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.

Pendahuluan. Jatuh merupakan salah satu masalah fisik yang sering terjadi dan mengakibatkan morbiditas serta mortalitas pada usia lanjut. Terdapat berbagai faktor risiko jatuh diantaranya adalah usia dan kemandirian dalam aktivitas seharihari. Metode. Penelitian inimerupakan studi observasional analitik dengan pendekatan cross sectional, yaitu dengan mengumpulkan data variabel bebas (usia dan aktivitas sehari-hari) melalui wawancara dan skor Indeks Barthel, variabel terikat (risiko jatuh) dengan cara observasi langsung mengunakan uji Timed Up and Go yang dianalisis dengan uji korelasi Rank Spearman. Jumlah sampel dengan teknik insidental sampling sebanyak 55 orang pasien Instalasi Rawat Jalan Geriatri RSUD Dr Soetomo Surabaya periode Agustus-Oktober 2017. Hasil. Hasil analisis bivariat menunjukkan bahwa ada hubungan antara usia dengan risiko jatuh (r = 0,334, p < 0,05) dan ada hubungan antara aktivitas sehari-hari dengan risiko jatuh (r =-0,460, p < 0,05) pasien Instalasi Rawat Jalan Geriatri RSUD Dr Soetomo Surabaya periode Agustus-Oktober 2017. Simpulan. Terdapat hubungan signifikan yang rendah dan searah antara usia dengan risiko jatuh serta terdapat hubungan signifikan yang sedang dan tidak searah antara aktivitas sehari-hari dengan risiko jatuh pada pasien Instalasi Rawat Jalan Geriatri RSUD Dr. Soetomo Surabaya periode Agustus sampai Oktober 2017.

Background: Sarcopenia is a decrease in muscle mass and strength that mostly happens in the elderly. Sarcopenia is a problem that is often found in the elderly who are at risk of disability, hospitalization and death. This data on muscle mass and strength with physical performance is expected to support the theory of sarcopenia and as a reference in promoting and preventing sarcopenia in elderly.Aims: To analyze the association between muscle mass and strength (handgrip strength) with physical performance assessed using Short Physical Performance Battery (SPPB) in an elderly community.Methods: This study was a cross-sectional observational analytic study involving 203 sample of elderly (age >60 years old). The subjects were categorized as the strong and weak muscle mass and muscle strength, also the high, moderate and low physical performance. We used Bioimpedance Analysis (BIA) and hand dynamometer to measure muscle mass and muscle strength (handgrip strength). SPPB was used to assess physical performance.The association between muscle mass and strength with physical performance was displayed in bivariate analysis with chi square.Result: Of all 203 subjects, 57 were males and 146 were females. Chi square test showed association between muscle strength (handgrip strength) with physical performance (SPPB) (p=0.001), with a weak correlation (r=0.26) and no association between muscle mass and physical performance (SPPB) (p=0.517).Conclusion: There is a positive association between muscle strength with physical performance, with a weak correlation and no association between muscle mass and physical performance in the elderly community in Surabaya.

Sarcopenia is common in hemodialysis patients, especially in the elderly patients undergoing hemodialysis. Various factors may contribute to the occurrence of sarcopenia, such as anabolic and catabolic imbalance. This study aims to investigate the correlation of insulin-like growth factor-1 (IGF-1) levels as an anabolic factor, myostatin levels, and insulin resistance as catabolic factors with sarcopenia in the pathogenesis of sarcopenia in elderly patients undergoing hemodialysis. A total of 40 subjects aged 60 years or more who undergoing hemodialysis in Dr. Soetomo Hospital Surabaya were included in this cross-sectional study. Sarcopenia was diagnosed according to Asian Working Group Sarcopenia 2019 criteria. IGF-1, myostatin, and insulin resistance levels were measured once before hemodialysis. Subjects with sarcopenia diagnosis were 33 (82.5%), that is, 19 (47.5%) men and 14 (35%) women. There were 28 (70%) of the subjects diagnosed with severe sarcopenia. Furthermore, there were significant differences in the characteristics and geriatric parameters between the sarcopenia and nonsarcopenia groups. There were differences between the two groups in hemoglobin levels, IGF-1 levels, myostatin levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, muscle mass, handgrip strength, body mass index status, mini nutritional assessment status, and physical activity scale for elderly status (all p  < 0.05). Correlation analyses showed that IGF-1 levels negatively correlated with sarcopenia status in elderly patients undergoing hemodialysis ( p  < 0.05). On the contrary, myostatin and HOMA-IR levels were positively correlated with sarcopenia status in elderly patients undergoing hemodialysis (all p  < 0.05). Based on this recent study, IGF-1, myostatin, and insulin resistance were significantly correlated with sarcopenia in elderly patients undergoing hemodialysis.

