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"Latar Belakang: Sarkopenia dan obesitas sering ditemukan pada populasi lanjut usia (lansia). Kombinasi sarkopenia dan obesitas, yaitu obesitas sarkopenia, memiliki morbiditas dan mortalitas lebih tinggi dibandingkan salah satu entitas saja. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara obesitas perifer dan sentral dengan komponen sarkopenia. Metode: Studi potong-lintang ini memakai data sekunder dari penelitian validasi skor Sarcopenia Quality of Life (SARQoL) terhadap lansia ≥60 tahun di Poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia, periode April–Juni 2018. Analisis multivariat dilakukan terhadap obesitas (indeks massa tubuh [IMT] dan lingkar pinggang [LP]) dan komponen sarkopenia (kekuatan genggam tangan [KGT], indeks massa otot [appendicular skeletal muscle mass per tinggi badan kuadrat, ASMM/TB2], dan kecepatan berjalan) untuk disesuaikan dengan perancu (usia, diabetes melitus, dan aktivitas fisik). Nilai potong diagnostik masing-masing komponen sarkopenia memakai panduan the Asian Working Group on Sarcopenia (AWGS) 2019. Hasil: Rerata usia dari 120 subjek adalah 71,89 (6,11) tahun, dengan proporsi wanita 61,70%. Seluruh subjek menunjukkan rerata IMT 22,48 (4,60) kg/m2; median LP 91,48 (65,40-113,00) cm; rerata ASMM/TB2 6,88 (0,96) kg/m2; median KGT 20 (10,00-40,00) kg; dan rerata kecepatan berjalan 0,76 (0,23) meter/detik. KGT rendah ditemukan lebih sedikit pada kelompok obesitas perifer dibandingkan nonobesitas perifer (adjusted odds ratio OR 0,419; interval kepercayaan IK 95% 0,183-0,959; p=0,040). ASMM/TB2 rendah lebih sedikit pada kelompok obesitas sentral dibandingkan nonobesitas sentral (adjusted OR 0,087; IK 95% 0,029-0,262; p <0,001). Simpulan: Terdapat efek protektif obesitas perifer dan sentral terhadap sarkopenia, tetapi hubungan ini terbatas pada IMT <30 kg/m2.

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Background: Increasing number of elderly is accompanied by increasing prevalence of sarcopenia and obesity. Combination of sarcopenia and obesity, which is called as sarcopenic obesity, associated with higher morbidity and mortality compared to either obesity or sarcopenia alone. Objectives: This study aimed to determine the association between obesity profiles and sarcopenia components.

Methods: This cross-sectional study was using data from the validation study of Sarcopenia Quality of Life (SARQoL) score, of which conducted in geriatric outpatient clinic of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Multivariate analysis between obesity (body mass index [BMI] and waist circumference [WC]) and sarcopenia components (handgrip strength [HGS], muscle mass index [appendicular skeletal muscle mass/ height square, ASMM/h2], and gait speed was adjusted to age, diabetes mellitus, and physical activities.

Results: Out of 120 subjects, there was 61.70% women. All subjects had mean of age 71.89 (6.11) years old; mean of BMI 22.48 (4.60) kg/m2; median of WC 91.48 (65.40-113.00) cm; mean of ASMM/h2 6.88 (0.96) kg/m2; median of HGS 20 (10.00-40.00) kg; and mean of gait speed 0.76 (0.23) meter/second. Low HGS was found statistically significant in lower proportion for peripheral obesity group than non-peripheral obesity group (adjusted odds ratio OR 0.419, 95% confidence interval CI 0.183-0.959, p=0.040); and low muscle mass index was lower in central obesity group than non-central obesity group (adjusted OR 0.087, 95% CI 0.029-0.262, p <0.001).

Conclusion: There were protective effects of peripheral and central obesity against sarcopenia"

