differences in age, sex, race, religion, education level, comorbidities, relationship with patient, duration of caregiving occupation, spouse's occupation, and monthly income according to the QoL domain. The men had longer median physical and psychological QoL (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) than did the women. Malays and Muslims had greater environmental QoL than did individuals of other races and religions (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The caregivers who worked in government and had a monthly income had a greater median QoL in all domains than did the other variables (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Being a relative to a PWD and having a tertiary education improve physical and environmental QoL (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate analysis of factors associated with the QoL of caregivers of PWDs.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"17\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c16\" colnum=\"16\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c17\" colnum=\"17\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFactors Variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003ePsychological\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c13\" namest=\"c10\"\u003e \u003cp\u003eSocial Relationship\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c17\" namest=\"c14\"\u003e \u003cp\u003eEnvironment\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e stat/\u003c/p\u003e \u003cp\u003eCorr.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e stat\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value/\u003c/p\u003e \u003cp\u003eadj. \u003cem\u003ep*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e stat/\u003c/p\u003e \u003cp\u003eCorr.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e stat\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value/\u003c/p\u003e \u003cp\u003eadj. \u003cem\u003ep*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e stat/\u003c/p\u003e \u003cp\u003eCorr.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e stat\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value/adj. \u003cem\u003ep*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003e\u003cem\u003eZ\u003c/em\u003e stat/\u003c/p\u003e \u003cp\u003eCorr.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c16\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e stat\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value/\u003c/p\u003e \u003cp\u003eadj. \u003cem\u003ep*\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (year)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.20\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.15 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.11 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.16 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Male\u003c/p\u003e \u003cp\u003e- Female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81.00(31.00)\u003c/p\u003e \u003cp\u003e63.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.37\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.00(44.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.99 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e69.00(50.00)\u003c/p\u003e \u003cp\u003e75.00(31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-1.33 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-2.60 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Single\u003c/p\u003e \u003cp\u003e- Married\u003c/p\u003e \u003cp\u003e- Widowed\u003c/p\u003e \u003cp\u003e- Divorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100.00(37.0)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e75.00(25.00)\u003c/p\u003e \u003cp\u003e56.00(32.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.88 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69.00(30.25)\u003c/p\u003e \u003cp\u003e69.00(32.00)\u003c/p\u003e \u003cp\u003e59.50(11.50)\u003c/p\u003e \u003cp\u003e63.00(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.34\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.504\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e69.00(37.00)\u003c/p\u003e \u003cp\u003e75.00(44.00)\u003c/p\u003e \u003cp\u003e62.50(22.00)\u003c/p\u003e \u003cp\u003e75.00(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e2.87\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(36.50)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e63.00(9.75)\u003c/p\u003e \u003cp\u003e69.00(0.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e1.53 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e0.675\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Malay\u003c/p\u003e \u003cp\u003e- Chinese\u003c/p\u003e \u003cp\u003e- India\u003c/p\u003e \u003cp\u003e- Others\u003c/p\u003e \u003cp\u003e*Chinese-Malay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(18.00)\u003c/p\u003e \u003cp\u003e63.00(32.75)\u003c/p\u003e \u003cp\u003e72.00(23.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.669\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e63.00(39.50)\u003c/p\u003e \u003cp\u003e72.00(21.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.84\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e75.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e56.00(32.50)\u003c/p\u003e \u003cp\u003e78.00(28.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e7.02\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e75.00(31.00)\u003c/p\u003e \u003cp\u003e63.00(25.00)\u003c/p\u003e \u003cp\u003e63.00(39.50)\u003c/p\u003e \u003cp\u003e66.00(35.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e11.26 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.014*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Muslim\u003c/p\u003e \u003cp\u003e- Buddhist\u003c/p\u003e \u003cp\u003e- Hindu\u003c/p\u003e \u003cp\u003e- Christian\u003c/p\u003e \u003cp\u003e- Others\u003c/p\u003e \u003cp\u003e*Muslim-Hindu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e56.