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"Latar Belakang: Meningkatnya populasi geriatri membuat sindrom frailty akan banyak ditemui di praktik klinik sehari-hari. Fenotip frailty dikaitkan dengan rendahnya massa otot secara teori, namun masih terdapat perbedaan hasil di antara penelitian yang ada. Tujuan: Mengetahui rerata indeks massa otot pada populasi geriatri di rawat jalan dan hubungannya dengan status frailty. Metode: Penelitian menggunakan desain potong lintang terhadap pasien berusia ≥60 tahun di poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, periode waktu April-Juni 2018. Dilakukan pengambilan data antropometri, pengisian kuesioner Cardiovascular Health Study (CHS) dan pengukuran indeks massa otot dengan dual energy X-ray absoprtiometry (DXA). Parameter indeks massa otot diukur berdasarkan appendicular lean mass (ALM) yang disesuaikan dengan tinggi badan (ALM/TB2) dan indeks massa tubuh (ALM/IMT). Hasil: Didapatkan proporsi subjek frail, pre-frail dan robust berdasarkan skor CHS berturut-turut adalah 29,17%, 58,33% dan 12,5%. Terdapat perbedaan rerata indeks massa otot dengan parameter ALM/TB2 antara pasien yang frail dan yang tidak (6,54 (1,01) Kg/m2 vs 7,03 (0,91) Kg/m2; p=0,01), namun tidak halnya dengan ALM/IMT (p=0,72). Tidak terdapat hubungan yang bermakna baik antara kejadian sindrom frailty dengan indeks massa otot ALM/TB2 (PR 2,03; 95% IK 0,80-5,15; p=0,13) maupun ALM/IMT (PR 5,09; 95% IK 0,45-58,06; p=0,2). Dari analisis multivariat faktor perancu didapatkan hubungan bermakna antara nutrisi (PR 3,67; 95% IK 1,59-8,49; p=0,02) dan status fungsional (PR 4,94; 95% IK 2,01-11,75; p=0,00) dengan kejadian sindrom frailty. Simpulan: Indeks massa otot yang rendah saja tidak dapat dijadikan faktor prediktif terjadinya sindrom frailty, melainkan perlu digabungkan dengan parameter lain seperti kualitas atau fungsi otot, status fungsional dan nutrisi. Penggunaan indeks massa otot dengan parameter ALM/TB2 lebih disarankan.

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Background: Population ageing worldwide is rapidly accelerating along with development of frailty syndrome. A theoretical link between frailty and low lean mass has been established, and low lean mass as frailty predictor, but studies conducted show inconclusive result. Objectives: To obtain appendicular lean mass values among geriatric outpatients and its association with frailty status. Methods. Cross-sectional study conducted to elderly patients (≥60 years old) in the Geriatric Outpatient Clinic of Cipto Mangunkusumo National Referral Hospital in April-June 2018. Each subject underwent anthropometric measurement, frailty evaluation using Cardiovascular Health Study (CHS) questionnaire dan lean mass measurement using dual energy X-ray absoprtiometry (DXA). Appendicular lean mass (ALM) measured was adjusted by height squared (ALM/ht2) and BMI (ALM/BMI) Results: The proportion of frail, pre-frail and robust according to CHS were 29,17%, 58,33% and 12,5% respectively. We found significant difference in ALM/ht2 between frail dan non-frail subjects (6.54 (1.01) Kg/m2 vs. 7.03 (0,91) Kg/m2; p=0.01) but nonsignificant result for ALM/BMI (p=0.72). No association was found between frailty and muscle mass index of ALM/ht2 (PR 2.03; 95%CI 0.80-5.15; p=0.13) or ALM/BMI (PR 5.09; 95% CI 0.45-58.06; p=0.2). From multivariate analysis, there was significant association between nutritional status (PR 3,67; 95% CI 1,59-8,49; p=0,02), functional status (PR 4,94; 95% CI 2,01-11,75; p=0,00) and frailty. Conclusion: Low lean mass alone cannot be used as predictive factor for frailty syndrome, further analysis using another parameter such muscle's quality or function, nutritional status and functional status are needed. This study supports ALM/ht2 as chosen muscle index."

