AbstrakMild Cognitive Impairment (MCI) meningkatkan risiko penyakit Alzheimer. Tekanan darah tinggi sering didapatkan pada beberapa pasien usia lanjut yang menderita MCI. Penelitian potong lintang ini bertujuan untuk mengetahui hubungan antara hipertensi dan MCI pada lanjut usia (usia ≥ 60 tahun) yang dipilih secara konsekutif dari pengunjung Puskesmas Joglo-I pada 12 _ 18 November 2012. Kuesioner Mini Mental State Examination (MMSE) digunakan untuk skrining gangguan fungsi kognitif dan tekanan darah diukur dengan manual sfigmomanometer menurut prosedur standar. Analisis statistik menggunakan Generalized Linear Model. Dari 32 responden, rata-rata usia adalah 61 tahun dan sebanyak 53,1% responden adalah perempuan. Hipertensi ditemukan pada 21 orang (65,6%) dan MCI pada 21 orang (65,6%). MCI didapatkan pada 17 orang (81%) di antara 21 responden hipertensi, dan 4 orang (36%) di antara 11 responden normotensi. Terdapat hubungan statistik yang bermakna antara hipertensi dan MCI. Risiko mild cognitive impairment pada usia lanjut hipertensi adalah 2,2 kali lebih besar daripada mereka yang normotensi (PR = 2,2; nilai p = 0,01). Hubungan ini tetap bermakna setelah faktor usia, diabetes, dan stroke disetarakan (nilai p = 0,04). Menurunkan kasus hipertensi dapat menjadi suatu upaya mengurangi risiko MCI pada usia lanjut.Kata kunci: Hipertensi, mild cognitive impairment, usia lanjut Abstract Mild cognitive impairment (MCI) may increase the risk of Alzheimer's disease. Some geriatric patients with MCI were often identified to have high blood pressures. This cross-sectional study aimed to know association between hypertension and MCI in geriatric patients (age ≥ 60 years), consecutively selected among people attending Joglo-I Primary Health Center between November 12 _ 18, 2012. The Mini Mental State Examination (MMSE) questionnaires were administered to screen for cognitive impairment, blood pressures were measured using a manual sphygmomanometer according to the standard protocols. Analyzes were done using the Hipertensi dan Risiko Mild Cognitive Impairment pada Pasien Usia Lanjut Hypertension and Risk of Mild Cognitive Impairment in Elderly PatientsKasmianto Abadi* Dian Wijayanti* Ellen A. Gunawan* Marcella Erwina Rumawas* Bambang Sutrisna** Generalized Linear Model procedure of 32 participants (median age: 61 years; 53.1% women), 21 respondents (65.6%) had hypertension, and 21 others (65.6%) had MCI. MCI were identified in 17 persons (81%) out of 21 respondents with hypertension, and in 4 persons (36%) out of 11 respondents with normal blood pressure. Hypertension was significantly associated with MCI. The risk that older individuals diagnosed with hypertension had MCI was 2.2 over that of their counterpart with normal blood pressure (PR = 2.2; p value = 0.01). This association remained significant after adjustment for age, diabetes, and stroke (p value = 0.04). Reduced hypertension may be one strategy to lower the risk of cognitive impairment among older adults. Keywords: Hypertension, mild cognitive impairment, geriatri...
Latar Belakang Penggunaan Antipsikotik pada lanjut usia (lansia) berhubungan dengan efek samping kardiovaskular. Beberapa efek samping kardiovaskular dapat terjadi pada lansia baik ringan hingga dapat menyebabkan kematian mendadak. Jenis antipsikotik yang digunakan diduga berhubungan dengan kejadian mortalitas sistem kardiovaskular.Metode: Pencarian terstruktur dilakukan di Pubmed, EBSCO, dan Science Direct menggunakan kata kunci berdasarkan konsep Boolean operators yang sesuai dengan pertanyaan klinis. Populasi target yaitu pasien lanjut usia yang menggunakan antipsikotik dan efek terhadap sistem kardiovaskular.Hasil: Setelah menyaring 68 judul dan abstrak dengan menggunakan kriteria inklusi dan eksklusi, didapatkan 2 artikel. Selanjutnya dilakukan telaah kritis berdasarkan kesahihan, kepentingan hasil, dan aplikasi. Kedua artikel memperlihatkan adanya hubungan yang signifikan antara penggunaan antipsikotik dan kejadian mortalitas kardiovaskular.Kesimpulan: Penggunaan antipsikotik pada lansia dapat menyebabkan risiko mortalitas kardiovaskular, perlu untuk menilai profil keuntungan dan risiko penggunaan obat antipsikotik serta penyesuaian dosis dan evaluasi efek samping.
Assessment of medication adherence is an important part of pharmacological treatment of psychotic disorders. This study aims to obtain a valid and reliable instrument to assess medication adherence in psychotic patients. This is a cross-sectional study conducted in the Psychiatric Outpatient Clinic of Cipto Mangunkusumo Hospital from January to July 2017. Subjects were recruited through consecutive sampling (n = 100, aged 18-59 years old). Psychotic disorders were diagnosed using Structured Clinical Interview and Diagnosis DSM-IV. The instrument was translated, adapted to Indonesian culture, and back-translated. Content validity and test-retest reliability (n = 35 using systematic sampling) of MARS Indonesian version were evaluated. All items in the instrument are relevant to theory, as showed by content validity coefficient of 0.90. Construct validity test showed that the items represent theoretical as well as conceptual construction of medication adherence. Internal consistency reliability was good, with Cronbach's alpha of 0.80 and 0.798 in the test-retest evaluation. This study produced a valid and reliable MARS Indonesian version. Currently there is no other instrument assessing medication adherence in psychotic patients in Indonesia.
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