"Sarkopenia menyebabkan luaran buruk pada populasi hemodialisis reguler. Panduan diagnosis dan cara pengukuran yang berbeda menyebabkan rentang prevalensi yang besar. Faktor yang berperan terhadap sarkopenia pada hemodialisis reguler belum diketahui. Tujuan: Mengetahui prevalensi dan hubungan fosfat dengan sarkopenia pada hemodialisis reguler. Metode: Studi potong lintang observasional pada 96 pasien hemodialisis reguler, usia ≥18 tahun, lama hemodialisis ≥120 hari di RSCM (Maret-Mei 2022).Uji deskriptif, analisis bivariat, dan regresi logistik mendapatkan prevalensi dan hubungan antara Simplify Creatinine Index, DM type 2, IL-6, status gizi, aktivitas fisik, dan fosfat dengan sarkopenia. Diagnosis sarkopenia menggunakan kriteria AWGS 2019. Hand Grip Strength untuk kekuatan otot, massa otot dengan Bioimpedance Spectroscopy dan performa fisik dengan uji berjalan 6 meter. Hasil: Prevalensi sarkopenia adalah 54,2% dan rerata kadar fosfat 4,08 mg/dL (SB 1,45 mg/dL). Beda rerata kadar fosfat kelompok sarkopenia dengan kelompok tanpa sarkopenia adalah 3,73mg/dL vs 4,5 mg/dL, p=0,008. Faktor lain yang berhubungan dengan sarkopenia adalah SCI (p=0,005), dan aktivitas fisik ringan (p=0,006). Fosfat tidak berhubungan bermakna setelah menambahkan perancu. Kesimpulan: Prevalensi sarkopenia dengan kriteria AWGS 2019 pada populasi hemodialisis reguler adalah 54,2%. Kelompok sarkopenia memiliki rerata fosfat lebih rendah dibandingkan dengan kelompok tanpa sarkopenia, hubungan menjadi tidak bermakna setelah menambahkan variabel perancu.

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Sarcopenia asscociated with worse outcomes in MHD patients. Difference in criteria and methods used to diagnose causing wide range of prevalence. Factors asscociated with sarcopenia in MHD have not been well studied. Objective: to investigate the prevalence and asscociation between phosphate and sarcopenia in MHD. Methods: Observational cross-sectional study in 96 MHD patients ≥18 years old, dialysis vintage ≥120 days in RSCM March-May 2022. Descriptive, bivariate, and logistic regression used to find prevalence and asccociation with Simplify Creatinine Index, type 2 DM, IL-6, nutritional status, physical activity, and phosphate. AWGS 2019 criteria used to diagnose sarcopenia, Hand Grip Strength for muscle strength, Bioimpedance Spectroscopy for muscle mass, and 6-meter walk for physical performance. Results: Sarcopenia prevalence was 54.2% and mean phosphate was 4,08 mg/dL (SD 1,45 mg/dL). Mean difference of phosphate in sarcopenia group compared to non-sarcopenia group is 3,73mg/dL vs 4,5 mg/dL, p=0,008. Factors with significant association were SCI (p=0.005) and low physical activity (p-0.006). Phosphate no longer asscociate significantly with sarcopenia after adjustement. Conclusions: Sarcopenia prevalence in MHD population with AWGS 2019 criteria was 54.2%. Sarcopenia group has significant lower mean phosphate compared to non-sarcopenia group, but the asscociation no longer significant after adjustment with confounding variables."

"Latar Belakang: Sarkopenia mempengaruhi prognosis karsinoma sel hati (KSH). Dalam penilaian klasifikasi Barcelona Clinic Liver Cancer (BCLC) terkandung penilaian status performa Eastern Cooperative Oncology Group (ECOG). Status performa ECOG merupakan penilaian aktivitas fisik terkait sarkopenia. Pemeriksaan baku emas sarkopenia pada KSH mahal dan membutuhkan banyak waktu. Pemeriksaan tebal otot paha dapat digunakan sebagai modalitas yang baru. Studi ini bertujuan untuk menilai hubungan antara status performa ECOG dengan sarkopenia pada KSH, mengetahui perbedaan rerata antara tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH, dan mengetahui perbedaan rerata antara tebal otot paha pasien sarkopenia dengan non sarkopenia pada KSH.Metode: Studi ini dilakukan di RS tersier selama Januari – Oktober 2021. Analisis statistik dilakukan untuk memperoleh hubungan antara status performa ECOG, tebal otot paha, dan status sarkopenik pasien KSH.Hasil: Delapan puluh lima subjek pasien KSH (usia median, 52 tahun) dilakukan analisis. Sarkopenia diamati pada 30,6% pasien KSH. Setelah melalui analisis multivariat, status performa ECOG buruk berhubungan dengan sarkopenia pada KSH (adjusted OR = 6,35, IK 95% 2,06-19,60). Terdapat perbedaan signifikan rerata tebal otot paha pasien status performa ECOG rendah dengan status performa ECOG tinggi pada KSH (p < 0,001). Terdapat juga perbedaan signifikan rerata tebal otot paha pasien sarkopenia dan non sarkopenia (p < 0,001).Kesimpulan: Terdapat hubungan antara status performa ECOG tinggi dengan sarkopenia pada KSH (aOR = 6,35, IK 95% 2,06-19,60). Rerata tebal otot paha pasien status performa ECOG rendah lebih besar dibanding dengan status performa ECOG tinggi pada karsinoma sel hati. Rerata tebal otot paha pasien non sarkopenia lebih besar dibanding dengan sarkopenia pada karsinoma sel hati.

