Linking Cognitive Status to Healthy Brain Ageing Functional Trajectories in a Multicultural Aging Population: A Cross-Sectional Community-Based Study 

Linking Cognitive Status to Healthy Brain Ageing Functional Trajectories in a Multicultural Aging Population: A Cross-Sectional Community-Based Study | 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 Linking Cognitive Status to Healthy Brain Ageing Functional Trajectories in a Multicultural Aging Population: A Cross-Sectional Community-Based Study Hui-Chen (Rita) CHANG, Yu (Carrie) CHENG, Fung Kuen KOO, Sara Shishehgar, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8361682/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Population aging is an inevitable phenomenon in the world that presents challenges for healthcare systems. Older adults from culturally and linguistically diverse (CALD) backgrounds experience many challenges that influence their access to healthcare services. Therefore, in this study, we aimed to evaluated functional changes and early cognitive impairment among culturally and linguistically diverse (CALD) older adults in Sydney, Australia. Methods In this cross-sectional study, data were collected from 221 community-dwelling adults (65+) at two organizations serving Mandarin/Cantonese and Arabic speakers, using the Healthy Brain Ageing Functional Assessment Questionnaire (HBA-FAQ) and the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8). Results The study included participants with a mean age of 75.31 years, predominantly Mandarin/Cantonese-speaking (67%) or Arabic-speaking (29%). A majority (67.4%) reported having chronic conditions. On the AD-8 screening tool, 53.9% of participants scored ≥ 2, a result indicating possible cognitive concerns. Functional decline was most pronounced in memory, emotional regulation and sleep. The AD8 Total score showed significant positive correlations with all HBA-FAQ domains (r = 0.315–0.578, all p = 0.001), with the strongest associations observed for higher-level thinking skills and memory. Key demographic factors, including older age (≥ 70), lower education, and Arabic language background, were associated with poorer functional outcomes. Chronic diseases and psychological disorders were associated with worse functional outcomes across all measures. Conclusion The study highlights the need for culturally sensitive interventions to address cognitive decline, manage chronic conditions, and promote functional well-being in diverse aging populations. Cognitive impairment Functional changes Older adults Culturally and linguistically diverse community Highlights • 53.9% of CALD Australian older adults screened positive for cognitive impairment (AD8 ≥ 2). • Strongest functional declines in memory, emotion regulation, and sleep domains. • Arabic-speaking participants showed greater functional challenges than Mandarin/Cantonese speakers. • AD8 and HBA-FAQ demonstrated robust correlations (r = 0.315–0.578, p < 0.001). • Older age, low education, and chronic diseases predicted poorer functional abilities. 1. Introduction Population aging is an inevitable phenomenon in the world that presents challenges for healthcare systems. By 2050, about 1.5 billion people will be 65 years and older, which indicates aged population will be doubled within the next 30 years 1 . As the aged population grows, age-related health issues such as cognitive decline and dementia increases. Cognitive impairment which is recognised as a preclinical stage for dementia is rated as 15.56% worldwide in community-dwelling older adults 2 . This rate increases with age 2 – 3 , and impacts an individual's daily functioning and quality of life 4 . A critical framework for assessing this functional impact involves evaluating Activities of Daily Living (ADLs), which are categorized into two distinct subtypes. Basic Activities of Daily Living (BADLs) refer to fundamental self-care tasks essential for personal independence and survival, such as bathing, dressing, toileting, transferring (e.g., moving from bed to chair), continence, and feeding. Instrumental Activities of Daily Living (IADLs) encompass more complex skills required for independent living within a community, including managing finances, shopping, preparing meals, housekeeping, using transportation, managing medications, and using communication devices 5 . The distinction is crucial in aging research, as BADL dependency often signifies more severe functional decline, while IADL difficulties can be among the earliest detectable signs of mild cognitive impairment 6 – 7 . Research underscores the link between cognitive status and functional dependency. A study in the United States found that people with cognitive impairment had a higher risk of ADLs dependency compared with people with normal cognition 8 . Similarly, a study in China presented a twofold higher risk of developing ADLs disability in people with cognitive impairment compared to the group without cognitive impairment 9 . Crucially, cognitive impairment often first affects the ability to perform IADLs, such as managing medications, finances, or transportation, before progressing to impact BADLs 4 . Although cognitive impairment is known as an age-related health issue that significantly impacts aged population’s daily function and quality of life, early detection and implications of interventions may reverse or slow down the adverse impacts. For example, while dementia doesn’t show perceptible cognitive impairments during its lengthy preclinical stage, neurogenerative changes are proceeding. Therefore, early detection of at-risk individuals and implementing interventions is essential to protect them from proceeding to the late stages of the disease in their late life 10 . Older adults from CALD backgrounds experience many challenges that influence their access to healthcare services. In the Australian context, the term "CALD" is commonly used to describe individuals and communities who identify with cultural or linguistic affiliations different from the majority Anglo-Australian population. This encompasses migrants, refugees, and their descendants, and acknowledges the diversity in languages, ethnicities, religions, and cultural norms that shape health beliefs and service use 11 . For this study, the term is particularly relevant for identifying populations who may experience specific barriers to cognitive health screening and support. These barriers include limited literacy on health and health care, social isolation, language and communication barriers and lack of culturally sensitive healthcare services 11 – 13 . Limited English language skills can significantly hinder their ability to communicate and access to health screening to receive timely and effective health care 3 , 11 , 14 . Similarly, cultural difference in beliefs about illness, aging and healthcare can lead to reluctance in seeking healthcare services among older CALD population 15 . For example, in some communities, functional decline and cognitive decline are considered as aging process consequently, less older people participate in health awareness or health support programs such as falls preventions or dementia support programs in Australia 13 , 16 . Therefore, culturally informed healthcare services are crucial to support older CALD older population. Strategies such as healthcare interpretation services, bilingual staff, community focused health awareness programs, culturally competent healthcare professionals are crucial to foster communication and trust, ultimately address cultural and healthcare needs of older people from CALD backgrounds 12 – 14 . Australia’s population is ageing due to increasing life expectancy, declining fertility rates, and mounted immigrant intakes. In 2020, approximately one in six Australians equal to 4.2 million people were aged 65 and over, which is 16% of Australia’s population 17 . This is projected that this number grows and older people in Australia including those from CALD background will form 21% to 23% of the total population by 2066 17 . This can bring compounding impacts of cultural, social, financial determinants of health on experience of ageing and cognitive and functional impairment in Australia 18 , which requires early recognition and proactive planning. There is an increasing literature discussing use of self-report tools in early detection of cognitive and functional changes in older population. Self-report instruments are widely employed in ageing research due to their efficiency, low cost, and applicability in community settings 19 – 20 . They capture older adults’ subjective experiences of functional or cognitive change, some of which have been shown to predict later functional decline or cognitive deterioration before impairments are detected on objective clinical tests 21– 22 . Previous studies reported a low specificity for self-reports of cognitive and functional problems due to their subjective and cross-sectional natures. The studies confirmed that factors, such as depression or personality traits influence accuracy of the reports 23 – 24 . However, a meta-analysis which included studies with heterogenous characteristics found lower cognitive function in those with more reports of problems 25 . A recent systematic review across 19 studies found self-reports of feeling worry and memory decline were predicting future cognitive decline 22 . To assess functional ability of older people, the Healthy Brain Ageing—Functional Assessment Questionnaire (HBA-FAQ), a 44-item self-report questionnaire, is being increasingly validated and used to measure elderly’s subjective perception of their optimal level of functioning in daily life and predict risk of dementia over the last year 26 – 27 . The studies found the questionnaire a valid and reliable self-report tool that is sensitive and efficient in early detection of subtle changes in daily functioning in older people at risk of dementia. A self-report tool to accurately identify subtle functional changes will empower older adults to take an active role in monitoring their health and functional abilities 27 . These findings underscore the importance of cognitive and functional self-assessments to identify at-risk individuals early and inform targeted interventions for CALD older adults. This study aims to investigate cognitive impairment and functional changes in culturally and linguistically diverse (CALD) older adults, using the HBA-FAQ. Research aim, objective and research questions Aim To investigate cognitive impairment, functional changes, and their demographic correlates in culturally and linguistically diverse older adults, using the AD8 and Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ). Objectives : Assess cognitive impairment using the AD8 scale in a linguistically diverse older population. Evaluate functional changes across ten domains of daily living using the HBA-FAQ. Compare the sensitivity of the AD8 and HBA-FAQ in detecting cognitive and functional decline. Examine demographic influences (age, education, language background, chronic diseases, psychological disorders) on cognitive and functional performance. Research questions : What is the prevalence and severity of cognitive impairment (AD8 ≥ 2) in this culturally diverse older cohort? How do functional abilities vary across domains as measured by the HBA-FAQ? How strongly are AD8 scores correlated with functional decline in specific HBA-FAQ domains (e.g., memory, higher-level thinking)? Which demographic factors (e.g., age ≥ 70, non-tertiary education, language background, chronic disease) most significantly predict worse functional outcomes? 2. Methods 2.1 Study Design This study employed a cross-sectional design to assess cognitive impairment, functional changes and their demographic correlates among culturally and linguistically diverse (CALD) older adults living in the community. 2.2 Study setting and sampling This study employed a purposive sampling strategy to recruit participants from two major culturally and linguistically diverse (CALD) communities in Sydney, Australia - Chinese (Mandarin and Cantonese speakers) and Arabic-speaking populations. The CALD population is often defined as individual born in non-English speaking countries or who speak non-English languages at home 28 . Indigenous peoples are a distinct research group and were not included in this classification 28 . The selection of these groups was based on: (1) their significant representation within Australia's population, with Mandarin 2.7%, Cantonese1.2% and Arabic 1.4% being among the top non-English languages spoken at home 29 ; and (2) the need to better understand the specific health challenges faced by these growing communities in the Australian healthcare context. Between June and September 2023, participants were recruited through established community organizations serving these ethnic groups in Sydney, New South Wales. These organizations were selected as recruitment partners due to their strong ties to the target communities; their ability to facilitate culturally appropriate research engagement and ability to support participants ‘communication needs. Inclusion Criteria : Participants were eligible for inclusion if they met all of the following criteria: Aged 65 years or older Currently attending activities hosted by either Chinese (Mandarin/Cantonese-speaking) or Arabic-speaking community organizations Living in the community (i.e., not institutionalized) Proficient in Mandarin, Cantonese, or Arabic (as a first language or primary language of communication) Born in a non-English-speaking country Exclusion Criteria : Individuals were excluded from the study if they met any of the following criteria: Had serious comorbid illnesses that would prevent active participation Had severe cognitive impairment, as indicated by a medical diagnosis or inability to provide informed consent Were receiving palliative care Had any health conditions deemed to preclude safe participation in the study 2.3 Sample size calculations To ensure adequate statistical power, G*Power version 3.0.9 was used to estimate the minimum required sample sizes for the quantitative analyses. For the bivariate (non-parametric) correlation analysis, a minimum of 139 participants was required, assuming a medium effect size (r = 0.30), an alpha level of 0.05, and 95% power. For independent t-tests, a sample size of 204 participants was needed based on an estimated effect size of 0.35, an alpha level of 0.10, and 75% power (two-tailed). The final sample of 221 participants exceeded these thresholds, enhancing the statistical reliability and generalizability of the findings. 2.4 Outcome Measures Two validated instruments were used to assess cognitive function and functional abilities among older adults. Cognitive impairment was measured using the AD8 Dementia Screening Interview, an 8-item informant-based questionnaire designed to detect early signs of dementia. Functional ability was assessed using the Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ), which evaluates self-reported changes across ten key domains of daily living. Cognitive Function Assessment: AD8 Scale Cognitive impairment was assessed using the validated 8-item Informant Interview to Differentiate Aging and Dementia (AD8), developed by Galvin 30 . This brief screening tool is designed to detect early cognitive changes associated with dementia and demonstrates strong psychometric properties. The AD8 assesses eight domains related to memory, orientation, judgment, and daily functioning using a simple yes/no format. It can be completed in approximately three minutes, either through self-report or by a knowledgeable informant (the preferred method). Each “Yes, there is a change” response is scored as 1, while “No, there is no change” and “Not applicable/don’t know” responses are scored as 0. Total scores range from 0 to 8, with scores of 0–1 indicating normal cognition and scores ≥ 2 suggesting probable cognitive impairment. Validation studies have shown the AD8 to possess excellent diagnostic accuracy, with sensitivity exceeding 84% and specificity above 80%. Its predictive validity is also strong, with a positive predictive value above 85% and a negative predictive value exceeding 70%. Receiver operating characteristic (ROC) analysis has demonstrated excellent discrimination between normal aging and cognitive impairment, with an area under the curve (AUC) of 0.908 (95% CI: 0.888–0.925) 30 . The Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ) Functional abilities were assessed using the Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ), a 44-item multidimensional instrument developed by Lin 27 that evaluates self-perceived functional changes across ten critical domains of daily living. The questionnaire covers basic activities (self-care, household tasks), instrumental activities (financial affairs, technology use), cognitive domains (memory, higher-level thinking), psychosocial functioning (social/work participation, emotion regulation, behaviour), and physiological function (sleep patterns). Participants rated changes in their functional abilities over the past 12 months using a 4-point Likert scale ranging from 0 (“no change from optimal functioning”) to 3 (“unable/no longer completes independently”). Subdomain scores were calculated by summing item responses, with a higher total score indicating greater functional decline (maximum score = 30). The HBA-FAQ has demonstrated excellent psychometric properties, including high internal consistency (Cronbach’s α = 0.89–0.93 across subscales) and strong test–retest reliability (intraclass correlation coefficient [ICC] = 0.85–0.91) 27 . The measure has also been validated against gold-standard functional assessments 27 . For this study, HBA-FAQ was professionally translated and culturally adapted for administration in Mandarin, Cantonese, and Arabic to ensure conceptual equivalence and appropriateness for the linguistically diverse participant population. 