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"ABSTRACTBackground: the aging process causes decreasing in the function of various organs. Skletal muscle is one of the organs affected by aging process. It is known as sarcopenia. Sarcopenia is defined as a syndrome characterized by progressive loss of muscle mass and strength. The handgrip strength examination is often applied as a sarcopenia filtering technique. This study aimed to determine the relationship between age, nutritional status, and chronic diseases such as stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD), and chronic obstructive pulmonary disease (COPD) with handgrip strength. Methods: a cross-sectional study to determine factors related to the handgrip strength in elderly patients was conducted in Geriatric outpatient clinic of Cipto Mangunkusumo Hospital and Mohammad Hoesin Hospital from August to October 2015. There were 352 eligible subjects in this study recruited with consecutive sampling. The independent variables in the study consisted of age, sex, nutritional status, chronic disease (stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD)), waist circumference while the dependent variable was handgrip strength. Results: age of more than 75 years old and malnutriton were risk factors that affected hangrip strength. Age of >75 years increase the risk for having low handgrip strength by 2,3-fold. Malnutrition increased risk for low handgrip strength for 1,9-fold. Conclusion: ages of >75 years old and malnutrition will increase the risk of low handgrip strength in elderly patients."

"Background: sarcopenia contributes to the development of frailty syndrome. Frailty syndrome is potentially improved by modifying insulin resistance, inflammation, and myostatin level. This study is aimed to investigate the effect of metformin on handgrip strength, gait speed, myostatin serum level, and health related quality of life (HR-QoL) among non diabetic pre frail elderly patients.Methods: a double blind randomized controlled trial study was conducted on non-diabetic elderly outpatients aged >60 years with pre frail status based on phenotype and/ or index criteria (Cardiovascular Health Study and/ or Frailty Index 40 items) consecutively recruited from March 2015 to June 2016 at Cipto Mangunkusumo Hospital. One hundred twenty subjects who met the research criteria were randomized and equally assigned into 3 x 500 mg metformin or placebo group. The study outcomes were measured at baseline and after 16 weeks of intervention.Results: out of 120 subjects, 43 subjects in metformin group and 48 subjects in placebo group who completed the intervention. There was a significant improvement on the mean gait speed of metformin group by 0.39 (0.77) second or 0.13 (0.24) meter/second that remained significant after adjusting for important prognostic factors (p = 0.024). There was no significant difference on handgrip strength, myostatin serum level, and HR QoL between both groups.Conclusion: 3 x 500 mg metformin for 16 weeks was statistically significant and clinically important in improving usual gait speed as one of the HR QoL dimensions, but did not significantly improve the EQ 5D index score, handgrip strength, nor myostatin serum level."

"ABSTRAK Imbang nitrogen pada pasien sakit kritis selalu negatif akibat respon stres. Pada lansia perubahan metabolismenya berisiko memperburuk imbang nitrogen. Tujuan penelitian ini adalah untuk mengetahui imbang nitrogen dan hubungannya dengan asupan energi dan protein pada lansia sakit kritis dalam 48 jam pertama di ICU. Penelitian ini menggunakan metode potong lintang, consecutive sampling. Subyek penelitian adalah 26 lansia sakit kritis. Hasil penelitian pada 24 jam I dan II adalah; imbang nitrogen -5,2 (-31,2 − -4,1) g dan -4,5+4,6; asupan energi 78,8+45,0% dan 91,1+50,2% terhadap target; asupan protein 0,57+0,35 g/kgBB/hari dan 0,71+0,37 g/kgBB/hari serta terdapat korelasi positif bermakna antara imbang nitrogen dengan asupan energi; r=0,6 dan r=0,5 dan korelasi positif bermakna antara imbang nitrogen dengan asupan protein; r=0,5 dan r=0,4. Kesimpulan penelitian ini adalah terdapat hubungan bermakna antara imbang nitrogen dengan asupan energi dan protein pada lansia sakit kritis

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ABSTRAK Nitrogen balance in criticaly ill patients tend to be negative due to stress response. In the elderly patients, the metabolic changes risk to worsening nitrogen balance.The aim of this study is to determine nitrogen balance and its relation with energy and protein intake in critically ill elderly patients within 48 hours in ICU. The study was cross sectional, consecutive sampling on 26 subjects. The nitrogen balances were -5.2 (-31.2 − -4.1) g and -4.5+4.6 g; energy intakes were 78.8+45.0% and 91.1+50.2% target; protein intakes were; 0.57+0.35 g/kgBW/d and 0.71+0.37 g/kgBW/d. There were positive correlation between nitrogen balance and energy intake; r=0.6 and r=0.5, and between nitrogen balance and protein intake; r=0.5 and r=0.4 in 24 hours I and II respectively. The conclusion is there were positive correlation between nitrogen balance with energy and protein intakes."

