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Abstrak :
Latar Belakang. Walaupun pasien HIV mendapat terapi antiretroviral yang efektif, penurunan fungsi fisik sering ditemukan lebih awal dan menimbulkan masalah baru berupa penuaan dan frailty. Tujuan. Mengetahui proporsi dan faktor-faktor yang berhubungan dengan prefrail dan frail pada pasien HIV dalam terapi antiretroviral. Metode. Desain studi potong lintang pada pasien HIV usia ≥30 tahun dalam terapi ARV minimal 6 bulan. Pasien yang memenuhi inklusi dilakukan pencatatan demografis, penyakit komorbid, faktor terkait HIV seperti lama terdiagnosis, lama ARV, dan CD4, pengukuran antropometri seperti indeks massa tubuh, penilaian depresi dengan Indo BDI-II, dan penilaian frailty dengan kriteria Fried. Pasien dengan riwayat infeksi otak, kanker, dan oportunistik aktif dieksklusi. Analisis bivariat dan multivariat dilakukan pada faktor-faktor tersebut. Hasil. Terdapat 164 pasien yang dianalisis. Proporsi prefrail sebanyak 51,2% (84 pasien) dan frail 3,7% (6 pasien), dengan komponen dominan pada kelemahan genggam. Pasien laki-laki sebanyak 72% dengan median usia (IQR) 40,5 (36-47) tahun, dan median CD4 nadir (IQR) 53 (21-147) sel/mm3, median CD4 awal (IQR) 77 (32 - 206) sel/mm3. Hepatitis C menjadi faktor komorbid terbanyak. Depresi berhubungan dengan prefrail dan frail dengan OR 2,14 (IK95%: 1,034-4,439) dan p = 0,036. Tidak terdapat hubungan faktor usia ≥50 tahun, ≥2 penyakit komorbid, lama terdiagnosis HIV ≥5 tahun, lama ARV ≥5 tahun, CD4 <200 sel/mm3, indeks massa tubuh ≥25 kg/m2, dan pendapatan rendah dengan prefrail dan frail. Kesimpulan. Terdapat proporsi prefrail sebanyak 51,2% dan frail 3,7%. Depresi merupakan salah satu faktor yang terbukti berhubungan terhadap prefrail dan frail pada pasien HIV dalam terapi ARV. ......Background. Although HIV patients receive effective antiretroviral therapy, decrease in physical function is often found earlier and creates new problems in the form of aging and frailty Aim. to determine the proportion and factors associated with prefrail and frail in HIV patients on antiretroviral therapy. Method. A cross-sectional study design in HIV patients aged ≥30 years who were on ARV therapy for at least 6 months. Patients who fulfilled the inclusion were recorded demographically, comorbid diseases, HIV-related factors such as length of diagnosis, duration of ARV, CD4, anthropometric measurements such as body mass index, depression assessment with Indo BDI-II, and frailty assessment with Fried criteria. Patients with a history of brain infection, cancer, and active opportunists were excluded. Bivariate and multivariate analysis was carried out on these factors. Results. There were 164 patients analyzed. The proportions of prefrail and frail were 51.2% and 3.7% respectively, with the dominant component in muscle weakness. Male patients were 72% with median age (IQR) 40.5 (36-47) years, median baseline CD4 (IQR) 77 (32 - 206) cell/mm3, and median nadir CD4 (IQR) 53 (21-147) cells/mm3. Hepatitis C is the most comorbid factor. Depression is related to prefrail and frail with OR 2.14 (95%CI: 1,034-4,439) and p = 0,036. There was no correlation between factors such as age ≥50 years, ≥2 comorbid diseases, length of diagnosis of HIV ≥5 years, duration of ARV ≥5 years, CD4 cell count <200 cells/mm3, body mass index ≥25 kg/m2, and low income with prefrail and frail. Conclusion. The proportions of prefrail and frail are 51.2% and 3.7% respectively. Depression is one of the factors that is proven to be related to prefrail and frail in HIV patients in ARV therapy.