2.5 Data collection The study implemented a comprehensive data collection protocol over a three-month period to assess cognitive and functional changes among older adults from Chinese and Arabic cultural backgrounds. The data collection process encompassed multiple domains, including sociodemographic characteristics, health status, and validated cognitive and functional assessment tools. Demographic and Health Variables The dataset captured key demographic information, including age, gender, education level, primary language, and country of birth. Participants also self-reported their health status, specifying the presence of chronic conditions (e.g., diabetes, hypertension, arthritis, asthma, cancer) and psychological disorders (e.g., depression, anxiety, or other diagnosed mental health conditions). Assessment Instruments and Translation Procedures Two validated tools were used in the study: AD8 Dementia Screening Interview – an 8-item informant-based questionnaire assessing cognitive function. Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ) – a 44-item self-report tool evaluating functional changes across ten domains of daily living. The AD8 was administered using validated Mandarin and Arabic versions, which had been previously culturally adapted and psychometrically tested in Chinese 31 and Arabic populations 32 . To ensure linguistic and cultural appropriateness, the HBA-FAQ was translated into Mandarin (both simplified and traditional forms), Cantonese, and Arabic. The translation process followed a rigorous multi-step protocol: initial translations were conducted by professional bilingual translators fluent in both English and the target languages; these were then independently back-translated into English by separate certified translators unfamiliar with the original instrument. The translated versions were reviewed by bilingual experts in aging and cognitive assessment to refine terminology and ensure cultural relevance. Final revisions were made based on expert feedback to achieve conceptual equivalence. Data collection was facilitated by trained community coordinators fluent in participants' native languages. These coordinators received two hours of training on standardized data collection protocols and were supported by the research team, which provided on-site supervision. Assessments were scheduled during regular community centre operating hours to accommodate participants’ routines and reduce disruption. Each session lasted approximately 25–35 minutes and was conducted in private spaces to ensure confidentiality. To maintain data quality, the research team implemented several quality control measures, including daily data verification, weekly team debriefings, and random fidelity checks during data collection sessions. 2.6 Data analysis Participant characteristics were summarized using frequencies and percentages for categorical variables. The same approach was applied to describe response distributions for the AD8 and HBA-FAQ. Mean values and standard deviations were used to report cognitive and functional ability scores. To examine associations between cognitive function and functional ability, nonparametric correlations were conducted using Spearman’s rank correlation coefficient. Correlation analyses were also performed to assess the relationship between age and both cognitive (AD8) and functional (HBA-FAQ) scores, providing insight into the influence of age on these outcomes. The study examined differences in cognitive and functional outcomes across seven demographic variables using independent t-tests. The variables included: age (categorized as < 70 years and ≥ 70 years, based on evidence indicating significant age-related cognitive and physical changes after age 70 33 , gender (male vs. female), education level (tertiary vs. non-tertiary), first language (Mandarin/Cantonese vs. Arabic), language spoken at home (Mandarin/Cantonese vs. Arabic), presence of chronic diseases (yes vs. no), and diagnosis of psychological disorders (yes vs. no). Mean scores for AD8 and HBA-FAQ were compared across these groups to identify significant differences. All statistical analyses were conducted using IBM SPSS Statistics, version 28. 2.7 Ethical considerations Ethical approval for this study was obtained from the Human Research Ethics Committee (HREC) of the University of New England (Approval Number: HE22-088). To ensure participants’ full understanding of the study, both the participant information sheet and consent form were professionally translated into their native languages. The purpose and procedures of the study were clearly explained prior to data collection, and informed consent was obtained from all participants. Participants were informed of their right to withdraw from the study at any time without any impact on the services or support they received. All data were anonymized and securely stored to safeguard participant confidentiality and privacy in accordance with ethical research standards. 3 Results 3.1 Participant characteristics The study included 221 participants who were recruited from two community organizations that provide community services and activities for older people. Table 1 presents a detailed demographic characteristics using frequency and percentage. The majority of participants were female (n = 169, 76.5%), while males accounted for 23.5% (n = 52) of the participants. Approximately half of participants held a high school certificate (n = 116, 52.7%). Educational attainment revealed distinct patterns across cultural-linguistic groups. While 52.7% (n = 116) of participants held high school certificates, tertiary education levels varied significantly: Chinese-background participants accounted for 22.2% (n = 49) of all bachelor's degrees, compared to only 0.9% (n = 2) among Arabic-background participants. Postgraduate qualifications were uncommon in both groups (Chinese: 1.4%, n = 3; Arabic: 1.8%, n = 4). Non-tertiary education included training college certificates (12.2%, n = 27), primary education (2.7%, n = 6), no formal schooling (2.7%, n = 6), and other qualifications (3.2%, n = 7). Most participants spoke Mandarin or Cantonese as their first language (n = 145, 65.6%), followed by Arabic (n = 64, 29.0%). Only 1.4% (n = 3) reported English as their first language. A substantial proportion reported having chronic diseases (n = 149, 67.4%), while fewer participants reported diagnosed psychological disorders (n = 19, 8.6%). Table 1 Participant characteristics Sociodemographic variables n (%) Gender Female 169 (76.5) Male 52 (23.5) Education Non-tertiary No school 6 (2.7) Primary 6 (2.7) High school certificate 116 (52.7) Training college 27 (12.2) Other 7(3.2) Tertiary Bachelor's degree (Chinese) 49 (22.2) Bachelor's degree (Arabic) 2 (0.9) Master's degree (Chinese) 3 (1.4) Master's degree (Arabic) 4 (1.8) First Language English 3(1.4) Mandarin or Cantonese 145 (65.6) Arabic 64 (29.0) Other (Armenia, French, Vietnamese, Indonesia) 9 (4.1) Language spoken at home Mandarin or Cantonese 148 (67.0) Arabic 64 (29.0) Other (Armenia, French, Vietnamese, Indonesia) 9 (4.1) Country of birth China 136 (61.5) French 1 (0.5) Hong Kong 8 (3.6) Indonesia 3 (1.4) Iraq 11 (5.0) Jordan 2 (0.9) Lebanon 20 (9.0) Malaysia 1 (0.5) Palatine 2 (0.9) Syria 31 (14.0) Turkey 1 (0.5) Vietnamese 5 (2.3) Any chronic diseases? (e.g., diabetes, hypertension, arthritis, asthma, cancer) No 72 (32.6) Yes 149 (67.4) Ever been diagnosed with psychological (mental) disorders? (e.g., depression, anxiety) No 202 (91.4) Yes 19 (8.6) 3.2 Cognitive changes (AD8) Table 2 presents cognitive changes among 221 participants using frequency, percentage, and mean methods. The findings indicated a high prevalence of self-reported cognitive concerns. A total of 53.9% (n = 118) of participants scored ≥ 2 points, which is the established cutoff suggestive of possible cognitive impairment (mean score = 2.37 ± 2.499). Individual items showed varying frequencies of reported cognitive changes: functional difficulties were most prominent, with 34.4% (n = 76) reporting trouble learning new devices and 33.9% (n = 75) experiencing difficulties managing complex financial affairs. Memory-related concerns were also prevalent, including 33.5% (n = 74) reporting daily thinking/memory problems and 29.0% (n = 64) having trouble remembering appointments. Judgment problems affected 28.5% (n = 63), while 28.1% (n = 62) showed reduced interest in hobbies. Repetitive behaviours (24.0%, n = 53) and temporal disorientation (24.0%, n = 53) were equally common. Table 2 Cognitive changes – AD8 Variables N (%) Total Score Yes No N/A 0 ~ 1 ≥ 2 Mean ± SD AD8 Total (Items) 102 (46.1%) 118 (53.9%) 2.37 ± 2.499 1.Problems with judgement 63 (28.5) 156 (70.6) 2 (0.9) 2.Less interest in hobbies/activities 62 (28.1) 156 (70.6) 2 (0.9) 3.Repeats the same things over and over (questions, stories, or statements) 53 (24.0) 163 (73.8) 5 (2.3) 4.Trouble learning how to use a tool, appliance, or gadget (e.g., VCR, computer, microwave, remote control) 76 (34.4) 140 (63.3) 5 (2.3) 5.Forgets correct month or year 53 (24.0) 166 (75.1) 1 (0.5) 6.Trouble handling complicated financial affairs 75 (33.9) 139 (62.9) 7 (3.2) 7.Trouble remembering appointments 64 (29.0) 155 (70.1) 2 (0.9) 8.Daily problems with thinking and/or memory 74 (33.5) 142 (64.3) 4 (1.8) Table 3 Healthy Brain Ageing Functional Assessment Questionnaire – Functional Ability Item No change Mild change for the worse Moderate change for the worse Unable/no longer complete independently Self-care Getting ready in the morning or getting ready to go out 130 (58.8%) 61 (27.6%) 24 (10.9%) 6 (2.7%) General self-grooming 160 (72.4%) 44 (19.9%) 14 (6.3%) 3 (1.4%) Seeking medical and/or dental advice where warranted 112 (50.7%) 66 (29.9%) 20 (9%) 19 (8.6%) Managing medications 136 (61.5%) 57 (25.8%) 12 (5.4%) 16 (7.2%) Average 60.9% 25.8% 7.9% 5.0% Financial affairs Handling money 167 (75.6%) 27 (12.2%) 10 (4.5%) 17 (7.7%) Managing complex financial affairs 131 (59.3%) 33 (14.9%) 16 (7.2%) 30 (13.6%) Managing household finances 138 (62.4%) 27 (12.2%) 9 (4.1%) 24 (10.9%) Average 65.8% 13.1% 5.3% 10.7% Social and work functioning Initiating and contributing to social activities with friends and/or family 172 (77.8%) 34 (15.4%) 9 (4.1%) 6 (2.7%) Withdrawal 152 (68.8%) 39 (17.6%) 16 (7.2%) 9 (4.1%) Driving restrictions 71 (32.1%) 16 (7.2%) 13 (5.9%) 40 (18.1%) Driving ability 70 (31.7%) 15 (6.8%) 12 (5.4%) 38 (17.2%) Work completion 84 (50%) 35 (15.8%) 22 (10%) 10 (4.5%) Work performance 89 (40.3%) 22 (10%) 9 (4.1%) 23 (10.4%) Average 50.1% 12.1% 6.1% 9.5% Household tasks Everyday household tasks such as vacuuming, cleaning, dusting, basic home maintenance 126 (57%) 41 (18.6%) 30 (13.6%) 23 (10.4%) Keeping the house in order 138 (62.4%) 36 (16.3%) 24 (10.9%) 22(10%) Preparing meals 133 (60.2%) 44 (19.9%) 25 (11.3%) 16 (7.2%) Cooking 126 (57%) 49 (22.2%) 25 (11.3%) 18 (8.1%) Grocery shopping 116 (52.5%) 45 (20.4%) 33 (14.9%) 24 (10.9%) Average 57.8% 19.5% 12.4% 9.3% Everyday technology Using the telephone/ mobile phone 150 (67.9%) 42 (19%) 18 (8.1%) 8 (3.6%) Using the computer or other digital device 117 (52.9%) 55 (24.9%) 18 (8.1%) 30 (13.6%) Using the remote control, television and video 138 (62.4%) 48 (21.7%) 16 (7.2%) 16 (7.2%) Average 61.1% 21.9% 7.8% 8.1% Sleep Difficulty falling asleep 95 (43.0%) 66 (29.9%) 34 (15.4%) 24 (10.9%) Waking during the night other than to go to the toilet 91 (41.2%) 66 (29.9%) 45 (20.4%) 18 (8.1%) Napping during the daytime or early evening 111 (50.2%) 79 (35.7%) 19 (8.6%) 7 (3.2%) Changes in sleep timing 106 (48%) 77 (34.8%) 24 (10.9%) 12 (5.4%) Acting out dreams 114 (51.6%) 82 (37.1%) 18 (8.1%) 5 (2.3%) Average 46.8% 33.5% 12.7% 6.0% Memory Day-to-day memory problems 87 (39.4%) 95 (43%) 28 (12.7%) 10 (4.5%) Being forgetful 81 (36.7%) 102 (46.2%) 27 (12.3%) 11 (5%) Being repetitive in conversation 122 (55.2%) 71 (32.1%) 20 (9.0%) 6 (2.7%) Word-finding problems 100 (45.2%) 96 (43.4%) 20 (9.0%) 3 (1.4%) Confusion in unusual situations or environments 115 (52.0%) 83 (37.6%) 19 (8.6%) 4 (1.8%) Forgetful during tasks 35(15.8%) 107(48.4%) 76(34.4) 3(1.4) Average 40.7% 41.8% 14.3% 2.8% Higher-level thinking skills Poorer judgment than usual 109 (49.3%) 73 (33.0%) 21 (9.5%) 17 (7.7%) Difficulty making decisions 116 (52.5%) 75 (33.9%) 14 (6.3%) 16 (7.2%) Concrete thinking 139 (62.9%) 56 (25.3%) 9 (4.1%) 14 (6.3%) Inflexible thinking 129 (58.4%) 72 (32.6%) 10 (4.5%) 8 (3.6%) Becoming easily overwhelmed or slower thinking 122 (55.2%) 68 (30.8%) 15 (6.8%) 5 (6.8%) Average 55.7% 31.1% 6.2% 6.3% Emotion regulation Irritability or temper outbursts 53(24%) 111(50.2) 54(24.4%) 3(1.4%) Mood changes 112 (50.7%) 68 (30.8%) 28 (12.7%) 13 (5.9%) Anxiety 123 (55.7%) 61 (27.6%) 25 (11.3%) 11 (5%) Average 43.5% 36.2% 16.1% 4.1% Behaviour change Inappropriate remarks or behaviour in social situations 172 (77.8%) 43 (19.5%) 4 (1.8%) 2 (0.9%) Visual experiences 139 (62.9%) 63 (28.5%) 15 (6.8%) 4 (1.8%) Appetite changes 156 (70.6%) 54 (24.4%) 10 (4.5%) 1 (0.5%) Reduced empathy 161 (72.9%) 49 (22.2%) 8 (3.6%) 3 (1.4%) Average 71.1% 23.7% 4.2% 1.2% 3.3 The Healthy Brain Ageing Functional Assessment Questionnaire The Healthy Brain Aging Functional Assessment Questionnaire revealed varying degrees of functional decline across ten domains. Self-care activities showed relatively preserved function, with 60.9% of participants reporting no changes, though 29.9% noted mild deterioration in seeking medical advice and 8.6% required fully assistance with medical consultations. Financial management proved more challenging, although 65.8% maintaining unchanged abilities, 10.7% unable to independently manage the financial affairs specially unable to manage complex finances independently (13.6%). The assessment of social and work functioning revealed that, on average, 50.1% of participants reported no significant changes in their abilities. However, distinct patterns of decline were observed across different domains. Social engagement remained relatively preserved, with 77.8% (n = 172) of participants reporting no difficulty initiating or maintaining social interactions, and only 2.7% (n = 6) becoming entirely dependent on others for such activities. Nevertheless, 17.6% (n = 39) exhibited mild social withdrawal, progressing to moderate withdrawal in 7.2% (n = 16). In contrast, driving capacity showed significant impairment, with only 31.7–32.1% of participants retaining full ability. Notably, 18.1% (n = 40) faced driving restrictions, and 17.2% (n = 38) could no longer drive independently. Work-related functioning was also substantially affected, with 50% (n = 84) maintaining baseline work completion, while 15.8% (n = 35) and 10% (n = 22) experienced mild and moderate declines, respectively. Work performance was even more compromised, with 40.3% (n = 89) reporting no change, yet 10.4% (n = 23) becoming unable to perform tasks without assistance. The assessment of household tasks showed that 57.8% of participants maintained their ability to perform domestic activities without changes, while 9.3% on average had become completely dependent on others for these tasks. Meal preparation showed the highest preservation of function (60.2% no change), followed by general housekeeping (62.4% no change). However, grocery shopping emerged as the most challenging task, with only 52.5% reporting no difficulties and 14.9% experiencing moderate decline. For technology use, 61.1% of participants reported no changes in device operation. Telephone and mobile phone use remained the most accessible technology, with 67.9% of participants reporting no difficulties in operation. However, more complex digital devices presented greater challenges - only 52.9% maintained full computer/digital device proficiency, while 13.6% had become completely dependent on others for these tasks. Notably, television-related technologies (remote controls, video systems) showed intermediate difficulty levels, with 62.4% reporting unchanged abilities. Across all technologies, an average of 21.9% experienced mild difficulties and 7.8% showed moderate impairment. The assessment of sleep-related changes revealed significant alterations in sleep quality and patterns among participants. On average, less than half of respondents (46.8%) reported no changes in their sleep behaviours, indicating widespread sleep disturbances in this aging population. The most prevalent issues included difficulty initiating sleep (29.9% mild, 15.4% moderate changes) and nocturnal awakenings (29.9% mild, 20.4% moderate changes), with 10.9% and 8.1% of participants respectively experiencing severe difficulties in these domains. The assessment of memory function revealed significant concerns among participants, with less than half (40.7% on average) reporting no changes in memory abilities. Notably, forgetfulness emerged as the most prevalent issue, affecting 46.2% of participants mildly and 12.3% moderately, while 5% reported severe impairment. Day-to-day memory problems were similarly common, with 43% experiencing mild difficulties and 12.7% moderate challenges. A striking pattern appeared in task-related memory, where only 15.8% maintained normal function, with 48.4% showing mild and 34.4% moderate impairment - the highest rate of moderate decline across all memory domains. Conversely, repetitive conversation (55.2% no change) and situational confusion (52% no change) were better preserved. Word-finding difficulties showed a bipolar distribution, with 45.2% unaffected but 43.4% reporting mild problems. The assessment of higher-level cognitive functions revealed relatively preserved abilities in most domains, with 55.7% of participants on average reporting no changes. Concrete thinking showed the highest preservation (62.9% unchanged), followed by decision-making capacity (52.5% unchanged). However, approximately one-third of participants (average 31.1%) experienced mild impairments, particularly in judgment (33.0%) and cognitive flexibility (32.6%). More severe difficulties were less common (average 6.2%), though 7.7% reported substantial judgment impairments. Emotional regulation proved more vulnerable, with only 43.5% maintaining stable function. Irritability was particularly prevalent, affecting 50.2% mildly and 24.4% moderately. Mood fluctuations (30.8% mild, 12.7% moderate) and anxiety (27.6% mild, 11.3% moderate) were also common. In contrast, behavioural changes were least pronounced, with 71.1% reporting no alterations. Social comportment remained largely intact (77.8% unchanged), though 28.5% experienced mild visual disturbances and 24.4% reported appetite changes. 