The Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, extends its warmest congratulations to Dr Ummi Ainaa binti Selamat on the successful completion of her Doctor of Public Health (DrPH) viva voce examination on 28 August 2026.
Her doctoral dissertation, entitled “Linking Adverse Childhood Experiences (ACEs) with Physical Frailty and Sarcopenia among Malaysian Older Adults: The Role of Protective Factors”, addresses an important and increasingly relevant public health question: how can experiences of adversity early in life continue to shape health and well-being decades later?
Understanding the Lifelong Impact of Childhood Adversity
Grounded in the Adverse Childhood Experiences (ACEs) Framework, Dr Ummi Ainaa’s research examines the long-term relationship between childhood adversity and health during older age, with particular attention to physical frailty and sarcopenia. The study also investigates whether protective factors, particularly resilience and social support, can help older adults navigate the lasting consequences of early-life adversity.
Using a mixed-methods approach, the quantitative component analysed secondary data from 1,928 Malaysian adults aged 60 years and above who participated in the Prevent Elder Abuse and negleCt initiativE (PEACE) project in Negeri Sembilan. This was complemented by in-depth interviews with 21 older adults with histories of ACEs, providing valuable insight into how adversity is experienced and understood across the life course.
The findings reveal the substantial burden of childhood adversity among Malaysian older adults. More than two-thirds (67.8%) of participants reported exposure to ACEs. Importantly, exposure to ACEs was associated with an increased likelihood of physical frailty, while its relationship with sarcopenia remained inconclusive.
The research also demonstrates that the relationship between adversity and later-life well-being is far from straightforward. ACE exposure was associated with a lower likelihood of resilience but, interestingly, with higher odds of good social support. The qualitative findings further illuminate this complexity, showing that individuals may develop different adaptive responses to adversity even when protective resources are present.
Together, these findings reinforce an important public health message: healthy ageing does not begin in old age. Experiences occurring during childhood may continue to influence physical, psychological and social well-being many decades later.
An Important Doctoral Achievement
Successfully completing a Doctor of Public Health viva voce represents a significant academic and professional milestone. Dr Ummi Ainaa’s work is particularly commendable for bringing together epidemiological evidence and the lived experiences of older Malaysians to examine health through a life-course perspective.
Her research moves beyond simply documenting the prevalence of ACEs. By examining frailty, sarcopenia, resilience and social support together, the thesis provides a more nuanced understanding of how childhood adversity may interact with protective resources and ageing processes.
The mixed-methods design further strengthens the work by placing statistical findings alongside the voices and experiences of older adults themselves. In doing so, the research reminds us that behind every epidemiological estimate is an individual life shaped by experiences, relationships, challenges and adaptations.
Contribution to Public Health
Dr Ummi Ainaa’s research has important implications for healthy ageing, trauma-informed healthcare and public health policy in Malaysia.
The high prevalence of ACEs identified among older adults demonstrates that childhood adversity should not be viewed solely as a childhood issue. Its potential consequences may extend across the life course and become relevant to healthcare, social support and healthy-ageing programmes many decades later.
Based on her findings, the thesis highlights three important directions for public health action: developing national mechanisms for ACE screening and surveillance; integrating trauma-informed care and person-centred approaches into health and social care systems; and strengthening community-based resources that foster resilience and social support.
These recommendations encourage public health practitioners and policymakers to consider ageing within a broader life-course framework. Prevention and early intervention during childhood remain essential, but healthcare and social systems must also recognise and respond sensitively to the enduring consequences of adversity among adults and older people.
Ultimately, this work contributes to a growing understanding that promoting healthy ageing requires attention not only to disease and disability in later life, but also to the social and psychological experiences accumulated throughout a person’s lifetime.
Acknowledgement
We wish to acknowledge the invaluable guidance and mentorship provided by Dr Ummi Ainaa binti Selamat’s supervisors, Professor Dr Noran Naqiah Mohd Hairi and Professor Dr Choo Wan Yuen, whose expertise and support were instrumental in the completion of her thesis.
We extend our sincere gratitude to Professor Dr Takeo Fujiwara, Director General, Institute of Future Science and Professor, Department of Public Health, Institute of Science Tokyo, Japan, the External Examiner, and Professor Dr Rafdzah Ahmad Zaki, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, the Internal Examiner.
We would also like to thank the Committee of Examiners for their thorough evaluation and insightful feedback, including Professor Dr Lai Siew Mei Pauline, the Chairperson of the viva voce session, and Dr Bala Murali a/l Sundram, Programme Coordinator, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya.
Our appreciation also goes to everyone who contributed, directly or indirectly, to Dr Ummi Ainaa’s doctoral journey and the successful completion of this important research.
Congratulations and Looking Ahead
Congratulations once again to Dr Ummi Ainaa binti Selamat on this outstanding achievement.
The successful completion of her DrPH viva voce marks both the culmination of an intensive doctoral journey and the beginning of another chapter as a public health professional and researcher. Her work provides an important foundation for further research and action addressing childhood adversity, trauma-informed care, resilience and healthy ageing in Malaysia.
We look forward to seeing Dr Ummi Ainaa translate the knowledge generated through her doctoral research into meaningful public health practice, policy and future scholarship.
Congratulations, Dr Ummi Ainaa, and best wishes for continued success in advancing public health and contributing towards healthier and more resilient communities.
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