"Pelayanan kesehatan lansia saat ini belum optimal. Puskesmas DTP Bayah untuk pelayanan kesehatan lansia belum memenuhi SPM (70%). Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan kunjungan ke posyandu lansia. Penelitian kuantitatif dengan desain cross sectional digunakan pada 140 lansia, data dikumpulkan melalui wawancara dengan kuesioner. Hasil penelitian didapatkan 88,6% berkunjung ke posyandu lansia. Umur, dukungan keluarga, pekerjaan dan pengetahuan berhubungan dengan kunjungan ke posyandu lansia dan pengetahuan faktor yang paling dominan. Lansia berpengetahuan tinggi kemungkinan 18x datang ke posyandu lansia dibandingkan yang rendah. Kepada dinas kesehatan dan puskesmas bersinergi dengan lintas sektoral untuk meningkatkan kunjungan ke posyandu lansia.

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Medical care for elderly health not optimalize. Puskemas DTP Bayah services has not met yet the 70% minimum service standards (SPM). The purpose of this study is to determine the relationship for visits to posyandu for elderly.This research is quantitative cross-sectional design. Data was collected by way of interviews with 140 elderly. The results shows that age has a significant association, family support, occupation and knowledge. Knowledge is the most dominant factor. The advice for health services and health centers is to cross-sector synergies that can support an increase in visits to Posyandu for the elderly"

"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."

"ABSTRAK Pernikahan suatu kebutuhan semua individu baik pria maupun wanitadewasa, pernikahan termasuk rangkaian hirarki kebutuhan dasar, kemampuanlansia yang tidak menikah dalam menemukan makna hidup sangat dibutuhkanTujuan penelitian mendapatkan pemahaman yang mendalam tentang makna hiduplansia tidak menikah. Penelitian ini menggunakan pendekatan kualitatif dengandesain fenomenologi, jumlah partisipan sebanyak tujuh orang, tempat penelitianpanti wreda di Kota Bandung. Hasil penelitian menemukan dua puluh satukategori dan enam tema yaitu memaknai sebuah pernikahan, alasan tidakmenikah, perhatian keluarga tentang pernikahan, konsekuensi psikologis tidakmenikah, menerima tidak menikah sebagai ketetapan Tuhan dan hikmah positiftidak menikah. Penelitian ini direkomendasikan bagi peneliti selanjutnya untukmelakukan penelitian sejenis dikomunitas.

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ABSTRACT Being married is a need for adult women and man. Marriage is a part ofhuman needs hierarchy. The ability of unmarried elderly in finding the meaning oflife is needed. The purpose of this study was to have a depth understanding of themeaning of life for unmarried elderly. This study used the qualitative researchmethod with fenomenological approach, number of participants as many as sevenpeople, place of this study in Nursing Home Bandung City. The finding of thisresearch revealed twenty one categorics and six main themes. The themes weremeaning of a marriage, the reasons of unmarried, family concern about marriage,psychological consequences of being unmarried, accepting of not being marriedas the GOD?s wish and a positive meaning for not being married. This researchwas recommended for further research to conduct similar research the community."

