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"ABSTRAKLatar Belakang: Kuesioner Identification of Senior at Risk ISAR merupakan instrumen penapis terbaik untuk stratifikasi risiko mortalitas pasien usia lanjut di IGD namun performanya belum cukup memuaskan sehingga perlu dilakukan modifikasi untuk meningkatkan kemampuan prediksinya. Delirium merupakan prediktor kuat kematian pasien usia lanjut di RSCM sehingga potensial ditambahkan untuk melakukan modifikasi ISAR. Tujuan: Menilai performa kuesioner ISAR dalam memprediksi mortalitas 30 hari pasien usia lanjut di IGD dan performa modifikasinya dengan penambahan variabel delirium Metode: Penelitian kohort prospektif berbasis penelitian prognostik pada pasien usia lanjut yang datang ke IGD RS Cipto Mangunkusumo selama September-Oktober 2016. Enam pertanyaan pada kuesioner ISAR dan 1 pertanyaan tentang delirium ditanyakan kepada pasien atau informan saat pasien tiba di triage IGD. Pasien kemudian diikuti 30 hari untuk dinilai luaran mortalitasnya. Performa ISAR dan modifikasinya dinilai melalui kemampuan kalibrasi uji Hosmer Lemeshow , diskriminasi area under ROC curve, ROC serta Nilai Duga Positif dan Nilai Duga Negatif. Hasil: Dari 306 subyek, didapatkan insidens mortalitas 30 hari sebesar 22,8 IK95 22,3-23,3 . Median usia subyek 68 tahun dengan 163 53,2 subyek laki-laki. Sebanyak 174 56,8 subyek memiliki skor ISAR lebih dari 2. Pasien yang datang dengan sindrom delirium sebanyak 26 subyek 8,4 . Kuesioner ISAR dengan titik potong 2 memiliki kalibrasi yang baik, AUC 0,59 IK95 0,56-0,62 , Nilai Duga Positif 0,26 IK95 0,21-0,35 , Nilai Duga Negatif 0,81 0,76-0,89 . Modifikasi kuesioner ISAR yang terdiri dari 3 pertanyaan saja ISAR-3 , berhasil meningkatkan AUC menjadi 0,67 IK95 0,62-0,72 dan Nilai Duga Negatif menjadi 0,87 IK95 0,84-0,89 . Simpulan: Kuesioner ISAR memiliki performa kalibrasi baik, diskriminasi kurang dan Nilai Duga Negatif baik. Modifikasi kuesioner ISAR dengan 3 pertanyaan ISAR-3 meningkatkan performa kalibrasi, diskriminasi dan Nilai Duga Negatif, sehingga dapat digunakan untuk mengidentifikasi pasien usia lanjut risiko rendah di IGD. Kata kunci: ISAR, modifikasi, delirium, usia lanjut, IGD

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ABSTRACT Background Among others, Identification of Senior at Risk ISAR questionnaire is the best screening instrument for mortality risk stratification of elderly visiting Emergency Department ED . Yet, current systematic review suggests modification to improve its predictive performance. As delirium is a strong predictor of mortality in elderly in Cipto Mangunkusumo Hospital, it becomes potential modification variable to add into ISAR. Objective To measure predictive validity of ISAR and ISAR Modification by adding delirium as a new variable to predict 30 days mortality Methods Prospective cohort study in elderly visiting ED of Cipto Mangunkusumo between September to October 2016. Calibration Hosmer Lemeshow test , discrimination AUC and predictive value of 30 days mortality were measured. Model updating was performed by bivariate and multivariate analysis of ISAR questions as variables. Result Of 306 subjects, 163 53,2 were men. 30 days mortality incidence was 22,8 95 CI 22,3 23,3 . Median age was 68 year and 174 56,8 subjects had ISAR score more than 2. Patients with delirium were 26 8,4 . ISAR , with cut off score of 2, shows good calibration, AUC 0,59 95 CI 0,56 0,62 , Positive Predictive Value PPV 0,26 IK95 0,21 0,35 , and Negative Predictive Value NPV 0,81 0,76 0,89 . Delirium as seventh question gives added value to original version of ISAR by increasing AUC to 0,61 0,58 0,64 and NPV to 0,84 0,76 0,89 . ISAR Modification, consists of 3 ISAR questions only, improves AUC to 0,67 IK95 0,62 0,72 and NPV to 0,87 IK95 0,84 0,89 . Internal validation using bootstrapping shows good calibration. Conclusion ISAR shows good calibration, poor to fair discrimination, and good NPV. Updating ISAR, by modify its questions, improves its discrimination performance and NPV, thus ISAR modification can be used to identify low risk elderly patients in ED. Key words ISAR, modification, elderly, ED "

