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"Tidak ada korelasi yang signifikan antara skor MMSE dan kadar testosteron (r=0,038). Penelitian ini menunjukkan bahwa pada laki-laki berusia 50 tahun ke atas dengan keluhan penurunan kognitif memiliki penurunan skor MMSE tetapi memiliki kadar testoteron dalam batas yang normal. Tidak ditemukan adanya korelasi antara skor MMSE dan kadar testosteron, hal ini mungkin disebabkan karena sebagian besar pasien telah memiliki kadar testosteron yang rendah."

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Latar belakang: Proses belajar penting bagi seorang anak dalam perkembangannya. Anak dapat belajar dengan baik bila didukung kondisi yang baik pula. Salah satu faktor pendukung tersebut adalah fungsi memori kerja. Penelitian menunjukkan memori kerja merupakan prediktor kapasitas belajar yang lebih bermakna daripada intelligence quotient (IQ). Bila fungsi ini terganggu, anak dapat mengalami kesulitan belajar. Studi melaporkan gangguan memori kerja banyak ditemukan pada gangguan pemusatan perhatian dan hiperaktivitas (GPPH). Oleh karena itu, penelitian ini mencoba mendapatkan data proporsi gangguan memori kerja pada anak GPPH dan perbandingan dengan anak tanpa GPPH. Data ini diharapkan dapat menjadi data dasar bagi pengembangan intervensi selanjutnya.

 

Metode: Penelitian ini dilakukan dengan desain potong lintang pada bulan Mei 2017 hingga Mei 2019. Pengambilan sampel dilakukan dengan metode randomized sampling menggunakan program SPSS. Instrumen Mini International Neuropsychiatry Interview KID (M.I.N.I. KID) digunakan untuk membantu menegakkan 24 diagnosis gangguan jiwa anak dan remaja yang terdapat di DSM-IV dan ICD-10 secara komprehensif dan Working Memory Rating Scale (WMRS) dgunakan untuk menentukan ada tidaknya defisit memori kerja pada anak berusia 5-11 tahun dan telah divalidasi dalam Bahasa Indonesia oleh Wiguna, dkk. (2012).

 

Hasil: Proporsi gangguan memori kerja pada kelompok anak dengan GPPH berbeda bermakna dibandingkan kelompok anak tanpa GPPH (44% vs 0%, p<0,05). Pada uji analisis, didapatkan prevalence ratio (PR) sebesar 40,4 (95%CI 2,22 - 738,01), artinya anak dengan GPPH berisiko mengalami gangguan memori kerja 40,4 kali lebih besar dibandingkan anak tanpa GPPH. Rerata WMRS juga menunjukkan perbedaan yang bermakna antara kelompok subjek dengan GPPH dan kelompok subjek tanpa GPPH [50,48 (SB=11,08) vs 30,60 (SB=8,04), p<0,05] namun tidak berbeda bermakna antara kelompok subjek dengan GPPH yang mengkonsumsi metilfenidat hidroklorida  dan yang tidak mengkonsumsi metilfenidat hidroklorida [50,93 (SB=10,25) vs 50,09 (SB=11,26), p=0,85].

 

Simpulan: Gangguan memori kerja lebih banyak ditemukan pada anak dengan GPPH. Temuan ini sesuai dengan hasil penelitian lainnya. Oleh karena itu, pemeriksaan memori kerja pada anak dengan GPPH sebaiknya dilakukan untuk mengantisipasi kesulitan belajar yang mungkin timbul di kemudian. Intervensi tambahan, seperti game therapy dapat dipertimbangkan untuk memperbaiki gangguan memori kerja yang ditemukan pada anak-anak dengan GPPH.

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Background: Learning process is important in child’s development. Children may learn well if supported by good conditions. One of the supporting factors is working memory. Research shows working memory is more meaningful learning capacity’s predictor than intelligence quotient (IQ). If this function is interrupted, children can experience learning difficulties. Studies reporting working memory impairment often found in attention deficit and hyperactivity disorder (ADHD). Therefore, this study tried to obtain data on the proportion of working memory impairment in ADHD children and its comparison with healthy children. Results is expected to be the basic data for the development of further interventions.

