Hubungan Komponen Comprehensive Geriatric Assessment dan Sarkopenia pada Usia Lanjut

Diar Meitha Wardhana, Novira Widajanti, Jusri Ichwani

Abstract

Pendahuluan. Sarkopenia merupakan penurunan massa dan kekuatan otot skeletal serta fungsinya dan berdampak meningkatkan angka hospitalisasi, angka kematian, serta beban kesehatan. Sarkopenia dapat terjadi karena kondisi multifaktorial pada proses menua. Untuk menilai kondisi multifaktorial pada lanjut usia (lansia) dapat dilakukan dengan menggunakan metode comprehensive geriatric assessment (CGA) yang didalamnya terdapat domain sosiodemografis, medis, psikologis, dan fungsional. Penelitian ini bertujuan menganalisis komponen CGA sebagai faktor yang berhubungan dengan kejadian sarkopenia pada komunitas usia lanjut di Surabaya.

Metode. Penelitian komunitas ini bersifat analitik observasional menggunakan rancangan potong lintang. Subjek penelitian adalah seluruh lansia yang datang ke lima pos pelayanan terpadu (posyandu) lansia terpilih selama waktu penelitian, yang memenuhi kriteria inklusi dan eksklusi. Sejumlah 308 data telah terkumpul kemudian dilakukan analisis bivariat dan multivariat untuk mengetahui komponen yang berhubungan dengan sarkopenia. Analisis bivariat dilakukan pada komponen usia, jenis kelamin, status nutrisi, komorbid, status kognitif, status mental, dan status fungsional. Variabel yang masuk dalam analisis multivariat adalah usia, jenis kelamin, status nutrisi, komorbid, status kognitif, dan status fungsional.

Hasil. Dari 308 data didominasi lansia perempuan sebanyak 74,7%. Median umur adalah 63 tahun (rentang 60-100 tahun). Setelah dilakukan analisis multivariat, komponen CGA yang berhubungan dengan sarkopenia adalah status nutrisi dengan skor MNA ≤ 23,5 (OR 3,61; IK 95% 2,11–6,19), usia ≥70 tahun (OR 2,82; IK 95% 1,58–5,04), serta jenis kelamin laki-laki (OR 1,83; IK 95% 1,04–3,24). Dari model prediksi didapatkan area under curve (AUC) sebesar 66,2%.

Simpulan. Status nutrisi dengan skor MNA ≤ 23,5, usia ≥70 tahun, dan jenis kelamin laki-laki dapat menentukan kejadian sarkopenia pada lansia di komunitas sebesar 66,2%.

Kata kunci: Comprehensive geriatric assessment, komunitas, sarkopenia

 

Association of Comprehensive Geriatric Assessment’s Component and Sarcopenia in Elderly

Introduction. Sarcopenia is defined as a declined in skeletal muscle mass and strength along with its function may causes an increase in hospitalization, mortality, and health burden. Multi-factorial conditions of the aging process may cause sarcopenia. To assess those multi-factorial conditions in the elderly, a comprehensive geriatric assessment (CGA) method should be used, in which comprises of socio-demographic, medical, psychological, and functional domains. This research aims to analyze the components of CGA, including age, gender, nutritional status, mental status, and functional status as factors associated to sarcopenia in the elderly community in Surabaya.

Methods. This community research was a cross sectional designed analytic observational study. The subjects were all elderly people visiting five chosen Posyandu, an integrated health service post, that meet the inclusion and exclusion criteria. A total of 308 data were collected and then bivariate and multivariate analyzes were performed to determine the components related to sarcopenia. Bivariate analysis was performed on components of age, sex, nutritional status, comorbidities, cognitive status, mental status, and functional status. Variables included in multivariate analysis were age, sex, nutritional status, comorbidities, cognitive status, and functional status.

Results. The subjects were dominated by elderly females (74.7%). The median of age were 63 years (range 60-100 years). After performing multivariate analysis, three variables had the association to sarcopenia which were nutritional status assessed by MNA score 23.5 (OR 3.61, 95% CI 2.11–6.19), age ≥70 years old (OR 2.82, 95% CI 1.58–5.04), and male (OR 1,83, 95% CI 1,04–3,24). An area under curve (AUC) of 66.2% was obtained from the prediction model.

Conclusion. The method of CGA has the power to predict sarcopenia of the elderly in the community as much as 66.2%.

Keywords

Community-dwelling, comprehensive geriatric assessment, sarcopenia

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