"Latar belakang: Sebagian besar pasien kanker usia lanjut terdiagnosis pada stadium lanjut dengan peningkatan risiko mortalitas. Identifikasi faktor prediktor yang memengaruhi terjadinya mortalitas satu tahun diharapkan dapat membantu stratifikasi risiko dan menjadi pertimbangan perencanaan pelayanan kesehatan, edukasi, serta persiapan advanced care planning.Tujuan: Mengetahui faktor prediktor mortalitas satu tahun pada lansia dengan kanker padat metastasis dan mengembangkan model prediksi mortalitas satu tahun.Metode: Studi kohort retrospektif dengan menelusuri rekam medis pasien berusia ≥60 tahun dengan kanker padat metastasis berdasarkan pemeriksaan histopatologi atau radiologi yang berobat di poli onkologi RS Kanker Dharmais pada Januari 2020 hingga Desember 2021. Dilakukan analisis bivariat chi-square antara usia, jenis kelamin, ADL, ECOG-PS, jenis kanker, metastasis organ, jumlah metastasis, status nutrisi, komorbid, jumlah komorbid, polifarmasi, gangguan kognitif, gangguan mood, dan best supportive care dengan mortalitas satu tahun sesudah diagnosis kanker metastasis. Analisis multivariat dan model prediksi dilakukan dengan regresi logistik.Hasil: Terdapat 210 subjek dengan hasil analisis bivariat menunjukkan hubungan antara ECOG-PS, status nutrisi, dan pemberian best supportive care dengan mortalitas satu tahun (p<0,05). Hasil regresi logistik menunjukkan faktor prediktor independen mortalitas yaitu metastasis organ (OR 2,468 [IK 95%1,163-5,317]), status nutrisi (OR 1,943 [IK 95%1,048-3,604]), ECOG-PS (OR 2,302 [IK 95%1,241-4,271]), dan best supportive care (OR 3,157 [IK 95%1,288-7,738]). Model prediksi mortalitas satu tahun memiliki nilai AUC 0,705 (IK 95%95%: 0,629 – 0,781).Kesimpulan:Faktor prediktor independen terhadap mortalitas 1 tahun sesudah diagnosis metastasis yaitu metastasis organ, ECOG-PS, status nutrisi, dan best supportive care.

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Background: Identification of patients on their final year is important to help physicians to make personalized treatment plan according to life expectancy and to guide patients and families to prepare an advanced care planning.

Methods: We retrospectively included patients aged ≥60 years who had metastatic solid cancer and in whom geriatric assessment was performed in Dharmais National Cancer Center outpatient clinic. A total of 210 subjects were enrolled between January 2020 to December 2021. The primary analyses were performed from April to May 2023. Chi square analysis was performed between age, sex, ADL, ECOG-PS, type of cancer, visceral metastasis, number of metastatic sites, nutritional status, comorbidity, multimorbidity, polypharmacy, cognitive impairment, mood disorder, and best supportive care with one-year mortality. Variables with p value <0.25 were analysed further with logistic regression to develop a prediction model. The model’s discriminative ability was assessed with model’s area under the curve. Calibration was performed using bootstrap method.

Result: We collected 210 subjects, with median age, 66,5 years. Lung cancer was the most common malignancy (44.3%). Logistic regression results showed visceral metastasis (OR 2.468; 95% CI 1.163-5.317), nutritional status (OR 1.943; 95% CI 1.048-3.604), ECOG-PS (OR 2.302; 95% CI 1.241-4.271), and best supportive care (OR 3.157; 95% CI 1.288-7.738) were independent predictors of one year mortality. The one-year mortality prediction model has an AUC value of 0.705 (95% CI: 0.629-0.781).

Conclusion: Model developed from this study can assist clinicians to identify patients in their last year of life who need palliative care and to prepare an advance care planning. "

"Penduduk Muslim Indonesia adalah 87 dari total populasi, sehingga Indonesia menjadi salah satu negara yang menyumbangkan jumlah jemaah haji terbanyak di dunia. Hal ini menjadi tantangan tersendiri bagi pemerintah khususnya Puskeshaji, yaitu masalah kesehatan dan kematian jemaah. Angka kematian jemaah haji dalam 3 tahun terakhir mengalami peningkatan. Tujuan penelitian ini adalah mengetahui kondisi kesehatan jemaah sebelum berangkat menunaikan ibadah serta insiden dan penyebab kematiannya pada tahun 2015, 2016, dan 2017. Penelitian ini memiliki rancangan observasional deskriptif menggunakan desain Cross Sectional. Proporsi jemaah haji reguler lansia yang wafat menurun dari tahun 2015 0,40 ke 2016 0,22 dan meningkat pada tahun 2017 0,32 dengan didominasi kelompok usia >=65 tahun sebanyak 49,6 - 62,5. Tren penyebab utama kematian adalah penyakit kardiovaskular 42,4-52,9 dan penyakit saluran pernapasan 28,2-40,1. Terdapat 52,5-74,0 jemaah haji lansia yang wafat dengan status risiko tinggi MERAH, 35,6-83,3 melakukan vaksinasi meningitis meningokokkus, 18,3-53,4 melakukan vaksinasi influenza, dan hanya 0,6-3,1 yang melakukan vaksinasi pneumokokus. Diperlukan upaya dari pemerintah untuk menegaskan penerapan peraturan yang berlaku, sedangkan masyarakat perlu meningkatkan kesadaran akan pentingnya kondisi kesehatan prima untuk melaksanakan ibadah. Dengan demikian diharapkan angka kematian jemaah haji dapat ditekan.

