Insomnia sebagai faktor risiko gangguan kognitif pada kelompok usia lanjut RS. Ludira Husada Tama Yogyakarta

KRAKSONO, Djoko, Prof. Dr. dr Samekto Wibowo, P.Far.K, SpFK(K), SpS(K)

2009 | Tesis | S2 PPDS I/Ilmu Penyakit Saraf

Latar Belakang: Insomnia dan gangguan fungsi kognitif merupakan keluhan yang sering dilaporkan pada usia lanjut (lansia). Prevalensi isomnia pada lansia sekitar 35% dan gangguan fungsi kognitif 17-34%. Insidensinya meningkat seiring dengan bertambahnya usia. Studi-studi epidemiologi menunjukkan adanya hasil yang kontroversial mengenai hubungan insomnia dengan gangguan fungsi kognitif. Penelitian seperti ini belum banyak dilakukan di Indonesia. Dengan melakukan pengkajian lebih lanjut diharapkan menjadi bahan masukan bagi klinisi untuk melakukan intervensi yang tepat masalah insomnia dan gangguan fungsi kognitif pada lansia dalam rangka meningkatkan kualitas hidupnya. Tujuan: Mengetahui proporsi insomnia dan besarnya risiko terjadinya gangguan kognitif pada kelompok lansia. Metode: Jenis penelitian Cross sectional, deskriptif analitik. Subjek penelitian adalah anggota kelompok lansia Rumah Sakit Ludira Husada Tama, Yogyakarta yang berumur > 60 tahun, tidak buta huruf, dan bersedia ikut dalam penelitian. Diagnosis gangguan fungsi kognitif jika nilai MMSE (Mini Mental State Examination) < 24. Insomnia ditegakkan berdasar kriteria DSM-IV (Diagnostic and Statistical Manual of Mental Disorder) dan PPDGJ III (Pedoman Penggolongan Diagnosis Gangguan Jiwa). Analisis data dengan univariat (chisquare) dan mulvariat (regresi logistik). Hasil: Didapatkan 116 orang lansia terdiri laki-laki 28(24,1%) dan perempuan 88(75,9%) dengan rata-rata umur 72,66 ± 6,76 tahun. Diantara jumlah tersebut, 77(66,4%) mengalami insomnia dan 39(33,6%) tidak. Sedangkan gangguan kognitif terjadi pada 25 subjek (21,6%). Insomnia dan depresi berpengaruh secara bermakna terhadap gangguan fungsi kognitif dengan nilai masing-masing RP: 4,00 (95%CI: 1,22 - 13,08) dan RP: 3,38 (95%CI: 1,18 - 9,69). Simpulan: Proporsi insomnia pada populasi lansia RS. Ludira Husada Tama, Yogyakarta tinggi. Insomnia sebagai faktor risiko penurunan fungsi kognitif pada populasi lansia RS. Ludira Husada Tama, Yogyakarta

Background: Insomnia and cognitive impairment are the complaints commonly reported in the elderly. The prevalence of isomnia in the elderly is approximately 35% while the the prevalence of cognitive impairment is 17 to 34%. The incidence increases along with age. Several studies have proven that insomnia affects cognitive function. Such this study has never been conducted in Indonesia. Epidemiological studies have shown controversial results about association of insomnia and cognitive impairment. This research have not been studied lately in Indonesia. Further analysis is expected to enrich the knowledge of clinicians in providing appropriate intervention for insomnia problem and cognitive impairment in the elderly. Objective: To assess the proportion of insomnia and risk factor of cognitive impairment in elderly population. Method: This is a cross sectional, descriptive analytical study. The subjects of the study were members of integrated health service for the elderly in Ludira Husada Tama, Yogyakarta. They were more than 60 years old, were literate, and allow to participate in the research. They were diagnosed cognitive impairment if the score of MMSE (Mini Mental State Examination) was less than 24. Insomnia is diagnosed by the criteria of DSM-IV (Diagnostic and Statistical Manual of Mental Disorder) and PPDGJ III (Pedoman Penggolongan dan Diagnosis Gangguan Jiwa). Analysis was made by univariate (chi-square) and multivariate (logistic regression). Result: There were 116 elderly subjects consisting of 28 males (24,1%) and 88 females (75,9%) at the average age of 72,66 ± 6,76 years. Of the numbers, 77 (66,4%) had insomnia while 39 (33,6%) did not. While 25 (21,6%) have cognitive impairment. Insomnia dan depression affect significantly on cognitive impairment with the respective value of RP of 4,00 (95%CI: 1,22 - 13,08) and 3,38 (95%CI: 1,18 - 9,69). Conclusion: Proportion of insomnia among elderly in Ludira Husada Tama Hospital population Yogyakarta is high. Insomnia is a risk factor of cognitive impairment among elderly population in Ludira Husada Tama, Yogyakarta.

Kata Kunci : Insomnia,Gangguan kognitif,Lansia,insomnia–cognitive impairment-elderly