Latar Belakang : lnstabilitas postural I jatuh adalah ketidakmampuan untuk mempertahankan pusat kekuatan anti gravitasi pada dasar penyanggah tubuh (misalnya, kaki saat berdiri), atau memberi respon secara cepat pada setiap perpindahan posisi atan keadaan staffs. Prevalensi instabilitas postural di AS 30% dari penduduk usia lebih 60 tahun pernah jatuh, di RSCM tahun 2003 sebesar 23,3%. Faktor risiko yang melatar belakangi terjadinya jatuh adalah faktor ekstrinsik an faktor intrinsik. Faktor intrinsik terbagi dua sistemik (pneumonia, hipatensi ortostatik, hiponatremi, gagal jantung, infeksi saluran kemih) dan lokal (OA servikal, OA gem, Benign paroxiysmalpositional vertigo (BPPV), gangguan penglihatan, gangguan pendengaran, kelemahan otot tungkai bawah). Jatuh memiliki penyulit yang cukup serius, mulai dari cedera ringan sampai fraktur femur. Dengan mengetahui faktor risiko jatuh sedini mungkin, maka kita dapat mencegah terjadinya jatuh dan penyulitnya.Tujuan : mengetahui sebaran faktor intrinsik lokal serta hubungannya dengan instabilitas postural I jatuh.Metodologi : Studi potong lintang dengan basal-sampel 97 orang usia Lanjut yang memenuhi kriteria inklusi. Waktu : Januari-Juni 2005 di Divisi Geriatri RSCM. Tingkat instabilitas diukur dengan posturografri.Hasil : Dari penelitian ini didapat hasil prevalensi instabilitas postural sebesar 64.9%. Prevalensi perempuan 52,3% dan laki-laki 47,7%. Menurut kelompok umur prevalensi tertinggi pada umur > 80 taken sebesar 75,0%. Pada analisa bivariat osteoariritis servikal merupakan faktor intrinsik lokal yang mempunyai hubungan bermakna terhadap kejadian instabilitas postural dengan OR 3,28 (1K 95% 1,25-8,63) p= 0,02 dan pada analisa multivariat dengan inetode backward regresi logistitik didapatkan nilai OR 3,22 (1K 95% 1,18-89,74) p = 0,02. Gangguan pendengaran merupalcan faktor intrinsik lokal yang mernpunyai hubungan bermalma terhadap instabilitas postural pada analisa bivariat dengan nilai OR : 3,95 (1,29-12,11) p= 0,02 dan pads analisa multivariat dengan ailai OR 3,22 (1,18-89,74) pr= 0,02. Osteoartritis genii, BPPV, gangguan penglffiatan dan kelemaban otot tungkai bawah hell m dapat dibuktilcan mempunyai hubungan bermakna dengan instabilitas postural pada penelitian ini.Simpulan : Prevalensi instabilitas postural pada penelitian ini sebesar 64,9%. Ganggaan pendengaran dan OA servikal menrpakan faktor instrinsik lokal yang mempunyai hubungan yang bermakna terhadap instabilitas postural. OA genii, BPPV, gangguan penglihatan dan kelemahan otot tungkai bawah belum dapat dibuktikan mempunyai hubungan bermakna dengan instabilitas postural pada penelitian ini.

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Backgrounds : Instability/falls is inability to maintain central anti gravity strength of supporting structures of the body (e.g. feet while standing) or to give adequate response to positional changes or static condition Prevalence of postural instability in US reached > 30% in population aged > 60 years old A Study conducted in RSCM by Handayani (2003) found the prevalence as high as 23.3%. -Risk factors that responsible for falls are intrinsic and extrinsic factors. Intrinsic factors consist of systemic (pneumonia, orthostatic hypotension, hyponatresmia, heart failure, urinary tract infection) and local factors (cervical OA, knee OA, BPPV, visual impairment, hearing impairment, lower lambs weakness). Falls may have mild complication like mild trauma to serious complications such as femoral fracture. By identifying risk factors of instability/falls earlier, we may prevent falls and its complications.

Objective = to determine intrinsic local factors and its relationship with instability/falls.

Methods : Cross sectional study on 97 elderly patients who fullfled inclusion criteria was conducted in RSCM from January to June 2005 in outpatient clinic, Geriatric Division FKUI 1 RSCM.

Results : From this study we found the prevalence of instability was 64.9%. The prevalence in female (52.3%) was higher than male (47.7%) patience According to age group, the highest prevalence was found in age group of > 80 years (75%). After bivariat analysis, we found cervical OA was intrinsic local factor which bad significant relation with incidence of postural instability with OR 3.28 (CI 95% 1.25-8.63); Bivariat and multivariate analysis of logistic regression using backward method we found OR 3.22 (Cl 95% 1.18-89.74); p= 0.02. Hearing impairment was local intrinsic factor that had significant relation with postural instability after bivariat analysis with OR 3.95 (Cl 95% 1.29-12_ l 1); p= 0.02 and multivariate analysis with OR. 3.22 (Cl 95% 1.18$9.74); p= 0.02. BPPV, knee OA, visual impairment and lower limb weakness had not been proven yet to have significant relation with postural instability in this study.

Conclusion : Prevalence of instability in thus study is 64.9%. Hearing impairment and cervical OA were intrinsic local factors that showed statistically significant relation with postural instability. Knee OA, BPPV, visual impairment, and lower limb weakness had not been proven to have significant relation with instability in this study.