"ABSTRAKIndonesia mengalami penuaan penduduk yang sangat cepat. Diperkirakan populasipenduduk lansia di Indonesia akan mencapai 28,8 juta (11,3%) pada tahun 2020dan mencapai 100 juta (28,68%) pada tahun 2050. Perhatian mengenai bagaimanapenuaan sukses dan determinanya menjadi sebuah isu penting yang harusdieksplorasi sebagai dukungan informasi bagi penentu kebijakan dalammerancang kebijakan dan intervensi efektif untuk meningkatkan kualitas hiduplansia di Indonesia. Tujuan penelitian ini adalah untuk mengeksplorasi aspekmultidimensional penuaan sukses dan memperoleh model prediksi penuaan suksespada lansia di Indonesia.Penelitian ini menggunakan desain studi kohort retrospektif menggunakan dataIFLS (Indonesian Family Life Survey) dengan mengikuti individu selama tujuhtahun yaitu pada titik waktu pengukuran survei IFLS 2000 dan IFLS 2007. Jumlahsampel penelitian ini adalah 2.344 lansia (≥ 53 tahun). Model pengukuran penuaansukses diuji dan dianalisis menggunakan comfirmatory factor analysis (CFA).Analisis regresi logistik ganda digunakan untuk memperoleh model prediksipenuaan sukses.Penelitian ini menghasilkan konsep model penuaan sukses multidimensional yangmemiliki kriteria kecocokan model yang baik serta validitas dan reliabilitas yangcukup baik dengan kontribusi masing-masing yaitu keberfungsian mental (78%),keterlibatan aktif (64%), keberfungsian fisik (62%), spiritualitas (2,7%) dan bebasdari penyakit (0,1%). Hasil model prediksi penuaan sukses terdiri dari tujuhvariabel meliputi faktor individu (usia, jenis kelamin, pendidikan, aktivitas fisikdan waist circumference) dan faktor lingkungan (tingkat pengeluaran nabati danpartisipasi program dana sehat). Kelompok usia 60-69 tahun memiliki peluangsukses 2,211 (95% CI=1,077-4,539), kelompok usia 53-59 tahun sebesar 3,568(95%CI=1,765-7,216). Lansia laki-laki memiliki peluang 1,595 (95%CI=1,133-2,247), lansia dengan pendidikan rendah memiliki peluang 2,805 (95%CI=1,776-4,429), pendidikan menengah/tinggi 4,128 (95%CI=2,272-7,500). Lansia denganaktivitas fisik sedang memiliki peluang sukses 4,258 (95%CI=2,352-7,709),aktivitas ringan 3,964 (95%CI=2,228-7,052) dan aktivitas berat 3,675(95%CI=2,054-6,576). Lansia dengan Waist Circumference tidak berisikomemiliki peluang sukses 1,688 (95%CI=1,092-2,610). Lansia dengan tingkatpengeluaran nabati tinggi memiliki peluang sukses 1,384 (95%CI=1,010-1,898),lansia yang berpastisipasi dalam program dana sehat berpeluang sukses 1,779(95%CI=1,181-2,680). Implikasi hasil penelitian terhadap kebijakan berupa tigapilar utama yang menentukan penuaan sukses yaitu partisipasi, kesehatan danjaminan sosial. Selain ketiga pilar tersebut, gender juga merupakan determinanapenting penuaan sukses. Oleh karena itu kesetaraan gender perlu dipertimbangkandalam setiap pilar kebijakan

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ABSTRACTIndonesia experienced rapid population aging. It is estimated that the elderlypopulation in Indonesia will reach 28.8 million (11.3%) in 2020 and 100 million(28.68%) in 2050. Caution regarding how successful aging and its determinantbecome an important issue that should be explored as support information forpolicy makers in designing effective policies and interventions to improve thequality of life of the elderly in Indonesia. The objective of this study was toexplore the multidimensional aspects of successful aging and obtain predictivemodels successful aging in the elderly in Indonesia.This study used a retrospective cohort study design using the data IFLS(Indonesian Family Life Survey) by following people for seven years, namely atthe point of measurement time survey IFLS IFLS 2000 and 2007. The amount ofthe sample is 2,344 elderly (≥ 53 years). Successful aging measurement modelwas tested and analyzed using Comfirmatory Factor Analysis (CFA). Multiplelogistic regression analysis is used to derive predictive model of successful aging.This research resulted in the concept of multidimensional models of successfulaging that has good validity and reliability. Each contribution were mentalfunctioning (78%), active involvement (64%), physical functioning (62%),spirituality (2.7%) and free of the disease (0.1%). Successful aging predictionmodels resulting from this study consisted of seven variables include individualfactors (age, gender, education, physical activity and waist circumference) andenvironmental factors (level of expenditure vegetable and healthy fund programparticipation). Age group 60-69 years had a chance of success 2.211 (95% CI =1.077 to 4.539), age group 53-59 years amounted to 3.568 (95% CI = 1.765 to7.216). Elderly men had chances 1.595 (95% CI = 1.133 to 2.247), elderly peoplewith low education had a chance 2.805 (95% CI = 1.776 to 4.429), secondaryeducation / high 4.128 (95% CI = 2.272 to 7.500). Elderly with moderate physicalactivity had a chance of success 4.258 (95% CI = 2.352 to 7.709), light activities3.964 (95% CI = 2.228 to 7.052) and strenuous activities 3,675 (95% CI = 2.054to 6.576). Elderly with no risk of waist circumference had a chance of success1.688 (95% CI = 1.092 to 2.610). Elderly with a high level of expenditurevegetable has a chance of success 1.384 (95% CI = 1.010 to 1.898), elderly whoparticipates in the healthy fund program likely to succeed 1.779 (95% CI = 1.181to 2.680). Implications of the results of research on policy in the form of the threemain pillars that determine successful aging, namely participation, health andsocial security. In addition to the three pillars, gender is also an importantdeterminana successful aging. Therefore, gender equality need to be considered inany policy pillars"