 

Method: This study was conducted in a cross-sectional design in May 2017 to May 2019. Sampling was done by randomized sampling method using the SPSS program. The Mini International Neuropsychiatry KID Interview Instrument (MINI KID) was used to establish 24 diagnoses of child and adolescent mental disorders comprehensively as in the DSM-IV and ICD-10, and the Working Memory Rating Scale (WMRS) was used to determine the presence or absence of working memory deficits in children aged 5-11 years and have been validated in Indonesian by Wiguna et al. (2012).

 

Results: Proportion of working memory impairments in ADHD group was significantly different compared to group without ADHD (44% vs 0%, p <0.05). Analysis test shows children with ADHD were at risk of experiencing working memory impairment 40.4 times greater than children without ADHD (prevalence ratio 40.4, 95% CI 2.22 - 738.01). The average WMRS scores also showed significant difference between group with ADHD and without ADHD [50.48 (SD = 11.08) vs 30.60 (SD = 8.04), p <0.05]

but not significantly different between who consumed and those who did not consume methylphenidate hydrochloride [50.93 (SD = 10.25) vs 50.09 (SD = 11.26), p = 0.85].

 

Conclusions: Working memory disorders are more common in children with ADHD. This finding is in accordance with the results of other studies. Therefore, examination of working memory in children with ADHD should be done to anticipate learning difficulties that may arise later. Additional interventions, such as game therapy, can be considered to improve working memory impairment found in children with ADHD.

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"Background: Depression is a significant geriatric problem. It will be a major health problem in developing nations by the year 2020. Signs and symptoms of depression among elderly people are usually so unspecific that they are often considered as a part of getting old. No wonder so many elderly depression cases remain uncured. When depression is under-diagnosed, the various problems accompanied with it will make the bio-psychosocial condition of the patient worsen. There is no primary data on the prevalence of depression in the Indonesian elderly population, especially in Eastern Indonesian conflict areas.Objective: The objective was to determine the prevalence and the severity of depression, as well as cognitive function in elderly subjects living in the conflict area in Buru Island, Maluku.Design: This study was designed as a survey, conducted in the Northeast Buru Region, Maluku, from March to May 2003. Questionnaires on the validated Geriatric Depression Scale and Mini Mental State Evaluation were performed by trained native speaker paramedics for the identification of depression, the severity of depression, and cognitive function. The 401 elderly people that participated in this survey ranged in age from 60 to 120 years. As many as 215 (53.6%) were women, and 223 (55.6%) were uneducated.Results: The prevalence of depression was 52.4%. A hundred and eighty seven subjects (94 females and 93 males) aged 60-120 years were in the mild depression category, and 23 subjects (14 females and 9 males) aged 60-85 years were severely depressed. While 82.6% elderly in severe depression category had an MMSE Score of less than 24 (dementia), 74.7% had mild depression, and only 57.1% of the elderly had no depression and received MMSE score less than 24. The majority of complaints among depression subjects were that they were bothered by thoughts they cannot get out of their head, they frequently worry about the future, they often became restless and fidgety, got bored, felt helpless, downhearted and blue, felt like crying, and that their life was empty. Seventy eight percents mild depressive elderly still enjoy getting up in the morning and 68% were hopeful about the future, which was on the contrary to the subjects with severe depression, where only 35% had these two positive outlooks.Conclusions: The prevalence of depression in Buru Island community was high, even though most of them were in the mild depression category. The worse the depression, the higher the percentage of cognitive impairment. There was still enough willingness to get better among subjects with mild depression. We need to think about the possibility of Post Traumatic Stress Disorder in the elderly population of this conflict area.Suggestions: Medical practitioners in conflict areas need to increase their awareness of depression and cognitive impairment among elderly people. Geriatrician and psychogeriatric experts are needed to ensure that the problem of depression in the elderly does not worsen in conflict areas. Further studies are needed to detect Post Traumatic Stress Disorder."

