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Abstrak :
Tesis ini bertujuan untuk mengetahui nilai titik potong tes SPPB sebagai tes performa fisik dalam mendiagnosa sarkopenia pada pasien lanjut usia di rawat jalan. Selain itu juga untuk mengetahui nilai sensitivitas dan spesifisitas tes SPPB berdasarkan kecepatan jalan 6 meter untuk estimasi performa fisik sebagai komponen sarkopenia. Penelitian ini merupakan studi potong lintang pada pasien lanjut usia rawat jalan di RSUPN Ciptomangunkusumo. Pada penelitian ini didapatkan 100 subjek yang diminta melakukan uji SPPB, uji kecepatan jalan 6 meter, uji penilaian massa otot dengan BIA (Bio Impedance Analysis), dan penilaian kekuatan otot dengan menggunakan handgrip dynamometer. Dari hasil penilaian didapatkan nilai titik potong 7 untuk populasi total dan populasi perempuan. Sedangkan untuk populasi laki laki didapatakan nilai 8. Setelah didapatkan titik potong baru, dilakukan uji diagnostik antara nilai SPPB titik potong baru dengan status performa fisik menurun berdasarkan kecepatan jalan 6 meter. Dari penilaian didapatkan sensitivitas 81.5% dan spesifisitas 73.7% untuk populasi total. Pada populasi perempuan didapatkan sensitivitas 81.4% dan spesifisitas 66.7%. Sedangkan untuk populasi laki laki menggunakan titik potong 8 didapatkan sensitivitas 81.8% dan spesifisitas 71.4%. Kesimpulan penelitian ini adalah SPPB dengan nilai titik potong 7 untuk populasi perempuan dan 8 untuk populasi laki laki baik dipakai sebagai alat uji untuk screening dan diagnostik performa fisik sebagai komponen sarkopenia rawat jalan. ......This thesis aims to determine the cut-off point of the SPPB test as a physical performance test in diagnosing sarcopenia in elderly patients on an outpatient basis. In addition, to determine the sensitivity and specificity of the SPPB test based on a walking speed of 6 meters to estimate physical performance as a component of sarcopenia. This study is a cross-sectional study of elderly outpatients at Ciptomangunkusumo General Hospital. In this study, 100 subjects were asked to perform the SPPB test, 6 meter walking speed test, muscle mass assessment test using BIA (Bio Impedance Analysis), and muscle strength assessment using a handgrip dynamometer. From the results of the assessment, it was found that the cut-off point was 7 for the total population and the female population. As for the male population, a score of cut oof point is 8. After obtaining a new cut-off point, a diagnostic test was conducted between the SPPB value of the new cut-off point and the decreased physical performance status based on a 6-metre walking speed. From the assessment, sensitivity was 81.5% and specificity was 73.7% for the total population. In the female population, sensitivity was 81.4% and specificity was 66.7%. Meanwhile, for the male population using the 8 cut-off point, the sensitivity was 81.8% and the specificity was 71.4%.The conclusion of this study is that the SPPB with a cutoff value of 7 for the female population and 8 for the male population can be used as a test tool for screening and diagnostic of physical performance as a component of outpatient sarcopenia.