"Latar Belakang: Pendekatan indeks frailty 40 item (FI-40) dianggap sebagai alat terbaik untuk evaluasi mortalitas dan hospitalisasi sindrom frailty, tetapi sulit diterapkan dalam praktik klinis sehari-hari. Pendekatan dengan sistem skor CHS, SOF, dan FI-CGA lebih mudah diterapkan dalam praktik klinis sehari-hari, namun hingga saat ini belum ada data validasi di Indonesia. Tujuan: Mendapatkan rekomendasi mengenai alat ukur sindrom frailty yang mudah diterapkan dalam praktik klinis sehari-hari di Indonesia. Metode: Penelitian ini merupakan studi potong lintang dengan pendekatan uji diagnostik yang dilakukan pada pasien di poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, dengan usia ≥60 tahun, pada periode Mei-Juni 2013. Setiap subjek dinilai menggunakan sistem skor CHS, SOF, FI-CGA, dan FI-40. Dilakukan penilaian sensitivitas, spesifisitas, nilai prediksi positif (NPP), nilai prediksi negatif (NPN), rasio kemungkinan positif (RK+), dan rasio kemungkinan negatif (RK-) untuk masing-masing sistem skor CHS, SOF, dan FI-CGA dibandingkan dengan FI-40. Hasil: Proporsi individu yang termasuk dalam kategori frail, pre-frail, dan fit berdasarkan indeks frailty 40 item berturut-turut adalah 25,3%, 71%, dan 3,7%. Untuk membedakan individu frail dengan tidak frail, skor CHS memiliki sensitivitas 41,2%, spesifisitas 95%, NPP 73,7%, NPN 82,7%, RK+ 8,41 dan RK- 0,62. Skor SOF memiliki sensitivitas 17,6%, spesifisitas 99,5%, NPP 92,3%, NPN 78,1%, RK+ 35,2 dan RK- 0,83. Sedangkan skor FI-CGA memiliki sensitivitas 8,8%, spesifisitas 100%, NPP 100%, NPN 76,4%, RK+ tak terbatas, dan RK- 0,91. Kesimpulan: Tidak ada sistem skor yang dapat digunakan sebagai alat skrining yang baik untuk sindrom frailty, namun masing-masing sistem skor dapat digunakan sebagai alat diagnostik yang baik untuk sindrom frailty.

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Background: The Frailty Index 40-item (FI-40) approach is considered the best tool for evaluating mortality and hospitalization outcomes related to frailty syndrome, although it is challenging to implement in daily clinical practice. The CHS, SOF, and FI-CGA scoring systems are easier to use in daily practice, but there is no validation data available in Indonesia.

Aim: To obtain recommendations for a frailty syndrome diagnostic tool that is easy to implement in daily clinical practice in Indonesia.

Methods: This was a cross-sectional study with a diagnostic test approach conducted on patients aged ≥60 years at the Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital from May to June 2013. Each subject was assessed using the CHS, SOF, FI-CGA, and FI-40 scoring systems. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated for each scoring system compared to FI-40.

Results: The proportions of frail, pre-frail, and robust individuals based on the 40-item frailty index were 25.3%, 71%, and 3.7%, respectively. To differentiate between frail and non-frail individuals, the CHS score showed a sensitivity of 41.2%, specificity of 95%, PPV of 73.7%, NPV of 82.7%, LR+ of 8.41, and LR- of 0.62. The SOF score showed a sensitivity of 17.6%, specificity of 99.5%, PPV of 92.3%, NPV of 78.1%, LR+ of 35.2, and LR- of 0.83. The FI-CGA score showed a sensitivity of 8.8%, specificity of 100%, PPV of 100%, NPV of 76.4%, LR+ infinite, and LR- of 0.91.

Conclusion: No scoring system was found to be suitable as a screening tool for frailty syndrome; however, all scoring systems can be used as effective diagnostic tools for frailty with good predictive ability."

"Penelitian ini merupakan penelitian potong lintang yang bertujuan mengetahui korelasi antara kadar seng serum dengan aktivitas SOD eritrosit pada pasien geriatri non-frail dan frail di Poliklinik Geriatri RSUPN Cipto Mangunkusumo Jakarta pada pertengahan bulan Agustus 2014 sampai pertengahan bulan September 2014. Subjek didapatkan secara consecutive sampling, sebanyak 60 orang (30 orang untuk masing-masing kelompok non-frail dan frail) yang memenuhi kriteria penelitian dan mengikuti penelitian sampai selesai. Tidak didapatkan korelasi signifikan antara kadar seng serum dengan aktivitas SOD eritrosit subjek penelitian, baik secara keseluruhan maupun per kelompok.

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This cross-sectional study aimed to know the correlation between serum zinc level and the erythrocyte SOD activity both in non-frail and frail geriatric patients. These subjects were collected from mid-August 2014 to mid-September 2014 from the clinic of Geriatric, Cipto Mangunkusumo General Hospital. Through conducting a consecutive sampling, 60 subjects who met the study criteria and completed all study progress, that consisted 30 persons who represent each non- frail and frail group, were enrolled into this study. Serum zinc level did not show significant correlation with erythrocyte SOD activity, both overall and per group."