Background Information about frailty status and its transition is important to inform clinical decisions. Predicting frailty transition is beneficial for its prevention. While Indonesia is the 4th largest geriatric population in Asia, data about frailty transition is limited. This study aimed to obtain data on prevalence of frailty, its risk factors, frailty state transition and its prognostic factors, as well as to develop prognostic score for frailty state transition. Methods Multicenter study on subjects aged ≥60 years old was done to obtain the prevalence of frailty status and to identify risk factors of frailty. Prospective cohort over 12 months was done to obtain data on frailty state transition. Multiple logistic regression analysis was performed to identify its prognostic factors from several clinical data, which then were utilized to develop prognostic score for frailty state worsening. Results Cross-sectional data from 448 subjects showed that 25.2% of the subjects were frail based on Frailty index-40 items. Risk factors of frailty were age (OR 2.72; 95% CI 1.58–4.76), functional status (OR 2.89; 95% CI 1.79–4.67), and nutritional status (OR 3.75; 95% CI 2.29–6.13). Data from the 162 subjects who completed the cohort showed 27.2% of the cohort had frailty state worsening. Prognostic factors for frailty state worsening were being 70 years or older (OR 3.9; 95% CI 1.2–12.3, p < 0.05), negative QoL, i.e., fair and poor QoL (OR 2.5; 95% CI 1.1–5.9, p < 0.05), and slow gait speed (OR 2.8; 95% CI 1.3–6.4, p < 0.05). The internal validation of the prognostic score consisted of those three variables showed good performance. Conclusion The prevalence of frailty in this study among Indonesian elderly in outpatient setting was 25.2%. The risk factors of frailty were age, functional status and nutritional status. The prognostic factors for frailty state worsening were being 70 years old or older, negative QoL (fair or poor quality of life), and slow gait speed. A prognostic score to predict frailty state worsening in 12 months had been developed.

Background: National long-term care development requires updated epidemiological data related to frailty. We aimed to find the prevalence of frailty and its associated factors among Indonesian elderly.Methods: We conducted first-phase cross-sectional analysis of Indonesia Longitudinal Aging Study (INALAS) data collected from community-dwelling outpatients aged 60 years and older without acute illness in nine geriatric service care centres. Descriptive, bivariate and multivariate analyses were conducted.Results: Among 908 elderly in this study, 15.10% were robust, 66.20% were pre-frail, and 18.70% were frail. Functional dependence was associated with frailty among Indonesian elderly (OR 5.97, 95% CI 4.04–8.80). Being depressed and at risk for malnutrition were also associated with frailty with OR 2.54, 95% CI 1.56–4.12, and OR 2.56, 95% CI 1.68–3.90, respectively. Prior history of fall (OR 1.77, 95% CI 1.16–2.72) and hospitalization (OR 1.46, 95% CI 0.97–2.20) in the previous 12 months were associated with frailty. There is also significant association between poly pharmacy and frailty (OR 2.42, 95% CI 1.50–3.91).Conclusion: Approximately one in five Indonesian community-dwelling elderly was frail. Frailty is associated with functional dependence, being at risk for malnutrition or being malnourished, depression, history of fall, history of hospitalization, and poly pharmacy. There may be bidirectional relationships between the risk factors and frailty. The development of long-term care in Indonesia should be considered, without forcing the elderly who need it.