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Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. HCC staging consists of Eastern Cooperative Oncology Group performance status (ECOG-PS). ECOG-PS is an assessment of physical activity related to sarcopenia. Gold standard examinations for sarcopenia in HCC are expensive and time-consuming. Thigh muscle thickness can be used as a new modality. This study was aimed to explore the association between ECOG-PS with sarcopenia, to seek thigh muscle thickness difference between poor and good performance status, and to know thigh muscle thickness difference between sarcopenic and non-sarcopenic patients with HCC.

Methods: The study was conducted in a tertiary hospital during January – October 2021. Statistical analysis was performed to obtain an association between ECOG-PS, thigh muscle thickness, and sarcopenic status of HCC patients.

Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 30,6% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 6,35, 95% CI 2,06-19,6, p < 0,001). There was a significant difference in thigh muscle thickness between good and poor performance status (p < 0,001). There was also a significant difference in thigh muscle thickness between sarcopenic and non-sarcopenic patients (p < 0,001).

Conclusion: There were association between ECOG-PS and sarcopenia in HCC (aOR = 6,35, IK 95% 2,06-19,60). Mean thigh muscle thickness was larger in HCC patients with good ECOG-PS than poor ECOG-PS. Mean thigh muscle thickness was larger in non-sarcopenic HCC patients than sarcopenic ones."

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Penurunan massa otot pada usia lanjut menimbulkan sarkopenia,salah satu penyebabnya adalah proses inflamasi. Rasio asam lemak omega-3/omega-6 dapat memengaruhi proses inflamasi, namun hubungannya dengan massa otot masih menunjukkan hasil yang beragam. Penelitian potong lintang ini bertujuan untuk mengeksplorasi korelasi rasio asupan asam lemak omega-3/omega-6 dan kadar asam lemak omega-3 dengan massa otot pada usia lanjut di lima panti wreda yang terdaftar di Kota Tangerang Selatan. Penelitian ini melibatkan 101 usila yang didapatkan menggunakan proportional random sampling. Rasio asupan asam lemak omega-3 dan omega-6 dinilai menggunakan food record 3x24 jam dan food frequency questionnaire semikuantitatif, kadar asam lemak omega-3 membran eritrosit diukur menggunakan gas chromatography-mass spectrometry, dan pemeriksaan massa otot menggunakan bioelectrical impedance analysis. Analisis korelasi menggunakan uji Spearman. Didapatkan rerata usia subjek adalah 75.5 ± 7.6 tahun dengan 73.3% subjek adalah perempuan. Rasio asupan asam lemak omega-3/omega-6 subjek menggunakan food record adalah 0,09 (0,05-0,22) dan 0,08 (0,05-0,23) menggunakan FFQ semikuantitatif. Nilai tengah kadar asam lemak omega-3 membran eritrosit subjek untuk ALA=10,06 (4,9-24,9) µg/mL, EPA=14,6 (5,06-81,02) µg/mL, DHA=115,5 (20,6-275,09) µg/mL, dan total omega-3=144,1 (89,3-332,1) µg/mL. Nilai tengah massa otot subjek adalah 35,5 (22,8-63,5) kg. Hasil penelitian ini menunjukkan tidak terdapat korelasi antara rasio asupan asam lemak omega-3/omega-6 dengan massa otot baik menggunakan food record (r = -0.2, p = 0.07), maupun FFQ semikuantitatif (r = 0.01, p = 0.9), dan tidak terdapat korelasi antara kadar ALA, EPA, DHA, total asam lemak omega-3 membran eritrosit dengan massa otot berturut-turut (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; dan r = -0.02, p = 0.8).

