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Abstrak :
[ABSTRAK
Latar Belakang. Gangguan fungsi kognitif dapat terjadi pada pekerja yang terpajan toluen. Gangguan fungsi kognitif tersebut terutama adalah penurunan memori, atensi dan konsentrasi, yang dapat menurunkan produktifitas kerja. Penelitian ini bertujuan mengetahui prevalensi gangguan fungsi kognitif dan faktor-faktor yang mempengaruhi Metode Penelitian. Desain potong lintang dilakukan pada 102 orang pekerja perempuan usia 19-40 tahun dan pendidikan minimal SMA. Data dikumpulkan dengan kuesioner, pemeriksaan fisik dan laboratorium serta MMSE. Kriteria inklusi adalah masa kerja ≥ 1 tahun dan bersedia menjadi responden dengan menandatangani informed consent. Kriteria eksklusi adalah hamil, menstruasi,merokok, minum alkohol, riwayat cedera kepala, hipertensi, gula darah dan dislipidemia. Faktor risiko yang diteliti antara lain umur, status perkawinan, masa kerja, lama kerja, kepatuhan pakai masker , stres kerja dan status gizi. Umur, status perkawinan,masa kerja dan lama kerja diambil dari data HRD. Status gizi didapatkan dari perhitungan Indeks Massa Tubuh. Kepatuhan pakai masker berdasarkan pengawasan kepatuhan APD. Stres kerja dinilai menggunakan kuesioner Survey Diagnostik Stress . Hasil. Walaupun kadar toluen didapat lebih kecil dari nilai ambang batas toluen , didapatkan prevalensi gangguan fungsi kognitif sebesar 52 %. Area kognitif yang menurun adalah atensi kalkulasi dan visuospasial. Faktor risiko yang secara bermakna mempengaruhi gangguan fungsi kognitif adalah masa kerja, lama kerja, kepatuhan pemakaian masker, stres kerja yang meliputi konflik peran, ketaksaan peran, beban kerja kualitatif, beban kerja kuantitatif, pengembangan karir dan tanggung jawab rekan kerja. Hasil analisis multivariat menunjukkan konflik peran merupakan faktor risiko yang paling mempengaruhi gangguan fungsi kognitif ( OR 7,546 Interval kepercayaan 95% 1,5 ? 41,88 ) Kesimpulan. Prevalensi penurunan fungsi kognitif studi ini lebih besar dari penelitian sebelumnya dan teori. Aspek kognitif yang menurun didominasi oleh atensi kalkulasi dan visuospasial. Konflik peran merupakan faktor risiko yang paling mempengaruhi gangguan fungsi kognitif.