Abstrak :
Latar Belakang. Walaupun pasien HIV mendapat terapi antiretroviral yang efektif, penurunan fungsi fisik sering ditemukan lebih awal dan menimbulkan masalah baru berupa penuaan dan frailty. Tujuan. Mengetahui proporsi dan faktor-faktor yang berhubungan dengan prefrail dan frail pada pasien HIV dalam terapi antiretroviral. Metode. Desain studi potong lintang pada pasien HIV usia ≥30 tahun dalam terapi ARV minimal 6 bulan. Pasien yang memenuhi inklusi dilakukan pencatatan demografis, penyakit komorbid, faktor terkait HIV seperti lama terdiagnosis, lama ARV, dan CD4, pengukuran antropometri seperti indeks massa tubuh, penilaian depresi dengan Indo BDI-II, dan penilaian frailty dengan kriteria Fried. Pasien dengan riwayat infeksi otak, kanker, dan oportunistik aktif dieksklusi. Analisis bivariat dan multivariat dilakukan pada faktor-faktor tersebut. Hasil. Terdapat 164 pasien yang dianalisis. Proporsi prefrail sebanyak 51,2% (84 pasien) dan frail 3,7% (6 pasien), dengan komponen dominan pada kelemahan genggam. Pasien laki-laki sebanyak 72% dengan median usia (IQR) 40,5 (36-47) tahun, dan median CD4 nadir (IQR) 53 (21–147) sel/mm3, median CD4 awal (IQR) 77 (32 – 206) sel/mm3. Hepatitis C menjadi faktor komorbid terbanyak. Depresi berhubungan dengan prefrail dan frail dengan OR 2,14 (IK95%: 1,034–4,439) dan p = 0,036. Tidak terdapat hubungan faktor usia ≥50 tahun, ≥2 penyakit komorbid, lama terdiagnosis HIV ≥5 tahun, lama ARV ≥5 tahun, CD4 <200 sel/mm3, indeks massa tubuh ≥25 kg/m2, dan pendapatan rendah dengan prefrail dan frail. Kesimpulan. Terdapat proporsi prefrail sebanyak 51,2% dan frail 3,7%. Depresi merupakan salah satu faktor yang terbukti berhubungan terhadap prefrail dan frail pada pasien HIV dalam terapi ARV. ......Background. Although HIV patients receive effective antiretroviral therapy, decrease in physical function is often found earlier and creates new problems in the form of aging and frailty Aim. to determine the proportion and factors associated with prefrail and frail in HIV patients on antiretroviral therapy. Method. A cross-sectional study design in HIV patients aged ≥30 years who were on ARV therapy for at least 6 months. Patients who fulfilled the inclusion were recorded demographically, comorbid diseases, HIV-related factors such as length of diagnosis, duration of ARV, CD4, anthropometric measurements such as body mass index, depression assessment with Indo BDI-II, and frailty assessment with Fried criteria. Patients with a history of brain infection, cancer, and active opportunists were excluded. Bivariate and multivariate analysis was carried out on these factors. Results. There were 164 patients analyzed. The proportions of prefrail and frail were 51.2% and 3.7% respectively, with the dominant component in muscle weakness. Male patients were 72% with median age (IQR) 40.5 (36-47) years, median baseline CD4 (IQR) 77 (32 - 206) cell/mm3, and median nadir CD4 (IQR) 53 (21–147) cells/mm3. Hepatitis C is the most comorbid factor. Depression is related to prefrail and frail with OR 2.14 (95%CI: 1,034-4,439) and p = 0,036. There was no correlation between factors such as age ≥50 years, ≥2 comorbid diseases, length of diagnosis of HIV ≥5 years, duration of ARV ≥5 years, CD4 cell count <200 cells/mm3, body mass index ≥25 kg/m2, and low income with prefrail and frail. Conclusion. The proportions of prefrail and frail are 51.2% and 3.7% respectively. Depression is one of the factors that is proven to be related to prefrail and frail in HIV patients in ARV therapy.

