Althea Medical Journal
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Association of Cognitive Function, Depression, and Social Engagement with Quality of Life among Community-Dwelling Elderly in West Jakarta, Indonesia
Full text linkBackground: As Indonesia’s elderly population grows, quality of life (QoL) has become a critical indicator of healthy aging. Evidence regarding the influence of cognitive function, depression, and social engagement on QoL remains inconsistent and is often limited to institutionalized elderly. This study examined these associations among community-dwelling elderly in an urban setting.Methods: A cross-sectional study was conducted at PUSAKA Kebon Jeruk, West Jakarta, from March to November 2023. Ninety-eight participants aged ≥60 years were selected using simple random sampling. Cognitive function was assessed using the Montreal Cognitive Assessment–Indonesian version (MoCA-INA), depression using the Geriatric Depression Scale (GDS), social engagement using the Social Disengagement Index, and QoL using the WHO Quality of Life–Brief Version (WHOQOL-BREF). Data were analyzed using Chi-square, Fisher’s exact, and multivariate logistic regression.Results: Most respondents were female (71.4%), aged 60–74 years (74.5%). The majority demonstrated normal cognitive function (63.3%), good social engagement (90.8%), and no depression. Overall QoL satisfaction was high, particularly in the social relationship (71.4%) and environmental domains (90.8%). Bivariate analysis showed associations between education, cognitive function, social engagement, gender, depression and specific QoL domains (p<0.05). Multivariate analysis identified gender as the strongest predictor of the environmental QoL (OR=5.63, p=0.025), education for social relationship (OR=2.99, p=0.020), and depression for general health perception (OR=3.16, p=0.041).Conclusions: Cognitive function, depression, education, and social engagement are key determinants of QoL among community-dwelling elderly. Community-based interventions focusing on mental health, cognitive stimulation, and social participation may improve QoL and support healthy aging.
Effect of Diabetes Self-Management Education on Knowledge and HbA1c Levels among Patients with Type 2 Diabetes Mellitus in Occupational Health Care
Full text linkBackground: Diabetes Self-Management Education (DSME) is a structured self-care program for managing type 2 diabetes mellitus (T2DM), including treatment adherence and complications prevention. This study aimed to evaluate the effect of DSME on diabetes-related knowledge and hemoglobin A1c (HbA1C) levels among patients with T2DM. Methods: A quasi-experimental pretest-posttest non-equivalent control group design was conducted from August 2023 to January 2024, involving 65 patients with T2DM in occupational health care in Cikarang and Tangerang, Indonesia. The DSME program included five key components: (1) diabetes mellitus education, (2) medical nutrition therapy, (3) physical exercise, (4) pharmacological intervention; and (5) blood glucose self-monitoring. The intervention group received DSME in six sessions over three weeks (45–60 minutes each), while the control group only reviewed 40 educational slides for 30 minutes. Knowledge was assessed using the Diabetes Knowledge Questionnaire (DKQ-24), and HbA1c levels were measured twice, six months apart. Data were analyzed using independent t-tests, dependent t-tests, and ANOVA. Results: The intervention group (n=26) and control group (n=39) had similar baseline characteristics. A significant improvement in diabetes knowledge was observed in both groups. Interestingly, only the intervention group showed a notable reduction in HbA1c levels (−1.9%), from 8.5% to 6.6%. Post-intervention HbA1c levels differed significantly between groups (p<0.05), with the control group remaining at 8.2%.Conclusions: The DSME program effectively improves knowledge and reduces HbA1c levels in patients with T2DM. It is recommended for integration into occupational health care settings to promote healthy lifestyles and enhance diabetes management
Spatial Pattern Analysis of Dating Status as a Risk Factor on Adolescent Sexual Activity in Surabaya, Indonesia