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The phenomenon of muscle mass deterioration appeared in the elderly called sarcopenia, one of the reasons was the inflammatory process. The ratio of omega-3 and omega-6 fatty acids are known to influence the inflammatory process. However, the relationship of this ratio with muscle mass are still conflicting. This cross-sectional study aimed to explore the correlations of omega-3/omega-6 fatty acids intake ratio and omega-3 fatty acids erythrocyte membrane levels with muscle mass among the elderly in five registered nursing homes in South Tangerang City. This study involved 101 elderly from the proportional random sampling method. The ratio of omega-3 and omega-6 fatty acids intake was assessed using 3-days food records and semi-quantitative food frequency questionnaire (SQ-FFQ). Moreover, omega-3 fatty acid erythrocyte membrane levels were measured using gas chromatography-mass spectrometry and muscle mass were examined using bioelectrical impedance analysis. We used Spearman analysis to investigate the correlation. The mean age of the participants was 75.5 ± 7.6 years and most of the participants were female (73.3%). Furthermore, the median value of omega-3 and omega-6 fatty acid intake ratio was 0.09 (0.05 – 0.22) using 3-days food records and 0.08 (0.05 – 0.23) using SQ-FFQ, the median value of omega-3 erythrocyte membrane levels for ALA = 10.06 (4.9-24.9) µg/mL, EPA = 14.6 (5.06 – 81.02) µg/mL, DHA = 115.5 (20.6 – 275.09) µg/mL, total omega-3 = 144.1 (89.3 – 332.1) µg/mL, and the median value of muscle mass were 35.5 (22.8 – 63.5) kg. We did not find strong correlation between omega-3/omega-6 fatty acids intake ratio and muscle mass using either 3-days food records (r = -0.2, p = 0.07), or SQ-FFQ (r = 0.01, p = 0.9), and no strong correlations found between ALA, EPA, DHA, total omega-3 fatty acids erythrocyte membrane levels and muscle mass (r = -0.03, p = 0.8; r = 0.01, p = 0.9; r = -0.06, p = 0.5; and r = -0.02, p = 0.8), respectively.

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"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponensarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potonglintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, statusnutrisi, status fungsional, status mental, dan komorbiditas namun temuan masihberagam. Selain itu, belum ada studi longitudinal untuk mengetahui hubunganperubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas dengan perubahan kekuatan genggamtangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjutyang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinalINA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisismultivariat regresi logistik digunakan untuk menilai hubungan antara usia, jeniskelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skorGDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggamtangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9)tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%),mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indekskomorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggamtangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002)berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggamtangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to

increased prevalence of sarcopenia and frailty. Handgrip strength is a component of

sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous

cross-sectional studies have assessed association of age, sex, nutritional status,

functional status, mental status and comorbodity but the results were varied. That being

said, there was no longitudinal study has been done to determine the correlation of

handgrip strength changes with age, sex, nutritional status, functional status, mental

status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional

status, depressive symptopms, comorbidity, and handgrip strength changes in elderly

patients.

Methods: A prospective cohort study using secondary data of elderly patients whom

routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital,

Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014).

The multivariate logistic regression analysis was used to assess correlation between

sex, age, nutrional status (MNA score), functional status (ADL score), depressive

symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9

(SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%),

independent (median 9- 20), not depressed (median 0-11), has average comorbidity

index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional

status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with

handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength

changes in out-patients elderly within 1 year."

"Latar Belakang: Sarkopenia merupakan salah satu sindrom geriatri yang dapat menyebabkan luaran yang buruk. Dibutuhkan pemeriksaan yang lebih sederhana dibandingkan Bioelectrical Impedance Analysis (BIA) atau Dual energy X- ray Absorptiometry (DXA) untuk mengukur massa otot sebagai komponen penting sarkopenia. Namun, belum ada studi di Indonesia yang meneliti perannya dalam memprediksi massa otot pada pasien usia 60 tahun atau lebih. Tujuan: Mengetahui performa diagnostik lingkar betis untuk estimasi massa otot sebagai komponen sarkopenia pada pasien usia 60 tahun atau lebih. Metode: Penelitian ini merupakan suatu uji diagnostik menggunakan desain uji potong lintang yang dilakukan di poliklinik geriatri Departemen Ilmu Penyakit Dalam FKUI-RSCM selama bulan April-Juni 2018. Pengukuran massa otot menggunakan DXA dan penentuan titik potong berdasarkan Asian Working Group of Sarcopenia (AWGS). Hasil: Dari 120 subjek didapatkan 46 lelaki (38,3%) dan 74 perempuan (61,7%). Didapatkan titik potong lingkar betis kelompok lelaki dibawah 34 cm (sensitivitas 64.7%, spesifitas 79.3%, NDP 64.7%, NDN 79.3%, AUC 73.1%) dan 29 cm untuk perempuan (sensitivitas 71.4%, spesifitas 95.5%, NDP 62.5%, NDN 97.0%, AUC 96.4%). Simpulan: Akurasi diagnostik lingkar betis cukup baik sebagai prediktor massa otot pada pasien perempuan usia 60 tahun atau lebih.