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ABSTRACT
Background. Cognitive Function Impairment can happen among workers expose by Toluene. This impairment mainly effect in attention, concentration and memory function, and can decrease working productivity. This study aims to calculate the prevalence of Cognitive Function impairment and related risk factors Method. Cross sectional design study was conducted on 102 female workers, age 19-40 years old and graduated from senior high school. Age and education were obtained from secondary data, and followed by interviews, physical and laboratory examination and Mini Mental States Examination. The inclusion criteria were age ≥ 1 year of work and willing to be the subject of research. Exclusion criteria were pregnancy, menstruation, smoker, Alcohol consumption, history of head injury, hypertension, diabetes mellitus and Dyslipidemia. Risk factor included in this study were age, marital status, duration of work,time of work, PPE obedience ,work stress and nutritional status. Age, Marital status, Duration and Time of work were from secondary data of HRD department. Nutritional status was obtained from body mass index calculation. face mask obedience was obtained from data of wearing mask compliance. Work stress was assessed using Survey Diagnostic Stress Questionnaire. Results. The prevalence of Cognitive Function Impairment was 52 % , mainly at Attention ? Calculation and Visuospasial Aspect respectively. Significant risk factors ( p value < 0,05 ) in this study were duration of work and time of work, PPE obedience and all of work stress domain. The Result of multivariate analysis show that conflict of role was the most influence factor ( OR 7,546 C.I 95% 1,5 ? 41,88 ) Conclusion. This study found that the prevalence of cognitive function impairment was higher than theory and other similar studies . Cognitive aspects mainly affected were attention ? calculation and visuospatial. Conflict of role was the most inluence risk factor relating with cognitive function impairment;Background. Cognitive Function Impairment can happen among workers expose by Toluene. This impairment mainly effect in attention, concentration and memory function, and can decrease working productivity. This study aims to calculate the prevalence of Cognitive Function impairment and related risk factors Method. Cross sectional design study was conducted on 102 female workers, age 19-40 years old and graduated from senior high school. Age and education were obtained from secondary data, and followed by interviews, physical and laboratory examination and Mini Mental States Examination. The inclusion criteria were age ≥ 1 year of work and willing to be the subject of research. Exclusion criteria were pregnancy, menstruation, smoker, Alcohol consumption, history of head injury, hypertension, diabetes mellitus and Dyslipidemia. Risk factor included in this study were age, marital status, duration of work,time of work, PPE obedience ,work stress and nutritional status. Age, Marital status, Duration and Time of work were from secondary data of HRD department. Nutritional status was obtained from body mass index calculation. face mask obedience was obtained from data of wearing mask compliance. Work stress was assessed using Survey Diagnostic Stress Questionnaire. Results. The prevalence of Cognitive Function Impairment was 52 % , mainly at Attention – Calculation and Visuospasial Aspect respectively. Significant risk factors ( p value < 0,05 ) in this study were duration of work and time of work, PPE obedience and all of work stress domain. The Result of multivariate analysis show that conflict of role was the most influence factor ( OR 7,546 C.I 95% 1,5 – 41,88 ) Conclusion. This study found that the prevalence of cognitive function impairment was higher than theory and other similar studies . Cognitive aspects mainly affected were attention – calculation and visuospatial. Conflict of role was the most inluence risk factor relating with cognitive function impairment, Background. Cognitive Function Impairment can happen among workers expose by Toluene. This impairment mainly effect in attention, concentration and memory function, and can decrease working productivity. This study aims to calculate the prevalence of Cognitive Function impairment and related risk factors Method. Cross sectional design study was conducted on 102 female workers, age 19-40 years old and graduated from senior high school. Age and education were obtained from secondary data, and followed by interviews, physical and laboratory examination and Mini Mental States Examination. The inclusion criteria were age ≥ 1 year of work and willing to be the subject of research. Exclusion criteria were pregnancy, menstruation, smoker, Alcohol consumption, history of head injury, hypertension, diabetes mellitus and Dyslipidemia. Risk factor included in this study were age, marital status, duration of work,time of work, PPE obedience ,work stress and nutritional status. Age, Marital status, Duration and Time of work were from secondary data of HRD department. Nutritional status was obtained from body mass index calculation. face mask obedience was obtained from data of wearing mask compliance. Work stress was assessed using Survey Diagnostic Stress Questionnaire. Results. The prevalence of Cognitive Function Impairment was 52 % , mainly at Attention – Calculation and Visuospasial Aspect respectively. Significant risk factors ( p value < 0,05 ) in this study were duration of work and time of work, PPE obedience and all of work stress domain. The Result of multivariate analysis show that conflict of role was the most influence factor ( OR 7,546 C.I 95% 1,5 – 41,88 ) Conclusion. This study found that the prevalence of cognitive function impairment was higher than theory and other similar studies . Cognitive aspects mainly affected were attention – calculation and visuospatial. Conflict of role was the most inluence risk factor relating with cognitive function impairment]

Abstrak :
Penderita epilepsi anak memiliki risiko tinggi mengalami gangguan kognitif yang mempengaruhi kualitas hidup. Penelitian ini dilakukan untuk mengetahui prevalensi gangguan kognitif pada usia 8-11 tahun menggunakan Mini Mental State Examination MMSE modifikasi Ouvrier. Metode penelitian potong lintang dilakukan di Rumah Sakit Cipto Mangunkusumo RSCM dan Pasar Rebo pada Mei-Juni 2018. Tiga puluh satu pasien diikutsertakan dalam penelitian ini. Jumlah laki-laki dan perempuan adalah 58,1 dan 41,9 . Sebagian besar subyek berasal dari RSCM 87,1 dengan kelompok usia terbanyak 10-11 tahun 48,4 . Prevalensi gangguan kognitif sebesar 74,2 . Sebanyak 87,5 subyek dengan obat anti epilepsi OAE politerapi mengalami gangguan kognitif. Terdapat perbedaan bermakna jumlah bangkitan 11-100 kali selama hidup dengan gangguan kognitif p

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Children with epilepsy are at high risk of cognitive disorders. We performed cross sectional study to evaluate clinical characteristics and prevalence of cognitive disorders in children aged 8 ndash 11 years using Ouvrier rsquo s Modified Mini Mental State Examination MMSE . The study was done in Cipto Mangunkusumo RSCM and Pasar Rebo Hospital from May June 2018. Thirty one patients were enrolled. Male and female were 58,1 and 41,9 . The prevalence of cognitive disorder was 74,2 . There was 87,5 patients with AEDs polytherapy had cognitive disorders. It was significantly different between lifetime seizure frequency 11 100 with cognitive disorder p10 times had 59,5 higher risk, and AEDs polytherapy showed tendency of cognitive impairment risk.