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Indonesia 39s Muslim population constitutes 87 of the total population, which make it is being one of country that give largest number of pilgrims in the world. It becomes a challenge for the government, especially Puskeshaji, which are health problems and mortality of the pilgrims. The death rate of pilgrims in the last 3 years has increased.

The purpose of this study is to know the health condition of pilgrims before leaving for pilgrimage, incidents, and causes of death in 2015, 2016, and 2017. This research is a descriptive observational using Cross Sectional design. The proportion of regular elderly Hajj pilgrims declined from 2015 0.40 to 2016 0.22 and increased in 2017 0.32 with a predominantly 49,6 62,5 age group 65 years.

The main causes of death are cardiovascular disease 42,4-52,9 and respiratory disease 28,2 40,1. There were 52,5 74,0 of elderly pilgrims who died with high risk status of RED, 35,6-83,3 get meningococcal meningitis vaccination, 18,3-53,4 get influenza vaccination, and only 0,6-3,1 who get pneumococcal vaccination. It takes effort from the government to affirm the applicability of the prevailing regulations, while the public needs to raise awareness of the importance of excellent health conditions to perform pilgrimage. Thus it is expected that the mortality rate can be suppressed."

"Latar Belakang: Kematian pasien Penyakit Ginjal Kronik (PGK) pada usia dewasa yang menjalankan hemodialisis setelah tiga bulan adalah jarang. Namun, masih mungkin terjadi. Padahal layanan hemodialisis dibutuhkan seumur hidup.Tujuan: Mengetahui faktor – faktor risiko yang berhubungan dengan kematian pasien PGK usia dewasa yang menjalankan hemodialisis reguler.Metode: Kasus kontrol tanpa pencocokkan (matching) dengan perbandingan 1:2. Uji statistik yang digunakan adalah regresi logistik.Hasil: Faktor risiko yang berhubungan terhadap kematian adalah riwayat gagal jantung (OR = 2,3; IK 95% = 1,2 – 4,4; nilai p = 0,009), riwayat obstruksi pasca ginjal (OR = 3,5; IK 95% = 1,6 – 7,6; nilai p = 0,002), glukosa sewaktu ≥140 mg/dl (OR = 2,1; IK 95% = 1,2 – 3,6; nilai p = 0,011), Gangguan Ginjal Akut (GGA) (OR = 6,5; IK 95% = 3,8 – 11,1; nilai p = 0,000), dan Indeks Massa Tubuh (IMT) <18,5 kg/mm2 (OR = 3,0; IK 95% = 1,2 – 7,6; nilai p = 0,019).Kesimpulan: Faktor – faktor risiko yang berhubungan dengan kematian pasien PGK pada usia dewasa yang menjalankan hemodialisis reguler adalah riwayat gagal jantung, riwayat obstruksi pasca ginjal, glukosa sewaktu ≥140 mg/dl, GGA, dan IMT <18,5 kg/mm2

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Background: Mortality of Chronic Kidney Disease (CKD) patients in adults undergoing hemodialysis after three months is rare. However, it is still possible. Even though hemodialysis services are needed for life.

Objective: To determine the risk factors associated with the death of adult CKD patients undergoing regular hemodialysis.

Method: Unmatched control case with a ratio of 1:2. The statistical test used was logistic regression.

Results: Risk factors were history of heart failure (OR = 2.3; CI 95% = 1.2 – 4.4; p value = 0.009), history of obstruction post renal (OR = 3.5; CI 95% = 1.6 – 7.6; p value = 0.002), random glucose ≥140 mg/dl (OR = 2.1; CI 95% = 1.2 – 3.6; p value= 0.011), Acute Kidney Injury (AKI) (OR = 6.5; CI 95% = 3.8 – 11.1; p value = 0.000), and Body Mass Index <18.5 kg/mm2 (OR = 3.0; CI 95% = 1.2 – 7.6; p value = 0.019).

Conclusion: Risk factors associated with mortality in adult CKD patients undergoing regular hemodialysis are a history of heart failure, a history of post-renal obstruction, random glucose ≥140 mg/dl, AKI, and IMT <18.5 kg/mm2."