Abstrak :
ABSTRAK
Latar Belakang: Influenza masih merupakan ancaman infeksi serius di dunia terutama pada populasi usia lanjut. Meskipun kejadian influenza dapat ditekan dengan pemberian vaksinasi, namun efikasi vaksin influenza masih diragukan pada usia lanjut, terutama individu yang frail. Hal ini dikarenakan immunosenescence yang menyebabkan sistem imun kurang mampu mengatasi stres berupa infeksi termasuk memberikan respon yang adekuat terhadap pemberian vaksin.Tujuan: Mengetahui hubungan status frailty dengan respon imun pasca vaksinasi influenza pada populasi usia lanjutMetode: Studi kohort retrospektif ini mengambil data dari penelitian induk dengan subjek usia lanjut berusia 60 tahun keatas yang tergabung dalam Posyandu Lansia di 4 kelurahan di Kecamatan Pulo Gadung, Jakarta Timur. Status frailty ditentukan berdasarkan kuisoner Frailty Index 40 Items FI-40 . Vaksin Influenza yang dievaluasi adalah vaksin influenza trivalen inaktif. Serokonversi didefinisikan sebagai peningkatan titer inhibisi hemagglutinin sebanyak 4x lipat. Seroproteksi didefinisikan sebagai titer inhibisi hemagglutinin ge; 1:40.Hasil: Terdapat 140 subjek penelitian. Tingkat serokonversi vaksin influenza pada kelompok frail, pre-frail, dan sehat adalah 37,9 , 39 , 60 . Tingkat seroproteksi vaksin influenza pada kelompok frail, pre-frail dan sehat adalah 80 , 92,2 , 94,8 . Risiko relatif RR kelompok pre-frail/frail untuk kejadian tidak serokonversi adalah 0,93 IK 95 0,72-1,02 , dan RR untuk kejadian tidak seroproteksi adalah 1,7x IK 95 0,5-6,2 .Kesimpulan: Tidak ditemukan hubungan bermakna secara statistik antara status frailty dengan serokonversi dan seroproteksi vaksin influenza pada populasi usia lanjut.

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ABSTRACT
Background Influenza still become serious illness in this world especially in elderly population. Despite the prevalence of this disease has been decreased by vaccination, the efficacy of the vaccine still doubt full in frail elderly people. Immunosenescence is the underlying process in immune defect and cause the immune system become less capable to cope the stress like an infection, and also give an adequate response to vaccination.Objective To determine association between frailty status and immune response after influenza vaccination in elderly.Method This Retrospective cohort study was conducted using secondary data from the parent study of elderly subjects age ge 60 years who live in the community of Posyandu lansia in Pulo Gadung Region, East Jakarta. Frailty status was stated by Frailty Index 40 Items FI 40 . The influenza vaccine evaluated was the Trivalent Inactivated Vaccine. Seroconversion defined as four fold increase hemagglutinin inhibition titre. Seroprotection defined as Hemagglutinin Inhibition titer ge 1 40.Result There are 140 subject included in this study. Seroconversion influenza vaccine rate in frail, pre frail, and robust group are 37,9 , 39 , 60 . Seroprotection rate in frail, pre frail, and robust group are 80 , 92,2 , 94,8 . Relative Risk RR pre frail frail group for not seroconverted is 0,93 CI 95 0,72 1,02 , and RR for not seroprotected is 1,7 CI 95 0,5 6,2 .Conclussions There is no statistically significant association between frailty status and seroconversion nor seroprotection of influenza vaccine.

Abstrak :