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Pendahuluan. Kalsidiol adalah metabolit vitamin D yang digunakan untuk menentukan status vitamin D. Kalsidiol adalah bentuk utama yang ada di sirkulasi dengan half life 2 hingga 3 minggu. Sarkopenia merupakan sindrom geriatrik baru terkait dengan mortalitas dan peningkatan beban biaya kesehatan pada usia lanjut (usila). Di Indonesia, belum didapatkan data penelitian tentang hubungan kadar serum kalsidiol dengan derajat keparahan sarkopenia. Tujuan dari penelitian ini adalah untuk menganalisis hubungan antara defisiensi kalsidiol serum dengan derajat sarkopenia pada komunitas usia lanjut di Surabaya.Metode. Penelitian komunitas ini bersifat analitik observasional menggunakan rancangan cross-sectional. Subjek penelitian adalah usila yang hadir ke salah satu dari lima posyandu terpilih selama Maret -April 2019 yang memenuhi kriteria inklusi dan eksklusi. Sarkopenia didiagnosis menggunakan pengukuran massa otot dievaluasi menggunakan bio-impedance analysis (BIA), kekuatan genggaman tangan diukur dengan handgrip dynamometer, dan performa fisik dinilai dari gait speed. Kadar serum kalsidiol diukur menggunakan electrochemiluminescence immunoassay (ECLIA). Uji komparasi dilakukan menggunakan uji chi square dengan penggabungan sel antara kelompok sufisiensi dan insufisiensi.Hasil. Dari 104 subjek, didominasi usila perempuan sebanyak 52,9%. Median usia subjek adalah 66,4 (60-82) tahun. Dari 104 subjek, 53 orang diantaranya merupakan kelompok sarkopenia (19 orang dengan sarkopenia berat), 22 orang presarkopenia, dan 29 orang normal (tidak sarkopenia). Jumlah subjek penelitian yang mengalami defisiensi kalsidiol serum sebanyak 55,8% dan yang tidak defisiensi sebanyak 44,2%. Hasil uji analisis menunjukkan adanya perbedaan kadar serum kalsidol yang signifikan pada berbagai derajat sarkopenia (p=0,03).Simpulan. Terdapat perbedaan yang signifikan antara kadar serum kalsidiol dengan derajat keparahan sarkopenia pada komunitas lansia.

Pendahuluan. Indonesia adalah negara tropis, namun prevalensi defisiensi vitamin D pada wanita usia lanjut masih cukup tinggi dikarenakan kurang terpapar sinar matahari dan asupan vitamin D yang rendah. Beberapa penelitian melaporkan bahwa subjek pedesaan memiliki kadar 25(OH)D serum lebih tinggi dibandingkan dengan subjek perkotaan. Penelitian ini bertujuan untuk menganalisis hubungan antara skor paparan matahari dan asupan vitamin D dengan kadar 25(OH)D serum pada wanita usia lanjut di komunitas pedesaan.Metode. Penelitian ini merupakan penelitian analitik cross-sectional yang melibatkan wanita usia lanjut di dua Desa di Kecamatan Wonorejo dan Kraton Kabupaten Pasuruan, pada Bulan Juni 2020 saat musim kemarau. Skor paparan matahari dihitung menggunakan kuesioner skor paparan matahari. Asupan vitamin D didapatkan dari food recall 2 x 24 jam. Kadar 25(OH)D serum diukur menggunakan chemiluminescent immuno assay. Analisis statistik menggunakan uji korelasi Spearman dan Pearson.Hasil. Sebanyak 40 subjek penelitian yang merupakan wanita berusia 60-93 tahun (median usia 70 tahun) diikutsertakan pada penelitian ini. Median skor paparan matahari adalah 14 dan median durasi terpapar matahari 40 menit. Sebanyak 90% subjek menggunakan kemeja lengan panjang dan rok panjang, dan seluruh subjek tidak pernah menggunakan tabir surya. Rerata asupan vitamin D subjek 1,73 μg/hari (simpang baku [SB] 3,21 μg/hari) dan seluruh subjek memiliki asupan vitamin D kurang. Sumber utama asupan vitamin D adalah ikan (67,5%), terutama ikan air tawar. Rerata kadar 25(OH)D serum subjek 27,75 ng/mL (SB 13,25 ng/mL), dengan 30% subjek mengalami defisiensi vitamin D. Skor paparan matahari berkorelasi positif dengan kadar 25(OH)D serum (r=0,425; p=0,006). Tidak didapatkan korelasi signifikan antara asupan vitamin D dengan kadar 25(OH)D serum (p= 0,246).Simpulan. Didapatkan hubungan positif yang bermakna antara skor paparan matahari dengan kadar 25(OH)D serum, namun tidak didapatkan hubungan yang bermakna antara asupan vitamin D dengan kadar 25(OH)D serum.

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