HUBUNGAN ANTARA SINDROM METABOLIK DENGAN GANGGUAN FUNGSI KOGNITIF PADA LANSIA

ANITA BUDIJANTO, dr Cecep S Kristanto SpKJ(K) ; Dr dr Carla R Marchira SpKJ(K)

2015 | Tesis-Spesialis | SP PSIKIATRI

Latar belakang : Di Indonesia laju pertambahan penduduk semakin meningkat dan juga diikuti oleh peningkatan proporsi penduduk lanjut usia. Sedangkan pada masa kini terjadi perubahan gaya hidup, diantaranya perubahan pola makan dan berkurangnya aktivitas fisik. Hal ini menyebabkan berkembangnya penyakit metabolik, diantaranya sindrom metabolik. Sindroma metabolik memiliki risiko tinggi timbulnya sejumlah penyakit, diantaranya diabetes melitus tipe 2, komplikasi kardiovaskuler, dan gangguan fungsi konitif. Prevalensi sindrom metabolik pada populasi lansia mencapai 14,9%. Sindroma metabolik dapat mempengaruhi fungsi kognisi dan meningkatkan risiko terjadinya demensia. Demensia adalah suatu kemunduran intelektual berat dan progresif yang mengganggu fungsi sosial, pekerjaan, dan aktifitas sehari-hari seseorang. Adanya sindrom metabolik dan dampaknya pada fungsi otak akan mempengaruhi kualitas hidup lansia. Tujuan : Mengetahui adanya hubungan antara sindrom metabolik dengan gangguan fungsi kognitif pada lansia dalam kelompok senam diabetes di RS Jiwa Prof dr, Soerojo Magelang. Metodologi : Penelitian ini merupakan studi non eksperimental dengan rancangan cross sectional. Kriteria sindrom metabolik berdasarkan NCEP ATP III yang telah dimodifikasi untuk negara/etnik Asia. Gangguan fungsi kognitif dinilai dengan The Mini Mental State Examination (MMSE). Subyek penelitian adalah lansia pada kelompok senam diabetes di RS Jiwa Prof dr, Soerojo Magelang yang memenuhi kriteria inklusi penelitian. Hasil : Jumlah subyek 62 orang, 20 laki-laki dan 42 perempuan. Rata-rata umur 67,2 + 5,2 tahun. Prevalensi gangguan kognitif hasil MMSE 56,5% dan sindrom metabolik 58,1%. Komponen sindrom metabolik meliputi obesitas/lingkar pinggang (77,4%), tingginya tekanan darah diastole (66,1%), tingginya tekanan darah sistol (48,4%), rendahnya kadar HDL (48,4%), tingginya gula darah puasa (40,3%), dan tingginya kadar trigliserida (24,25%). Tekanan darah sistol yang rendah (r = -0,256; p = 0,044) dan tingginya lingkar pinggang (r = 0,241; p = 0,059) berhubungan dengan gangguan kognitif. Hasil uji regresi logistik multipel dengan metode backward menunjukkan rendahnya HDL berhubungan dengan peningkatan gangguan kognitif (OR = 0,926; 95% CI = 0,876 – 0,980). Kesimpulan : Tidak terdapat hubungan yang bermakna antara sindrom metabolik dengan gangguan fungsi kognitif pada lansia (di Kelompok Senam Diabetes RS Jiwa Magelang).

Background: Indonesia has a rapid population growth so that the proportion of elderly is also rapidly increased. Current trend also shows alterations in life styles, such as changes in dietary intake and reduction in physical activities. These are the risk factors for the development of metabolic disorders, for example metabolic syndrome. Metabolic syndrome is a risk factor for the development of diseases, such as type II diabetes mellitus, cardiovascular complications, and cognitive function impairments. It has been reported that the prevalence of metabolic syndrome among elderly is as high as 14.9%. Metabolic syndrome can influence cognitive functions and increased the risk to develop dementia. Dementia is severe and progressive intellectual declines that disrupt daily activities, social and occupational functions of individual. The presence of metabolic syndrome and its impact on nervous system in elderly will likely to affect their quality of life. Objectives: This study was aimed to examine the association between metabolic syndrome and cognitive impairments in elderly in the diabetic exercise group in Prof. dr. Soerojo Mental Hospital, Magelang. Methods: This study is a non experimental study with a cross sectional design. The metabolic syndrome is established based on the NCEP ATP III criteria, which has been modified for Asian population. The cognitive function was examined with the Mini Mental State Examination (MMSE). The subjects of this study are elderly in the diabetic exercise group in Prof. dr. Soerojo Mental Hospital, Magelang who meet the inclusion criteria. Results: Our subjects was 62 people (20 men dan 42 women). The average age was 67,2 + 5,2 years old. The prevalence of cognitive impairment based on MMSE was 56,5% dan metabolic syndrome was 59,1%. He component of the metablic syndrome included obesity/waist circumference (77,4%), high diastolic blood pressure (66,1%), high systolic blood pressure (48,4%), low HDL level (48,4%), high bood glucose level (40,3%), and high triglyceride level (24,25%). High systolic blood pressure (r = -0,256; p = 0,044) and waist circumference (r = 0,241; p = 0,059) were associated with cognitive impairment. The mutiple logistic regression analysis with backward method showed that low HDL was also associated with cognitive impairment (OR = 0,926; 95% CI = 0,876 – 0,980). Conclusion: We found no significant association between metabolic syndrome and cognitive impairment in elderly (in Diabetic Exercise Group Magelang Mental Hospital).

Kata Kunci : gangguan fungsi kognitif, lansia, sindrom metabolik