Prevalensi pre-frail tinggi pada usia lanjut dan kondisi tersebut dapat berubah menjadi frail. Kolekalsiferol diduga memiliki potensi untuk memperbaiki sindrom frailty pada usia lanjut. Penelitian ini bertujuan mengkaji pengaruh kolekalsiferol terhadap kekuatan genggam tangan, kecepatan berjalan serta reseptor vitamin D (vitamin D receptor/VDR), interleukin-6 (IL-6), dan insulin-like growth factor-1 (IGF-1) monosit pada usia lanjut dengan pre-frail. Uji klinis acak tersamar ganda dilakukan di Poliklinik Geriatri RSCM pada bulan April–Desember 2021. Sebanyak 120 subjek dirandomisasi menjadi kelompok yang mendapat kolekalsiferol 4.000 IU/hari (60 subjek) serta kelompok yang mendapat plasebo/hari (60 subjek). Seluruh subjek mendapat suplementasi kalsium laktat 500 mg /hari. Pengamatan dilakukan selama 12 minggu. Terdapat 57 subjek pada kelompok kolekalsiferol dan 56 subjek pada kelompok plasebo yang menjalani penelitian hingga selesai. Analisis intention to treat dilakukan untuk mengevaluasi luaran kekuatan genggam tangan dan kecepatan berjalan, sedangkan analisis per protokol untuk mengevaluasi VDR, IL-6 dan IGF-1 monosit. Pada akhir pengamatan, tidak terdapat perbedaan bermakna pada kekuatan genggam tangan (p = 0,228), kecepatan berjalan (p = 0,734), VDR monosit (p = 0,45), IL-6 monosit (p = 0,57) dan IGF-1 monosit (p = 0,72) antara kedua kelompok perlakuan. Tidak ada korelasi antara perubahan VDR, IL-6 dan IGF-1 monosit dengan kekuatan genggam tangan dan kecepatan berjalan. Terdapat peningkatan kadar 25(OH)D yang bermakna pada masing-masing kelompok perlakuan dan peningkatan bermakna pada kelompok kolekalsiferol dibandingkan plasebo. Pemberian kolekalsiferol 4.000 IU pada usia lanjut pre-frail 12 minggu meningkatkan kadar 25(OH)D secara bermakna, namun belum terbukti dapat memperbaiki kekuatan genggam tangan, kecepatan berjalan, meningkatkan VDR dan IGF-1 monosit serta menurunkan IL-6 monosit. Fungsi ginjal memiliki pengaruh terhadap efek kolekalsiferol pada IGF-1 monosit. Kolekalsiferol meningkatkan jumlah monosit dengan IGF-1+ pada eGFR > 90, namun tidak pada eGFR 30–59. ......Pre-frail prevalence is higher in the elderly. Frailty status is a dynamic condition. Pre-frail can fall into a frail condition. Cholecalciferol is regarded to have potential effect to improve frailty syndrome in the elderly. This study aimed to determine the effect of cholecalciferol on hand grip strength, walking speed, vitamin D receptors, IL-6, and IGF-1 monocyte in pre-frail elderly. A randomized double-blind clinical trial study at the RSCM Geriatric Polyclinic was conducted from April to December 2021. A total of 120 subjects were randomized into groups receiving 4000 IU cholecalciferol/day (60 subjects) and groups receiving placebo/day (60 subjects). All subjects received calcium lactate supplementation 500 mg/day. Observations were made for 12 weeks. There were 57 subjects in the cholecalciferol group and 56 subjects in the placebo group who completed the study. An intention to treat analysis was performed to evaluate the output of hand grip strength and walking speed, while a per protocol analysis was performed to evaluate monocyte VDR, IL-6 and IGF-1.There were no significant differences in hand grip strength (p = 0,228), walking speed (p = 0,734), VDR monocyte (p = 0,45), IL-6 monocyte (p = 0,57) and IGF-1 monocyte (p = 0,72) between treatment groups. There were no correlation between changes in the VDR, IL-6 and IGF-1 monocytes with changes in hand grip strength and walking speed. There was a significant increase in 25(OH)D levels in each group and a significant difference between groups. Supplementation of cholecalciferol 4.000 IU daily for 12 weeks increased serum 25(OH)D level significantly, however it did not improve hand grip strength and walking speed, and did not affect VDR, IL-6 and IGF-1 monocytes in pre-frail elderly. Kidney function had an influence on the effect of cholecalciferol on monocyte IGF-1. Cholecalciferol increased the number of monocytes with IGF-1+ at eGFR > 90, but not at eGFR 30–59.

