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Abstrak :
ABSTRACT
Background: 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.

Abstrak :
ABSTRACT
Background: there are differences in factors associated with frailty syndrome in elderly population. The aim of this research was to determine frailty status (fit, pre-frail and frail) and to identify factors associated with physical frailty in urban community-dwelling elderly women. Methods: a cross-sectional study of community-dwelling women aged 60 years and older was conducted in West and Central Jakarta regions, Indonesia, from July until September 2017. The Cardiovascular Health Study (CHS) score was used to determine frailty status (fit/pre-frail/frail). Chi-Square Test and logistic regression analysis were used to determine association between independent variables and physical frailty. Results: there were 325 female subjects with a median age of 67 (60-94) years; 95,7% had income below the Provincial Minimum Income of DKI Jakarta in 2017 (<3,3 million IDR=238 USD/month), and 92.6% had a level of education ≤9 years. Subjects were classified into this following groups: fit (12,6%), pre-frail (63,4%) and frail (24%). Factors associated with physical frailty were age above 70 years old with OR 5,27, lower Barthel Index for Activities of Daily Living (B-ADL) with OR 2,85, depressive symptoms with OR 6,79, and Euro Quality of Life-5 Dimensions (EQ-5D) index with OR 1,96. Conclusion: elderly women in the urban community with low socioeconomic status were classified as fit (12,6%), pre-frail (63,4%) and frail (24%). Factors associated with physical frailty were age above 70 years old, depressive symptoms, lower functional status and health-related quality of life index.

Abstrak :
ABSTRACT
Background: sarcopenia is one of many geriatric problems that may lead to major clinical outcomes. Calf and thigh circumference have good correlation with muscle mass, whereas SARC-F questionnaire is very predictive of muscle function. There has not been a study that evaluates the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire in detecting sarcopenia. The aim of this study was to investigate the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire compared to standard diagnostic methods of sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) to predict sarcopenia in patient aged 60 years or older. METHODS: this cross-sectional study was conducted in Geriatric Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia during April-June 2018. Analysis was performed using receiver operating characteristic (ROC) curve to determine the cut-off point as well as sensitivity (Sn), specificity (Sp), positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR+ and LR-) of calf and thigh circumference as an indicator of low muscle mass, and SARC-F questionnaire score to detect decreased muscle function. RESULTS: from 120 participants, there were 46 men (38.3%) and 74 women (61.7%). The combination of calf circumference with cut-off point below 34 cm in men and below 29 cm in women, thigh circumference below 49 cm in men and below 44 cm in women with SARC-F questionnaire score of ≥4 have Sn, Sp, PPV, NPV, LR+, and LR- of 15.79%; 99.01%; 75.00%; 86.21%; 15.95; and 0.85 respectively. CONCLUSION: combination of calf and thigh circumference with SARC-F questionnaire showed good diagnostic accuracy in predicting sarcopenia in elderly outpatients.

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.