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(18.00)\u003c/p\u003e \u003cp\u003e69.00(32.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.48 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e56.00(19.00)\u003c/p\u003e \u003cp\u003e69.00(32.00)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.08\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e75.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e50.00(45.25)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e75.00(37.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e8.16\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e75.00(31.00)\u003c/p\u003e \u003cp\u003e63.00(38.00)\u003c/p\u003e \u003cp\u003e63.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e63.00(13.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e12.06 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.040*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Primary\u003c/p\u003e \u003cp\u003e- Secondary\u003c/p\u003e \u003cp\u003e- Tertiary\u003c/p\u003e \u003cp\u003e- No formal education\u003c/p\u003e \u003cp\u003e*primary-tertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.00(25.00)*\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e75.00(31.00)*\u003c/p\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.26 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56.00(37.00)\u003c/p\u003e \u003cp\u003e69.00(26.50)\u003c/p\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7.17\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e56.00(22.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e75.00(45.50)\u003c/p\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e7.78\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e44.00(43.50)\u003c/p\u003e \u003cp\u003e63.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e10.28 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlace of living\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Urban\u003c/p\u003e \u003cp\u003e- Rural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e62.50(28.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.02 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69.00(32.00)\u003c/p\u003e \u003cp\u003e69.00(18.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.49 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e72.00(44.00)\u003c/p\u003e \u003cp\u003e72.00(29.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.50 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e66.00(21.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-0.29 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e0.775\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidity\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- No\u003c/p\u003e \u003cp\u003e- Yes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e75.00(28.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-2.25 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.025\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e62.50(38.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.26 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e75.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(50.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.17 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.867\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-0.93 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e0.352\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship with patient\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Spouse\u003c/p\u003e \u003cp\u003e- Son or daughter\u003c/p\u003e \u003cp\u003e- Relative\u003c/p\u003e \u003cp\u003e- Other\u003c/p\u003e \u003cp\u003e*spouse-relative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.00(19.00)*\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e81.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(34.50)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.13 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.019*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(32.00)\u003c/p\u003e \u003cp\u003e94.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(59.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.83\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e56.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(44.00\u003c/p\u003e \u003cp\u003e81.00(44.00)\u003c/p\u003e \u003cp\u003e75.00(40.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e3.04\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.386\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(50.00)\u003c/p\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e94.00(31.00)\u003c/p\u003e \u003cp\u003e63.00(31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e8.56 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.036\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of caregiving (year)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eN\u0026thinsp;=\u0026thinsp;201`\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.19 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.20 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.13 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-0.22 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Unemployed\u003c/p\u003e \u003cp\u003e- Government sector\u003c/p\u003e \u003cp\u003e- Private sector\u003c/p\u003e \u003cp\u003e- Housewife\u003c/p\u003e \u003cp\u003e- Others\u003c/p\u003e \u003cp\u003e*unemployed-private\u003c/p\u003e \u003cp\u003e*unemployed-government\u003c/p\u003e \u003cp\u003e*housewife-government\u003c/p\u003e \u003cp\u003e*housewife-private\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.00(28.00)\u003c/p\u003e \u003cp\u003e72.00(25.00)\u003c/p\u003e \u003cp\u003e81.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(18.