Abstrak :
Proporsi usia lanjut di Indonesia meningkat setiap tahunnya sehingga perlu diikuti dengan rencana strategis perawatan kesehatan. Frailty dikaitkan dengan ketidakmandirian akibat fungsi yang buruk, berakibat turunnya performa fisik. Uji Timed Up and Go (TUG) merupakan pengukuran performa fisik yang dilakukan di klinis. Latihan beban merupakan salah satu intervensi untuk mencegah keadaan pre-frail menjadi frail atau mencegah frail menjadi lebih buruk. Jarak dan biaya untuk ke fasilitas merupakan salah satu kendala, sehingga dibutuhkan latihan yang sederhana, ekonomis dan aman untuk dilakukan di rumah. Penelitian ini menggunakan One group Pre and Post-test design pada 21 orang usia lanjut dengan pre-frail dan frail. Setelah dilakukan latihan beban dengan pita elastis 3x/ minggu selama 8 minggu, didapatkan penurunan waktu uji TUG dari 9.98 ± 2.01 menjadi 8.79 ± 1.53 detik (p<0.001) yang disebabkan oleh peningkatan massa otot akibat sintesis protein, pengurangan kortisol mengakibatkan berkurangnya proses katabolik pada otot dan peningkatan adaptasi neuromuskular. Peningkatan indeks EQ5D5L 0.881 menjadi 0.914 (p= 0.016) dan VAS-EQ5D5L 80 menjadi 85 (p<0.001). Aspek kemampuan berjalan dan rasa depresi/ cemas memainkan peran penting dalam seluruh aspek kualitas hidup. Terdapat peningkatan performa fisik disertai peningkatan kualitas hidup usia lanjut dengan pre-frail dan frail setelah latihan beban dengan pita elastis. ......The proportion of elderly in Indonesia increases every year so a health care strategic plan is needed. Frailty is associated with independence due to poor functioning, resulting in decreased physical performance. Timed Up and Go Test (TUG) is used in clinical settings for physical performance. Resistance training is an intervention to prevent the pre-frail becoming frail or prevent frailty getting worse. Distance and cost to the facility is one of the obstacles. A simple and safe training in home is needed. This study is One group Pre and Post-test design on 21 people elderly with pre-frail and frail. After 3x/ week for 8 weeks resistance training using elastic bands, the TUG was decreased from 9.98 ± 2.01 to 8.79 ± 1.53 seconds (p <0.001) due to increased muscle mass caused by protein synthesis, reduced cortisol resulted in reduced catabolic process and increasing neuromuscular adaptation. The EQ5D5L index of 0.881 to 0.914 (p = 0.016) and VAS-EQ5D5L 80 to 85 (p <0.001). Mobility and anxiety/ depression play an important role in all aspects of quality of life. Physical performance is increasing followed by increasing the quality of life in elderly with pre-frail and frail after resistance training with elastic bands.

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ABSTRAK
Terapi metformin berpotensi untuk memperbaiki sindrom frailty dengan memodifikasi resistensi insulin, inflamasi, dan konsentrasi miostatin. Penelitian ini bertujuan untuk mengkaji peran metformin terhadap kekuatan genggam tangan, kecepatan berjalan, konsentrasi miostatin serum, dan kualitas hidup terkait kesehatan pada pasien usia lanjut dengan pre-frail. Uji klinis acak tersamar ganda dilakukan pada pasien rawat jalan berusia 60 tahun dengan status pre-frail yang direkrut secara konsekutif Maret 2015 ndash;Juni 2016 di RSCM. Pasien dieksklusi bila menyandang diabetes melitus, skor Geriatric Depression Scale ge; 10, skor Abbreviated Mental Test < 8, fase akut penyakit, dan kontraindikasi terhadap metformin. Evaluasi luaran penelitian dilakukan sebelum dan pasca-intervensi selama 16 minggu. Randomisasi terhadap 120 subjek menempatkan 60 subjek untuk tiap kelompok perlakuan. Sebanyak 43 subjek kelompok metformin 3 x 500 mg dan 48 subjek kelompok plasebo menyelesaikan penelitian. Terdapat peningkatan kecepatan berjalan yang bermakna dengan rerata sebesar 0,39 0,77 detik atau 0,13 0,24 meter/detik pada kelompok metformin dan tetap bermakna setelah dilakukan penyesuaian terhadap faktor prognostik penting yang tidak setara p = 0,024 . Pada analisis ITT ada tidaknya peningkatan kecepatan berjalan > 0,1 meter/detik didapatkan ARR 8,3 IK95 -7,9 ndash;24 , dengan NNT sebesar 12. Tidak terdapat perbedaan bermakna kekuatan genggam tangan, konsentrasi miostatin serum, dan kualitas hidup terkait kesehatan antara kedua kelompok perlakuan. Konsentrasi miostatin serum berkorelasi negatif lemah r = -0,247; p = 0,018 dengan kecepatan berjalan, namun tidak berkorelasi dengan kekuatan genggam tangan. Skor indeks EQ-5D berkorelasi positif sedang dengan kecepatan berjalan r = 0,566; p = 0,000 dan berkorelasi positif lemah dengan kekuatan genggam tangan r = 0,355; p = 0,001. Sebagai simpulan, pemberian metformin 3 x 500 mg selama 16 minggu secara statistik dan klinis bermakna dalam meningkatkan kecepatan berjalan sebagai salah satu dimensi kualitas hidup terkait kesehatan, namun belum dapat meningkatkan skor indeks EQ-5D, tidak meningkatkan kekuatan genggam tangan, dan belum menurunkan konsentrasi miostatin serum. Kata kunci. kecepatan berjalan, kekuatan genggam tangan, kualitas hidup terkait kesehatan, metformin, miostatin, pre-frail, usia lanjut.