"ABSTRAKLatar Belakang: Gangguan keseimbangan dan mobilitas merupakan penyebab terbesar disabilitas pada usia lanjut 60 tahun atau lebih. Keseimbangan dan mobilitas merupakan faktor penting dalam melakukan aktivitas fungsional. Masalah paling serius dari gangguan mobilitas adalah kecenderungan usia lanjut untuk jatuh dan menjadi cedera akibat jatuh. Faktor lainnya yang mempengaruhi jatuh adalah rasa takut jatuh. Latihan keseimbangan dapat menurunkan insiden jatuh pada usia lanjut, namun usia lanjut yang berisiko jatuh sering menolak untuk mengikuti program latihan di rumah sakit. Program latihan di rumah memungkinkan individu untuk latihan secara mandiri, dengan biaya yang murah, dan sesuai untuk usia lanjut dengan keterbatasan akses ke fasilitas latihan. Penelitian ini bertujuan untuk mengetahui pengaruh latihan keseimbangan yang dilakukan di rumah selama 8 minggu terhadap mobilitas fungsional dan rasa takut jatuh pada usia lanjut.Metode: Disain penelitian ini adalah Randomized Controlled Trial. Populasi terjangkau adalah usia lanjut ≥ 60 tahun yang ada di Poliklinik Geriatri Terpadu dan Poliklinik Rehabilitasi Medik rumah sakit Cipto Mangunkusumo Jakarta yang memenuhi kriteria penelitian. Pengambilan sampel dilakukan secara consecutive sampling, dan dibagi menjadi dua kelompok secara randomisasi permutasi blok. Kelompok keseimbangan diberi latihan keseimbangan dan kelompok kontrol diberi latihan penguatan ekstremitas atas selama 8 minggu. Untuk menilai mobilitas fungsional digunakan uji Time Up and Go (TUG), sedangkan rasa takut jatuh dinilai dengan instrumen Falls Efficacy Scale – International (FES-I).Hasil: 94 responden mengikuti program latihan sampai selesai, kelompok keseimbangan (46 orang) dengan rerata umur 69,7 ± 6,03 tahun, dan kelompok kontrol (48 orang) dengan rerata umur 70,35 ± 6,95 tahun. Nilai uji TUG kelompok keseimbangan pada minggu ke-1 adalah 10,11 (7,41-16,52) detik dan menurun menjadi 9,24 (7,11-17,00) detik setelah 8 minggu latihan, (p < 0,001), dibandingkan dengan kelompok kontrol terdapat penurunan yang signifikan pada uji TUG minggu ke-1 dan minggu ke-8, p = 0,001. Nilai FES-I minggu ke-1 adalah 23,0 (16-38), dan setelah 8 minggu latihan terdapat penurunan menjadi 18,5 (16-35), p < 0,001, namun dibandingkan dengan kelompok kontrol tidak menunjukkan perbedaan yang signifikan, p = 0,166 Kesimpulan: Terdapat peningkatan mobilitas fungsional yang bermakna secara statistik berdasarkan uji TUG pada kelompok keseimbangan dibandingkan dengan kelompok kontrol, setelah 8 minggu latihan. Dan terdapat penurunan rasa takut jatuh yang diukur menggunakan nilai FES-I pada kelompok keseimbangan setelah 8 minggu latihan, namun dibandingkan dengan kelompok kontrol tidak ada perbedaan bermakna.