"Akibat kekurangan estrogen pada wanita menopause timbullah berbagai masalah kesehatan. Gangguan susunan saraf pusat seperti stroke dan Alzheimer sering ditemukan pada wanita menopause. Estrogen sangat berperan memicu regulasi pertumbuhan sel-sel neuron dan memiliki juga khasiat sinaptogenik yang meningkatkan fungsi memori. Terapi sulih hormon (TSH) menurunkan risiko stroke hingga 30% dan mengurangi risiko kematian karena stroke hingga 60%. Terapi sulih hormon mempengaruhi fungsi memori wanita menopause dan menurunkan risiko timbulnya demensia. Wanita yang mendapatkan TSH menunjukkan peningkatan fungsi memori dan dapat menjawab soal-soal dengan lebih baik dibandingkan wanita yang mendapatkan plasebo. Perdarahan pervaginam merupakan keluhan terbanyak bagi wanita dengan TSH kombinasi. (Med J Indones 2002; 11: 246-9)

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As a result of estrogen deficiency in menopausal women various health problems occur. Disorders of central nervous system such as stroke and dementia due to Alzheimer?s disease are frequently encountered in menopausal women. Estrogen plays an important role in the maintenance of the dense network of neural fibres connecting one nerve cell to another, and in the synaptic activity facilitating cognitive thought and memory. Hormone replacement therapy (HRT) reduced the risk of stroke by 30 % and a reduction of 60 % in risk of stroke mortality. The HRT influence cognitive functioning in menopausal women and may reduce the risk of developing dementia. Women who received HRT performed better on several tests of memory and logical reasoning than women taking placebo. Vaginal bleeding episodes constitute the major cause of women?s dissatisfaction with combined HRT. (Med J Indones 2002; 11: 246-9"

"Penurunan fungsi paru berperan pada peningkatan insiden PPOK  pada lansia. Penurunan fungsi kognitif dapat mempengaruhi ketepatan penggunaan inhaler dapat berdampak negatif terhadap prognosis. Tujuan Penelitian mengetahui hubungan fungsi kognitif dengan ketepatan penggunaan inhaler pada lansia PPOK. Metode penelitian menggunakan cross sectional dengan lokasi penelitian di poliklinik Paru Asma-PPOK. Sampel pada penelitian dipilih melalui teknik consecutive sampling berjumlah 96 responden lansia PPOK. Analisis data terdiri dari analisis univariat, analisis bivariat menggunakan uji Chi-square dan analisis multivariat menggunakan uji Regresi Logistik. Hasilnya responden mengalami gangguan fungsi kognitif dengan kategori tidak tepat dalam penggunaan inhaler sebanyak 46 responden (55.2%). Uji statistik regresi logistik didapatkan variabel fungsi kognitif berhubungan dengan ketepatan penggunaan inhaler (p=0,001; OR=40,524; CI 95% 12,537- 130,984). Kesimpulan ada hubungan antara fungsi kognitif dengan ketepatan penggunaan inhaler pada lansia PPOK setelah dilakukan uji statistik. Lansia mengalami gangguan fungsi kognitif tidak optimal dalam penggunaan inhaler. Pemberian edukasi pada lansia serta keluarga/caregiver dengan metode disesuaikan kemampuan kognitif lansia, seperti demonstrasi langsung, video instruksional, dan materi visual.