"Latar Belakang: Rapid Emergency Medicine Score (REMS) merupakan sistem skor yang sudah tervalidasi dengan baik dalam memprediksi mortalitas selama rawat untuk pasien non bedah yang mengunjungi instalasi gawat daruat (IGD). Namun penggunaanya pada populasi usia lanjut yang umumnya menunjukkan tanda vital normal walaupun kondisi medik berat masih belum diketahui. Kami bertujuan untuk mengevaluasi performa REMS dengan menambahkan nilai kadar natrium dan lingkar lengan atas yang rendah dalam memprediksi mortalitas di rumah sakit pada pasien usia lanjut non bedah yang datang ke IGD. Tujuan: Untuk mengetahui nilai tambah kadar natrium dan lingkar lengan atas pada skor REMS dalam memprediksi mortalitas di rumah sakit pada pasien usia lanjut non bedah yang datang ke IGD. Metode: Studi kohort prospektif dengan subjek penelitian pasien usia ³60 tahun, non bedah, yang datang ke IGD RS Cipto Mangunkusumo (RSCM) periode September- Oktober 2018. Subjek diikuti sampai diketahui luaran selama rawat di rumah sakit. Uji Hosmer-Lemeshow dan kurva ROC digunakan untuk mengetahui performa kalibrasi dan diskriminasi dari REMS dan modifikasi REMS. Hasil: Dari 272 subjek, median usia adalah 66 tahun (rentang 7). Insiden kematian selama rawat di rumah sakit sebesar 22,1%. Nilai Area Under Curve (AUC) untuk REMS adalah 0,72 (95% CI 0,56-0,74), dan modifikasi REMS dengan menambahkan kadar natrium dan lingkar lengan atas adalah 0,79, p=,000 (IK95% 0,72-0,85), dengan nilai performa kalibrasi menggunakan uji Hosmer-Lemeshow yaitu p=0,759. Simpulan: Kadar natrium dan lingkar lengan atas memiliki nilai tambah pada skor REMS dalam memprediksi mortalitas selama rawat di rumah sakit pada pasien usia lanjut non bedah yang datang ke IGD RSCM.

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Background. Rapid Emergency Medicine Score (REMS) is a well validated scoring system in predicting in-hospital mortality for non-surgical patients visiting Emergency Department (ED). None has been known about its use in elderly population who frequently shows normal vital signs despite of severe condition. We aim to evaluate the performance of REMS by adding value of sodium level and mid-upper arm circumference (MUAC), to predict in hospital mortality of elderly visiting ED in Indonesia.

Objective. To evaluate added value of sodium serum level and mid-upper arm circumference to REMS in predicting in-hospital mortality for non-surgical elderly patients visiting Emergency Department (ED).

Methods. A prospective cohort study in non-surgical elderly aged 60 years or older visiting ED of Cipto Mangunkusumo hospital (RSCM) between September to October 2018 was performed. Subjects were followed during hospitalization for outcome assesment. Hosmer-Lemeshow test and area under receiving operating characteristic (ROC) curve were used to determine the calibration and discrimination of REMS and modified REMS.

Results. From the 272 partcipants, the median age was 66 years (range 10). The incidence of in-hospital mortality was 22.1%. The area under curve (AUC) score of REMS was 0,72 (95% CI 0.65-0.80), and the modified REMS by adding sodium level and mid-upper arm circumference was 0.79, p=.000 (IK95% 0.72-0.85), with calibration performance using Hosmer-Lemeshow test showed p=0,759.

Conclusion. Serum sodium level and mid-upper arm circumference have added value to REMS in predicting in-hospital mortality of non-surgical elderly patient visiting RSCM ED."

"Latar Belakang: Identifikasi risiko mortalitas pascabedah diketahui hanya pada 66 pembedahan dan 34 sisanya tidak teridentifikasi. Modalitas P-POSSUM dianggap lebih superior dibandingkan dengan modalitas ASA dalam memprediksi morbiditas dan mortalitas karena memperhitungkan beban pembedahan.Metode: Uji kesahihan ini dilakukan di RSUPN dr. Cipto Mangunkusumo. Dilakukan penelusuran data fisiologis dan operatif dari enam puluh delapan pasien bedah risiko tinggi elektif kemudian dilakukan perhitungan prediksi risiko dengan koefisien perhitungan skor P-POSSUM dalam situs internet http://www.riskprediction.org.uk dan dibandingkan dengan luaran mortalitas aktual. Kesahihan dinilai dengan penilaian kemampuan kalibrasi dan diskriminasi. Dilakukan analisis untuk mengetahui hubungan parameter-parameter P-POSSUM dengan mortalitas. Hipotesis penelitian ini adalah P-POSSUM sahih dalam memprediksi mortalitas 30 hari pasien bedah risiko tinggi dengan kemampuan prediksi lebih dari 80 .Hasil: Kemampuan diskriminasi didapatkan dengan menghitung luas AUC yaitu sebesar 89.2 IK 95 0,756 ndash;1,000; p=0,000 . Kemampuan kalibrasi dinilai baik dari analisis Hosmer-Lemeshow p=0,23 . Pada analisis bivariat hanya hemoglobin p=0,003 , tekanan darah sistolik p=0,031 dan leukosit p=0,007 yang berhubungan dengan mortalitas. Pada analisis regresi logistik didapatkan hanya tekanan darah sistolik p=0,043 dan leukosit p=0,010 yang berhubungan dengan mortalitas.Simpulan: P-POSSUM sahih dalam memprediksi mortalitas 30 hari pasien bedah risiko tinggi dengan kemampuan prediksi lebih dari 80 . Berdasarkan analisis bivariat didapatkan hemoglobin, tekanan darah sistolik dan leukosit yang berhubungan dengan mortalitas. Setelah analisis regresi logistik didapatkan hanya tekanan darah sistolik dan leukosit yang berhubungan dengan mortalitas. Kata Kunci: kesahihan, P-POSSUM, mortalitas, risiko tinggi