3.4 Correlation between AD8 and HBA-FAQ Nonparametric correlation analysis revealed significant positive associations between AD8 scores and all functional domains measured by the HBA-FAQ (Table 4 ). The strongest correlations emerged with higher-level thinking skills (r = 0.578, p < 0.001) and memory (r = 0.559, p < 0.001), demonstrating that cognitive decline most substantially impacts these core executive functions. Moderate correlations were observed for instrumental activities of daily living, including household task management (r = 0.488, p < 0.001), self-care (r = 0.437, p < 0.001), and technology use (r = 0.433, p < 0.001). Behavioural changes also showed moderate association with cognitive impairment (r = 0.426, p < 0.001). These findings suggest that cognitive difficulties substantially affect both practical daily functioning and behavioural adaptation. Table 4 Non-parametric Correlation between AD8 Total and HBA-FAQ Variables Self-care Financial affairs Social and work functioning Household tasks Everyday Technology sleep Memory Higher-level thinking skills Emotion regulation Behaviour change AD8 Total 0.437 ( p = 0.001) 0.391 ( p = 0.001) 0.315 ( p = 0.001) 0.488 ( p = 0.001) 0.433 ( p = 0.001) 0.445 ( p = 0.001) 0.559 ( p = 0.001) 0.578 ( p = 0.001) 0.388 ( p = 0.001) 0.426 ( p = 0.001) 3.5 Relationship between demographic factors and HBA-FAQ The analysis revealed significant associations between demographic characteristics and functional abilities across all HBA-FAQ domains (Table 5 ). Age emerged as a consistent predictor, with participants aged ≥ 70 showing significantly greater functional difficulties than younger counterparts (< 70 years) in financial affairs (t=-3.659, p < 0.001), social/work functioning (t=-3.615, p < 0.001), household tasks (t=-4.356, p < 0.001), and higher-level thinking skills (t=-3.282, p < 0.01). Table 5 Relationship between demographic factors and HBA-FAQ Variables (Group) Self-care Financial affairs Social and work functioning Household tasks Everyday Technology Mean(SD) t p Mean(SD) t p Mean(SD) t p Mean(SD) t p Mean(SD) t p Age -3.029 < 0.010 -3.659 < 0.001 -3.615 < 0.001 -4.356 < 0.001 -3.379 < 0.001 < 70 0.35 ± 0.50 0.21 ± 0.43 0.27 ± 0.53 0.30 ± 0.58 0.29 ± 0.52 ≥ 70 0.65 ± 0.70 0.69 ± 0.99 0.79 ± 0.84 0.88 ± 0.97 0.75 ± 0.88 Gender -0.318 0.751 -0.405 0.686 0.667 -0.506 -1.083 0.280 -0.596 0.552 Male 0.59 ± 0.72 0.60 ± 0.97 0.60 ± 0.76 0.84 ± 1.09 0.60 ± 0.79 Female 0.56 ± 0.65 0.54 ± 0.89 0.67 ± 0.81 0.69 ± 0.85 0.68 ± 0.92 Education 2.520 < 0.010 2.422 < 0.010 2.605 < 0.010 2.958 < 0.001 3.369 < 0.001 Non-Tertiary 0.63 ± 0.71 0.64 ± 0.99 0.72 ± 0.85 0.98 ± 0.60 0.72 ± 0.87 tertiary 0.38 ± 0.46 0.32 ± 0.57 0.42 ± 0.58 0.42 ± 0.60 0.31 ± 0.56 First language -7.244 < 0.001 -9.557 < 0.001 -12.336 < 0.001 -11.918 < 0.001 -6.378 < 0.001 Mandarin or Cantonese 0.38 ± 0.50 0.22 ± 0.49 0.32 ± 0.53 0.34 ± 0.51 0.40 ± 0.64 Arabic 1.03 ± 0.76 1.30 ± 1.13 1.36 ± 0.77 1.59 ± 1.00 1.10 ± 0.91 Language at home -7.385 < 0.001 - 9.691 < 0.001 - 12.506 < 0.001 -12.088 < 0.001 -6.505 < 0.001 Mandarin or Cantonese 0.38 ± 0.50 0.22 ± 0.49 0.31 ± 0.53 0.33 ± 0.51 0.39 ± 0.63 Arabic 1.03 ± 0.76 1.30 ± 1.13 1.36 ± 0.77 1.59 ± 1.00 1.10 ± 0.91 Chronic diseases diagnosed 4.306 < 0.001 3.102 < 0.001 3.757 < 0.001 4.337 < 0.001 3.013 < 0.010 Yes 0.69 ± 0.70 0.69 ± 0.95 0.78 ± 0.81 0.90 ± 0.94 0.73 ± 0.86 No 0.30 ± 0.49 0.29 ± 0.74 0.38 ± 0.71 0.35 ± 0.74 0.38 ± 0.70 Psychological(mental) disorders diagnosed 5.354 < 0.001 4.338 < 0.001 2.026 < 0.050 4.447 < 0.001 2.728 < 0.010 Yes 1.30 ± 0.87 1.39 ± 0.87 1.22 ± 0.89 1.58 ± 1.01 1.11 ± 0.85 No 0.50 ± 0.82 0.48 ± 0.82 0.59 ± 0.77 0.57 ± 0.81 0.57 ± 0.81 Variables (Group) sleep Memory Higher-level thinking skills Emotion regulation Behaviour change Mean(SD) t p Mean(SD) t p Mean(SD) t p Mean(SD) t p Mean(SD) t p Age -1.943 0.053 -3.336 < 0.010 -3.282 < 0.010 -2.591 < 0.050 -2.071 < 0.050 < 70 0.62 ± 0.63 0.60 ± 0.46 0.36 ± 0.53 0.62 ± 0.64 0.25 ± 0.41 ≥ 70 0.82 ± 0.71 0.86 ± 0.54 0.73 ± 0.81 0.88 ± 0.66 0.40 ± 0.52 Gender 1.172 0.242 1.132 0.259 0.367 0.714 0.070 0.994 0.134 0.893 Male 0.68 ± 0.92 0.71 ± 0.46 0.64 ± 0.76 0.80 ± 0.69 0.35 ± 0.57 Female 0.80 ± 0.69 0.81 ± 0.55 0.59 ± 0.76 0.81 ± 0.66 0.34 ± 045 Education 2.819 < 0.010 1.132 0.052 3.213 < 0.010 2.796 < 0.010 1.739 0.083 Non Tertiary 0.84 ± 0.72 0.82 ± 0.54 0.72 ± 0.82 0.88 ± 0.68 0.38 ± 0.50 tertiary 0.55 ± 0.57 0.67 ± 0.48 0.35 ± 0.46 0.60 ± 0.57 0.25 ± 0.36 First language -4.638 < 0.001 -1.599 0.111 -6.054 < 0.001 -9.858 < 0.001 -4.701 < 0.001 Mandarin or Cantonese 0.62 ± 0.66 0.75 ± 0.55 0.43 ± 0.57 0.55 ± 0.50 0.26 ± 0.40 Arabic 1.10 ± 0.69 0.88 ± 0.49 1.08 ± 0.97 1.36 ± 0.66 0.59 ± 0.59 Language at home -4.550 < 0.001 -1.634 0.104 -6.166 < 0.001 -9.927 < 0.001 -4.794 < 0.001 Mandarin or Cantonese 0.63 ± 0.66 0.75 ± 0.55 0.43 ± 0.56 0.55 ± 0.49 0.25 ± 0.39 Arabic 1.09 ± 0.69 0.88 ± 0.50 1.08 ± 0.97 1.36 ± 0.66 0.59 ± 0.59 Chronic diseases diagnosed 3.957 < 0.001 3.316 < 0.010 2.618 < 0.010 4.708 < 0.001 3.487 < 0.010 Yes 0.89 ± 0.72 0.87 ± 0.52 0.72 ± 0.75 0.95 ± 0.70 0.43 ± 0.50 No 0.51 ± 0.54 0.62 ± 0.52 0.44 ± 0.74 0.52 ± 0.47 0.19 ± 0.40 Psychological (mental) disorders diagnosed 2.682 < 0.010 4.373 < 0.001 5.094 < 0.001 3.075 < 0.010 3.837 < 0.001 Yes 1.17 ± 0.69 1.28 ± 0.74 1.43 ± 0.96 1.25 ± 0.67 0.75 ± 0.70 No 0.73 ± 0.68 0.74 ± 0.49 0.55 ± 0.70 0.77 ± 0.65 0.32 ± 0.44 Educational attainment demonstrated substantial effects, with non-tertiary educated individuals scoring significantly worse across multiple domains including self-care (t = 2.520, p < 0.01), household tasks (t = 2.958, p < 0.001), and emotion regulation (t = 2.796, p < 0.01). Language background showed particularly strong associations, with Arabic speakers displaying markedly greater impairment than Mandarin/Cantonese speakers in household tasks (t=-11.918, p < 0.001), social functioning (t=-12.336, p < 0.001), and emotion regulation (t=-9.858, p < 0.001). The analysis revealed significant associations between language background (both first language and language spoken at home) and functional abilities across multiple HBA-FAQ domains. Arabic-speaking participants demonstrated substantially greater functional difficulties compared to Mandarin/Cantonese speakers, with particularly strong effects observed in household tasks (t = -11.92 to -12.09, p < 0.001), social and work functioning (t = -12.34 to -12.51, p < 0.001), and emotion regulation (t = -9.86 to -9.93, p < 0.001). The language effects were remarkably consistent whether measured by first language or primary home language, reinforcing the robustness of these findings. However, not all domains showed equal sensitivity to language differences - while instrumental activities like financial management (t = -9.56 to -9.69, p < 0.001) and technology use (t = -6.38 to -6.51, p 0.10). Health status variables were strongly predictive of functional outcomes. Chronic disease diagnosis was associated with significantly worse functioning across all domains (all p < 0.01), most notably in household tasks (t = 4.337, p < 0.001). Similarly, participants diagnosed with psychological disorders report more difficulties in all functional areas than those who have not been diagnosed with psychological disorders. Psychological disorders showed particularly strong associations with memory (t = 4.373, p < 0.001) and higher-level thinking skills (t = 5.094, p < 0.001). 4.Discussion This study investigated cognitive impairment and functional ability among culturally and linguistically diverse (CALD) older adults in community settings. Using the AD8 screening tool and the Healthy Brain Ageing Functional Assessment Questionnaire (HBA-FAQ), our findings reveal a substantial burden of cognitive and functional decline, as well as the influence of key demographic and health-related factors. 4.1 Cognitive Impairment This study revealed a high prevalence of probable cognitive impairment (53.9% scoring ≥ 2 on the AD8) among culturally and linguistically diverse (CALD) older adults in Sydney, Australia. The most commonly reported difficulties included trouble learning new technologies, managing complex finances, memory lapses, and impaired judgment. This prevalence is notably higher than findings from Khanna & Metgud 34 , who reported an 8.4% cognitive impairment rate in community-dwelling older adults in an urban area of Belagavi, suggesting that CALD populations may face unique risk factors, such as language barriers, limited healthcare access, or cultural differences in symptom reporting. The AD8’s sensitivity in detecting early cognitive changes aligns with prior validation studies 30 – 31 , reinforcing its utility in diverse settings. The high rate of cognitive concerns observed in this study highlights the need for proactive cognitive screening and culturally appropriate interventions in diverse aging populations. 4.2 Functional Decline Functional decline was most pronounced in memory, emotional regulation, and sleep, with moderate to strong correlations between cognitive impairment (AD8) and functional difficulties (HBA-FAQ). Higher-level thinking (*r* = 0.578) and memory (*r* = 0.559) showed the strongest associations, consistent with research linking executive dysfunction to instrumental activities of daily living (IADLs) 35 . Challenges in technology use and financial management mirrored findings by Lindqvist 36 , highlighting how cognitive decline disrupts complex tasks. Sleep disturbances and emotional dysregulation were also prevalent, underscoring the bidirectional relationship between cognitive and mental health in aging 37 . Our study found that behavioral changes were also associated with cognitive impairment. Consistent with this, previous research by Desmarais 38 and Wahlund 39 has demonstrated that cognitive impairment is closely linked to behavioral disturbances, including inappropriate social behavior, visual experiences, and reduced empathy. 4.3 Demographic Influences Key demographic factors significantly predicted functional outcomes: Age emerged as a significant predictor of functional decline, with participants aged ≥ 70 years demonstrating greater difficulties in financial management, social functioning, and higher-level thinking compared to their younger counterparts. These findings align with established literature on age-related cognitive slowing 40 and impairments in instrumental activities of daily living (IADLs) that demand executive function, such as multitasking and decision-making 41 . Education and language background were key determinants of functional ability in this CALD cohort. Participants without tertiary education showed greater difficulties in self-care and emotional regulation, likely due to fewer psychosocial resources and limited health literacy 42 – 43 . Arabic-speaking adults faced pronounced challenges in household tasks, social functioning, and emotional regulation compared to Mandarin/Cantonese speakers. These disparities may stem from language barriers—limiting healthcare access and community engagement 3 , 44 – 45 —and migration-related stressors, such as trauma histories and disrupted support networks 46 . Culturally adapted interventions, including multilingual services and tailored health materials, are critical to address these inequities 11 . Health Status significantly predicted functional outcomes, with chronic diseases and psychological disorders associated with global functional decline. Participants with chronic conditions showed pronounced limitations in household tasks (e.g., cleaning, cooking), likely due to symptom burden and reduced physical capacity 47 – 48 . Psychological disorders were particularly linked to memory and executive function impairments. These findings align with evidence that multimorbidity accelerates functional disability by compounding physical and cognitive demands 49 – 50 . Our findings present both convergences and divergences with existing literature. While the observed prevalence of cognitive impairment (53.9%) exceeds rates reported in general population studies, it aligns with emerging research highlighting underdiagnosis and cultural barriers in CALD populations 28 . The robust correlation between AD8 and HBA-FAQ scores substantiates established models of cognitive-functional interdependence 51 , while our identification of sleep and emotional regulation as key vulnerable domains expands current understanding of neurobiological aging processes 52 . The marked disparities between Arabic and Mandarin/Cantonese speakers reinforce the critical need for linguistically and culturally adapted healthcare approaches 44 . These findings collectively underscore the necessity of developing targeted, culturally sensitive screening and intervention strategies to address the unique needs of aging CALD communities. 4.4 Implications for Practice and Policy The findings underscore the need for culturally sensitive interventions in clinical practice and policy development. Implementing tailored programs such as multilingual cognitive screenings and community-based memory workshops could effectively address linguistic and cultural barriers to care. For early detection and intervention, health systems should incorporate brief assessment tools like the AD8 and HBA-FAQ into routine health evaluations for CALD populations, while simultaneously training community health workers to identify early signs of cognitive and functional decline. These approaches would facilitate timely referrals and support the development of appropriate, targeted interventions for at-risk individuals. 4.5 Strengths and Limitations This study has several notable strengths, including its large, linguistically diverse sample of CALD older adults—a population often underrepresented in aging research. The use of validated, culturally adapted measures (AD8 and HBA-FAQ) enhances the reliability of cognitive and functional assessments across different language groups. Additionally, the comprehensive evaluation of multiple functional domains provides a nuanced understanding of daily challenges faced by this population. However, several limitations should be acknowledged. The cross-sectional design precludes causal inferences about the relationships between cognitive impairment, functional decline, and demographic factors. Selection bias may exist, as community-dwelling participants likely represent a healthier subgroup compared to institutionalized or severely impaired individuals who were excluded. The reliance on self-reported measures, while valuable for capturing subjective experiences, may introduce recall bias. Furthermore, the study did not account for potential confounding variables such as duration of residence in Australia or acculturation levels, which could influence functional outcomes. Future research should employ longitudinal designs to establish temporal relationships and causal pathways. Including clinical diagnoses of cognitive impairment and incorporating objective functional assessments would strengthen the findings. Investigations into the role of acculturation, social support, and healthcare access could further elucidate the complex interplay between cultural factors and functional health in aging CALD populations. 5. Conclusion This study highlights the substantial burden of cognitive impairment (53.9% prevalence) and functional decline among culturally and linguistically diverse (CALD) older adults, with particular vulnerabilities in memory, emotional regulation, and higher-level thinking. Key demographic factors - including advanced age (≥ 70 years), lower education levels, Arabic language background, and chronic health conditions which were strongly associated with poorer functional outcomes. The robust correlation between cognitive impairment (AD8) and functional decline (HBA-FAQ) underscores their interconnected nature in the aging process. These findings have important implications for policy and practice. There is an urgent need to implement culturally sensitive screening programs that utilise brief, validated tools like the AD8 and HBA-FAQ in CALD communities. Healthcare systems must prioritise linguistically appropriate interventions, including multilingual cognitive assessments and community-based support services tailored to specific cultural needs. Future research should employ longitudinal designs to better understand causal pathways while incorporating both subjective and objective measures of cognitive and functional health. This study provides compelling evidence for the development of targeted strategies to support healthy aging in CALD populations, ultimately working towards health equity for all older adults regardless of cultural or linguistic background. Declarations Funding: Not applicable. Author Contribution WPY and HCC is responsible for the conceptual research, YC and WPY jointly analyse and interpret the data. The first draft is completed by HCC, YC，and SS, the manuscript is reviewed and edited by all authors, and the final reviewed and edited by WPY and HCC. All authors thoroughly reviewed and gave their consent to the final version of the manuscript. The statistical expert of this study is WPY. Acknowledgement We sincerely thank the Chinese Australian Services Society (CASS) and Arabic Council Australia (ACA) for their essential support in participant recruitment and data collection. Their staff provided invaluable assistance with survey administration and cultural liaison, enabling successful engagement with Mandarin/Cantonese and Arabic-speaking communities. This research would not have been possible without their partnership. Data Availability Due to ethical and privacy restrictions, the data collected in partnership with community organisations are not publicly available. De-identified data may be provided upon reasonable request. References Kannan Navaneetham, Arunachalam D. Global Population Aging, 1950–2050. Springer Nat. 2023;1–18. https://doi.org/10.1007/978-981-16-1914-4_154-1 . Bai W, Chen P, Cai H, et al. 