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ABSTRACT
Metformin is considered to have potential effects to improve frailty syndrome by modifying insulin resistance, inflammation, and myostatin serum level. This study aimed at investigating the effect of metformin on handgrip strength, gait speed, myostatin serum level, and health related quality of life HR QoL in pre frail elderly. A double blind randomized controlled trial was conducted on elderly outpatients aged 60 years and older with pre frail status consecutively recruited from March 2015 to June 2016 at Cipto Mangunkusumo Hospital. Patients with history of diabetes mellitus, Geriatric Depression Scale score ge 10, Abbreviated Mental Test score 8, acute phase of diseases, and contraindication s to metformin were excluded. The measurement of study outcomes was conducted at baseline and after 16 weeks of intervention. One hundred twenty subjects were randomized and equally assigned into metformin 3 x 500 mg or placebo group. There were 43 subjects in metformin group and 48 subjects in placebo group completed the intervention. The mean gait speed in metformin group significantly improved by 0.39 0.77 second or 0.13 0.24 meter second, even after adjusted for importance prognostic factors p 0,024 . Intention to treat analysis on the presence or absence of increased gait speed 0.1 meter second showed ARR 8.3 95 CI 7.9 ndash 24 , with NNT of 12. There were no significant differences on handgrip strength, myostatin serum level, and HR QoL between the two intervention groups. Myostatin serum level had weak negative correlation with gait speed r 0.247 p 0.018 , but did not correlate with handgrip strength. EQ 5D index had moderate positive correlation with gait speed r 0.566 p 0.000 and weak positive correlation with handgrip strength r 0.355 p 0.001. In conclusion, metformin 3 x 500 mg for 16 weeks significantly improved gait speed as one of the HR QoL dimensions, but not significantly improved the EQ 5D index score and handgrip strength nor decreased myostatin serum level. Keywords. gait speed, handgrip strength, health related quality of life, metformin, myostatin, pre frail, elderly.

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ABSTRAK
Proses degeneratif pada lansia menyebabkan penurunan fungsi berbagai sistem organ yang memicu terjadinya sindrom kelamahan. Tidak adekuatnya asuhan yang diberikan dapat meningkatkan terjadinya disabilitas bahkan kematian. Asuhan keperawatan bertujuan untuk mempertahankan dan meningkatkan fleksibilitas sendi sehingga tidak terjadi kontraktur yang membuat lansia semakin terbatas dalam melakukan perawatan diri. Intervensi yang dilakukan adalah latihan rentang pergerakan sendi pasif dua kali sehari, selama 20 menit, delapan kali tiap gerakan, enam hari per minggu selama empat minggu. Hasil evaluasi menunjukkan terdapat peningkatan fleksisbilitas sendi peluru-bahu 30o sampai 40o dan sendi engsel-lutut 50o, fleksibilitas sendi lain dalam kisaran normal kecuali sendi yang sudah kontraktur. Latihan rentang pergerakan sendi dapat dilakukan pada lansia dengan sindrom kelemahan untuk mencegah disabilitas.Kata Kunci : Lansia, sindrom kelemahan, Latihan rentang pergerakan sendi pasif, fleksibilitas sendi

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ABSTRACT
Degenerative process in the elderly leads to decreased function of multiple organ systems that trigger the frail elderly syndrome. Inadequate care provided can increase disability and even death. Nursing care aims to maintain and increase joint flexibility in order to no contractures that cause the elderly more limited in self care. Interventions are the passive range of motion twice a day, 20 minutes, eight repetitions per movement, six days per week for four weeks. Evaluation results show an increase in flexibility of the shoulder joints 30o to 40o, knee joints 50o, flexibility of other joints in the normal range except already contracted joints. Passive range of motion exercise can be performed for frail elderly syndrome to prevent disability.Keywords Elderly, frail elderly syndrome, Passive range motion range exercises, joint flexibility

Abstrak :
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.