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Background: Sarcopenia is one of the geriatric syndromes that lead to poor outcomes. A simpler method than Bioelectrical Impedance Analysis (BIA) or Dual energy X- ray Absorptiometry (DXA) is needed to measure muscle mass as essential component of sarcopenia. Previous studies have shown calf circumference (CC) as surrogate marker of muscle mass. However there has been no study on the role of CC in predicting muscle mass in both gender of elderly outpatient. Objectives: To investigate the diagnostic performance of CC to estimate muscle mass in elderly outpatient. Methods: A cross sectional study was conducted at Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital Jakarta during April-June 2018, using DXA as a reference test for measuring muscle mass. Asian Working Group of Sarcopenia (AWGS) criteria was used to classify muscle mass as normal or low. Results: Of the 120 subjects, 46 subjects were male (38.3%) and 74 were female (61.7%).The optimal Cut-off for CC that indicate low muscle mass was 34 cm for (sensitivity 64.7%, specificity 79.3%, PPV 64.7%, NPV 79.3%, AUC 73.1%) and 29 cm for female (sensitivity 71.4%, specificity 95.5%, PPV 62.5%, NPV 97.0%, AUC 96.4%). Conclusion: CC can be used to estimate muscle mass in female elderly outpatient, with good diagnostic performance."

"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."

"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.

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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."

"Indonesia akan mengalami penuaan penduduk dengan proyeksi peningkatan populasi lanjut usia (lansia) sebesar 15.8% pada tahun 2035. Peningkatan populasi lansia dapat mempengaruhi peningkatan kejadian penyakit degeneratif, termasuk sarkopenia yang ditandai dengan hilangnya massa dan kekuatan otot secara progresif. Lansia obesitas dapat mengalami sarkopenia di mana kondisi ini disebut obesitas sarkopenia dengan morbiditas dan mortalitas lebih tinggi dibandingkan hanya obesitas atau sarkopenia. Penelitian ini bertujuan mengetahui hubungan kadar kolesterol total dengan kondisi obesitas sarkopenia pada pasien lansia. Penelitian ini merupakan studi potong lintang dilakukan pada populasi pasien lansia dengan sarkopenia. Penilaian obesitas sarkopenia pada subjek dilakukan berdasarkan kuesioner SARC-F dan BIA untuk komponen sarkopenia, IMT untuk komponen obesitas, dan kadar kolesterol total dari uji laboratorium melalui data rekam medis RSCM dari bulan Januari – Agustus 2022. Hasil: Terdapat 157 subjek penelitian dengan prevalensi yang mengalami obesitas sarkopenia sebanyak 94 orang (59.87%). Pada analisis bivariat, didapatkan hasil bahwa kadar kolesterol total memiliki hubungan yang tidak signifikan dengan obesitas sarkopenia (p= 0.376). Rerata kadar kolesterol total pada kelompok sarkopenia tanpa obesitas adalah 177.65 ± 38.75 dan pada kelompok obesitas sarkopenia adalah 176.21 ± 46.73. Kesimpulan: Tidak terdapat hubungan yang signifikan antara kadar kolesterol total dengan kondisi obesitas sarkopenia pada pasien lansia.

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Indonesia will experience an aging population, with a projected increase in the elderly population by 15.8% in 2035. An increase in the elderly population can affect the incidence of degenerative diseases, including sarcopenia, characterized by progressive muscle mass and strength loss. The elderly with obesity can experience sarcopenia. This condition is called obesity sarcopenia, with higher morbidity and mortality than only obesity or sarcopenia. This study aims to determine the relationship between total cholesterol levels and obesity sarcopenia in elderly patients.

Method: This research is a cross-sectional study of elderly patients with sarcopenia. Sarcopenic obesity assessment was performed on subjects based on the SARC-F and BIA questionnaires for sarcopenic components, BMI for obesity components, and total cholesterol levels from laboratory tests through RSCM medical record data from January - August 2022.

Result: There was 157 subjects in total, with a sarcopenic obesity prevalence of 94 people (59.87%). The bivariate analysis showed that total cholesterol levels had no significant relationship with sarcopenic obesity (p = 0.376). The mean total cholesterol level in the sarcopenia group without obesity was 177.65 ± 38.75 and in the sarcopenia obesity group was 176.21 ± 46.73.

Conclusion: There is no significant relationship between total cholesterol levels and sarcopenic obesity in elderly patients. "