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.10 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.007*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.009*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56.00(31.00)\u003c/p\u003e \u003cp\u003e75.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e13.62\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.031*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.00(44.00)\u003c/p\u003e \u003cp\u003e87.50(25.00)\u003c/p\u003e \u003cp\u003e75.00(50.00)\u003c/p\u003e \u003cp\u003e56.00(25.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e17.15 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.018*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.002*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e63.00(25.00)\u003c/p\u003e \u003cp\u003e88.00(29.50)\u003c/p\u003e \u003cp\u003e69.00(44.00)\u003c/p\u003e \u003cp\u003e63.00(37.00)\u003c/p\u003e \u003cp\u003e69.00(12.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e15.34 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.014*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.018*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSpouse Occupation\u003c/b\u003e\u003c/p\u003e \u003cp\u003e- Unemployed\u003c/p\u003e \u003cp\u003e- Government sector\u003c/p\u003e \u003cp\u003e- Private sector\u003c/p\u003e \u003cp\u003e- Housewife\u003c/p\u003e \u003cp\u003e- Others\u003c/p\u003e \u003cp\u003e*unemployed-government\u003c/p\u003e \u003cp\u003e*others-government\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003cp\u003e75.00(28.50)\u003c/p\u003e \u003cp\u003e75.00(26.75)\u003c/p\u003e \u003cp\u003e66.00(39.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.26 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.372\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e66.00(31.00)\u003c/p\u003e \u003cp\u003e81.00(29.50)\u003c/p\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e59.50(51.25)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9.62\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e0.047\u003c/b\u003e\u003c/p\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e56.00(31.00)\u003c/p\u003e \u003cp\u003e81.00(25.00)\u003c/p\u003e \u003cp\u003e75.00(50.00)\u003c/p\u003e \u003cp\u003e37.50(76.75)\u003c/p\u003e \u003cp\u003e69.00(34.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e16.10 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.027*\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.008*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e63.00(34.00)\u003c/p\u003e \u003cp\u003e91.00(34.00)\u003c/p\u003e \u003cp\u003e69.00(39.50)\u003c/p\u003e \u003cp\u003e53.00(39.00)\u003c/p\u003e \u003cp\u003e69.00(31.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e13.69 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e0.006*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFormal Assistant\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e- Yes\u003c/p\u003e \u003cp\u003e- No\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.00(26.75)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.95 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(25.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.59 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.554\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e75.00(44.00)\u003c/p\u003e \u003cp\u003e69.00(40.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-0.72 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003cp\u003e69.00(38.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e-1.23 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Household Income (MYR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.26\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.28*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.35 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e0.33 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c17\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003ea\u003c/sup\u003e Mann‒Whitney test was used for 2 categorical data points. \u003csup\u003eb\u003c/sup\u003e using the Kruskal‒Wallis test for \u0026gt;\u0026thinsp;2 categorical data. \u003csup\u003ec\u003c/sup\u003eUsing the Spearman coefficient correlation.\u003c/p\u003e \u003cp\u003e*Post hoc test for significant variable p\u0026thinsp;\u0026lt;\u0026thinsp;0.05; a significant value was adjusted by the Bonferroni correction for multiple tests (pair wire comparison).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the factors that influence caregivers' quality of life (QoL) for people with dementia. The study focusses on four major aspects of QoL: physical, psychological, social relationships, and environmental. The findings are derived from a multivariate linear regression model, which examines the various sociodemographic factors on caregivers' well-being. The model found a significant linear relationship between factors associated with a caregiver's sociodemographic status and all four domains of QoL.\u003c/p\u003e \u003cp\u003eThere is a significant positive relationship among male gender, relative relationships with dementia patients, caregivers working in the private and public sectors, and spouse caregivers working in the government sector. However, there is a negative relationship between the four domains of QoL and Chinese ethnicity, Hinduism, spouses working as housewives, unemployed caregivers, and monthly income.\u003c/p\u003e \u003cp\u003eMale caregivers reported significantly higher QoL across all domains than female caregivers. Males experienced a 7.15-point increase in psychological QoL (95% CI: 1.67, 12.62; p\u0026thinsp;=\u0026thinsp;0.011). Caregivers of Chinese descent experienced a significant decrease in environmental quality of life, with a reduction of 9.01 points compared to caregivers of other races (95% CI: -14.61, -3.40; p\u0026thinsp;=\u0026thinsp;0.002). Single caregivers had a lower social relationship QoL than divorced caregivers, by 10.09 points (95% CI: -17.72, 2.67; p\u0026thinsp;=\u0026thinsp;0.008). Hindu caregivers reported significantly lower social relationships and environmental quality of life (QOL) than caregivers of other religions, indicating a negative impact on their overall well-being.