Full text linkBackground: Many adolescents misinterpret the definition of sexual activity, which is only generalized as having sex. In fact, many other activities can trigger the emergence of sexually transmitted infections. Therefore, this study aimed to analyze various factors that influence the occurrence of sexual activity in adolescents.Methods: This study used a cross-sectional analytical design with non-probability sampling involving 152 active college students aged 18-24 years from Surabaya, Indonesia. Data was collected using a questionnaire about their experiences of sexual activity at a young age. The questionnaire was distributed online in July–August 2023. The data obtained was analyzed using the chi-square test and simple logistic regression. Then, Q-GIS software was used to describe data spatially. Results: Dating relationship status had an association with the occurrence of sexual activity (p-value= 0.00; OR: 8.84; 95%CI: 3.34 - 23.40). Spatial data showed that sexual activity of students in the eastern region of Surabaya City had a relatively high rate compared to other regions. Conclusion: Dating relationship status is associated with sexual activity. This study also shows that students who have ever dated and who have had sexual relations is directly proportional in each region in Surabaya. Awareness and education of adolescents about healthy sexual activities should be increased to protect them from the negative impacts of premarital sex
PPAR-γ, but not KCNJ11, Is Associated with Type 2 Diabetes Mellitus Progression among First-Generation Offspring of Lembak Ethnicity in Bengkulu, Indonesia
Full text linkBackground: Genetic and environmental factors influence the onset and progression of type 2 diabetes mellitus (T2DM). Variants affecting peroxisome proliferator activated-receptor gamma (PPAR-γ) and potassium, inwardly rectifying channel subfamily J member 11 (KCNJ11) may alter insulin secretion and sensitivity. This study investigated the association between PPAR-γ and KCNJ11 gene expression and the risk of T2DM among first-generation (F1) offspring of T2DM patients of Lembak ethnicity in Bengkulu, Indonesia.Methods: A cross-sectional observational study was conducted from July to September 2024, recruiting 60 unrelated participants aged 18–40 years, all of whom were exposed to the neron tradition (high-sugar consumption). Gene expression of PPAR-γ and KCNJ11 was determined using real-time quantitative PCR (qRT-PCR).Results: F1 offspring of T2DM patients (n=30) had significantly (p0.05). Linear regression showed 30.4% of PPAR-γ and 45.8% of KCNJ11 variability.Conclusions: PPAR-γ expression is associated with T2DM onset among Lembak F1 offspring, whilst KCNJ11 expression is not. Multiple genetic and environmental factors likely contribute to disease progression. Screening for PPAR-γ expression may support interventions targeting insulin sensitivity and lipid metabolism
Association Between Smoking and Central Obesity in Individuals Aged ≥40 Years Based on the Indonesian Family Life Survey-5
Full text linkBackground: Obesity and smoking are major public health concerns and leading causes of preventable morbidity and mortality. Smoking may contribute to central obesity through multiple mechanisms, and individuals aged ≥40 years are at higher risk. This study aimed to examine the association between smoking and central obesity, considering sociodemographic factors, using data from the Indonesian Family Life Survey-5 (IFLS-5).Methods: A cross-sectional study was conducted using secondary data from IFLS-5. Participants included Indonesians aged ≥40 years with complete data on smoking and waist circumference. Smoking status was assessed using the Brinkman Index (BI) and classified as light (0–199), moderate (200–599), or heavy (>600). Central obesity was defined as waist circumference ≥90 cm for male and ≥80 cm for female. Associations were analyzed using Chi-square tests at 95% confidence interval.Results: Of 3,391 participants, the majority were male (95.4%) with a mean age of 52.76±9.78 years (range 40–101). The prevalence of central obesity was 22.3% (n=790), and the largest group of participants were moderate smokers (54.9%). Central obesity was significantly associated with smoking status (p=0.003), age (p<0.001), gender (p<0.001), and education level (p<0.001). No significant associations were found with marital status (p=0.826), occupation (p=0.374), or residence (p=0.750).Conclusions: Smoking, age, gender, and education level are significantly associated with central obesity among Indonesians aged ≥40 years. Preventive measures, including smoking cessation and lifestyle interventions, are essential to reduce central obesity and the risk of cardiovascular disease
25-hydroxyvitamin D Serum Level and Risk of Knee Osteoarthritis in the Elderly