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BMC Geriatr. 2018;18. https://doi.org/10.1186/s12877-018-0879-z . Pearson O, Uglik-Marucha N, Miskowiak KW, et al. The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review. J Affect Disord. 2023;327:207–16. https://doi.org/10.1016/j.jad.2023.01.114 . Desmarais P, Lanctôt KL, Masellis M, et al. Social inappropriateness in neurodegenerative disorders. Int Psychogeriatr. 2017;30:197–207. https://doi.org/10.1017/s1041610217001260 . Wahlund L-O, Pihlstrand E, Jönhagen ME. Mild cognitive impairment: experience from a memory clinic. Acta Neurol Scand. 2003;107:21–4. https://doi.org/10.1034/j.1600-0404.107.s179.3.x . Murman D. The Impact of Age on Cognition. Semin Hear. 2015;36:111–21. https://doi.org/10.1055/s-0035-1555115 . Feger DM, Willis SL, Thomas KR, et al. Incident Instrumental Activities of Daily Living Difficulty in Older Adults: Which Comes First? Findings From the Advanced Cognitive Training for Independent and Vital Elderly Study. Front Neurol. 2020;11. https://doi.org/10.3389/fneur.2020.550577 . Amegbor PM, Kuuire VZ, Robertson H, Kuffuor OA. Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana. Arch Gerontol Geriatr. 2018;77:81–8. https://doi.org/10.1016/j.archger.2018.04.006 . Chlapečka A, Katrin Wolfová B, Fryčová P Čermáková. Educational attainment and anxiety in middle-aged and older Europeans. Sci Rep. 2023;13. https://doi.org/10.1038/s41598-023-40196-4 . Li C, Abdulkerim N, Jordan CA, Son CGE. Overcoming Communication Barriers to Healthcare for Culturally and Linguistically Diverse Patients. North Am J Med Sci. 2017;10:103–10. https://doi.org/10.7156/najms.2017.1003103 . Schouten BC, Cox A, Duran G, et al. Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach. Patient Educ Couns. 2020;103:2604–8. https://doi.org/10.1016/j.pec.2020.05.001 . Ritesh Chimoriya, Mohammad Y, Thomson R, et al. Mental illness stigma and associated factors among Arabic-speaking refugee and migrant populations in Australia. Int J Mental Health Syst. 2023;17. https://doi.org/10.1186/s13033-023-00580-z . Arkhipov V, Aringazina A. Effect of Different Homework on Chronic Morbidity among Single Older People. Open Public Health J. 2022;15. https://doi.org/10.2174/18749445-v15-e2112240 . Cipriani G, Danti S, Picchi L, et al. Daily Functioning and Dementia. Dement Neuropsychologia. 2020;14:93–102. https://doi.org/10.1590/1980-57642020dn14-020001 . Schrock JM, Sugiyama LS, Naidoo N et al. (2022) Greater chronic morbidity is associated with greater fatigue in six countries. Evolution, Medicine, and Public Health 10:156–169. https://doi.org/10.1093/emph/eoac011 Yen L, McRae I, Jeon Y-H, et al. The impact of chronic illness on workforce participation and the need for assistance with household tasks and personal care by older Australians. Health Soc Care Commun. 2011;19:485–94. https://doi.org/10.1111/j.1365-2524.2011.00994.x . Mlinac ME, Feng MC. Assessment of Activities of Daily living, self-care, and Independence. Arch Clin Neuropsychol. 2016;31:506–16. https://doi.org/10.1093/arclin/acw049 . Bettio LEB, Rajendran L, Gil-Mohapel J. The effects of aging in the hippocampus and cognitive decline. Neurosci Biobehavioral Reviews. 2017;79:66–86. https://doi.org/10.1016/j.neubiorev.2017.04.030 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 04 Feb, 2026 Reviewers agreed at journal 05 Jan, 2026 Reviewers invited by journal 03 Jan, 2026 Editor assigned by journal 17 Dec, 2025 Submission checks completed at journal 17 Dec, 2025 First submitted to journal 14 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-8361682","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":600881938,"identity":"378bdea7-3e2e-4248-aa65-8b8b6e9d6759","order_by":0,"name":"Hui-Chen (Rita) CHANG","email":"data:image/png;base64,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","orcid":"","institution":"Western Sydney University","correspondingAuthor":true,"prefix":"","firstName":"Hui-Chen","middleName":"(Rita)","lastName":"CHANG","suffix":""},{"id":600881943,"identity":"7b2221ad-7a83-4e70-8223-f5b4801bf192","order_by":1,"name":"Yu (Carrie) CHENG","email":"","orcid":"","institution":"Western Sydney University","correspondingAuthor":false,"prefix":"","firstName":"Yu","middleName":"(Carrie)","lastName":"CHENG","suffix":""},{"id":600881948,"identity":"28b6f8c2-306d-4f32-bdf7-bf5217fb4e05","order_by":2,"name":"Fung Kuen KOO","email":"","orcid":"","institution":"Western Sydney University","correspondingAuthor":false,"prefix":"","firstName":"Fung","middleName":"Kuen","lastName":"KOO","suffix":""},{"id":600881952,"identity":"2cb76bb6-cdc8-4300-82fd-069ea8f19a67","order_by":3,"name":"Sara Shishehgar","email":"","orcid":"","institution":"Western Sydney University","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"","lastName":"Shishehgar","suffix":""},{"id":600881953,"identity":"1e8b92bf-8812-4c44-b37e-383467bd2aaa","order_by":4,"name":"Dami Limbu","email":"","orcid":"","institution":"Western Sydney University","correspondingAuthor":false,"prefix":"","firstName":"Dami","middleName":"","lastName":"Limbu","suffix":""},{"id":600881955,"identity":"ed7de9ff-247a-4bce-8a5e-d134368de50e","order_by":5,"name":"Jiayi (Winnie) HUANG","email":"","orcid":"","institution":"Chinese Australian Services Society","correspondingAuthor":false,"prefix":"","firstName":"Jiayi","middleName":"(Winnie)","lastName":"HUANG","suffix":""},{"id":600881960,"identity":"1885413a-25ac-4cfe-a168-33f74104d7bb","order_by":6,"name":"Wenpeng YOU","email":"","orcid":"","institution":"Western Sydney University","correspondingAuthor":false,"prefix":"","firstName":"Wenpeng","middleName":"","lastName":"YOU","suffix":""}],"badges":[],"createdAt":"2025-12-15 04:23:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8361682/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8361682/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105034917,"identity":"f2f71cde-2cc6-4408-8460-e527e3649443","added_by":"auto","created_at":"2026-03-20 07:24:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1991307,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8361682/v1/e317b22c-186d-4173-a5be-acde5f80aa68.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Linking Cognitive Status to Healthy Brain Ageing Functional Trajectories in a Multicultural Aging Population: A Cross-Sectional Community-Based Study ","fulltext":[{"header":"Highlights","content":"\u003cp\u003e\u0026bull; 53.9% of CALD Australian older adults screened positive for cognitive impairment (AD8\u0026thinsp;\u0026ge;\u0026thinsp;2).\u003c/p\u003e\u003cp\u003e\u0026bull; Strongest functional declines in memory, emotion regulation, and sleep domains.\u003c/p\u003e\u003cp\u003e \u0026bull; Arabic-speaking participants showed greater functional challenges than Mandarin/Cantonese speakers.\u003c/p\u003e\u003cp\u003e\u0026bull; AD8 and HBA-FAQ demonstrated robust correlations (r\u0026thinsp;=\u0026thinsp;0.315\u0026ndash;0.578, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u0026bull; Older age, low education, and chronic diseases predicted poorer functional abilities.\u003c/p\u003e"},{"header":"1. Introduction","content":"\u003cp\u003ePopulation aging is an inevitable phenomenon in the world that presents challenges for healthcare systems. By 2050, about 1.5\u0026nbsp;billion people will be 65 years and older, which indicates aged population will be doubled within the next 30 years\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. As the aged population grows, age-related health issues such as cognitive decline and dementia increases. Cognitive impairment which is recognised as a preclinical stage for dementia is rated as 15.56% worldwide in community-dwelling older adults\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. This rate increases with age\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e, and impacts an individual's daily functioning and quality of life \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. A critical framework for assessing this functional impact involves evaluating Activities of Daily Living (ADLs), which are categorized into two distinct subtypes. \u003cb\u003eBasic Activities of Daily Living (BADLs)\u003c/b\u003e refer to fundamental self-care tasks essential for personal independence and survival, such as bathing, dressing, toileting, transferring (e.g., moving from bed to chair), continence, and feeding. \u003cb\u003eInstrumental Activities of Daily Living (IADLs)\u003c/b\u003e encompass more complex skills required for independent living within a community, including managing finances, shopping, preparing meals, housekeeping, using transportation, managing medications, and using communication devices\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The distinction is crucial in aging research, as BADL dependency often signifies more severe functional decline, while IADL difficulties can be among the earliest detectable signs of mild cognitive impairment\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eResearch underscores the link between cognitive status and functional dependency. A study in the United States found that people with cognitive impairment had a higher risk of ADLs dependency compared with people with normal cognition\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Similarly, a study in China presented a twofold higher risk of developing ADLs disability in people with cognitive impairment compared to the group without cognitive impairment\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Crucially, cognitive impairment often first affects the ability to perform IADLs, such as managing medications, finances, or transportation, before progressing to impact BADLs\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAlthough cognitive impairment is known as an age-related health issue that significantly impacts aged population\u0026rsquo;s daily function and quality of life, early detection and implications of interventions may reverse or slow down the adverse impacts. For example, while dementia doesn\u0026rsquo;t show perceptible cognitive impairments during its lengthy preclinical stage, neurogenerative changes are proceeding. Therefore, early detection of at-risk individuals and implementing interventions is essential to protect them from proceeding to the late stages of the disease in their late life \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOlder adults from CALD backgrounds experience many challenges that influence their access to healthcare services. In the Australian context, the term \"CALD\" is commonly used to describe individuals and communities who identify with cultural or linguistic affiliations different from the majority Anglo-Australian population. This encompasses migrants, refugees, and their descendants, and acknowledges the diversity in languages, ethnicities, religions, and cultural norms that shape health beliefs and service use\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. For this study, the term is particularly relevant for identifying populations who may experience specific barriers to cognitive health screening and support.\u003c/p\u003e \u003cp\u003eThese barriers include limited literacy on health and health care, social isolation, language and communication barriers and lack of culturally sensitive healthcare services\u003csup\u003e\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Limited English language skills can significantly hinder their ability to communicate and access to health screening to receive timely and effective health care\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Similarly, cultural difference in beliefs about illness, aging and healthcare can lead to reluctance in seeking healthcare services among older CALD population\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. For example, in some communities, functional decline and cognitive decline are considered as aging process consequently, less older people participate in health awareness or health support programs such as falls preventions or dementia support programs in Australia\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Therefore, culturally informed healthcare services are crucial to support older CALD older population. Strategies such as healthcare interpretation services, bilingual staff, community focused health awareness programs, culturally competent healthcare professionals are crucial to foster communication and trust, ultimately address cultural and healthcare needs of older people from CALD backgrounds\u003csup\u003e\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAustralia\u0026rsquo;s population is ageing due to increasing life expectancy, declining fertility rates, and mounted immigrant intakes. In 2020, approximately one in six Australians equal to 4.2\u0026nbsp;million people were aged 65 and over, which is 16% of Australia\u0026rsquo;s population\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. This is projected that this number grows and older people in Australia including those from CALD background will form 21% to 23% of the total population by 2066\u003csup\u003e17\u003c/sup\u003e. This can bring compounding impacts of cultural, social, financial determinants of health on experience of ageing and cognitive and functional impairment in Australia\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, which requires early recognition and proactive planning.\u003c/p\u003e \u003cp\u003eThere is an increasing literature discussing use of self-report tools in early detection of cognitive and functional changes in older population. Self-report instruments are widely employed in ageing research due to their efficiency, low cost, and applicability in community settings\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. They capture older adults\u0026rsquo; subjective experiences of functional or cognitive change, some of which have been shown to predict later functional decline or cognitive deterioration before impairments are detected on objective clinical tests\u003csup\u003e21\u0026ndash; \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Previous studies reported a low specificity for self-reports of cognitive and functional problems due to their subjective and cross-sectional natures. The studies confirmed that factors, such as depression or personality traits influence accuracy of the reports\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. However, a meta-analysis which included studies with heterogenous characteristics found lower cognitive function in those with more reports of problems\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. A recent systematic review across 19 studies found self-reports of feeling worry and memory decline were predicting future cognitive decline\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e .\u003c/p\u003e \u003cp\u003eTo assess functional ability of older people, the Healthy Brain Ageing\u0026mdash;Functional Assessment Questionnaire (HBA-FAQ), a 44-item self-report questionnaire, is being increasingly validated and used to measure elderly\u0026rsquo;s subjective perception of their optimal level of functioning in daily life and predict risk of dementia over the last year \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. The studies found the questionnaire a valid and reliable self-report tool that is sensitive and efficient in early detection of subtle changes in daily functioning in older people at risk of dementia. A self-report tool to accurately identify subtle functional changes will empower older adults to take an active role in monitoring their health and functional abilities\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. These findings underscore the importance of cognitive and functional self-assessments to identify at-risk individuals early and inform targeted interventions for CALD older adults. This study aims to investigate cognitive impairment and functional changes in culturally and linguistically diverse (CALD) older adults, using the HBA-FAQ.\u003c/p\u003e \u003cp\u003e \u003cb\u003eResearch aim, objective and research questions\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eAim\u003c/strong\u003e \u003cp\u003eTo investigate cognitive impairment, functional changes, and their demographic correlates in culturally and linguistically diverse older adults, using the AD8 and Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eObjectives\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAssess cognitive impairment using the AD8 scale in a linguistically diverse older population.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eEvaluate functional changes across ten domains of daily living using the HBA-FAQ.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCompare the sensitivity of the AD8 and HBA-FAQ in detecting cognitive and functional decline.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eExamine demographic influences (age, education, language background, chronic diseases, psychological disorders) on cognitive and functional performance.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eResearch questions\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat is the prevalence and severity of cognitive impairment (AD8\u0026thinsp;\u0026ge;\u0026thinsp;2) in this culturally diverse older cohort?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHow do functional abilities vary across domains as measured by the HBA-FAQ?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHow strongly are AD8 scores correlated with functional decline in specific HBA-FAQ domains (e.g., memory, higher-level thinking)?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhich demographic factors (e.g., age\u0026thinsp;\u0026ge;\u0026thinsp;70, non-tertiary education, language background, chronic disease) most significantly predict worse functional outcomes?