\u003c/p\u003e \u003cp\u003eFurthermore, caregivers in government positions reported improved social relationships, with a 20.33 point increase (95% CI: 8.71, 31.96; p\u0026thinsp;=\u0026thinsp;0.001). In contrast, unemployed caregivers had a 10.62 point decrease in psychological QOL (95% CI: -18.53, -2.71; p\u0026thinsp;=\u0026thinsp;0.009). The caregiver's spouse's occupation had a significant impact on their psychological health. Spouses in government roles increased psychological QOL by 9.60 points (95% CI: 1.56, 17.65; p\u0026thinsp;=\u0026thinsp;0.020). Caregivers with a housewife, on the other hand, reported a significant decrease in social relationship quality of life by 28.11 points (95% CI: -51.64, -4.60; p\u0026thinsp;=\u0026thinsp;0.019). Every additional year of caregiving was associated with a slight decrease in physical activity (-0.23 points, 95% CI: -1.39, -0.18; p\u0026thinsp;=\u0026thinsp;0.012) and psychological QoL (-0.75 points, 95% CI: -1.40, -0.09; p\u0026thinsp;=\u0026thinsp;0.026). Income also influences QoL. For example, higher monthly income was positively correlated with environmental QoL, with an increase of 0.001 points for each additional MYR (95% CI: 0.000, 0.002; p\u0026thinsp;=\u0026thinsp;0.016).\u003c/p\u003e \u003cp\u003eThis study's analysis shown three interactions. There is a significant interaction effect between male caregivers and spouses working in government positions in terms of psychological QoL. Male caregivers whose spouses work in government report an increase in psychological QoL of 17.47 points (95% CI: 1.30, 33.65; p\u0026thinsp;=\u0026thinsp;0.034). Caregivers in the government sector with housewife spouses improve their social relationship QoL by 20.33 points (95% CI: 8.71, 31.96; p\u0026thinsp;=\u0026thinsp;0.001). Similarly, caregivers working in the private sector with housewife spouses report an increase in social relationship QoL of 11.89 points (95% CI: 4.79, 18.98; p\u0026thinsp;=\u0026thinsp;0.001). The model accounts for 13.8% of the variation in psychological QoL (R\u0026sup2;=0.138), 14.4% in social relationship QoL (R\u0026sup2;=0.144), and 14.2% in environmental QOL (R\u0026sup2;=0.142) in the study sample.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate linear analysis of factors associated with the 4 QoL domains of caregivers of PWDs.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFactors Variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"12\" nameend=\"c13\" namest=\"c2\"\u003e \u003cp\u003eMultiple Linear Regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003ePsychological\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eSocial Relationship\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e \u003cp\u003eEnvironmental\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e - Female (references)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.61,11.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.67,12.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e6.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1.27,12.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale*Spouse (government) interaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.30,33.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.034\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace -\u003c/b\u003e Others (References)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChinese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-9.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-14.61, -3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e - Divorced (References)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-10.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-17.72,2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion -\u003c/b\u003e Others (references)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHindu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-12.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-22.52, -2.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e-10.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-18.87, -1.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship with patient -\u003c/b\u003e Others (\u003cb\u003ereferences)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.55,24.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.69,23.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.038\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupational -\u003c/b\u003e Others (references)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-10.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-18.53, -2.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.89,12.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e20.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.71,31.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate sector\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e11.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.79,18.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGovernment*Housewife(spouse) interaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e20.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.71,31.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrivate* Housewife(spouse) interaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e11.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.79,18.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSpouse Occupation\u003c/b\u003e - Others (References)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.56,17.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e-28.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-51.64, -4.