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.

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.

No abstract

ABSTRAKPendahuluan. Jatuh merupakan masalah kesehatan yang umum dijumpai pada kelompok lanjut usia karena menyebabkan gangguan fisik dan psikis, bahkan kematian. Timed up and go test (TUG) merupakan metode skrining yang umum digunakan dalam praktik medis sebagai pemeriksaan dasar untuk menilai mobilitas, keseimbangan, dan risiko jatuh. Tujuan penelitian ini untuk menentukan hubungan riwayat jatuh dan TUG pada pasien geriatri di Rumah Sakit Umum daerah (RSUD) Dr.Soetomo Surabaya, Indonesia.Metode. Penelitian ini menggunakan desain deskriptif analitik cross-sectional dengan pendekatan observasional retrospektif.Subjek adalah pasien geriatri di RSUD Dr. Soetomo dengan kriteria usia ≥ 60 tahun, nilai mini mental state examination (MMSE) ≥ 17, tidak menderita stroke hemiplegia, dan tidak menggunakan alat bantu berjalan. Subjek dengan kriteria tersebut dilakukan wawancara untuk mengetahui riwayat jatuh 12 bulan terakhir, tingkat pendidikan, dan komorbiditas. Selanjutnya dilakukan penilaian MMSE, pengukuran IMT (indeks massa tubuh), dan penilaian TUG. Analisis statistika dilakukan menggunakan uji Fisher exact test.Hasil. Sebanyak 73 subjek ikut serta pada penelitian ini yang 56,16% di antaranya adalah perempuan. Dari 73 subjek, sebanyak 18 subjek memiliki riwayat jatuh dan 72,22% di antaranya adalah perempuan. Hasil uji Fisher menunjukkan adanya hubungan yang signifikan antara riwayat jatuh dan TUG dengan nilai p = 0,048 dan koefisien kontingensi 0,305.Simpulan. Terdapat hubungan yang lemah antara riwayat jatuh dan TUG pada pasien geriatri di RSUD Dr.Soetomo Surabaya. Penelitian selanjutnya perlu menambah dan memilih sampel dengan sebaran karakteristik merata agar hasil yang didapat bisa merepresentasikan keseluruhan populasi lanjut usia di RSUD Dr. Soetomo Surabaya. ABSTRACTIntroduction. Fall is the global major problem in geriatrics as it causes physical and physicological impairment, even leads to mortality. Timed up and go test (TUG) is the screening method which commonly used in medical practice as standard examination to assess mobility, balance, and fall risk.This study aimed to determine the correlation between TUG and history of falls in geriatric patients at General Hospital Dr. Soetomo Surabaya, Indonesia. Methods.A cross-sectional study was conducted among geriatric patients in Dr. Soetomo hospital with criteria ≥ 60 years old, mini mental state examination (MMSE) score ≥ 17, did not suffer from hemiplegic stroke, and did not use walking aids. Subjects with these criteria were interviewed to know the fall history from the past 12 months, level of education, and comorbidity. Then the subjects carried out MMSE assessment, BMI (body mass index) measurement, and TUG assessment. Statistical analysis was done with Fisher exact test.. Results.A total of 73 subjects participated in this study of which 56.16% were women. Among 73 subjects, 18 subjects had a history of falls and 72.22% of them were women. The Fisher test results showed a significant relationship between history of falls and TUG with p value= 0.048 and...

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.