Abstrak :
Prevalensi gejala depresi pada orang dengan demensia ODD berkisar 30-50 . Hal ini menandakan bahwa pada sebagian besar ODD gejala depresi timbul beriringan dengan penurunan kognitif. Beberapa penelitian mengemukakan bahwa gejala depresi pada demensia timbul karena ODD kehilangan kemandirian dalam beraktivitas sehari-hari serta melupakan banyak hal esensial dalam hidup, seperti nama keluarga dan kerabat, terutama pada ODD dengan tingkat pendidikan yang tinggi. Penelitian ini ingin melihat apakah terdapat korelasi antara skor gejala depresi dan skor kognitif global dengan memeriksa 42 ODD menggunakan Montgomery-Asberg Depression Rating Scale MADRS untuk menilai skor gejala depresi dan Mini Mental State Examination MMSE untuk menilai skor kognitif global. Pada penelitian ini ODD yang digunakan sebagai subjek penelitian dibatasi, yaitu hanya ODD dengan rentang skor MMSE 17-23 gangguan kognitif ringan dan MADRS.

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T is estimated that 30 50 of people with dementia PWD suffer from significant depression. This fact marks that in most PWD, depression occurs at the same time with cognitive decline. Several researches explain that this happens because PWD cannot run their daily activities independently and forgot many essential things, such as family. It is also known that depression occurs more in highly educated people. Therefore, this research is made with the intention to find the correlation between the depression score and global cognitive score in 42 PWD using Montgomery Asberg Depression Rating Scale MADRS to assess the symptoms of depression and Mini Mental State Examination MMSE to assess te global cognitive score. PWD that are included in this research restricted only they who had MMSE score between 17 and 23 mild cognitive impairment , and MADRS score below 34 no depression, mild depression, and moderate depression . Of 42 subjects, depression occurred in 41 97,6 of 42 subjects and the global cognitive score mean is 19,53. Depression score has a strong correlation with global cognitive score r 0,647, p

Abstrak :
Salah satu dampak dari proses penuaan adalah penurunan kognitif. Penurunan kognitif merupakan manifestasi awal dari masalah demensia. Lansia dengan demensia akan menimbulkan masalah keperawatan pada dirinya. Salah satu masalah keperawatan yang ditemui pada lansia degan demensia yaitu konfusi kronis. Konfusi kronis merupakan masalah keperawatan yang memerlukan asuhan keperawatan jangka panjang. Tujuan dari penulisan ini yaitu memaparkan hasil asuhan keperawatan pada Warga Binaan Sosial J di PSTW Budi Mulya 01 Cipayung, DKI Jakarta dengan instrumen evaluasi berupa Mini Mental State Examination. Intervensi keperawatan unggulan untuk mengatasi masalah konfusi kronik pada klien J adalah dengan stimulasi kognitif menggunakan metode Neurobic Exercise. Hasil yang didapatkan menunjukkan bahwa klien mengalami peningkatan skor MMSE dari sebelumnya 11 yang berarti gangguan kognitif berat menjadi 16 masih dengan gangguan kognitif berat. Neurobic Exercise dilakukan selama 5 minggu dengan durasi 45 menit sebanyak 2 hari setiap pekan untuk membantu meningkatkan atau mempertahankan fungsi kognitif pada lansia.

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One of the effects of aging is cognitive decline. Cognitive decline is an early manifestation of dementia problems. Older adults with dementia will cause nursing problems. One of the nursing problems encountered in the older adults with dementia is chronic confusion. Chronic confusion is a nursing problem that requires long-term nursing care. The purpose of this paper is to describe the results of nursing care in client J in PSTW Budi Mulya 01 Cipayung, DKI Jakarta with evaluation instruments in the form of Mini Mental State Examination. Superior nursing orders to overcome chronic confusion problems in client J is by cognitive stimulation using the Neurobic Exercise method. The results show that the client experienced an increase in MMSE score from the previous 11 wich is severe cognitive impairment to 16 still same as severe cognitive impairment. Neurobic Exercise is performed for 5 weeks with 45 minutes duration of 2 days per week to help improve or maintain cognitive function in the older adults.