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of caregiving (year)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.39, -0.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.40, -0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.026\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Income (MYR)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.000,0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e0.016\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eR\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBackward multiple linear regression was applied. Multivariate linear regression model (enter) for significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) variables during univariate analysis. The mean (SD) domain scores were 70.91 (\u0026plusmn;\u0026thinsp;18.45), 70.05 (\u0026plusmn;\u0026thinsp;19.89), 68.25 (\u0026plusmn;\u0026thinsp;24.79), and 70.12 (\u0026plusmn;\u0026thinsp;20.13). *One two-way interaction was detected for the Male*Spouse (Government) interaction in the Psychological Domain and for the Single, Private, and Government caregiver*Spouse (Housewife) interactions in the Social Relationships domain. However, for the Chinese religion, the interaction of the Hindu religion occurs in the environmental domain. No multicollinearity was detected (VIF\u0026thinsp;\u0026lt;\u0026thinsp;10). Model assumptions are met.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eCaregiver factors\u003c/h2\u003e \u003cp\u003eThe majority of PWD caregivers were women (64.9%), 70.8% were married, 43.1% were Chinese, and 96% lived in cities indicating that Hospital Kuala Lumpur is located in an urban setting and most likely serves a Chinese population. In general, women's longer life expectancy indirectly contributes to their role as caregivers aligning with broader Asian cultural practices, and social norms emphasize familial responsibility in caring for older people compared to men (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong the caregivers, 48.5% had a tertiary education, 73.3% had not received formal assistance and had no comorbidities. A total of 53% of the caregivers worked in the private sector, 40.6% of their spouses also worked in a similar sector and earned an average income of RM 4000 per month. Well-informed caregivers demonstrate greater comprehension, acceptance, awareness, and adaptability, which results in better patient care. This study focused on the importance of education, stable employment, and financial assistance in caregivers\u0026rsquo; roles, as in previous studies (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Similarly, additional earnings from employment may help alleviate financial constraints and duration of care (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003ePatient Factors\u003c/h2\u003e \u003cp\u003eThe demographic characteristics of the PWDs in this study reveal significant insights into the factors influencing caregiver dynamics. The finding that 61.4% of patients are female aligns with existing literature, indicating a higher prevalence of dementia among women. This pattern reflects broader trends observed in both Western and Asian contexts, where females typically exhibit longer life expectancies, leading to a higher incidence of age-related conditions, including dementia (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Understanding the gender distribution of PWDs can guide targeted interventions and support mechanisms for caregivers, especially given the additional burdens faced by female caregivers.\u003c/p\u003e \u003cp\u003eFurthermore, the significant representation of Chinese patients (43.6%) raises important cultural considerations. Previous studies have indicated that cultural background can influence caregiving practices and perceptions of dementia, with Chinese families often adhering to strong familial obligations and cultural expectations (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This cultural context may impact the caregivers' stress levels and coping mechanisms, highlighting the need for culturally sensitive support programs tailored to the unique challenges faced by caregivers in these communities.\u003c/p\u003e \u003cp\u003eThe marital status of patients also offers valuable insights into the dynamics of caregiving. With half of the patients being married, the role of spouses as primary caregivers is emphasized. This finding is crucial, as spousal caregivers often face intense emotional and physical strain, leading to higher levels of caregiver burden and stress (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The caregiving relationship, especially between spouses, can significantly affect the QolL for both parties, suggesting that interventions should include strategies to support spousal caregivers specifically.\u003c/p\u003e \u003cp\u003eMoreover, the presence of a religious affiliation, particularly among the Buddhist and Chinese patients, may shape both the caregivers' and patients' experiences with dementia. Previous research suggests that religious beliefs can provide a framework for coping with chronic illnesses, offering emotional support and a sense of purpose (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). However, the challenges associated with caregiving within these cultural and religious contexts can also create unique stressors, reinforcing the need for holistic support that addresses both emotional and practical caregiving needs.