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BACKGROUND Postsurgery mortality risk identified only in 66 surgery and 34 remain unknown. P POSSUM considered more superior than ASA stratification in predicting morbidity and mortality since it calculates surgical risk.METHODS This research was performed in RSUPN dr. Cipto Mangunkusumo. Physiological and surgical parameter of sixty eight high risk patients were taken from medical record and then risk prediction was calculated by calculation coefficient of P POSSUM scoring from http www.riskprediction.org.uk. The comparison between predicted and actual mortality was performed. Validation is assessed by calibration and discrimination ability. The researchers also analyzed the correlation between P POSSUM parameters and mortality. We hypothesized that P POSSUM valid in predicting 30 days mortality high risk surgical patients with predicting ability more than 80.RESULTS Pada analisis regresi logistik didapatkan hanya tekanan darah sistolik p 0,043 dan leukosit p 0,010 yang berhubungan dengan mortalitas. Discrimination ability was assessed by calculating AUC area which is 89.2 CI 95 0,756 ndash 1,000 p 0,000 . Calibration ability is good based on Hosmer Lemeshow analysis p 0,23 . From bivariat analysis only hemoglobin p 0,003 , sistolic blood pressure p 0,031 and leukocyte p 0,007 have relationship with mortality. From multivariate logistic regression anylisis only sistolic blood pressure p 0,043 and leukocyte p 0,010 have relationship with mortality.CONCLUSION P POSSUM is valid in predicting 30 days mortality high risk surgical patients with predicting ability more than 80 . From bivariat analysis only hemoglobin, sistolic blood pressure and leukocyte have relationship with mortality. From multivariate logistic regression anylisis only sistolic blood pressure and leukocyte have relationship with mortality. Keywords validation, P POSSUM, mortality, high risk "

"[Tujuan : Mengetahui komponen manakah dari EQ-5D yang paling berhubunganterhadap kualitas hidup pasien rawat inap usia lanjut, menilai hubungankomponen EQ-5D terhadap kualitas hidup pasien rawat inap usia lanjut diRSUPNCM serta menilai hubungan antara usia lanjut yang bekerja maupun tidakbekerja terhadap penyakit seperti penyakit infeksi, kardiovaskular maupunpenyakit lainnya. ABSTRAKMetode : Desain observasional potong lintang deskriptif. Penelitian dilakukan pada 150 responden yang didapat secara konsekutif, berusia ≥ 60 tahun dan memenuhi kriteria penelitian. Penilaian kualitas hidup dengan kuesioner European Quality of Life-5 Dimensions (EQ-5D), pemeriksaan fungsi kognitif menggunakan formulir Mini Mental State Examination (MMSE), penilaian aktivitas kehidupan sehari-hari dengan Barthel Index, pemeriksaan depresi menggunakan formulir Geriatric Depression Scale (GDS), serta penilaian kondisi kesehatan responden hari itu dengan menunjukkannya pada Visual Analog Scale (VAS). Hasil : Penilaian kualitas hidup menggunakan EQ-5D menunjukkan bahwa sebagian besar responden tidak ada masalah atau nilai 1, kecuali pada komponen rasa kesakitan / tidak nyaman sebagian besar responden yaitu sebanyak 97 responden (64.7%) memperlihatkan beberapa masalah atau nilai 2. Semua responden memiliki nilai MMSE yang normal dengan nilai tengah 27 dimana nilai minimumnya 25 dan maksimum 30. Pada penilaian Barthel Index didapatkan nilai tengah 17 dengan nilai minimum 5 dan maksimum 20 serta modus 19 (32%).Pada pemeriksaan menggunakan GDS didapatkan nilai tengah 3 dengan nilai minimum 0 dan maksimum 9 serta modus 2 (37,3%). Penilaian kualitas hidup menggunakan EQ VAS didapatkan nilai tengah 70 dengan nilai minimum 50 dan maksimum 100 serta modus 70 (30,7%). Nilai tengah usia 68 tahun (berkisar 60-88 tahun). Kesimpulan : Komponen EQ-5D yang paling berhubungan terhadap kualitas hidup pasien rawat inap usia lanjut di RSUPNCM adalah komponen rasa kesakitan / tidak nyaman. Terdapat hubungan yang bermakna dengan korelasi negatif antara semua komponen EQ-5D terhadap kualitas hidup pasien rawat inap usia lanjut di RSUPNCM. Terdapat hubungan yang bermakna antara usia lanjut yang bekerja maupun tidak bekerja terhadap penyakit seperti penyakit infeksi, kardiovaskular maupun penyakit lainnya.

