Tesis

Faktor-faktor yang berhubungan dengan gejala depresi pada pasien insomnia usia lanjut di rawat jalan = Factors associated to depression symptom in insomnia elderly outpatient.

Latar Belakang : Populasi lanjut usia meningkat secara global, diperkirakan 1.5 miliar (15% total penduduk) di dunia tahun 2050. Indonesia merupakan populasi menua, dengan 10.7% (>7%) penduduk lansia pada 2020. Insomnia keluhan kesehatan tersering lansia, memiliki komplikasi salah satunya depresi. Banyak studi meneliti faktor berhubungan dengan insomnia dan depresi pada lansia, dan insomnia prediktor depresi pada lansia. Namun, belum ada studi mengenai faktor berhubungan dengan depresi pada populasi lansia khusus yaitu dengan insomnia. Tujuan : Mengetahui mengetahui faktor yang berhubungan dengan gejala depresi pada lansia dengan insomnia di unit rawat jalan. Metode : Studi potong lintang pada pasien usia ³60tahun di unit rawat jalan RSCM Jakarta, Indonesia dengan seleksi consecutive sampling, dimana pasien dengan insomnia, PSQI (Pittsburgh Sleep Questionaire Index) > 5, menjadi subjek penelitian dan dilakukan wawancara untuk mengambil data meliputi sosiodemografi, kesendirian, durasi insomnia, gejala depresi (GDS-15 item), status fungsional (B-ADL), status kognitif (MMSE), status nutrisi (MNA), dan penyakit komorbid (CIRSG skor). Hasil : Subjek penelitian sebanyak 209 lansia insomnia, rerata usia 72.88 (SB 6.98) tahun, proporsi depresi 6.7%. Dari uji bivariat terdapat hubungan signifikan antara ketergantungan (PR 5.24, 95%IK 1.50-18.29), malnutrisi (PR 11.54, 95%IK 4.77-27.92), dan penyakit komorbid, skor CIRSG ³9 (PR 4.15, 95%IK 1.18-14.50) dengan gejala depresi pada lansia yang insomnia. Tidak terdapat hubungan antara sosiodemografi, kesendirian, durasi insomnia, dan status kognitif dengan depresi. Dari analisis multivariat dengan regresi logistik, didapatkan hubungan bermakna secara statistik antara malnutrisi dengan gejala depresi (p < 0.0001). Kesimpulan : Terdapat hubungan bermakna antara malnutrisi dengan gejala depresi pada pasien insomnia usia lanjut di rawat jalan.
Kata kunci : insomnia, depresi, usia lanjut, malnutrisi


Background: The elderly population is increasing globally, estimated to be 1.5 billion (15% of the total population) in the world by 2050. Indonesia is an aging society, 10.7% (>7%) of the population is elderly in 2020. Insomnia, most often health complained by the elderly, has complications one of which is depression. Previous studies have examined factors associate to insomnia and depression in elderly and insomnia is a predictor of depression. No studies yet examined factors associated to depression symptom in the specific population, elderly with insomnia. Objective: To analyze factors associated with depression symptom in the elderly with insomnia in the outpatient_unit. Method: Cross-sectional study of patients aged >60 years in the outpatient unit of Cipto Mangunkusumo Hospital Jakarta, Indonesia using consecutive sampling to select the sample, where patients with insomnia, PSQI (Pittsburgh Sleep Questionnaire Index) >5, became research subjects and being interviewed to collect data including sociodemographic, loneliness, duration of insomnia, Depression symptom (GDS-15 items), physical activity which means the ability to do activity that measured by functional status (B-ADL), cognitive status (MMSE), nutritional status (MNA), and comorbidities (CIRSG). Data was analyzed using STATA software to do bivariate and multivariate analysis. Results: The research subjects were 209 elderly people with insomnia, mean age 72.88 (SB 6.98) years, proportion of depression symptom is 6.7%. There is an association between dependency (PR 5.24, 95% CI 1.50-18.29), malnutrition (PR 11.54, 95% CI 4.77-27.92), and chronic illness, CIRSG score > 9 (PR 4.15, 95% CI 1.18-14.50) with depression symptom in elderly with insomnia from bivariate analysis. From multivariate analysis with logistic regression, malnutrition has a statistically significant association to depression symptom (p < 0.0001) in elderly people with insomnia. Conclusion : There is a significant association between malnutrition and depression symptom in insomnia elderly_outpatient.
Keywords : insomnia, depression, elderly, malnutrition