\u003c/p\u003e \u003cp\u003eIn terms of quality of life (QoL), the median scores reported in this study were consistent with findings from other Asian countries, indicating a common experience among caregivers across these regions. However, the reported scores also highlight the disparities that exist within different demographic groups. For instance, the relatively low environmental QoL reported by Chinese and Hindu caregivers suggests that these groups may face specific challenges related to their living conditions and social support systems. Addressing these challenges through targeted community interventions may be vital in enhancing their overall well-being and caregiving efficacy (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eBy understanding patient factors is crucial for informing the development of effective caregiver support strategies. Recognizing the interplay between gender, cultural background, marital status, and religious beliefs can lead to more tailored interventions that enhance the QoL of both caregivers and PWDs. Future research should continue to explore these dynamics to develop comprehensive support systems that recognize and address the multifaceted challenges faced by caregivers in different contexts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eQOL in the Four Domains\u003c/h2\u003e \u003cp\u003eThis study aimed to explore the associations between sociodemographic factors and the four domains of QoL; physical, psychological, social relationships, and environmental among caregivers of PWDs in Malaysia. The findings from the multivariate linear regression analysis provide important insights into how these factors influence caregivers\u0026rsquo; QoL. The median score for the four QoL domains was the same as that reported in studies from China (87.2), Taiwan (87.6), and Hong Kong (79.6) (Guan et al. 2016; Wong et al. 2012). These parallels have been linked to culture, caregivers\u0026rsquo; perceptions of their own well-being, and expectations for multiple stakeholders to take responsibility for reducing the burden of dementia care on society (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePhysical Domain\u003c/strong\u003e \u003cp\u003eOur results indicate that male caregivers, particularly those in a spousal relationship and employed in government positions, reported significantly higher physical QoL scores. This may reflect the traditional role of men as primary providers in Malaysian culture, which could lead to better access to resources and support systems. Conversely, unemployed caregivers experienced a decrease in their physical QoL, highlighting the impact of economic status on caregivers' well-being (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePsychological Domain\u003c/strong\u003e \u003cp\u003eThe psychological QoL scores revealed that male caregivers in spousal roles also had significantly higher scores compared to their female counterparts. Additionally, caregivers of Chinese ethnicity demonstrated lower psychological well-being, potentially reflecting cultural stigma surrounding mental health. The significant interaction between gender and spousal occupation suggests that financial stability may contribute to psychological resilience among male caregivers (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSocial Relationships Domain\u003c/strong\u003e \u003cp\u003eThe results underscore the critical role of the caregiver's relationship with the patient. Relatives of patients reported significantly higher social relationship scores, indicating that family ties may provide emotional support and reduce feelings of isolation. However, single caregivers experienced lower social relationship scores, suggesting that social networks are vital for emotional support, particularly in a collectivist society like Malaysia (\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEnvironmental Domain\u003c/strong\u003e \u003cp\u003eIn the environmental domain, caregivers practicing Hinduism scored lower, possibly due to cultural and religious factors influencing access to supportive resources. The results also indicated that higher monthly income positively correlates with better environmental QoL reinforcing the notion that socioeconomic status significantly impacts caregivers\u0026rsquo; living conditions and access to care services (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003eBased on all QoL domain in multivariate regression analysis reveals that sociodemographic factors such as gender, ethnicity, marital status, occupation, and income significantly influence the QoL of caregivers in the physical, psychological, social relationship, and environmental domains. Specifically, male caregivers, those in spousal relationships, and those with higher incomes generally reported better QoL across all domains.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe cross-sectional study design limits its ability to establish causal relationships. Another limitation is that this study was conducted in a single health facility; therefore, the results should be interpreted with caution. Some biases, such as comprehension and interpretation bias, may have an impact on self-reporting methods. A significant limitation not previously addressed is the lack of assessment regarding the presence or absence of collaborating persons in caregiving roles. For instance, if a primary caregiver, such as a wife, has the support of a cooperating spouse or other family members, this could reduce the caregiving burden and enhance the caregiver's quality of life. The absence of this variable in our study may limit our understanding of the full context surrounding caregiver experiences and quality of life. Additionally, some biases, such as comprehension and interpretation bias, may impact the accuracy of self-reported data. Participants' ability to understand and accurately express their experiences may vary, potentially influencing the validity of the findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe current study provides important insights into the QoL of caregivers for PWDs in Malaysia. Factors positively influencing the four domains of QoL include being male, having a relative relationship with the patient, working in the private sector, and collaborating with a spouse in caregiving responsibilities. Conversely, being female, serving as a spouse caregiver, identifying as Chinese or Hindu, and providing care for a