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ABSTRACTObjective : To determine which of the components of the EQ-5D are most related to the quality of life of elderly hospitalized patients, assessing the EQ-5D relations component of the quality of life of elderly inpatients in RSUPNCM and to assess the relationship between the elderly who work or do not work against the disease such as infectious diseases, cardiovascular and other diseases.Methods : A cross-sectional descriptive observational design. The study was conducted on 150 respondents who obtained consecutively, aged ≥ 60 years and met the study criteria. Assessment of quality of life questionnaires European Quality of Life-5 Dimensions (EQ-5D), examination of cognitive function using the Mini Mental State Examination form (MMSE), assessment of activities of daily life with the Barthel Index, the examination form of depression using the Geriatric Depression Scale (GDS), as well as evaluating the health condition ofrespondents day by showing it to the Visual Analogue Scale (VAS). Results : Assessment of quality of life using the EQ-5D shows that mostrespondents do not have a problem or a value of 1, except for the components of a sense of pain / discomfort most respondents as many as 97 respondents (64.7%) showed some problem or the value 2. All respondents had a MMSE score normal with mean 27 where in the minimum value of 25 and a maximum of 30. In the Barthel Index assessment middle values 17 obtained with a minimum of 5 and amaximum value of 20 as well as the mode of 19 (32%). On examination using GDS obtained mean of 3 with a minimum value of 0 and a maximum of 9 and mode 2 (37.3%). Assessment of quality of life using the EQ VAS score is the middle values 70 with a minimum of 50 and a maximum value of 100 as well as the mode of 70 (30.7%). The median age of 68 years (range 60-88 years). Conclusion : EQ-5D component that is most related to the quality of life of elderly inpatients in RSUPNCM is a flavor component of pain / discomfort. There is a significant relationship with the negative correlation between all the components of the EQ-5D of the quality of life of elderly inpatients in RSUPNCM. There is a significant association between advanced age who work or do not work against diseases such as infectious diseases, cardiovascular and other diseases.;Objective : To determine which of the components of the EQ-5D are most relatedto the quality of life of elderly hospitalized patients, assessing the EQ-5D relationscomponent of the quality of life of elderly inpatients in RSUPNCM and to assessthe relationship between the elderly who work or do not work against the diseasesuch as infectious diseases, cardiovascular and other diseases. Methods : A cross-sectional descriptive observational design. The study wasconducted on 150 respondents who obtained consecutively, aged ≥ 60 years andmet the study criteria. Assessment of quality of life questionnaires EuropeanQuality of Life-5 Dimensions (EQ-5D), examination of cognitive function usingthe Mini Mental State Examination form (MMSE), assessment of activities ofdaily life with the Barthel Index, the examination form of depression using theGeriatric Depression Scale (GDS), as well as evaluating the health condition ofrespondents day by showing it to the Visual Analogue Scale (VAS). Results : Assessment of quality of life using the EQ-5D shows that mostrespondents do not have a problem or a value of 1, except for the components of asense of pain / discomfort most respondents as many as 97 respondents (64.7%)showed some problem or the value 2. All respondents had a MMSE score normalwith mean 27 where in the minimum value of 25 and a maximum of 30. In theBarthel Index assessment middle values 17 obtained with a minimum of 5 and amaximum value of 20 as well as the mode of 19 (32%). On examination usingGDS obtained mean of 3 with a minimum value of 0 and a maximum of 9 andmode 2 (37.3%). Assessment of quality of life using the EQ VAS score is the middle values 70 with a minimum of 50 and a maximum value of 100 as well asthe mode of 70 (30.7%). The median age of 68 years (range 60-88 years). Conclusion : EQ-5D component that is most related to the quality of life of elderlyinpatients in RSUPNCM is a flavor component of pain / discomfort. There is asignificant relationship with the negative correlation between all the componentsof the EQ-5D of the quality of life of elderly inpatients in RSUPNCM. There is a significant association between advanced age who work or do not work against diseases such as infectious diseases, cardiovascular and other diseases. ;Objective : To determine which of the components of the EQ-5D are most relatedto the quality of life of elderly hospitalized patients, assessing the EQ-5D relationscomponent of the quality of life of elderly inpatients in RSUPNCM and to assessthe relationship between the elderly who work or do not work against the diseasesuch as infectious diseases, cardiovascular and other diseases. Methods : A cross-sectional descriptive observational design. The study wasconducted on 150 respondents who obtained consecutively, aged ≥ 60 years andmet the study criteria. Assessment of quality of life questionnaires EuropeanQuality of Life-5 Dimensions (EQ-5D), examination of cognitive function usingthe Mini Mental State Examination form (MMSE), assessment of activities ofdaily life with the Barthel Index, the examination form of depression using theGeriatric Depression Scale (GDS), as well as evaluating the health condition ofrespondents day by showing it to the Visual Analogue Scale (VAS). Results : Assessment of quality of life using the EQ-5D shows that mostrespondents do not have a problem or a value of 1, except for the components of asense of pain / discomfort most respondents as many as 97 respondents (64.7%)showed some problem or the value 2. All respondents had a MMSE score normalwith mean 27 where in the minimum value of 25 and a maximum of 30. In theBarthel Index assessment middle values 17 obtained with a minimum of 5 and amaximum value of 20 as well as the mode of 19 (32%). On examination usingGDS obtained mean of 3 with a minimum value of 0 and a maximum of 9 andmode 2 (37.3%). Assessment of quality of life using the EQ VAS score is the middle values 70 with a minimum of 50 and a maximum value of 100 as well asthe mode of 70 (30.7%). The median age of 68 years (range 60-88 years). Conclusion : EQ-5D component that is most related to the quality of life of elderlyinpatients in RSUPNCM is a flavor component of pain / discomfort. There is asignificant relationship with the negative correlation between all the componentsof the EQ-5D of the quality of life of elderly inpatients in RSUPNCM. There is a significant association between advanced age who work or do not work against diseases such as infectious diseases, cardiovascular and other diseases. , Objective : To determine which of the components of the EQ-5D are most relatedto the quality of life of elderly hospitalized patients, assessing the EQ-5D relationscomponent of the quality of life of elderly inpatients in RSUPNCM and to assessthe relationship between the elderly who work or do not work against the diseasesuch as infectious diseases, cardiovascular and other diseases. Methods : A cross-sectional descriptive observational design. The study wasconducted on 150 respondents who obtained consecutively, aged ≥ 60 years andmet the study criteria. Assessment of quality of life questionnaires EuropeanQuality of Life-5 Dimensions (EQ-5D), examination of cognitive function usingthe Mini Mental State Examination form (MMSE), assessment of activities ofdaily life with the Barthel Index, the examination form of depression using theGeriatric Depression Scale (GDS), as well as evaluating the health condition ofrespondents day by showing it to the Visual Analogue Scale (VAS). Results : Assessment of quality of life using the EQ-5D shows that mostrespondents do not have a problem or a value of 1, except for the components of asense of pain / discomfort most respondents as many as 97 respondents (64.7%)showed some problem or the value 2. All respondents had a MMSE score normalwith mean 27 where in the minimum value of 25 and a maximum of 30. In theBarthel Index assessment middle values 17 obtained with a minimum of 5 and amaximum value of 20 as well as the mode of 19 (32%). On examination usingGDS obtained mean of 3 with a minimum value of 0 and a maximum of 9 andmode 2 (37.3%). Assessment of quality of life using the EQ VAS score is the middle values 70 with a minimum of 50 and a maximum value of 100 as well asthe mode of 70 (30.7%). The median age of 68 years (range 60-88 years). Conclusion : EQ-5D component that is most related to the quality of life of elderlyinpatients in RSUPNCM is a flavor component of pain / discomfort. There is asignificant relationship with the negative correlation between all the componentsof the EQ-5D of the quality of life of elderly inpatients in RSUPNCM. There is a significant association between advanced age who work or do not work against diseases such as infectious diseases, cardiovascular and other diseases. ]"