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003e2. Methods\u003c/b\u003e \u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Design\u003c/h2\u003e \u003cp\u003eThis study employed a cross-sectional design to assess cognitive impairment, functional changes and their demographic correlates among culturally and linguistically diverse (CALD) older adults living in the community.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study setting and sampling\u003c/h2\u003e \u003cp\u003eThis study employed a purposive sampling strategy to recruit participants from two major culturally and linguistically diverse (CALD) communities in Sydney, Australia - Chinese (Mandarin and Cantonese speakers) and Arabic-speaking populations. The CALD population is often defined as individual born in non-English speaking countries or who speak non-English languages at home\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Indigenous peoples are a distinct research group and were not included in this classification\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. The selection of these groups was based on: (1) their significant representation within Australia's population, with Mandarin 2.7%, Cantonese1.2% and Arabic 1.4% being among the top non-English languages spoken at home\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e ; and (2) the need to better understand the specific health challenges faced by these growing communities in the Australian healthcare context. Between June and September 2023, participants were recruited through established community organizations serving these ethnic groups in Sydney, New South Wales. These organizations were selected as recruitment partners due to their strong ties to the target communities; their ability to facilitate culturally appropriate research engagement and ability to support participants \u0026lsquo;communication needs.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion Criteria\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eParticipants were eligible for inclusion if they met all of the following criteria:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAged 65 years or older\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCurrently attending activities hosted by either Chinese (Mandarin/Cantonese-speaking) or Arabic-speaking community organizations\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eLiving in the community (i.e., not institutionalized)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eProficient in Mandarin, Cantonese, or Arabic (as a first language or primary language of communication)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBorn in a non-English-speaking country\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eExclusion Criteria\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eIndividuals were excluded from the study if they met any of the following criteria:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHad serious comorbid illnesses that would prevent active participation\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHad severe cognitive impairment, as indicated by a medical diagnosis or inability to provide informed consent\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWere receiving palliative care\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHad any health conditions deemed to preclude safe participation in the study\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Sample size calculations\u003c/h2\u003e \u003cp\u003eTo ensure adequate statistical power, G*Power version 3.0.9 was used to estimate the minimum required sample sizes for the quantitative analyses. For the bivariate (non-parametric) correlation analysis, a minimum of 139 participants was required, assuming a medium effect size (r\u0026thinsp;=\u0026thinsp;0.30), an alpha level of 0.05, and 95% power. For independent t-tests, a sample size of 204 participants was needed based on an estimated effect size of 0.35, an alpha level of 0.10, and 75% power (two-tailed). The final sample of 221 participants exceeded these thresholds, enhancing the statistical reliability and generalizability of the findings.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Outcome Measures\u003c/h2\u003e \u003cp\u003eTwo validated instruments were used to assess cognitive function and functional abilities among older adults. Cognitive impairment was measured using the AD8 Dementia Screening Interview, an 8-item informant-based questionnaire designed to detect early signs of dementia. Functional ability was assessed using the Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ), which evaluates self-reported changes across ten key domains of daily living.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCognitive Function Assessment: AD8 Scale\u003c/b\u003e \u003c/p\u003e \u003cp\u003eCognitive impairment was assessed using the validated 8-item Informant Interview to Differentiate Aging and Dementia (AD8), developed by Galvin\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. This brief screening tool is designed to detect early cognitive changes associated with dementia and demonstrates strong psychometric properties. The AD8 assesses eight domains related to memory, orientation, judgment, and daily functioning using a simple yes/no format. It can be completed in approximately three minutes, either through self-report or by a knowledgeable informant (the preferred method).\u003c/p\u003e \u003cp\u003eEach \u0026ldquo;Yes, there is a change\u0026rdquo; response is scored as 1, while \u0026ldquo;No, there is no change\u0026rdquo; and \u0026ldquo;Not applicable/don\u0026rsquo;t know\u0026rdquo; responses are scored as 0. Total scores range from 0 to 8, with scores of 0\u0026ndash;1 indicating normal cognition and scores\u0026thinsp;\u0026ge;\u0026thinsp;2 suggesting probable cognitive impairment.\u003c/p\u003e \u003cp\u003eValidation studies have shown the AD8 to possess excellent diagnostic accuracy, with sensitivity exceeding 84% and specificity above 80%. Its predictive validity is also strong, with a positive predictive value above 85% and a negative predictive value exceeding 70%. Receiver operating characteristic (ROC) analysis has demonstrated excellent discrimination between normal aging and cognitive impairment, with an area under the curve (AUC) of 0.908 (95% CI: 0.888\u0026ndash;0.925)\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFunctional abilities were assessed using the Healthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ), a 44-item multidimensional instrument developed by Lin\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e that evaluates self-perceived functional changes across ten critical domains of daily living. The questionnaire covers basic activities (self-care, household tasks), instrumental activities (financial affairs, technology use), cognitive domains (memory, higher-level thinking), psychosocial functioning (social/work participation, emotion regulation, behaviour), and physiological function (sleep patterns).\u003c/p\u003e \u003cp\u003eParticipants rated changes in their functional abilities over the past 12 months using a 4-point Likert scale ranging from 0 (\u0026ldquo;no change from optimal functioning\u0026rdquo;) to 3 (\u0026ldquo;unable/no longer completes independently\u0026rdquo;). Subdomain scores were calculated by summing item responses, with a higher total score indicating greater functional decline (maximum score\u0026thinsp;=\u0026thinsp;30). The HBA-FAQ has demonstrated excellent psychometric properties, including high internal consistency (Cronbach\u0026rsquo;s α\u0026thinsp;=\u0026thinsp;0.89\u0026ndash;0.93 across subscales) and strong test\u0026ndash;retest reliability (intraclass correlation coefficient [ICC]\u0026thinsp;=\u0026thinsp;0.85\u0026ndash;0.91)\u003csup\u003e27\u003c/sup\u003e. The measure has also been validated against gold-standard functional assessments\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. For this study, HBA-FAQ was professionally translated and culturally adapted for administration in Mandarin, Cantonese, and Arabic to ensure conceptual equivalence and appropriateness for the linguistically diverse participant population.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data collection\u003c/h2\u003e \u003cp\u003eThe study implemented a comprehensive data collection protocol over a three-month period to assess cognitive and functional changes among older adults from Chinese and Arabic cultural backgrounds. The data collection process encompassed multiple domains, including sociodemographic characteristics, health status, and validated cognitive and functional assessment tools.\u003c/p\u003e \u003cp\u003e \u003cb\u003eDemographic and Health Variables\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe dataset captured key demographic information, including age, gender, education level, primary language, and country of birth. Participants also self-reported their health status, specifying the presence of chronic conditions (e.g., diabetes, hypertension, arthritis, asthma, cancer) and psychological disorders (e.g., depression, anxiety, or other diagnosed mental health conditions).\u003c/p\u003e \u003cp\u003e \u003cb\u003eAssessment Instruments and Translation Procedures\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTwo validated tools were used in the study:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAD8 Dementia Screening Interview \u0026ndash; an 8-item informant-based questionnaire assessing cognitive function.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eHealthy Brain Aging Functional Assessment Questionnaire (HBA-FAQ) \u0026ndash; a 44-item self-report tool evaluating functional changes across ten domains of daily living.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThe AD8 was administered using validated Mandarin and Arabic versions, which had been previously culturally adapted and psychometrically tested in Chinese\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e and Arabic populations\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo ensure linguistic and cultural appropriateness, the HBA-FAQ was translated into Mandarin (both simplified and traditional forms), Cantonese, and Arabic. The translation process followed a rigorous multi-step protocol: initial translations were conducted by professional bilingual translators fluent in both English and the target languages; these were then independently back-translated into English by separate certified translators unfamiliar with the original instrument. The translated versions were reviewed by bilingual experts in aging and cognitive assessment to refine terminology and ensure cultural relevance. Final revisions were made based on expert feedback to achieve conceptual equivalence.\u003c/p\u003e \u003cp\u003eData collection was facilitated by trained community coordinators fluent in participants' native languages. These coordinators received two hours of training on standardized data collection protocols and were supported by the research team, which provided on-site supervision. Assessments were scheduled during regular community centre operating hours to accommodate participants\u0026rsquo; routines and reduce disruption. Each session lasted approximately 25\u0026ndash;35 minutes and was conducted in private spaces to ensure confidentiality. To maintain data quality, the research team implemented several quality control measures, including daily data verification, weekly team debriefings, and random fidelity checks during data collection sessions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Data analysis\u003c/h2\u003e \u003cp\u003eParticipant characteristics were summarized using frequencies and percentages for categorical variables. The same approach was applied to describe response distributions for the AD8 and HBA-FAQ. Mean values and standard deviations were used to report cognitive and functional ability scores.\u003c/p\u003e \u003cp\u003eTo examine associations between cognitive function and functional ability, nonparametric correlations were conducted using Spearman\u0026rsquo;s rank correlation coefficient. Correlation analyses were also performed to assess the relationship between age and both cognitive (AD8) and functional (HBA-FAQ) scores, providing insight into the influence of age on these outcomes. The study examined differences in cognitive and functional outcomes across seven demographic variables using independent t-tests. The variables included: age (categorized as \u0026lt;\u0026thinsp;70 years and \u0026ge;\u0026thinsp;70 years, based on evidence indicating significant age-related cognitive and physical changes after age 70\u003csup\u003e33\u003c/sup\u003e, gender (male vs. female), education level (tertiary vs. non-tertiary), first language (Mandarin/Cantonese vs. Arabic), language spoken at home (Mandarin/Cantonese vs. Arabic), presence of chronic diseases (yes vs. no), and diagnosis of psychological disorders (yes vs. no). Mean scores for AD8 and HBA-FAQ were compared across these groups to identify significant differences. All statistical analyses were conducted using IBM SPSS Statistics, version 28.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Ethical considerations\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e for this study was obtained from the Human Research Ethics Committee (HREC) of the University of New England (Approval Number: HE22-088). To ensure participants\u0026rsquo; full understanding of the study, both the participant information sheet and consent form were professionally translated into their native languages. The purpose and procedures of the study were clearly explained prior to data collection, and informed consent was obtained from all participants.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eParticipants were informed of their right to withdraw from the study at any time without any impact on the services or support they received. All data were anonymized and securely stored to safeguard participant confidentiality and privacy in accordance with ethical research standards.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Participant characteristics\u003c/h2\u003e \u003cp\u003eThe study included 221 participants who were recruited from two community organizations that provide community services and activities for older people. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents a detailed demographic characteristics using frequency and percentage. The majority of participants were female (n\u0026thinsp;=\u0026thinsp;169, 76.5%), while males accounted for 23.5% (n\u0026thinsp;=\u0026thinsp;52) of the participants. Approximately half of participants held a high school certificate (n\u0026thinsp;=\u0026thinsp;116, 52.7%). Educational attainment revealed distinct patterns across cultural-linguistic groups. While 52.7% (n\u0026thinsp;=\u0026thinsp;116) of participants held high school certificates, tertiary education levels varied significantly: Chinese-background participants accounted for 22.2% (n\u0026thinsp;=\u0026thinsp;49) of all bachelor's degrees, compared to only 0.9% (n\u0026thinsp;=\u0026thinsp;2) among Arabic-background participants. Postgraduate qualifications were uncommon in both groups (Chinese: 1.4%, n\u0026thinsp;=\u0026thinsp;3; Arabic: 1.8%, n\u0026thinsp;=\u0026thinsp;4). Non-tertiary education included training college certificates (12.2%, n\u0026thinsp;=\u0026thinsp;27), primary education (2.7%, n\u0026thinsp;=\u0026thinsp;6), no formal schooling (2.7%, n\u0026thinsp;=\u0026thinsp;6), and other qualifications (3.2%, n\u0026thinsp;=\u0026thinsp;7). Most participants spoke Mandarin or Cantonese as their first language (n\u0026thinsp;=\u0026thinsp;145, 65.6%), followed by Arabic (n\u0026thinsp;=\u0026thinsp;64, 29.0%). Only 1.4% (n\u0026thinsp;=\u0026thinsp;3) reported English as their first language. A substantial proportion reported having chronic diseases (n\u0026thinsp;=\u0026thinsp;149, 67.4%), while fewer participants reported diagnosed psychological disorders (n\u0026thinsp;=\u0026thinsp;19, 8.6%).\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\u003eParticipant characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSociodemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e169 (76.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (23.5)\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 \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNon-tertiary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school certificate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (52.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraining college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (12.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(3.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTertiary\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor's degree (Chinese)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (22.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelor's degree (Arabic)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaster's degree (Chinese)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (1.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaster's degree (Arabic)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (1.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst Language\u003c/b\u003e\u003c/p\u003e \u003cp\u003eEnglish\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(1.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145 (65.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (29.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther (Armenia, French, Vietnamese, Indonesia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (4.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLanguage spoken at home\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148 (67.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (29.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther (Armenia, French, Vietnamese, Indonesia)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (4.