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Decreased lung function contributes increased incidence of COPD in older adults. Impairment cognitive function affect accuracy of inhalers could have bad prognosis. Aim of study was to determine relationship between cognitive function with accuracy of inhaler usage in older adults with COPD. The research method used cross sectional location at polyclinic Asma-PPOK. The respondents were selected method through consecutive sampling technique, totalling 96 older adults with COPD. Data analysis consisted of univariate analysis, bivariate analysis using the Chi-square / Pearson Chi-square test, and multivariate analysis using the Logistic Regression test. Result respondents impaired cognitive function with inappropriate  use of inhalers as many as 46 respondents (55.2%). Logistic regression statistical obtained cognitive function correlated with accuracy of inhaler use (p=0.001; OR=40.524; CI95% 12.537- 130.984). Conclusion there correlation between cognitive function with accuracy of inhaler usage in older adults with COPD after statistical analysis. Older adults with impaired cognitive function are not optimal use inhalers. Providing education to older adults and caregivers by methods adjusted cognitive function, such as direct demonstrations, instructional videos, and visual materials."

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Latar belakang: Perkembangan kognitif anak dipengaruhi oleh status gizi yang merupakan masalah di Indonesia (17,7%). SYSTEMS-R adalah salah satu pemeriksaan fungsi kognitif dengan waktu pengerjaan singkat, serta sensitivitas (83%) dan spesifisitas (76%) tinggi. Penelitian ini bertujuan untuk melihat hubungan status gizi dengan fungsi kognitif anak usia 6-15 tahun dengan pemeriksaan SYSTEMS-R.

Metode: Penelitian ini memiliki desain kasus kontrol yang dilakukan pada anak usia 6-15 tahun di SDN dan SMPN dengan teknik consecutive sampling.

Hasil: Penelitian ini terdiri dari 105 subyek, yaitu 60 subyek kelompok kasus (kognitif kurang berdasarkan usia dan tingkat pendidikan) dan 45 subyek kelompok kontrol (kognitif baik). Subyek penelitian dengan pendapatan orang tua di bawah UMR berisiko 2,4 kali memiliki kognitif kurang (63,6%) dengan p <0,05. Penelitian ini tidak menunjukkan hubungan bermakna antara status gizi dan fungsi kognitif. Subyek dengan gizi baik dan tinggi badan normal cenderung memiliki kognitif baik berdasarkan usia dan tingkat pendidikan.

Kesimpulan: Pendapatan orang tua memiliki hubungan dengan fungsi kognitif. Penelitian ini tidak menunjukkan hubungan bermakna antara status gizi dan fungsi kognitif. Subyek penelitian dengan gizi baik dan tinggi badan normal cenderung memiliki kognitif baik.

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Background: Children’s cognitive development is influenced by nutritional status which is a problem in Indonesia (17,7%). SYSTEMS-R is an cognitive examination with a short processing time, high sensitivity (83%) and specificity (76%). This study aims to see the relationship of nutritional status and cognitive function of 6-15 years old child with The School Years Screening Test For Evaluation Of Mental Status Revised (SYSTEMS-R).

Methods: This case control study was carried out in children aged 6-15 years at Elementary and Junior High School with consecutive sampling techniques.

Results: This study consists of 105 subjects, which is 60 subjects in case group (cognitive dysfunction) and 45 subjects in control group (normal cognitive function). Subject with low parental income had 2,4 times the risk of having cognitive dysfunction (63,6%) with p <0,05. This study did not show a significant relationship between nutritional status and cognitive function. Subjects with normal nutritional status and height tend to have normal cognitive function based on age and education level.

Conclusions: Parental income has a relationship with cognitive function. This study did not show a significant relationship between nutritional status and cognitive function. Subjects with normal nutritional status and height tend to have normal cognitive function.