"Tujuan: Mengetahui tingkat kualitas hidup pada usia lanjut di Klub Jantung Sehat (KJS) Kelurahan Pondok Kelapa serta faktor-faktor yang mempengaruhinya, dipandang dari faktor sosiodemografi, status fungsional serta kesehatan mental. Metode: Desain observasional potong lintang deskriptif. Penelitian dilakukan pada 69 subjek yang didapat secara konsekutif, berusia ≥ 60 tahun dan memenuhi kriteria penelitian. Penilaian kualitas hidup dengan kuesioner European Quality of Life-5 Dimensions (EQ-5D), tingkat kesehatan mental menggunakan Geriatric Depression Scale (GDS) serta dilakukan penilaian status fungsional dengan uji performa 6 Minutes Walking Test (6MWT). Hasil: Kualitas hidup pada 62,3% subjek memiliki hasil baik dengan nilai EQ5D Indeks tertinggi yaitu 1.000. Status fungsional didapatkan jarak tempuh 6MWT 401,73 ± 49,75 meter. Kesehatan mental 98,5% subjek memiliki nilai normal. Faktor yang paling berpengaruh adalah faktor usia (p = 0,009), dengan subjek berusia rerata 66 tahun (berkisar 60 ? 79 tahun) memiliki kualitas hidup yang lebih baik dibandingkan subjek berusia rerata 61,5 tahun (berkisar 60 - 82 tahun). Faktor sosiodemografi lain, status fungsional serta tingkat depresi tidak memiliki hubungan yang bermakna (p > 0,05). Kesimpulan: Kualitas hidup usia lanjut dalam penelitian ini mayoritas baik, dengan faktor yang paling berpengaruh adalah faktor usia. Subjek lebih tua memiliki kualitas hidup lebih baik, dapat disebabkan karena pada usia lebih muda terdapat penambahan angka individu yang tidak bekerja dan pensiunan yang cukup signifikan, sehingga mereka harus beradaptasi berkaitan dengan hal tersebut.

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Objective:To know the quality of life in elderly joining "Klub Jantung Sehat" (KJS) Pondok Kelapa and the factors that influence it, in terms of sociodemographic factors, functional status, and mental health.

Methods: Descriptive cross-sectional observational study in 69 subjects taken consecutively, elderly ≥ 60 years old who met the study criteria. Quality of life were assessed with European Quality of Life-5 Dimensions (EQ-5D), mental health with Geriatric Depression Scale (GDS), and functional status by 6 Minutes Walking Test (6MWT) performance test.