Abstrak :
Latar belakang: Pengkajian Paripurna Pasien Geriatri (P3G) bermanfaat dalam pelayanan pasien lanjut usia. Domain yang sering dinilai adalah status fungsional, disabilitas, status nutrisi, dan kognitif. Namun, pengerjaan P3G membutuhkan waktu yang lebih lama, sehingga dikembangkan bentuk singkat P3G, di antaranya Geriatric 8 (G8). Belum ada publikasi mengenai kesahihan, keandalan, dan performa diagnosis G8 pada populasi umum lansia di Indonesia. Tujuan: mengetahui kesahihan, keandalan, dan performa diagnostik G8. Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di Poli Geriatri RSCM. Dilakukan pemeriksaan G8 dan P3G terhadap pasien yang memenuhi kriteria seleksi subjek penelitian, kemudian dilakukan uji kesahihan dengan mencari koefisien korelasi dan analisis kappa. Pasien dengan gangguan pada satu domain P3G dikatakan gangguan P3G, yaitu ADL  19, IADL  7, MoCA-INA  25, MNA < 24, atau timed up and go  10 detik. Hasil: terdapat 80 orang subjek penelitian dengan rerata usia 73,68 tahun, Interrater dan intrarater concordance masing-masing adalah 1 dan 0,904 (p<0,005). Interclass corelation coefficient berkisar antara 0,77 (0,412 – 0,913) sampai dengan 1 (1 – 1). Didapatkan nilai Cronbach 0,697. Titik potong acuan yang digunakan 14,25 menunjukkan sensitivitas 70,27 (58,82 – 80,34), spesifisitas 83,33 (35,88 – 99,58), dengan AUC 0,846 (p<0,005), IK95% 0,667- 1,0) Simpulan: G8 cukup sahih dan memiliki keandalan yang baik sebagai instrumen penapisan pasien rawat. Titik potong G8 yang disarankan adalah 14,5 sehingga pasien dengan skor lebih rendah disarankan untuk menjalani pemeriksaan P3G lengkap. ......Background: Comprehensive geriatric assessment (CGA) has been proved to be beneficial for older adults care. Domains that usually assessed in CGA are functional status, disability, cognitive function, and nutrtion status. However, CGA takes more time to complete, hence shorter versions of CGA were developed, including Geriatric 8 (G8). G8 was developed to screen older adults with cancer who would benefit the complete CGA. There was no publication regarding validity, reliability, and diagnostic performance of G8 for general population of older adults in Indonesia. Objective: This study aimed to evaluate validity, reliability, and diagnostic performance of G8 in older adults. Methods: This is a cross-sectional study conducted in Geriatric Clinic of Cipto Mangunkusumo National Hospital. Both CGA and G8 were performed, concordance between these tests were analyzed to determine validity, reliability, and diagnostic performance of G8. Abnormal CGA is defined by at least one abnormal CGA domain is identified, i.e ADL  19, IADL  7, GDS  5, MoCA-INA  25, MNA < 24, or timed up and go  10. Commorbidities was assessed by CIRS-G. Results: We found strong inter-rater and intra-rater condordance (kappa=1 and kappa=0.904, p<0.005, respectively). Interclass Coefficient Corelation was ranged 0.77 (0.412 – 0.913) to 1 (1 – 1). We also found acceptable Cronbach of 0.697. For diagnostic performance, the sensitivity was 70.27 (58.82 – 80.34), specificity 83.33 (35.88 – 99.58), with AUC 0.846 (p<0.005), CI95% 0.667-1.0). Conclusion: G8 screening tool is valid and reliable to be used in older adults. G8 also demonstrated good diagnostic performance. We propose 14.5 as cut off point for older adults who need full form geriatric assessment.

Abstrak :
In this paper, fasting refers to the Muslim fast, defined as refraining from eating and drinking and all other activities that annul the fast from sunrise to sunset (approximately 14 hours). Fasting can be performed at any time in the year, but is usually performed during certain the compulsory month or recommended days. The fasting of the month of Ramadan is an activity that is health-wise quite difficult, since the person has to refrain from eating and drinking from sunset to sunrise (approximately 13 to 14 days per day) for 29-30 consecutive days.