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"[ABSTRAK Latar Belakang Diabetes melitus DM tipe 1 paling banyak ditemukan pada masa anak dan remaja dengan prevalens sebesar 1 500 anak Hiperglikemia kronik pada diabetes menyebabkan komplikasi pada berbagai organ Komplikasi ini berhubungan dengan kadar HbA1C sebagai faktor yang memengaruhi fungsi kognitif Pasien DM tipe 1 juga dapat mengalami komplikasi hipoglikemia berat sehingga mengakibatkan atrofi neuron di otak Identifikasi dini terhadap risiko gangguan fungsi kognitif penting untuk intervensi klinis dan psikoedukasi terhadap anak Tujuan Mengidentifikasi prevalens anak DM dengan fungsi kognitif di bawah normal di Indonesia dan menganalisis korelasi antara usia awitan DM durasi sakit DM ketoasidosis diabetikum KAD HbA1C dan hipoglikemia berat dengan fungsi kognitif anak DM tipe 1 Metode Penelitian ini merupakan studi yang mempelajari faktor risiko dengan metode potong lintang dilakukan di Jakarta pada Mei sampai dengan Juni 2015 Pemeriksaan fungsi kognitif menggunakan instrumen the Wechsler Intelligence Scale for Children WISC IV Subyek pada penelitian ini adalah pasien DM tipe 1 yang berusia 5 ndash 18 tahun Analisis statistik dilakukan untuk mencari korelasi antara fungsi kognitif dengan usia awitan durasi sakit kadar HbA1C dan frekuensi kejadian KAD Analisis statistik komparasi dilakukan untuk mencari rerata perbedaan full scale intelligence quotient IQ pasien dengan riwayat hipoglikemia berat dan tidak Hasil Penelitian dilakukan terhadap 58 subyek dengan hasil rerata full scale IQ adalah 100 16 Terdapat 26 subyek dengan full scale IQ di bawah normal Korelasi bermakna secara statistik didapatkan antara fungsi kognitif dengan usia awitan r 0 285 p 0 030 kadar HbA1C r 0 270 p 0 041 dan frekuensi riwayat kejadian KAD r 0 289 p 0 028 Tidak didapatkan korelasi antara durasi sakit dengan full scale IQ dan tidak didapatkan perbedaan full scale IQ antara kelompok dengan riwayat hipoglikemia berat dan kontrol Simpulan Terdapat korelasi negatif antara full scale IQ dengan usia awitan frekuensi KAD dan kadar HbA1C Durasi sakit dan riwayat hipoglikemia berat tidak memengaruhi full scale IQ Kata kunci faktor fungsi kognitif DM tipe 1 ABSTRACT Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes;Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes, Background Type 1 diabetes is mostly found in childhood and adolescence with prevalence of 1 500 children Chronic hyperglycemia causes complications in organs especially the eyes kidneys nerves blood vessels and heart These complications are associated with HbA1C levels as one of the factors affecting cognitive ability Patients with type 1 diabetes may also experience complications caused by severe hypoglycemia resulting in atrophy of neurons in the brain Early identification to the risk of complication in cognitive ability is important for clinical interventions and psychoeducation Aim To identify the prevalence of diabetic children with under average cognitive ability in Indonesia and to determine the correlation between the age of onset of diabetes duration of illness diabetic ketoacidosis DKA HbA1C severe hypoglycemia and cognitive ability of children with type 1 diabetes mellitus Method This is a cross sectional and risk factors study held in Jakarta from May to June 2015 Assessment of cognitive ability was done with the Wechsler Intelligence Scale for Children WISC IV Subjects in this study were type 1 diabetic patients aged 5 18 years Statistical analysis was performed to find the correlation among cognitive ability and age of onset duration of illness HbA1C levels and frequency of DKA Comparative statistical analysis was performed to find the mean difference in full scale IQ intelligence quotient of patients who had or did not have a history of severe hypoglycemia Result This study had 58 subjects with a mean full scale IQ 100 16 Nineteen percent subjects had full scale IQ under average We found statistically significant correlations between cognitive ability and the age of onset r 0 285 p 0 030 HbA1C levels r 0 270 p 0 041 and the frequency of occurrence DKA history r 0 289 p 0 028 There was no correlation between the duration of illness and full scale IQ There was no full scale IQ difference between groups with a history of severe hypoglycemia and control Conclusion There were negative correlations between full scale IQ and age of onset frequency DKA and HbA1C levels The duration of illness and history of severe hypoglycemia did not affect the full scale IQ Keywords factors cognitive function type 1 diabetes]"