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCountry of birth\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (61.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrench\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHong Kong\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (3.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndonesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (1.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIraq\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (5.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJordan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLebanon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (9.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePalatine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSyria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (14.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTurkey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVietnamese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (2.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAny chronic diseases? (e.g., diabetes, hypertension, arthritis, asthma, cancer)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (32.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149 (67.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEver been diagnosed with psychological (mental) disorders? (e.g., depression, anxiety)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e202 (91.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (8.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Cognitive changes (AD8)\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents cognitive changes among 221 participants using frequency, percentage, and mean methods. The findings indicated a high prevalence of self-reported cognitive concerns. A total of 53.9% (n\u0026thinsp;=\u0026thinsp;118) of participants scored\u0026thinsp;\u0026ge;\u0026thinsp;2 points, which is the established cutoff suggestive of possible cognitive impairment (mean score\u0026thinsp;=\u0026thinsp;2.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.499). Individual items showed varying frequencies of reported cognitive changes: functional difficulties were most prominent, with 34.4% (n\u0026thinsp;=\u0026thinsp;76) reporting trouble learning new devices and 33.9% (n\u0026thinsp;=\u0026thinsp;75) experiencing difficulties managing complex financial affairs. Memory-related concerns were also prevalent, including 33.5% (n\u0026thinsp;=\u0026thinsp;74) reporting daily thinking/memory problems and 29.0% (n\u0026thinsp;=\u0026thinsp;64) having trouble remembering appointments. Judgment problems affected 28.5% (n\u0026thinsp;=\u0026thinsp;63), while 28.1% (n\u0026thinsp;=\u0026thinsp;62) showed reduced interest in hobbies. Repetitive behaviours (24.0%, n\u0026thinsp;=\u0026thinsp;53) and temporal disorientation (24.0%, n\u0026thinsp;=\u0026thinsp;53) were equally common.\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\u003eCognitive changes \u0026ndash; AD8\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\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=\"left\" 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 \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eTotal Score\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026thinsp;~\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAD8 Total (Items)\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\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e102 (46.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e118 (53.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e2.37\u0026thinsp;\u0026plusmn;\u0026thinsp;2.499\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.Problems with judgement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63 (28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156 (70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.Less interest in hobbies/activities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62 (28.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156 (70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.Repeats the same things over and over (questions, stories, or statements)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e163 (73.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (2.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.Trouble learning how to use a tool, appliance, or gadget (e.g., VCR, computer, microwave, remote control)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76 (34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140 (63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (2.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5.Forgets correct month or year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (24.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e166 (75.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6.Trouble handling complicated financial affairs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e75 (33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139 (62.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (3.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7.Trouble remembering appointments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (29.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e155 (70.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8.Daily problems with thinking and/or memory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (33.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142 (64.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (1.8)\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 \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\u003eHealthy Brain Ageing Functional Assessment Questionnaire \u0026ndash; Functional Ability\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=\"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=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo change\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMild change for the worse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate change for the worse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eUnable/no longer complete independently\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGetting ready in the morning or getting ready to go out\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (58.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral self-grooming\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160 (72.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (19.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (6.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeeking medical and/or dental advice where warranted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112 (50.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (8.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManaging medications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (61.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (25.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (5.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFinancial affairs\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHandling money\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167 (75.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManaging complex financial affairs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (59.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (14.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (13.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManaging household finances\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138 (62.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (12.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial and work functioning\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInitiating and contributing to social activities with friends and/or family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e172 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (15.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWithdrawal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152 (68.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDriving restrictions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (32.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (18.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDriving ability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (31.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (5.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38 (17.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork completion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (15.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork performance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (40.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousehold tasks\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEveryday household tasks such as vacuuming, cleaning, dusting, basic home maintenance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (18.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (13.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeeping the house in order\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138 (62.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (16.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22(10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreparing meals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e133 (60.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (19.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCooking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18 (8.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGrocery shopping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (52.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33 (14.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEveryday technology\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsing the telephone/ mobile phone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e150 (67.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (19%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (8.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsing the computer or other digital device\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117 (52.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (24.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (8.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (13.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsing the remote control, television and video\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138 (62.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (21.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSleep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDifficulty falling asleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (43.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34 (15.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWaking during the night other than to go to the toilet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (41.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18 (8.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNapping during the daytime or early evening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111 (50.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79 (35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (8.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (3.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChanges in sleep timing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e106 (48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77 (34.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (10.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (5.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActing out dreams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (51.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e82 (37.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (8.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.0%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMemory\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay-to-day memory problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87 (39.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (12.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeing forgetful\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81 (36.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e102 (46.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeing repetitive in conversation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122 (55.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71 (32.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (9.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (2.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWord-finding problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (45.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96 (43.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (9.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfusion in unusual situations or environments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115 (52.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (37.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (8.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForgetful during tasks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(15.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107(48.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76(34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(1.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHigher-level thinking skills\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorer judgment than usual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e109 (49.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73 (33.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (9.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17 (7.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDifficulty making decisions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e116 (52.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75 (33.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (6.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (7.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConcrete thinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e139 (62.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (25.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 (4.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14 (6.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInflexible thinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e129 (58.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72 (32.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBecoming easily overwhelmed or slower thinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122 (55.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (30.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotion regulation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrritability or temper outbursts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111(50.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54(24.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3(1.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMood changes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112 (50.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (30.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (12.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (5.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (55.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.5%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.1%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBehaviour change\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInappropriate remarks or behaviour in social situations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e172 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (0.9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisual experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e139 (62.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63 (28.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (6.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppetite changes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156 (70.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (24.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReduced empathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e161 (72.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAverage\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71.1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.3 The Healthy Brain Ageing Functional Assessment Questionnaire\u003c/h2\u003e \u003cp\u003eThe Healthy Brain Aging Functional Assessment Questionnaire revealed varying degrees of functional decline across ten domains. Self-care activities showed relatively preserved function, with 60.9% of participants reporting no changes, though 29.9% noted mild deterioration in seeking medical advice and 8.6% required fully assistance with medical consultations. Financial management proved more challenging, although 65.8% maintaining unchanged abilities, 10.7% unable to independently manage the financial affairs specially unable to manage complex finances independently (13.6%).