Abstrak :
Persentase penduduk usia lanjut di Indonesia meningkat sekitar dua kali lipat dalam lima dekade terakhir. Pasien usia lanjut yang akan menjalani pembedahan mempunyai risiko mengalami komplikasi pascabedah. Pengkajian Paripurna Pasien Geriatri (P3G) dan klasifikasi ASA dapat digunakan untuk mengevaluasi kesehatan pasien geriatri. Program prehabilitasi yang direkomendasikan oleh berbagai guideline perioperatif untuk memperbaiki kesehatan fisik dan status fungsional preoperatif dapat meningkatkan pemulihan pascabedah dan luaran klinis. Penelitian ini bertujuan untuk mengetahui hubungan komponen P3G, status ASA dan prehabilitasi preoperatif terhadap komplikasi pascabedah 30 hari pasien usia lanjut yang menjalani pembedahan artroplasti panggul dan lutut elektif dan untuk mengembangkan model prediksi komplikasi pascabedah 30 hari berdasarkan faktor prediktor tersebut. Penelitian ini adalah penelitian kohort retrospektif yang menggunakan data sekunder dari rekam medis pasien usia lanjut yang menjalani pembedahan artroplasti panggul dan lutut elektif di RSUPN Dr. Cipto Mangunkusumo periode Januari 2017 – Oktober 2022. Performa pengembangan model prediksi komplikasi pascabedah 30 hari dilakukan dengan menentukan nilai kalibrasi (uji Hosmer-Lemeshow) dan diskriminasi (Area Under the Curve [AUC]). Didapatkan 144 pasien yang telah memenuhi kriteria dan dapat dianalisis. Angka komplikasi pascabedah 30 hari sebesar 29,2%. Faktor yang dianalisis sebagai prediktor komplikasi di antaranya status depresi (HR=5,11; IK95% 2,549-10,244), status frailty (HR=2,44; IK95% 1,329-4,473), komorbiditas (HR=1,53; IK95% 0,786-2,982) serta prehabilitasi preoperatif (HR=1,77; IK95% 0,906-3,459). Model prediksi komplikasi pascabedah 30 hari memiliki kualitas kalibrasi dan diskriminasi yang baik dan cukup kuat [AUC 0,690 (p<0,001; IK 95% 0,586-0,794)]. Status depresi, status frailty, komorbiditas dan prehabilitasi preoperatif berhubungan dengan komplikasi pascabedah 30 hari  pada pasien usia lanjut yang menjalani pembedahan artroplasti panggul dan lutut elektif. Model prediksi komplikasi pascabedah 30 hari memiliki kualitas kalibrasi dan diskriminasi yang baik dan cukup kuat. ......The percentage of the geriatric population in Indonesia has roughly doubled in the last five decades. Elderly patients who will undergo surgery are at risk of experiencing postoperative complications. The Comprehensive Geriatric Assessment (CGA) and ASA Classification can be used to evaluate the health of geriatric patients. Prehabilitation programs that various preoperative guidelines suggest to improve physical health and preoperative functional status may increase the rate of postoperative recovery and clinical outcomes. This study aims at determining the relationship between the CGA components, ASA status, and preoperative prehabilitation on complications within 30 days after the surgery in elderly patients undergoing elective hip and knee arthroplasty, as well as developing a prediction model for 30-day postoperative complications. This research is a retrospective cohort study using secondary data from medical records and interviews with elderly patients who underwent elective hip and knee arthroplasty at Cipto Mangunkusumo Hospital between January 2017 and October 2022. The performance of the 30-day postoperative complication predictor model was measured by determining the calibration (Hosmer-Lemeshow test) and discrimination (Area Under the Curve [AUCC]) value. 144 patients who met the criteria were analyzed. The 30-day postoperative complication rate was 29.9%. The factors analyzed as complication predictors including depression status (HR=5.11; 95%CI 2.549-10.244), frailty status (HR=2.44; 95%CI 1.329-4.473), comorbidity (HR=1.53; 95%CI 0.786-2.982) and preoperative prehabilitation (HR=1.77; 95%CI 0.906-3.459). The 30-day postoperative complication prediction model has good and strong enough calibration and discrimination qualities [AUC 0.690 (p<0.001; 95% CI 0.586-0.794)]. Depressive status, frailty status, comorbidity, and preoperative prehabilitation were significantly associated with 30-day postoperative complications in elderly patients undergoing elective hip and knee arthroplasty surgery. The 30-day postoperative complication prediction model has good and strong enough calibration and discrimination qualities.

Abstrak :
This book is designed to summarize unique methodological issues relevant to the study of aging, biomarkers of aging and the biology/physiology of aging and in-depth discussions of the etiology and epidemiology of common geriatric syndromes and diseases. Contributing authors in the book represent many disciplines, not only epidemiology and clinical geriatrics, but also demography, health services, research, cardiovascular disease, diabetes, psychiatry, neurology, social services, musculoskeletal diseases and cancer.

Abstrak :
Gerontology for the Health Care Professional, Third Edition is a comprehensive, practical text covering the evolving field of gerontology, written for health care students and professionals. Written by experts across many health professions, Gerontology for the Health Care Professional, Third Edition presents an up-to-date and realistic view on the aging process. With topics presented in an introductory fashion, this book covers all the important aspects of aging and instills an appreciation for the multidimensional aspects of aging for those who are working with and caring for elderly patients or clients. Each chapter includes objectives, chapter outlines, cast studies, multiple-choice review questions, and learning activities. The Third Edition begins with chapters on different aspects of the aging process. Later chapters explore various issues that are of primary importance to the older population. This comprehensive, accessible text concludes with the future concerns of an aging society. There is also an epilogue encouraging all health care professionals to embrace patient or client advocacy, especially for older adults.