Full text linkBackground: Osteoarthritis (OA) is a degenerative joint disease that commonly affects the elderly, particularly in the knees. The OA may lead to chronic pain, physical limitations, depression, and significantly impact an individual's ability to participate in social, occupational, and community activities, ultimately reducing quality of life. Vitamin D has been suggested as a factor that may help reduce the risk of knee OA in older adults. This study aimed to investigate the relationship between 25-hydroxyvitamin D levels and the risk of knee OA among elderly.Methods: This cross-sectional study involved elderly residents of a nursing home in North Jakarta, Indonesia. Data was collected through interviews and physical examinations of both knees following the American Rheumatism Knee OA diagnostic criteria. Participants who met these criteria were classified as high-risk for knee OA. Blood samples were taken to measure 25-hydroxyvitamin D (25(OH)D) levels using an enzyme-linked immunosorbent assay. The Chi-square test was used for bivariate analysis.Results: Of the 48 participants involved, the majority were female (64.6%) and aged between 70-79 years (47.9%). A total of 22.9% of participants were classified as 25(OH)D insufficient and 25% were deficient. Interestingly, 62.5% were at high risk of knee OA. There was a significant association between 25(OH)D levels and the risk of knee OA (p=0.031).Conclusions: The 25(OH)D serum level has a significant association with the risk of knee OA. Increasing sunlight exposure through daily outdoor activities and considering vitamin D supplementation can help mitigate the risk of knee OA, thereby improving bone health and preventing OA in the elderly
Nuclear Changes Features in Buccal Mucosa Smear of Adult Male Smokers Using Pappaniculou Staining
Full text linkBackground: Tobacco smoke contains a combination of chemicals that could be harmful to the buccal mucosa as the first part of the body that has been exposed. Damage to the buccal epithelial cells has the potential to become a malignant lesion. This study aimed to describe changes in the nuclear epithelial of the buccal mucosa using Pappaniculou staining as an indicator of mucosal damage in smokers.Methods: This was a descriptive analytical study, involving adult male participants from Bale Endah District, Bandung Regency, Indonesia aged >35 years, who had smoked for ≥10 years. Buccal mucosa smear was taken, and the features of nuclear epithelial changes were observed per 500 cells, each at 400x magnification with Pappaniculou stain to evaluate the features of micronucleus, broken egg, karyorrhexis, karyolysis. Those who did not smoke were recruited as a control group.Results: Smokers were mostly light active smokers or kretek cigarettes, with a smoking duration of ≥15 years. The frequency of micronucleus (p<0.001), broken eggs (p<0.001), karyorrhexis (p=0.001), karyolysis (p=0.003) in the buccal mucosal epithelial was significantly different between the smoker and non-smoker groups.Conclusions: All epithelial nuclear changes have shown significant differences between smoker and non-smoker groups. Nuclear epithelial features in smoker may be associated with future malignancies, therefore, smoking cessation programs are necessary to substantially reduce tobacco use, thus fostering a healthy lifestyle for everyone
Effect of Vitamin D Supplementation on Irisin, Telomerase, Klotho, and Tumor Necrosis Factor-alpha (TNF-α) in Elderly: A Quasi-Experimental Study
Full text linkBackground: Vitamin D plays a crucial role in aging by regulating mitochondrial function, inflammation, oxidative stress, and telomere stability. Vitamin D deficiency is common among the elderly and is linked to accelerated aging. Biomarkers such as irisin, telomerase, klotho, and tumor necrosis factor-alpha (TNF-α) are associated with aging processes. This study aimed to evaluate the effect of vitamin D supplementation on these biomarkers in elderly individuals.Methods: This quasi-experimental pretest-posttest study was conducted in Kadugadung Village, Banten, Indonesia from Maret to September 2024. A total of 47 healthy elderly individuals (≥60 years) were recruited using purposive sampling. The treatment group (n=25) received 800 IU/day of vitamin D for 20 days, whereas the control group (n=22) received none. Blood samples were collected before and after the intervention to measure serum irisin, telomerase activity, klotho, and TNF-α. Baseline variables included body mass index (BMI), blood pressure, hemoglobin, hematocrit, blood glucose, cholesterol, and uric acid. Data were analyzed using paired and independent statistical tests.Results: Vitamin D supplementation significantly