\u003c/p\u003e \u003cp\u003eThe assessment of social and work functioning revealed that, on average, 50.1% of participants reported no significant changes in their abilities. However, distinct patterns of decline were observed across different domains. Social engagement remained relatively preserved, with 77.8% (n\u0026thinsp;=\u0026thinsp;172) of participants reporting no difficulty initiating or maintaining social interactions, and only 2.7% (n\u0026thinsp;=\u0026thinsp;6) becoming entirely dependent on others for such activities. Nevertheless, 17.6% (n\u0026thinsp;=\u0026thinsp;39) exhibited mild social withdrawal, progressing to moderate withdrawal in 7.2% (n\u0026thinsp;=\u0026thinsp;16). In contrast, driving capacity showed significant impairment, with only 31.7\u0026ndash;32.1% of participants retaining full ability. Notably, 18.1% (n\u0026thinsp;=\u0026thinsp;40) faced driving restrictions, and 17.2% (n\u0026thinsp;=\u0026thinsp;38) could no longer drive independently. Work-related functioning was also substantially affected, with 50% (n\u0026thinsp;=\u0026thinsp;84) maintaining baseline work completion, while 15.8% (n\u0026thinsp;=\u0026thinsp;35) and 10% (n\u0026thinsp;=\u0026thinsp;22) experienced mild and moderate declines, respectively. Work performance was even more compromised, with 40.3% (n\u0026thinsp;=\u0026thinsp;89) reporting no change, yet 10.4% (n\u0026thinsp;=\u0026thinsp;23) becoming unable to perform tasks without assistance.\u003c/p\u003e \u003cp\u003eThe assessment of household tasks showed that 57.8% of participants maintained their ability to perform domestic activities without changes, while 9.3% on average had become completely dependent on others for these tasks. Meal preparation showed the highest preservation of function (60.2% no change), followed by general housekeeping (62.4% no change). However, grocery shopping emerged as the most challenging task, with only 52.5% reporting no difficulties and 14.9% experiencing moderate decline.\u003c/p\u003e \u003cp\u003eFor technology use, 61.1% of participants reported no changes in device operation. Telephone and mobile phone use remained the most accessible technology, with 67.9% of participants reporting no difficulties in operation. However, more complex digital devices presented greater challenges - only 52.9% maintained full computer/digital device proficiency, while 13.6% had become completely dependent on others for these tasks. Notably, television-related technologies (remote controls, video systems) showed intermediate difficulty levels, with 62.4% reporting unchanged abilities. Across all technologies, an average of 21.9% experienced mild difficulties and 7.8% showed moderate impairment.\u003c/p\u003e \u003cp\u003eThe assessment of sleep-related changes revealed significant alterations in sleep quality and patterns among participants. On average, less than half of respondents (46.8%) reported no changes in their sleep behaviours, indicating widespread sleep disturbances in this aging population. The most prevalent issues included difficulty initiating sleep (29.9% mild, 15.4% moderate changes) and nocturnal awakenings (29.9% mild, 20.4% moderate changes), with 10.9% and 8.1% of participants respectively experiencing severe difficulties in these domains.\u003c/p\u003e \u003cp\u003eThe assessment of memory function revealed significant concerns among participants, with less than half (40.7% on average) reporting no changes in memory abilities. Notably, forgetfulness emerged as the most prevalent issue, affecting 46.2% of participants mildly and 12.3% moderately, while 5% reported severe impairment. Day-to-day memory problems were similarly common, with 43% experiencing mild difficulties and 12.7% moderate challenges.\u003c/p\u003e \u003cp\u003eA striking pattern appeared in task-related memory, where only 15.8% maintained normal function, with 48.4% showing mild and 34.4% moderate impairment - the highest rate of moderate decline across all memory domains. Conversely, repetitive conversation (55.2% no change) and situational confusion (52% no change) were better preserved. Word-finding difficulties showed a bipolar distribution, with 45.2% unaffected but 43.4% reporting mild problems.\u003c/p\u003e \u003cp\u003eThe assessment of higher-level cognitive functions revealed relatively preserved abilities in most domains, with 55.7% of participants on average reporting no changes. Concrete thinking showed the highest preservation (62.9% unchanged), followed by decision-making capacity (52.5% unchanged). However, approximately one-third of participants (average 31.1%) experienced mild impairments, particularly in judgment (33.0%) and cognitive flexibility (32.6%). More severe difficulties were less common (average 6.2%), though 7.7% reported substantial judgment impairments.\u003c/p\u003e \u003cp\u003eEmotional regulation proved more vulnerable, with only 43.5% maintaining stable function. Irritability was particularly prevalent, affecting 50.2% mildly and 24.4% moderately. Mood fluctuations (30.8% mild, 12.7% moderate) and anxiety (27.6% mild, 11.3% moderate) were also common. In contrast, behavioural changes were least pronounced, with 71.1% reporting no alterations. Social comportment remained largely intact (77.8% unchanged), though 28.5% experienced mild visual disturbances and 24.4% reported appetite changes.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Correlation between AD8 and HBA-FAQ\u003c/h2\u003e \u003cp\u003eNonparametric correlation analysis revealed significant positive associations between AD8 scores and all functional domains measured by the HBA-FAQ (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The strongest correlations emerged with higher-level thinking skills (r\u0026thinsp;=\u0026thinsp;0.578, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and memory (r\u0026thinsp;=\u0026thinsp;0.559, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), demonstrating that cognitive decline most substantially impacts these core executive functions. Moderate correlations were observed for instrumental activities of daily living, including household task management (r\u0026thinsp;=\u0026thinsp;0.488, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), self-care (r\u0026thinsp;=\u0026thinsp;0.437, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and technology use (r\u0026thinsp;=\u0026thinsp;0.433, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Behavioural changes also showed moderate association with cognitive impairment (r\u0026thinsp;=\u0026thinsp;0.426, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). These findings suggest that cognitive difficulties substantially affect both practical daily functioning and behavioural adaptation.\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\u003eNon-parametric Correlation between AD8 Total and HBA-FAQ\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\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=\"left\" 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=\"left\" 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 \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eSelf-care\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eFinancial affairs\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eSocial and work functioning\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eHousehold tasks\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eEveryday Technology\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003esleep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eMemory\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003eHigher-level thinking skills\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eEmotion regulation\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003eBehaviour change\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\u003eAD8 Total\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.437\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.391\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.315\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.488\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.445\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.559\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.578\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.426\u003c/p\u003e \u003cp\u003e(\u003cem\u003ep\u0026thinsp;=\u003c/em\u003e\u0026thinsp;0.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Relationship between demographic factors and HBA-FAQ\u003c/h2\u003e \u003cp\u003eThe analysis revealed significant associations between demographic characteristics and functional abilities across all HBA-FAQ domains (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Age emerged as a consistent predictor, with participants aged\u0026thinsp;\u0026ge;\u0026thinsp;70 showing significantly greater functional difficulties than younger counterparts (\u0026lt;\u0026thinsp;70 years) in financial affairs (t=-3.659, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), social/work functioning (t=-3.615, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), household tasks (t=-4.356, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and higher-level thinking skills (t=-3.282, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationship between demographic factors and HBA-FAQ\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"16\"\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=\"left\" 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=\"left\" 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=\"left\" 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 \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables (Group)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e\u003cem\u003eSelf-care\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e\u003cem\u003eFinancial affairs\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e\u003cem\u003eSocial and work functioning\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e \u003cp\u003e\u003cem\u003eHousehold tasks\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c16\" namest=\"c14\"\u003e \u003cp\u003e\u003cem\u003eEveryday Technology\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eMean(SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eMean(SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eMean(SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003eMean(SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cem\u003eMean(SD)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-4.356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.65\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\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 \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.318\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.751\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.686\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.667\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.506\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-1.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.552\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.79\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.56\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.54\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\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 \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.422\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.605\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.958\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-Tertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst language\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-7.244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-9.557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-12.336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-11.918\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-6.378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLanguage at home\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-7.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003cp\u003e9.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003cp\u003e12.506\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-12.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-6.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.30\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic diseases diagnosed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.757\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychological(mental) disorders diagnosed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5.354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.58\u0026thinsp;\u0026plusmn;\u0026thinsp;1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.48\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.57\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\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 \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"16\"\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=\"left\" 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=\"left\" 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=\"left\" 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 \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables (Group)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003esleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003e\u003cem\u003eHigher-level thinking skills\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e \u003cp\u003e\u003cem\u003eEmotion regulation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c16\" namest=\"c14\"\u003e \u003cp\u003e\u003cem\u003eBehaviour change\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-1.943\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-3.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-2.591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-2.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.050\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.40\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\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 \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.994\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.893\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.71\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.34\u0026thinsp;\u0026plusmn;\u0026thinsp;045\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 \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.796\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e1.739\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon Tertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.84\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003etertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFirst language\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-4.638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-1.599\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-6.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-9.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-4.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.26\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.10\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLanguage at home\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-4.550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-1.634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-6.166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-9.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-4.794\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMandarin or Cantonese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArabic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic diseases diagnosed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.618\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.708\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.487\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.87\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.72\u0026thinsp;\u0026plusmn;\u0026thinsp;0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.44\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychological (mental) disorders diagnosed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e2.682\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e4.373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e5.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e3.837\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c16\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74\u0026thinsp;\u0026plusmn;\u0026thinsp;0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.44\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\u003eEducational attainment demonstrated substantial effects, with non-tertiary educated individuals scoring significantly worse across multiple domains including self-care (t\u0026thinsp;=\u0026thinsp;2.520, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), household tasks (t\u0026thinsp;=\u0026thinsp;2.958, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and emotion regulation (t\u0026thinsp;=\u0026thinsp;2.796, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Language background showed particularly strong associations, with Arabic speakers displaying markedly greater impairment than Mandarin/Cantonese speakers in household tasks (t=-11.918, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), social functioning (t=-12.336, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and emotion regulation (t=-9.858, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eThe analysis revealed significant associations between language background (both first language and language spoken at home) and functional abilities across multiple HBA-FAQ domains. Arabic-speaking participants demonstrated substantially greater functional difficulties compared to Mandarin/Cantonese speakers, with particularly strong effects observed in household tasks (t = -11.92 to -12.09, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), social and work functioning (t = -12.34 to -12.51, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and emotion regulation (t = -9.86 to -9.93, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The language effects were remarkably consistent whether measured by first language or primary home language, reinforcing the robustness of these findings. However, not all domains showed equal sensitivity to language differences - while instrumental activities like financial management (t = -9.56 to -9.69, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and technology use (t = -6.38 to -6.51, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were strongly associated with language background, memory performance showed no significant language-based differences (t = -1.59 to -1.63, p\u0026thinsp;\u0026gt;\u0026thinsp;0.10).