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Latar Belakang: Gangguan kognitif merupakan salah satu masalah kesehatan lansia dan merupakan prediktor mayor kejadian demensia yang masih menjadi permasalahan kesehatan dan sosial. Penurunan fungsi intelektual merupakan masalah paling serius ketika proses penuaan yang akan mengakibatkan lansia sulit untuk hidup mandiri, dan meningkatkan risiko terjadinya demensia sehingga lansia akan mengalami gangguan perilaku dan penurunan kualitas hidup. Tujuan: Melihat faktor-faktor yang berhubungan dengan gangguan kognitif pada lansia di Panti Sosial Tresna Werdha Wana Seraya Denpasar, Bali. Metode: Studi ini menggunakan desain analitik potong lintang dengan metode pengambilan sampel adalah total sampling. Sebanyak 30 sampel terkumpul, dengan 10 sampel dengan fungsi kognitif normal dan 20 sampel memiliki gangguan kognitif. Sampel dilakukan wawancara untuk mengetahui karakteristik demografi. Variabel gangguan pendengaran dinilai dengan kuisioner Hearing  Handicap  Inventory  for  the  Elderly-Screening, Frailty diukur dengan menggunakan Fried Frailty Index, tingkat kemandirian dinilai dengan Activity Daily Living Barthel dan fungsi kognitif dengan kuisioner Montreal Cognitive Assessment Indonesia. Analisis data menggunakan SPSS 17 dengan uji fisher’s exact. Hasil: Sejumlah 30 sampel lansia yang berusia 61-94 tahun mengikuti studi ini dengan median usia 73,73 tahun. Sebanyak 20 sampel didapatkan ada gangguan kognitif dan 10 sampel memiliki fungsi kognitif normal. Skor MoCA-INA berkisar antara 11 – 27 dengan rata-rata skor 19. Dari berbagai variabel yang dianalisis, gangguan pendengaran(p=0,000), tingkat kemandirian (p=0,005), frailty (p=0,017) berhubungan dengan gangguan kognitif secara bermakna. Simpulan: Terdapat 20 orang (67%) mengalami gangguan kognitif. Gangguan pendengaran, frailty, tingkat kemandirian merupakan variabel yang berhubungan dengan gangguan kognitif pada studi ini.

Abstrak Latar belakang: Sarkopenia adalah sindrom yang ditandai dengan penurunan massa otot disertai penurunan kekuatan otot dan atau fungsi otot. Stres oksidatif dan proses inflamasi dikenal sebagai faktor pemicu untuk sarkopenia dengan melepaskan rangsangan katabolik interleukin-6 (IL-6) dan protein C-reaktif (CRP). Penelitian ini bertujuan untuk menentukan hubungan antara IL-6 dan kadar CRP terhadap parameter sarkopenia seperti massa otot, kekuatan pegangan, dan kecepatan berjalan. Metode: Penelitian ini menggunakan desain cross-sectional analitik yang dilakukan di Desa Pedawa, Kabupaten Buleleng, Bali pada bulan Agustus 2016. Sekitar 79 responden berusia ≥ 60 tahun menggunakan teknik sampling acak stratifikasi. Variabel yang dinilai yaitu parameter sarkopenia (massa otot, kekuatan pegangan, dan kecepatan berjalan) termasuk IMT, serta IL-6 dan pemeriksaan tingkat CRP. Uji korelasi spearman dan parsial digunakan untuk menilai korelasi antara parameter IL-6, CRP, dan sarkopenia. Hasil: Kadar IL-6 dan CRP tidak berkorelasi signifikan dengan tiga parameter sarkopenia. Kadar CRP berkorelasi dengan IL-6 (r = 0.37; p = 0.001) dan IMT (r = 0.29; p = 0.009). Pada kelompok pria, IL-6  hanya berkorelasi dengan CRP (r = 0.40; p = 0.011). Sedangkan pada kelompok wanita, IL-6 berkolerasi dengan CRP (r = 0.38; p = 0.017), kecepatan berjalan (r = 0.33; p = 0.037) serta CRP berkorelasi dengan IMT (r = 0.32; p = 0.049) dan massa otot total (r = -0.32; p = 0.043).  Setelah penyesuaian untuk variabel IMT, IL-6 berkorelasi dengan CRP (r = 0.43; p = 0,001) dan massa otot total (r = -0.25; p = 0.026) serta secara signifikan berkorelasi pada kelompok kurus (IMT<18.5 kg/m2) (r = -0.50; p = 0.026). CRP tidak berkorelasi secara signifikan dengan tiga parameter sarkopenia pada uji spearman, korelasi parsial, dan uji korelasi spesifik spearman berdasarkan pada kelompok IMT. Kesimpulan: Kadar IL-6 berhubungan dengan penurunan massa otot total pada keseluruhan lansia desa Pedawa setelah penyesuaian variabel IMT. Kata kunci: IL-6, Protein C-Reaktif (CRP), Sarkopenia, Lanjut usia, Desa Pedawa.   Abstract  Background: Sarcopenia is a syndrome characterized by decreased muscle mass with decreased muscle strength and or muscle function. Oxidative stress and inflammatory processes are known as triggering factors for sarcopenia by releasing catabolic stimuli of interleukin-6 (IL-6) and C-reactive protein (CRP).This study aims to determine the relationship between IL-6 and CRP levels to sarcopenia parameter such as muscle mass, grip strength, and walking speed. Methods: This study was an analytic cross-sectional design conducted at Pedawa Village, Buleleng District, Bali in August 2016. About 79 respondents aged ≥ 60 years using stratified random sampling technique. The assessed variables were sarcopenia parameter (muscle mass, grip strength, and walking speed) including BMI, as well as IL-6 and CRP levels examination. Spearman and partial correlation test were used to assess the correlation among IL-6, CRP, and sarcopenia parameters. Results: IL-6 levels and CRP were not significantly correlated with the three parameters of sarcopenia. CRP levels correlated with IL-6 (r = 0.37; p = 0.001) and BMI (r = 0.29; p = 0.009). In the male group, IL-6 was only correlated with CRP (r = 0.40; p = 0.011). While in the women group, IL-6 correlated with CRP (r = 0.38; p = 0.017), walking speed (r = 0.33; p = 0.037) and CRP correlated with BMI (r = 0.32; p = 0.049) and total muscle mass (r = -0.32; p = 0.043).  After adjustment to BMI variable, IL-6 was correlated with CRP (r = 0,43; p = 0,001) and total muscle mass (r = -0.25; p = 0.026) and significantly correlated in underweight groups (BMI<18.5 kg/m2) (r=-0.50; p=0.026). CRP was not significantly correlated with the three parameters of sarcopenia on Spearman, partial correlation, and Spearman's specific correlation test based on BMI group. Conclusion: IL-6 levels were associated with total muscle mass loss after BMI adjustmentin Pedawa village’s elderly as a whole. Keywords: IL-6, C-Reactive Protein (CRP), Sarcopenia, Elderly, Pedawa village.

Introduction The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms. Method This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy. Results This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not. Conclusion A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.