The elderly population will increase as well as increasing life expectancy. Health problems in elderly will be more complex and need a comprehensive management. One of the problems that arise from the aging process is sarcopenia. Sarcopenia is a decreasing in muscle mass and muscle strength or muscle function caused by multifactorial not only due to aging process, but also nutrition, immobilization, genetics and others risk factors. Muscle is an endogen organ that produces various proteins that can affect the health system. This protein is referred to as myokine. Myokine is anti-inflammation cytokine and peptide produced by striated muscles. Physical activity results in myokine secretion that can reduce inflammation due to a sedentary lifestyle. Inflammation can lead to worsening sarcopenia and fat accumulation in striated muscles, thus reducing muscle mass, muscle strength and causing physical inactivity. The most of this type myokine have antiinflammation effect have work as autocrine, paracrine and endocrine. Chronic inflammation is a contributor that plays a role in the pathophysiology of various diseases including sarcopenia, it will protected by myokine. Myokine can affect the metabolism of glucose, fatty acids, angiogenesis, myogenesis, neurogenesis, and can explain the relationship between muscle, liver, fat, tissue and brain. Some knewn myokines include interleukin (IL)-6, IL-8, IL-5, brain-derived neurotrophic factor (BDNF), fibroblast growth factor 21 (FGF-21), leukemia Inhibitory factor (LIF), irisin and secreted protein acidic and rich in cysteine (SPARC). Physical exercise can induce myokine secretion from striated muscle to circulation. Through these mechanisms, myokine is expected to improve metabolism of glucose, fat and protein muscle, liver, fat, tissue, brain and reduce the incidence some comorbidity especially sarcopenia. Finally, it's will be decreasing of disability, morbidity and mortality rate in elderly.Keywords: myokine, sarcopenia, elderly

Latar Belakang: Depresi adalah gangguan psikiatri yang paling sering ditemukan pada usia lanjut di seluruh dunia. Insiden depresi pada usia lanjut sering tidak terdeteksi dan bentuk depresi onset lambat sangat terkait dengan gangguan kognitif, risiko penyakit, kecacatan, dan kualitas hidup yang rendah. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara depresi, gangguan kognitif, dan kualitas hidup penduduk di Desa Pedawa, Singaraja. Metode: Penelitian ini merupakan penelitian potong-lintang yang dilakukan pada 13-14 Agustus 2016 dengan sampel sebanyak 117 orang. Penilaian depresi menggunakan kuesioner GDS-15, gangguan kognitif menggunakan kuesioner AMT, dan kualitas hidup dinilai menggunakan kuesioner EQ5D. Sampel diperoleh dengan menggunakan metode konsekutif sampling dan data dianalisis menggunakan SPSS versi 16.0. Hasil: Karakteristik sampel adalah 54 orang (46,2%) pria dan 63 orang (53,8%) adalah wanita. Prevalensi depresi didapatkan sebanyak 24 orang (20,5%) dan gangguan kognitif sebanyak 64 orang (54,7%). Sampel dengan kualitas hidup yang baik, sedang dan buruk masing-masing adalah 35 (29,9%), 66 (56,4%), dan 16 orang (13,7%). Hasil analisis bivariat didapatkan hubungan bermakna antara depresi dengan gangguan fungsi kognitif dan tingkat ekonomi (p < 0,05). Sedangkan hubungan antara depresi dan kualitas hidup diperoleh hasil yang tidak bermakna (p = 0,49). Simpulan: Didapatkan hubungan yang bermakna antara depresi dan gangguan kognitif dan tingkat ekonomi pada penduduk di Desa Pedawa, Kecamatan Singaraja, Bali

Salah satu risiko akibat hipertensi adalah gangguan kognitif meskipun ada risiko lain. Tujuan penelitian ini adalah untuk mengetahui korelasi hipertensi terhadap gangguan kognitif. Penelitian menggunakan analitik observasional dengan pendekatan cross sectional. Subyek dalam penelitian ini adalah 46 lansia di Panti Werdha Wana Seraya Denpasar. Data dikumpulkan melalui kuesioner MMSE dan pengukuran tekanan darah. Prevalensi hipertensi dan gangguan kognitif adalah 47% (22/46) dan 47% (22/46). Di antara 39% (18/46) individu yang mengalami hipertensi, gangguan kognitif ditemukan perbedaan yang signifikan (p=0,000). Ada korelasi yang signifikan antara gangguan kognitif dengan hipertensi jika gangguan kognitif sebagai variable dependen (r = 0,636; p = 0,001). Kesimpulan terdapat korelasi antara gangguan kognitif dan hipertensi. Hipertensi mempengaruhi fungsi kognitif.