Abstrak :
Kejadian demensia merupakan masalah kesehatan yang memiliki banyak dampak terhadap kualitas hidup serta ditakuti sebagian besar lansia. Demensia merupakan suatu sindrom gangguan fungsi kognitif yang bersifat progresif yang dapat mengganggu fungsional seseorang akibat dari penurunan fungsi kognitif yang cukup kompleks mulai dari penurunan ingatan hingga gangguan fungsi sosial. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran dan pengaruh penerapan DAHLIA (Andal dan Ahli Dalam Merawat Lansia Demensia): Modifikasi Cognitive Stimulation Therapy sebagai bentuk Evidence Based Nursing Practice pada lansia demensia. Penelitian ini dilakukan dengan desain studi kasus di keluarga dan komunitas dengan lansia dan keluarga sebagai partisipan dengan jumlah 10 keluarga dan 70 lansia di komuitas yang dipilih sesuai kriteria dan secara convenience sampling. Hasil evaluasi intervensi DAHLIA menunjukkan terjadi peningkatan sebelum dan sesudah intervensi pada kemandiran keluarga (rerata 3,7), pengetahuan, sikap, dan keterampilan lansia (p = 0.000), nilai HVLT (p = 0.000), dan nilai MMSE (p = 0.000). Intervensi DAHLIA efektif untuk meningkatkan kemandirian keluarga dalam merawat lansia dan fungsi kognitif pada lansia demensia. Intervensi ini sebaiknya dapat dilakukan secara berkelanjutan untuk meningkatkan status kesehatan dan kualitas hidup lansia dengan masalah demensia di wilayah Kelurahan Mekarjaya, Depok

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The incidence of dementia is a health problem that has many impacts on quality of life and is feared by most of the elderly. Dementia is a progressive syndrome of cognitive dysfunction that can disrupt a person's function due to a decline in cognitive function that is quite complex ranging from memory loss to impaired social function. This study aims to provide an overview and influence of the application of DAHLIA (Reliable and Expert in Caring for Elderly Dementia): Modification of Cognitive Stimulation Therapy as a form of Evidence Based Nursing Practice in elderly dementia. This research was conducted with a case study design in families and communities with the elderly and families as participants with a total of 10 families and 70 elderlies in the community selected according to criteria and by convenience sampling. The results of the evaluation of DAHLIA interventions showed an increase before and after the intervention on family independence (mean 3.7), elderly people's knowledge, attitudes and skills (p = 0,000), HVLT values (p = 0,000), and MMSE values (p = 0,000) . DAHLIA interventions are effective for increasing family independence in caring for the elderly and cognitive function in the elderly with dementia. This intervention should be carried out continuously to improve the health status and quality of life of the elderly with dementia problems in the Mekarjaya district, Depok

