Sarcopenia in a Multiethnic State: A Cross-Sectional Data Analysis of Multicentre Indonesia Longitudinal Aging Study.

BACKGROUND: Previous regional studies related to sarcopenia in multiethnic Indonesia suggested inconsistent findings. We aimed to find the prevalence of sarcopenia and its associated factors among Indonesian older adults. METHODS: In this cross-sectional analysis, we utilised the data of Indonesia Longitudinal Aging Study (INALAS) from community-dwelling outpatients in eight centres. Statistical analyses included descriptive, bivariate, and multivariate analyses. We categorised older adults into sarcopenia group based on the criteria of the SARC-F questionnaire, namely strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire. RESULTS: Among 386 older adults, 17.6% were in sarcopenia group. The prevalence of sarcopenia was found to be the lowest in Sundanese group (8.2%). Following appropriate statistical adjustment, sarcopenia was associated with female sex (OR 3.01, 95% CI 1.34-6.73), dependent functional capacity (OR 7.38, 95% CI 3.26-16.70), frailty (OR 11.82, 95% CI 5.41-25.80), and history of fall (OR 5.17 (95% CI 2.36-11.32). Sarcopenia was not significantly associated with age 70 years and older (OR 1.67, 95% CI 0.81-3.45), Sundanese group (OR 0.44, 95% CI 0.15-1.29), and being at high risk for malnutrition or malnourished (OR 2.98, 95% CI 0.68-13.15). All centenarians had no sarcopenia nor frailty, and 80% of them were Sundanese older adults. CONCLUSION: One in five Indonesian community-dwelling older adults had sarcopenia, associated with female sex, dependent functional capacity, frailty, and history of fall. Albeit statistically nonsignificant, there may still be link between Sundanese, age 70 years and older, as well as being at high risk for malnutrition, and sarcopenia.

Indonesian Geriatrics Society Consensus on COVID-19 Management in Older Adults.

More than 80% of death cases and 95% of severe COVID-19 occur in patients aged over 60 years. Atypical clinical manifestations with high morbidity and mortality further emphasize the importance of COVID-19 management in older adults. Some older patients may appear asymptomatic while other may present with acute respiratory distress syndrome and multi organ failure. Fever, higher respiratory rate and crackles may present. The most common chest x-ray finding is ground glass opacity. Other imaging modalities that are often used are pulmonary computed tomography scan and lung ultrasonography. COVID-19 management in older adults should be comprehensive, starting from oxygen, fluid, nutritional, physical rehabilitation, pharmacology and psychosocial therapy. In this consensus, we also discuss about management of older adults with special condition such as diabetes mellitus, kidney disease, malignancy, frailty, delirium, immobilization and dementia. In post COVID-19 phase, we believe that physical rehabilitation is important as it is done to improve fitness.

Sedentary Lifestyle of Older Adults and Its Associated Factors: A Multicentre Cross-Sectional Study During COVID-19 Pandemic in Indonesia.

BACKGROUND: COVID-19 is here to stay, and humans ought to decide how to adapt. We aimed to describe lifestyle changes during COVID-19 pandemic, and to determine the prevalence and factors associated with sedentary lifestyle among older adults. METHODS: We obtained data from community-dwelling older adults aged ≥60 years. We presented the data descriptively and used multivariate analysis to assess the association between Physical Activity Scale for the Elderly (PASE) -based sedentary lifestyle and other variables in several tertiary geriatric centres. RESULTS: Among 601 participants, 21.1% had sedentary lifestyle. Ethnic groups with the highest prevalence of sedentary lifestyle were Minang, Balinese, and Sundanese. Changes related to food intake, body weight, and physical activity were seen in a small proportion of older adults. Sun exposure habit was described. Sedentary lifestyle was associated with less consumption of food (OR 2.59, 95% CI 1.07-6.30), weight loss (OR 3.00, 95% CI 1.64-5.48), and higher intensity of snacking (OR 0.45, 95% CI 0.20-0.99). CONCLUSION: During COVID-19 pandemic, one out of five older adults had sedentary lifestyle, which was positively associated with less consumption of food and weight loss, and negatively associated with higher intensity of snacking. The prevalence of sedentary lifestyle varied across ethnic groups. Adequate and appropriate food intake may be crucial to keep older adults active, preventing them from entering vicious cycle of malnutrition, sarcopenia, and frailty.

Factors Associated with Physical Frailty in Elderly Women with Low Socioeconomic Status in Urban Communities: A Cross-Sectional Study.

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.

Frailty and Its Associated Risk Factors: First Phase Analysis of Multicentre Indonesia Longitudinal Aging Study.

Background: National long-term care development requires updated epidemiological data related to frailty. We aimed to find the prevalence of frailty and its associated factors among Indonesian elderly. Methods: We conducted first-phase cross-sectional analysis of Indonesia Longitudinal Aging Study (INALAS) data collected from community-dwelling outpatients aged 60 years and older without acute illness in nine geriatric service care centres. Descriptive, bivariate and multivariate analyses were conducted. Results: Among 908 elderly in this study, 15.10% were robust, 66.20% were pre-frail, and 18.70% were frail. Functional dependence was associated with frailty among Indonesian elderly (OR 5.97, 95% CI 4.04-8.80). Being depressed and at risk for malnutrition were also associated with frailty with OR 2.54, 95% CI 1.56-4.12, and OR 2.56, 95% CI 1.68-3.90, respectively. Prior history of fall (OR 1.77, 95% CI 1.16-2.72) and hospitalization (OR 1.46, 95% CI 0.97-2.20) in the previous 12 months were associated with frailty. There is also significant association between poly pharmacy and frailty (OR 2.42, 95% CI 1.50-3.91). Conclusion: Approximately one in five Indonesian community-dwelling elderly was frail. Frailty is associated with functional dependence, being at risk for malnutrition or being malnourished, depression, history of fall, history of hospitalization, and poly pharmacy. There may be bidirectional relationships between the risk factors and frailty. The development of long-term care in Indonesia should be considered, without forcing the elderly who need it.