Results: Quality of life in 62.3% subjects had good results with the highest value of EQ5D index 1,000. Functional status with the 6MWT distance 401.73 ± 49.75 meters. Mental health in 98.5% subjects were normal. The most influence factorwas age (p = 0.009), with the mean of 66 years old (range 60-79 years) had a better quality of life than mean 61.5 years old (range 60 - 82 years). Other sociodemographic factors, functional status, and depression levels did not have a significant association (p > 0.05).

Conclusion: Quality of life majority ofsubjectswere good, with the most influence factor was age. Older subjects had a better quality of life, this might be caused by at younger age there was a significant increased inelderly individuals who did not work and retired, so they had to adapt more to this condition."

"Tujuan : Mengetahui rerata waktu tempuh uji jalan 400 meter pada usia lanjut, mengetahui tingkat kemandirian fungsional berdasarkan instrumen FIM (Functional Independence Measure) pada usia lanjut, dan mengetahui hubungan antara waktu tempuh uji jalan 400 meter dengan tingkat kemandirian fungsional pada usia lanjut.Metode: Disain penelitian ini adalah potong lintang. Populasi terjangkau adalah usia lanjut di Panti Sosial Tresna Werdha DKI Jakarta yang memenuhi kriteria dan mau berpartisipasi dalam penelitian selama kurun waktu April s.d. Agustus 2012. Sampel didapatkan berdasarkan cluster random sampling dari 5 panti di DKI Jakarta, yang memenuhi kriteria penerimaan dan pengeluaran. Utuk menilai kemampuan mobilitas digunakan waktu tempuh uji jalan 400 meter, sedangkan tingkat kemandirian dinilai menggunakan instrumen FIM.Hasil : 58 subyek penelitian usia 60 tahun ke atas dianalisa pada penelitian ini. Nilai waktu tempuh uji jalan 400 meter pada usia lanjut di PSTW adalah median 413 detik (6:53 menit) dengan minimum 281 detik (4:41 menit) dan maksimum 901 detik (15:01 menit). Tingkat kemandirian fungsional berdasarkan instrumen FIM pada usia lanjut adalah sebesar rerata 120 ± 5, dengan 13,8% subyek mempunyai tingkat mandiri penuh. Terdapat hubungan kuat antara waktu tempuh uji jalan 400 meter dengan tingkat kemandirian fungsional (r = - 0,941, Spearman p < 0,001), dengan nilai 7 menit sebagai batas waktu yang membedakan kemampuan kemandirian secara signifikan. Kesimpulan : Terdapat hubungan yang kuat antara waktu tempuh uji jalan 400 meter dengan kemandirian fungsional pada usia lanjut. Kemampuan kemandirian terendah yang harus diperhatikan pada usia lanjut adalah pada domain locomotion (stairs, walk), transfer (toilet dan shower), dan social cognition (problem solving dan social interaction). Waktu tempuh cukup baik untuk memprediksi kemampuan kemandirian usia lanjut di aspek locomotion, transfer dan selfcare (dressing lower body, bathing, dan toileting), tapi tidak akurat untuk memprediksi sphingter control dan kognitif. Batas waktu tempuh uji jalan 400 meter sebesar 7 menit, dapat menjadi cut-off point yang membedakan kemampuan kemandirian pada usia lanjut.

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The aim: To know the avarage of timed to finish 400 meter walk test in elderly, to know the functional independency level in elderly, and to know the correlation between timed to finish 400 meter walk test and functional independency in elderly.

Methods: The design of the study was cross sectional. The population was the elderly at Panti Sosial Tresna Werdha (PSTW) DKI Jakarta who fit the criteria and want to partcipate in April-August 2012. Sampling method was cluster random sampling from 5 PSTW in DKI Jakarta. The mobility capacity was assessed by measure the timed to finish 400 meter walk test, and to asses the functional independence was used the Functional Independence Measure (FIM) instrument.

Results: 58 subjects aged 60 years old and above were analyzed in this study. The median value of 400 meter walk test timed was 413 seconds (6:53 minutes) with minimum 281 seconds (4:41 minutes) and maximum 901 seconds (15:01minutes). The mean of functional independence level according to FIM tools was 120 ± 5, with 13,8% subjects were complete independence. There were strong correlation between timed to finish 400 meter walk test and functional independency in elderly (r = - 0,941, Spearman p < 0,001), with the boundary seven minute as the cut-off point that differentiate independence level significantly.

Conclusions: There was strong correlation between timed to finish 400 meter walk test and functional independency in elderly.The lowest functional independence level in elderly that must be concerned of were on locomotion (stairs, walk), transfer (toilet and shower), and social cognition (problem solvingand social interaction) domain. Timed to walk 400 meter was good enough to predict functional indenpendence in elderly, at locomotion, transfer, and selfcare (dressing lower body, bathing, and toileting) domain, but can’t predict sphincter control and cognitif level accurately. Seven minutes is a cut-off point time to differentiate independence level among elderly."