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ABSTRACTBackground: Impaired balance and mobility are the biggest cause of disability in the elderly 60 years or more. Balance and mobility is an important factor in performing functional activities. The most serious problem is the tendency of the mobility-impaired elderly to fall and be injured by falling. Another factor affecting the fall is fear of falling. Balance training can reduce the incidence of falls in the elderly, however, older adults who are at risk usually refuse to participate in hospital-based exercise programs. Home-based exercises may allow individuals to practice independently, with low cost, and may be appropriate for the elderly with limited access to exercise facilities. The aim of this study is to determine the effect of balance exercises done at home for 8 weeks on functional mobility and the fear of falling in the elderly.Methods: The design of the study was randomized controlled trial. The population was the elderly ≥ 60 years old at Integrated Geriatric Polyclinic and Physical Medicine and Rehabilitation Polyclinic in Cipto Mangunkusumo Hospital Jakarta who fit the criteria. Sampling was done by consecutive sampling, and were divided into two groups by randomized block permutation. The balance group was given balance exercises and the control group was given upper extremity strengthening exercises for 8 weeks. Functional mobility was assessed by Time Up and Go test (TUG), and to assess fear of falling was used the Falls Efficacy Scale - International (FES-I) instrument.Results: 94 respondents were completed the exercise program, the balance group (46 people) mean age 69.7 ± 6.03 years old, and the control group (48 people) mean age 70.35 ± 6.95 years old. TUG test in balance group was 10.11 (7.41-16.52) seconds at week-1 and improved to 9.24 (7.11-17.00) seconds after 8 weeks training, (p < 0.001). Compared to the control, the balance group had significantly improvement between TUG test week-1 and week-8, p = 0.001. FES-I test in balance group was 23.0 (16-38) at week-1 and after 8 weeks there is a decline to 18.5 (16-35), p < 0.001, but compared to the control group showed no significant difference, p = 0.166 .Conclusion: There is statistically significant increasing of functional mobility based on the TUG test in the balance group compared to the control group, after 8 weeks of training program, and there is a statistically significant reduction in fear of falling were measured using FES-I instrument in the balance group after 8 weeks of training program, but compared to the control group there is no significant difference."

"Penelitian-penelitian terdahulu menunjukkan bahwa perawatan anggota rumah tangga lansia yang mengalami disabilitas dan membutuhkan long-term care lebih banyak dilakukan oleh perempuan dan berpotensi mempengaruhi alokasi waktu yang dimiliki perempuan tersebut antara untuk perawatan anggota keluarga termasuk lansia, dan berperan aktif dalam angkatan kerja. Perempuan, terutama perempuan kawin, biasanya akan keluar dari pasar kerja atau mengurangi jam kerja mereka apabila terdapat lansia yang membutuhkan perawatan di dalam rumah tangganya. Menggunakan data SUSENAS Kor 2018 dan regresi multinomial dan regresi tobit, penelitian ini bertujuan untuk mengetahui hubungan antara skor gangguan fungsional lansia, yang merupakan pendekatan kebutuhan long-term care, dengan status bekerja (formal dan informal) dan jam kerja perempuan kawin yang ada di Indonesia.Penelitian ini menemukan bahwa lansia yang tinggal bersama dengan perempuan kawin di Indonesia secara rata-rata masih berada pada kelompok lansia "muda" dan dalam taraf belum membutuhkan long-term care. Dengan kondisi demikian, penelitian ini belum dapat menunjukkan hubungan yang negatif dan signifikan antara peningkatan skor gangguan fungsional lansia dan status bekerja (formal dan informal) serta jam kerja perempuan kawin yang tinggal bersama dengan lansia tersebut.

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Previous studies showed that the caregiving to disabled and requiring long-term care elderly is mostly performed by women. The caregiving women, especially the married ones, often facing the problem of time allocations, between work and caring for family members and disabled elderly. Using SUSENAS Kor 2018 data, this study investigates the relationship between the score of functional impairment of the elderly, which is an approach to long-term care needs, with working status (formal and informal) and working hours of married women co-residing with the elderly in Indonesia.This study found that the elderly who co-reside with married women in Indonesia are, on average, still in the "young old" age group and at the stage where they do not need long-term care yet. Consequently, this study provides no evidence of the negative and significant relationship between the increasing scores of functional impairment of the elderly and working status (formal and informal) and the working hours of married women living in the same household with the elderly."