Abstrak :
Latar Belakang: Saat ini prevalensi kebutuhan anestesi umum pada pasien geriatri semakin meningkat. Tanpa modalitas pemantauan yang memadai, pemberian agen anestesi yang berlebihan dapat menciptakan plana anestesi yang lebih dalam. Bispectral index (BIS) merupakan alat pemantauan kedalaman hipnosis melalui pengolahan data elektroensefalogram (processed EEG). Penelitian ini bertujuan membandingkan durasi deep hypnotic time (DHT) pada pasien geriatri yang menjalani anestesi umum dengan penambahan pemantauan BIS dibandingkan pemantauan standar. Metode: Penelitian ini merupakan uji klinis acak tersamar tunggal melibatkan 44 pasien geriatri yang menjalani anestesi umum untuk prosedur operasi. Subjek dibagi menjadi dua kelompok yakni kelompok perlakuan yang mendapatkan tambahan pemantauan BISTM dan kelompok kontrol dengan pemantauan standar sesuai ASA. Data BISTM dari kedua kelompok akan direkam secara kontinyu untuk dianalisis selanjutnya. Terhadap subjek, dilakukan pemeriksaan MMSE prabedah dan pascabedah serta pencatatan waktu emergence. Hasil: Penambahan pemantauan BISTM dapat menurunkan durasi DHT bila dibandingkan dengan pemantauan standar dengan durasi DHT untuk kelompok BIS dan kontrol masing-masing sebesar 12 menit (0-122) dan 21,5 menit (0-200 menit) (nilai p = 0,36). Pada populasi penelitian didapatkan nilai BIS loss of consciousness (BIS LOC) sebesar 80,55 ± 6,48. Penurunan nilai MMSE pascabedah lebih kecil pada kelompok BIS (0,5 vs 2,0; nilai p = 0,06). Durasi waktu pulih sadar didapatkan lebih panjang pada kelompok BIS yakni 28,45 ± 13,48 bila dibandingkan dengan kelompok kontrol sepanjang 22,35 ± 7,81 (nilai p = 0,09; IK 95% -1,01 s/d 13,21 menit). Terdapat kecenderungan terjadinya anestesi yang lebih dangkal pada pemantauan standar yang ditunjukkan oleh nilai BIS tertinggi intraoperatif dan durasi BIS >60. Nilai BIS tertinggi didapatkan lebih tinggi pada kelompok kontrol (73,2 ± 11,41 vs 69,4 ± 8,31) dengan durasi BIS >60 yang lebih panjang pada kelompok kontrol (30 menit vs 8,5 menit) Simpulan: Tidak terdapat perbedaan bermakna antara durasi DHT pada pasien geriatri yang menjalani anestesi umum dengan penambahan pemantauan BISTM dibandingkan pemantauan standar. ......Background: The current need for general anesthesia in geriatric population has increased. Without adequate monitoring modality, the administration of anesthetic agents can create unnecessary deeper anesthetic plane. Bispectral index (BIS) is an equipment to monitor the depth of hypnosis through processing raw EEG data. This study aims to compare the duration of deep hypnotic time (DHT) in geriatric patients undergoing general anesthesia with additional BIS monitor compared to standard monitoring. Methods: This study was a randomized, single-blind clinical trial involving 44 geriatric patients undergoing general anesthesia for surgical procedures. Subjects are divided into two groups, one with additional BISTM monitor and the other with standard monitoring according to ASA. Data acquired from BISTM will continually be recorded to be analyzed afterward. Subjects will be eveluated with MMSE prior and after undergoing general anesthesia and emergence time will be recorded. Result: Additional BISTM monitor can decrease duration of DHT compared to standard monitoring with DHT for BIS and control group, respectively, 12 minutes (0-122) and 21.5 minutes (0-200 menit) (p value = 0.36). In study population, BIS value for loss of consciousness (BIS LOC) is 80.55 ± 6.48. The decrease of MMSE value post operative is smaller in BIS group compared to control group (0.5 vs 2.0; p value = 0.06). Emergence time is longer in BIS group (28.45 ± 13.48 minutes) compared to control group (22.35 ± 7.81 minutes) with p value = 0.09, 95% CI - 1.01 s/d 13.21 minutes. There was tendency of light anesthesia conduct in control group as shown in comparison of intraoperative highest BIS value and duration of BIS value >60. Higher BIS value is observed in control group (73.2 ± 11.41 vs 69.4 ± 8.31) with longer duration of BIS value >60 compared to BIS group (30 minutes vs 8.5 minutes, respectively). Conclusion: There is no significant difference in duration of DHT between geriatric population undergoing general anesthesia with additional BISTM monitor compared to standard monitoring.

Abstrak :
Background: overactive bladder (OAB) affects 17-41% older adults in community dwelled setting. For several years, antimuscarinics have been validated as the first-line medical treatment for OAB. Despite abundant data obtained from clinical trials provisions the use of antimuscarinics, investigation about the effect of this drug on cognitive function in elderly remains scarce. The objective of this study is to investigate the effect of antimuscarinics therapy on cognitive functions in OAB geriatric patients. Methods: this study design is a systematic review and meta-analysis. Studies were collected using several search engines; those were PubMed, Science Direct, Cochrane, and EBSCOhost using predetermined MeSH keywords with Boolean operators. Selection of studies was done by three reviewers. Studies which fulfilled the inclusion and exclusion criteria underwent full-text review. For every selected full text, we extracted the following data if available: patients demographics, types of antimuscarinics used, placebo, dose, follow-up period, and Mini-Mental State Examination (MMSE) total score. Results: a total of 8 studies from an initial 146 publications were selected. There were 8 antimuscarinic agents evaluated in the studies, including Oxybutynin, Darifenacin, Tolterodine, Trospium, Imidafenacin, Propiverine hydrochloride, Fesoterodine, and Solifenacin. Oxybutynin was shown to have largest effect towards the decline of MMSE score [Mean difference: -2.90; 95% CI: -4.07, -1.73]. Darifenacin and Tolterodine were also shown to be significant in the decline of total MMSE score, although still inferior to Oxybutynin. Conclusion: the use of most antimuscarinics medication has little to no effect towards the cognitive function in the management of overactive bladder in elderly patients. However, Oxybutynin, Darifenacin, and Tolterodine was shown to have significant decrease in cognitive functions, as shown in the decline of total MMSE score.