Tesis

Hubungan antara Penyakit Arteri Perifer (PAP) dengan Kejadian Frailty pada Pasien Lansia = The Association Between Peripheral Artery Disease (PAD) and Frailty in Elderly Patients.

Latar Belakang: Peningkatan angka harapan hidup berkontribusi terhadap peningkatan jumlah populasi lanjut usia. Frailty merupakan salah satu sindrom geriatri modern, berpotensi reversibel, sering ditemukan pada populasi lansia dan meningkatkan luaran kesehatan yang tidak diinginkan seperti risiko jatuh, imobilisasi hingga mortalitas. Penyakit arteri perifer (PAP) dapat menurunkan fungsi status fisik, sebagai salah satu komponen dari frailty. Namun demikian, hubungan antara PAP dan frailty belum sepenuhnya diketahui Tujuan: Mengetahui hubungan antara PAP dengan kejadian frailty pada pasien lansia Metode: Penelitian ini merupakan studi potong lintang yang dilakukan pada populasi usia lanjut (≥ 60 tahun) di unit rawat jalan dan rawat inap RS Cipto Mangunkusumo (RSCM) pada Mei-Agustus 2025. PAP didiagnosis melalui pemeriksaan Ankle Brachial Index (ABI), sedangkan frailty didiagnosis menggunakan Frailty Index-40 (FI-40), yang terintegrasi dalam pengkajian paripurna geriatri. Dilakukan analisis bivariat, multivariat dan analisis sensitivitas. Hasil: Sebanyak 150 subjek diikutsertakan, terdiri dari 52% pasien rawat jalan dan 48% rawat inap. PAP ditemukan pada 48% subjek (29,3% ringan, 18,7% sedang). Frailty ditemukan pada 26% subjek. Analisis bivariat menunjukkan hubungan bermakna antara PAP (PR=2,5;IK95% 1,41-4,40), usia ≥70 tahun (PR=1,74;IK95% 1,06-2,87), hipertensi (PR=1,81;IK95% 1,04-3,14) serta gangguan kognitif (PR=1,84;IK95% 1,09-3,10) dengan frailty. Analisis multivariat menunjukkan PAP tetap memiliki hubungan bermakna dengan frailty (aPR=1,94;IK95% 1,04-3,60;p=0,035), meskipun sudah di adjust dengan variabel usia, gangguan kognitif dan hipertensi. Analisis sensitivitas menunjukkan PAP berhubungan signifikan pada pasien rawat jalan, namun tidak pada pasien rawat inap. Kesimpulan: PAP berhubungan signifikan dengan frailty pada pasien lansia Oleh karena tingginya prevalensi keduanya serta frailty yang berpotensi reversibel maka deteksi dini PAP dan frailty penting dilakukan, khususnya pada populasi rawat jalan.
Kata kunci : Penyakit arteri perifer (PAP), frailty, usia lanjut


Introduction: The increase in life expectancy contributes to the growing number of older adults. Frailty is a modern geriatric syndrome that is potentially reversible and commonly found among the elderly, leading to adverse health outcomes such as falls, immobility, and even mortality. Peripheral artery disease (PAD) may impair physical function, which is one of the components of frailty. However, the association between PAD and frailty has not been fully elucidated. Aims: To investigate the association between PAD and frailty in elderly patients. Method: This cross-sectional study included adults aged ≥60 years from outpatient and inpatient units at Cipto Mangunkusumo Hospital, Indonesia (May–August 2025). PAD was assessed using the Ankle-Brachial Index (ABI), and frailty was measured with the 40-item Frailty Index (FI-40) as part of a comprehensive geriatric assessment. Bivariate, multivariate, and sensitivity analyses were performed. Results: A total of 150 participants were enrolled (52% outpatients, 48% inpatients). PAD was present in 48% (29.3% mild, 18.7% severe), while frailty was observed in 26%. In bivariate analysis, PAD (PR=2.5; 95%CI 1.41–4.40), older age (PR=1.74; 95%CI 1.06–2.87), hypertension (PR=1.81; 95%CI 1.04–3.14), and cognitive impairment (PR=1.84; 95%CI 1.09–3.10) were significantly associated with frailty. Multivariate analysis confirmed PAD remained independently associated with frailty aPR=1,94; 95%CI 1.41–4.40; p=0,035) after adjustment for confounders. Sensitivity analysis showed the association was significant in outpatients but not in inpatients. Conclusion: PAD is significantly associated with frailty among older adults. Given their high prevalence and the reversible nature of frailty, early screening for PAD and frailty is warranted, particularly in outpatient settings.
Keywords: Peripheral artery disease (PAD), frailty, elderly