\u003c/p\u003e \u003cp\u003eHealth status variables were strongly predictive of functional outcomes. Chronic disease diagnosis was associated with significantly worse functioning across all domains (all p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), most notably in household tasks (t\u0026thinsp;=\u0026thinsp;4.337, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, participants diagnosed with psychological disorders report more difficulties in all functional areas than those who have not been diagnosed with psychological disorders. Psychological disorders showed particularly strong associations with memory (t\u0026thinsp;=\u0026thinsp;4.373, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and higher-level thinking skills (t\u0026thinsp;=\u0026thinsp;5.094, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003c/div\u003e"},{"header":"4.Discussion","content":"\u003cp\u003eThis study investigated cognitive impairment and functional ability among culturally and linguistically diverse (CALD) older adults in community settings. Using the AD8 screening tool and the Healthy Brain Ageing Functional Assessment Questionnaire (HBA-FAQ), our findings reveal a substantial burden of cognitive and functional decline, as well as the influence of key demographic and health-related factors.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Cognitive Impairment\u003c/h2\u003e \u003cp\u003eThis study revealed a high prevalence of probable cognitive impairment (53.9% scoring\u0026thinsp;\u0026ge;\u0026thinsp;2 on the AD8) among culturally and linguistically diverse (CALD) older adults in Sydney, Australia. The most commonly reported difficulties included trouble learning new technologies, managing complex finances, memory lapses, and impaired judgment. This prevalence is notably higher than findings from Khanna \u0026amp; Metgud\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e, who reported an 8.4% cognitive impairment rate in community-dwelling older adults in an urban area of Belagavi, suggesting that CALD populations may face unique risk factors, such as language barriers, limited healthcare access, or cultural differences in symptom reporting. The AD8\u0026rsquo;s sensitivity in detecting early cognitive changes aligns with prior validation studies\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e, reinforcing its utility in diverse settings. The high rate of cognitive concerns observed in this study highlights the need for proactive cognitive screening and culturally appropriate interventions in diverse aging populations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Functional Decline\u003c/h2\u003e \u003cp\u003eFunctional decline was most pronounced in memory, emotional regulation, and sleep, with moderate to strong correlations between cognitive impairment (AD8) and functional difficulties (HBA-FAQ). Higher-level thinking (*r* = 0.578) and memory (*r* = 0.559) showed the strongest associations, consistent with research linking executive dysfunction to instrumental activities of daily living (IADLs)\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Challenges in technology use and financial management mirrored findings by Lindqvist\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e, highlighting how cognitive decline disrupts complex tasks. Sleep disturbances and emotional dysregulation were also prevalent, underscoring the bidirectional relationship between cognitive and mental health in aging\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. Our study found that behavioral changes were also associated with cognitive impairment. Consistent with this, previous research by Desmarais\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e and Wahlund\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e has demonstrated that cognitive impairment is closely linked to behavioral disturbances, including inappropriate social behavior, visual experiences, and reduced empathy.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Demographic Influences\u003c/h2\u003e \u003cp\u003eKey demographic factors significantly predicted functional outcomes:\u003c/p\u003e \u003cp\u003eAge emerged as a significant predictor of functional decline, with participants aged\u0026thinsp;\u0026ge;\u0026thinsp;70 years demonstrating greater difficulties in financial management, social functioning, and higher-level thinking compared to their younger counterparts. These findings align with established literature on age-related cognitive slowing\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e and impairments in instrumental activities of daily living (IADLs) that demand executive function, such as multitasking and decision-making\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e .\u003c/p\u003e \u003cp\u003eEducation and language background were key determinants of functional ability in this CALD cohort. Participants without tertiary education showed greater difficulties in self-care and emotional regulation, likely due to fewer psychosocial resources and limited health literacy \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e. Arabic-speaking adults faced pronounced challenges in household tasks, social functioning, and emotional regulation compared to Mandarin/Cantonese speakers. These disparities may stem from language barriers\u0026mdash;limiting healthcare access and community engagement\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e\u0026mdash;and migration-related stressors, such as trauma histories and disrupted support networks\u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e. Culturally adapted interventions, including multilingual services and tailored health materials, are critical to address these inequities\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHealth Status significantly predicted functional outcomes, with chronic diseases and psychological disorders associated with global functional decline. Participants with chronic conditions showed pronounced limitations in household tasks (e.g., cleaning, cooking), likely due to symptom burden and reduced physical capacity\u003csup\u003e\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. Psychological disorders were particularly linked to memory and executive function impairments. These findings align with evidence that multimorbidity accelerates functional disability by compounding physical and cognitive demands\u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur findings present both convergences and divergences with existing literature. While the observed prevalence of cognitive impairment (53.9%) exceeds rates reported in general population studies, it aligns with emerging research highlighting underdiagnosis and cultural barriers in CALD populations\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. The robust correlation between AD8 and HBA-FAQ scores substantiates established models of cognitive-functional interdependence\u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e, while our identification of sleep and emotional regulation as key vulnerable domains expands current understanding of neurobiological aging processes\u003csup\u003e\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. The marked disparities between Arabic and Mandarin/Cantonese speakers reinforce the critical need for linguistically and culturally adapted healthcare approaches\u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e. These findings collectively underscore the necessity of developing targeted, culturally sensitive screening and intervention strategies to address the unique needs of aging CALD communities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Implications for Practice and Policy\u003c/h2\u003e \u003cp\u003eThe findings underscore the need for culturally sensitive interventions in clinical practice and policy development. Implementing tailored programs such as multilingual cognitive screenings and community-based memory workshops could effectively address linguistic and cultural barriers to care. For early detection and intervention, health systems should incorporate brief assessment tools like the AD8 and HBA-FAQ into routine health evaluations for CALD populations, while simultaneously training community health workers to identify early signs of cognitive and functional decline. These approaches would facilitate timely referrals and support the development of appropriate, targeted interventions for at-risk individuals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e4.5 Strengths and Limitations\u003c/h2\u003e \u003cp\u003eThis study has several notable strengths, including its large, linguistically diverse sample of CALD older adults\u0026mdash;a population often underrepresented in aging research. The use of validated, culturally adapted measures (AD8 and HBA-FAQ) enhances the reliability of cognitive and functional assessments across different language groups. Additionally, the comprehensive evaluation of multiple functional domains provides a nuanced understanding of daily challenges faced by this population.\u003c/p\u003e \u003cp\u003eHowever, several limitations should be acknowledged. The cross-sectional design precludes causal inferences about the relationships between cognitive impairment, functional decline, and demographic factors. Selection bias may exist, as community-dwelling participants likely represent a healthier subgroup compared to institutionalized or severely impaired individuals who were excluded. The reliance on self-reported measures, while valuable for capturing subjective experiences, may introduce recall bias. Furthermore, the study did not account for potential confounding variables such as duration of residence in Australia or acculturation levels, which could influence functional outcomes.\u003c/p\u003e \u003cp\u003eFuture research should employ longitudinal designs to establish temporal relationships and causal pathways. Including clinical diagnoses of cognitive impairment and incorporating objective functional assessments would strengthen the findings. Investigations into the role of acculturation, social support, and healthcare access could further elucidate the complex interplay between cultural factors and functional health in aging CALD populations.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study highlights the substantial burden of cognitive impairment (53.9% prevalence) and functional decline among culturally and linguistically diverse (CALD) older adults, with particular vulnerabilities in memory, emotional regulation, and higher-level thinking. Key demographic factors - including advanced age (\u0026ge;\u0026thinsp;70 years), lower education levels, Arabic language background, and chronic health conditions which were strongly associated with poorer functional outcomes. The robust correlation between cognitive impairment (AD8) and functional decline (HBA-FAQ) underscores their interconnected nature in the aging process. These findings have important implications for policy and practice. There is an urgent need to implement culturally sensitive screening programs that utilise brief, validated tools like the AD8 and HBA-FAQ in CALD communities. Healthcare systems must prioritise linguistically appropriate interventions, including multilingual cognitive assessments and community-based support services tailored to specific cultural needs. Future research should employ longitudinal designs to better understand causal pathways while incorporating both subjective and objective measures of cognitive and functional health. This study provides compelling evidence for the development of targeted strategies to support healthy aging in CALD populations, ultimately working towards health equity for all older adults regardless of cultural or linguistic background.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eWPY and HCC is responsible for the conceptual research, YC and WPY jointly analyse and interpret the data. The first draft is completed by HCC, YC，and SS, the manuscript is reviewed and edited by all authors, and the final reviewed and edited by WPY and HCC. All authors thoroughly reviewed and gave their consent to the final version of the manuscript. The statistical expert of this study is WPY.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe sincerely thank the Chinese Australian Services Society (CASS) and Arabic Council Australia (ACA) for their essential support in participant recruitment and data collection. Their staff provided invaluable assistance with survey administration and cultural liaison, enabling successful engagement with Mandarin/Cantonese and Arabic-speaking communities. This research would not have been possible without their partnership.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eDue to ethical and privacy restrictions, the data collected in partnership with community organisations are not publicly available. De-identified data may be provided upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKannan Navaneetham, Arunachalam D. Global Population Aging, 1950\u0026ndash;2050. 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Neurosci Biobehavioral Reviews. 2017;79:66\u0026ndash;86. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.neubiorev.2017.04.030\u003c/span\u003e\u003cspan address=\"10.1016/j.neubiorev.2017.04.030\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":true,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"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":"journal-of-immigrant-and-minority-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"joih","sideBox":"Learn more about [Journal of Immigrant and Minority Health](http://link.springer.com/journal/10903)","snPcode":"10903","submissionUrl":"https://submission.springernature.com/new-submission/10903/3","title":"Journal of Immigrant and Minority Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Cognitive impairment, Functional changes, Older adults, Culturally and linguistically diverse community","lastPublishedDoi":"10.21203/rs.3.rs-8361682/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8361682/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003ePopulation aging is an inevitable phenomenon in the world that presents challenges for healthcare systems. Older adults from culturally and linguistically diverse (CALD) backgrounds experience many challenges that influence their access to healthcare services. Therefore, in this study, we aimed to evaluated functional changes and early cognitive impairment among culturally and linguistically diverse (CALD) older adults in Sydney, Australia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this cross-sectional study, data were collected from 221 community-dwelling adults (65+) at two organizations serving Mandarin/Cantonese and Arabic speakers, using the Healthy Brain Ageing Functional Assessment Questionnaire (HBA-FAQ) and the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe study included participants with a mean age of 75.31 years, predominantly Mandarin/Cantonese-speaking (67%) or Arabic-speaking (29%). A majority (67.4%) reported having chronic conditions. On the AD-8 screening tool, 53.9% of participants scored\u0026thinsp;\u0026ge;\u0026thinsp;2, a result indicating possible cognitive concerns. Functional decline was most pronounced in memory, emotional regulation and sleep. The AD8 Total score showed significant positive correlations with all HBA-FAQ domains (r\u0026thinsp;=\u0026thinsp;0.315\u0026ndash;0.578, all p\u0026thinsp;=\u0026thinsp;0.001), with the strongest associations observed for higher-level thinking skills and memory. Key demographic factors, including older age (\u0026ge;\u0026thinsp;70), lower education, and Arabic language background, were associated with poorer functional outcomes. Chronic diseases and psychological disorders were associated with worse functional outcomes across all measures.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe study highlights the need for culturally sensitive interventions to address cognitive decline, manage chronic conditions, and promote functional well-being in diverse aging populations.\u003c/p\u003e","manuscriptTitle":"Linking Cognitive Status to Healthy Brain Ageing Functional Trajectories in a Multicultural Aging Population: A Cross-Sectional Community-Based Study ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-19 11:02:44","doi":"10.21203/rs.3.rs-8361682/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-02-04T22:57:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"210194569044340052173028045088202016651","date":"2026-01-05T10:50:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-03T09:45:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-17T11:05:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-17T11:05:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Immigrant and Minority Health","date":"2025-12-15T04:11:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-immigrant-and-minority-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"joih","sideBox":"Learn more about [Journal of Immigrant and Minority Health](http://link.springer.com/journal/10903)","snPcode":"10903","submissionUrl":"https://submission.springernature.com/new-submission/10903/3","title":"Journal of Immigrant and Minority Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"b49b9d7f-5801-49de-982f-3481b4a7dfc6","owner":[],"postedDate":"March 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-19T11:02:44+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-19 11:02:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8361682","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8361682","identity":"rs-8361682","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}