Background Information about frailty status and its transition is important to inform clinical decisions. Predicting frailty transition is beneficial for its prevention. While Indonesia is the 4th largest geriatric population in Asia, data about frailty transition is limited. This study aimed to obtain data on prevalence of frailty, its risk factors, frailty state transition and its prognostic factors, as well as to develop prognostic score for frailty state transition. Methods Multicenter study on subjects aged ≥60 years old was done to obtain the prevalence of frailty status and to identify risk factors of frailty. Prospective cohort over 12 months was done to obtain data on frailty state transition. Multiple logistic regression analysis was performed to identify its prognostic factors from several clinical data, which then were utilized to develop prognostic score for frailty state worsening. Results Cross-sectional data from 448 subjects showed that 25.2% of the subjects were frail based on Frailty index-40 items. Risk factors of frailty were age (OR 2.72; 95% CI 1.58–4.76), functional status (OR 2.89; 95% CI 1.79–4.67), and nutritional status (OR 3.75; 95% CI 2.29–6.13). Data from the 162 subjects who completed the cohort showed 27.2% of the cohort had frailty state worsening. Prognostic factors for frailty state worsening were being 70 years or older (OR 3.9; 95% CI 1.2–12.3, p < 0.05), negative QoL, i.e., fair and poor QoL (OR 2.5; 95% CI 1.1–5.9, p < 0.05), and slow gait speed (OR 2.8; 95% CI 1.3–6.4, p < 0.05). The internal validation of the prognostic score consisted of those three variables showed good performance. Conclusion The prevalence of frailty in this study among Indonesian elderly in outpatient setting was 25.2%. The risk factors of frailty were age, functional status and nutritional status. The prognostic factors for frailty state worsening were being 70 years old or older, negative QoL (fair or poor quality of life), and slow gait speed. A prognostic score to predict frailty state worsening in 12 months had been developed.
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.
Purpose Within low-income communities in urban slums, access to housing is limited because individuals in these communities cannot afford to purchase homes. One area of Indonesia with these conditions is Kampung Kajen, Danukusuman, Surakarta, where, oftentimes, a single house is inhabited by several families and is passed down from generation to generation. This causes a change in space, a narrowing of that which is inhabited by the next generation. This paper aims to examine the transformation of space within low-income homes in Kampong Kajen. Design/methodology/approach The research method was a qualitative case study approach, and data were collected through direct interviews and field observation. Informants in this study were classified into three groups: residents, non-residents and government agencies. Findings The space transformation that occurred in the studied samples was partial. The transformation continued to occur as the new families grew, and the area of space used by the new families experienced a narrowing for future generations. Originality/value The novelty of this research is in regard to the findings about the partial transformation of the house from generation to generation, which details changes in the layout and the extent of the house interior, the narrowing of the house, the change of owners and the changing behaviour of the house inhabitants. Partial transformation continues to occur in line with the addition of new families living in one house.
Objectives Up to 90% of people with dementia in long term care (LTC) have hearing and/or vision impairment. Hearing/vision difficulties are frequently under‐recognised or incompletely managed. The impacts of hearing/vision impairment include more rapid cognitive decline, behavioural disturbances, reduced quality of life, and greater care burden. This research investigated LTC staff knowledge, attitudes and practice regarding hearing/vision care needs for residents with dementia. Methods A survey of staff in LTC facilities in England, South Korea, India, Greece, Indonesia and Australia. Respondents used a five‐point scale to indicate agreement or YES/NO response to questions regarding sensory‐cognitive care knowledge (what is known); attitudes (what is thought); practice (what is done). Results Respondents reported high awareness of hearing/vision care needs, although awareness of how to identify hearing/vison difficulties or refer for assessment was low. Most felt that residents were not able to use hearing/vision devices effectively due to poor fit, being poorly tolerated or lost or broken devices. A substantial minority of respondents reported low confidence in supporting use of assistive hearing/vision devices, with lack of training the main reason. Most staff did not undertake routine checking of hearing/vision devices, and it was rare for facilities to have designated staff responsible for sensory needs. Variation among countries was not significant after accounting for staff experience and having received dementia training. Conclusions There is a need to improve sensory support for people with dementia in LTC facilities internationally. Practice guidelines and training to enhance sensory‐cognitive knowledge, attitudes and practice in professional care teams is called for.
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