longer duration are associated with a decrease in QoL. In the context of Malaysia's unique cultural and social landscape, it is essential to recognize and address the challenges faced by caregivers. Supporting caregivers through educational programs and resources that enhance their physical, psychological, social, and environmental well-being is critical for improving QOL outcomes associated with caregiving for individuals with dementia\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMOH; Ministry of Health, MREC; Medical Research and Ethical Committee, MYR; Malaysia Ringgit, QoL; Quality of Life, SD; Standard Deviation, UKM; Universiti Kebangsaan Malaysia, PWDs; Patient with Dementia\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study included patient and caregiver data, and confidentiality was maintained at all times. Ethical approval was obtained from the Universiti Kebangsaan Malaysia (UKM) Medical Research and Ethics Committee (MREC) UKMPP1/111/8/JEP-2021-306; registration with the National Medical Research Register (NMRR-21-492-58143 (IIR), KKM); and approval from the director and the head of the geriatric unit, Hospital Kuala Lumpur.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used to support the findings of this study are available from the corresponding author upon request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a self-funding study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMRAM conceived and designed the study. NFT collected materials and data. MHF analysed the data and drafted the manuscript. MRAM and MHF contributed to interpret the results and critically reviewed the manuscript. All authors read and approved the final manuscript. All authors contributed equally to this work.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAppreciation was extended to the director of Kuala Lumpur Hospital Head of the Clinical Research Centre Kuala Lumpur Hospital, the Head of the Medical Department of Kuala Lumpur Hospital, the Head of the Geriatrics Unit at Kuala Lumpur Hospital, and Geriatric specialists at Kuala Lumpur Hospital, who were core searchers who helped a lot in making this study successful.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAhman A. World Health Organization quality of life assessment: brief version in Bahasa Malaysia. 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An introduction to regression analysis.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Quality of Life, Caregivers, Dementia, Geriatric, WHOQOL-BREF","lastPublishedDoi":"10.21203/rs.3.rs-5318883/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5318883/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDementia is major cause of disability and dependency in patients around the world. The studies report a high level of burden in caring for patient with dementia (PWD), especially in the Malaysian culture-norm. This study aimed to assess the four domains of Quality of Life (QoL) of caregivers for PWDs in Kuala Lumpur.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional survey was conducted among 202 dementia caregivers recruited from the Geriatric Memory Clinic at Hospital Kuala Lumpur. The WHO QoL -BREF Malay version was used to assess the participants' QoL. Multivariate regression models were conducted to establish predictors of caregivers QoL, including caregivers\u0026rsquo; sociodemographic characteristics.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMale caregivers, working, and had stable monthly income had better median QoL scores in \u003cb\u003eall three domains\u003c/b\u003e physical 69.00 (25.00), psychological 69.00 (32.00), social 72.00 (44.00), and environment 69.00 (44.00) with p-value (\u0026lt;\u0026thinsp;0.005). Caregivers in the public and private sectors are a major predictor of QoL score, with an adjusted coefficient of \u0026lsquo;high score\u0026rsquo; ranging from 0.24 to 0.25 for environmental QoL and \u0026lsquo;lower score\u0026rsquo; for the Chinese race, with an adjusted coefficient of -0.22 for environmental QoL. Caregivers such as female, spouses, lower education, provided care for a longer period and unemployed experienced a higher level of physical, emotional, social, and environmental distress leads to a lower QoL.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe current study provides important insights into the QoL of caregivers for PWDs in Malaysia. Factors positively influencing the four domains of QoL include being male, having a relative relationship with the patient, working in the private sector, and collaborating with a spouse in caregiving responsibilities. Conversely, being female, serving as a spouse caregiver, identifying as Chinese or Hindu, and providing care for a longer duration are associated with a decrease in QoL. In the context of Malaysia's unique cultural and social landscape, it is essential to recognize and address the challenges faced by caregivers. Supporting caregivers through educational programs and resources that enhance their physical, psychological, social, and environmental well-being is critical for improving QOL outcomes associated with caregiving for individuals with dementia.\u003c/p\u003e","manuscriptTitle":"IntroductionQuality of Life and its associated factors among Patient with Dementia Caregivers: A Cross-Sectional Study in Geriatric Clinic, Hospital Kuala Lumpur, Malaysia.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-06 17:19:43","doi":"10.21203/rs.3.rs-5318883/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1b5927c2-2e54-4acd-a920-e9f120a2802e","owner":[],"postedDate":"November 6th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-01T10:48:49+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-06 17:19:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5318883","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5318883","identity":"rs-5318883","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}