increased serum irisin levels (p=0.016), meanwhile no significant changes were observed in telomerase activity (p=0.128), klotho (p=0.819), or TNF-α (p=0.098). In the treatment group, blood glucose was correlated positively with TNF-α (r=0.423, p<0.05), whereas cholesterol was correlated negatively with TNF-α (r=-0.51, p<0.01). Furthermore, telomerase activity was correlated positively with irisin (r=0.348, p<0.05)Conclusion: Vitamin D supplementation at 800 IU/day significantly enhances serum irisin, but does not affect telomerase, klotho, or TNF-α. These findings suggest a potential role of vitamin D in modulating aging-related biomarkers. Correction Notice: This article has been corrected. See the Erratum published in Althea Medical Journal, Volume 12, Number 4 (2025)
Protein Insufficiency Among First-Trimester Pregnant Women in Jambi, Indonesia
Full text linkBackground: Insufficient protein intake or specific patterns of plasma amino acid levels during pregnancy has been associated with adverse maternal and neonatal outcomes. Studies in non-pregnant women have reported an association between protein intake and amino acid levels, however, data in pregnant women remain limited. Jambi, a region rich in freshwater fish, has a traditional dishes based on fish, which may affect maternal protein adequacy. This study aimed to assess protein sufficiency intake, plasma essential amino acid levels, and the relationship between fish consumption and protein intake among first-trimester pregnant women. Methods: A cross-sectional study was conducted in 2022 involving pregnant women at 9-16 weeks of gestation in Jambi, Indonesia, selected through purposive sampling. Protein intake and fish consumption data were collected using Food Frequency Questionnaires. Plasma essential amino acid levels were measured using Liquid Chromatography-Mass Spectrometry. Bivariate analyses were performed using Mann-Whitney and Chi-square tests.Results: Among 30 participants, 23.3% had insufficient protein intake and had lower plasma essential amino acid levels. Lysine levels showed a statistically significant difference between groups (p=0.010). Women with adequate protein intake reported significant higher fish consumption, particularly of freshwater fish (p=0.033).Conclusion: Adequate protein intake during early pregnancy is related to higher plasma essential amino acid levels. Consumption of local freshwater fish contributes to maintaining sufficient protein intake. These findings emphasize the importance of integrating healthy dietary patterns and locally sourced nutrient-rich foods into prenatal care to support maternal wellness and long-term health outcomes
Consumption of Sugar-Sweetened Beverages Is Related to Fasting Blood Glucose and the Nutritional Status among Young Adults in Indonesia
Full text linkBackground: Habitual consumption of sugar-sweetened beverages (SSBs) is linked to elevated blood glucose and increased body weight. Medical students often experience high stress, which may increase SSBs consumption. This study aimed to examine the associations between SSB consumption, fasting blood glucose, body mass index (BMI), and waist circumference among medical students.Methods: A cross-sectional study was conducted in October 2022 using a total sampling method involving 184 first-year students at the Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia. SSBs consumption was assessed using a semi-quantitative food frequency questionnaire (SQ-FFQ). Fasting blood glucose was measured by glucometer after an overnight fast. Body height, weight, and waist circumference were measured using a stadiometer, digital scale, and tape measure, respectively. Physical activity was assessed with the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Associations were tested using Kruskall Wallis, independent t-test, and chi square as appropriate.Results: Most students consumed SSBs 3–4 times per week and in amount >495 mL. The volume of SSBs consumption was associated with BMI (p=0.02), fasting blood glucose (p<0.001), and waist circumference (p<0.01). Similarly, the frequency of SSBs consumption was associated with fasting blood glucose (p=0.04) and waist circumference (p<0.01), but not with BMI (p=0.16). Conclusion: Consumption of SSBs among students is high. Frequent and high-volume consumption of SSBs is associated with elevated fasting blood glucose levels and the nutritional status, whereas higher volume is associated with increased BMI. Reducing SSB intake and promoting healthier beverage choices may support a sustainable healthy lifestyle in young adults.