1.Components of Sarcopenia and Frailty in Relation to Cognitive Impairment in Older Adults: An Ambispective Cohort Study from a Tertiary Hospital
Jessica Marsigit ; Siti Setiati ; Tiara Aninditha ; Ikhwan Rinaldi ; Irsan Hasan ; Robert Sinto ; Noto Dwimartutie ; Suryo Anggoro Kusumo Wibowo ; Eric Daniel Tenda
Acta Medica Indonesiana 2026;58(1):67-76
Abstract
Background: Sarcopenia and frailty are common geriatric syndromes that may contribute to mild cognitive impairment (MCI). Evidence regarding the independent roles of individual sarcopenia components and frailty in MCI remains limited in low- and middle-income countries. This study evaluated the association between sarcopenia components, frailty, and MCI among older adults in Indonesia. Methods: An ambispective cohort study was conducted among adults aged ≥60 years attending the Geriatric Outpatient Clinic of Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Sarcopenia components were assessed using SARC-Calf (low muscle mass indicator), handgrip strength, and the five-times sit-to-stand test. Frailty was evaluated using the FRAIL scale. Cognitive function was assessed using the Rapid Cognitive Screening. Multivariate log-binomial or Poisson regression with robust variance was used to estimate adjusted risk ratios (RRs) for MCI. Results: A total of 121 participants (median age 74 years; 68.6% female) were included, with an MCI prevalence of 21.5%. After adjustment for confounders, low muscle mass indicator (RR 2.206; 95% CI 1.045–4.652) and low muscle strength (RR 3.006; 95% CI 1.202–7.517) were independently associated with MCI. Low physical performance (RR 1.773; 95% CI 0.796–3.773) and frailty (RR 1.086; 95% CI 0.377–3.134) were not significantly associated with MCI. Conclusion: Low muscle mass indicators and reduced muscle strength were independently associated with MCI, supporting the integration of simple sarcopenia screening tools into routine geriatric cognitive assessment.
sarcopenia
;
frailty
;
mild cognitive impairment
;
rapid cognitive screening
2.RUNX1 alterations and survival outcomes in AML: leukocyte dynamics and thrombocytosis insights from an Indonesian cohort
Ikhwan RINALDI ; Elly Yanah ARWANIH ; Kevin WINSTON ; Farida Farah ADIBAH ; Yuli Maulidiya SHUFIYANI ; Rafida Amalia SALMA
Blood Research 2025;60():49-
Purpose:
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy with varying prognostic outcomes. This study aimed to observe potential patterns or association between RUNX1 mutations and clinical features of AML patients, including hyperleukocytosis, thrombocytosis, and 12-month survival outcomes.
Methods:
A prospective cohort study involving 38 patients diagnosed with de novo AML was conducted at the RSUPN Dr. Cipto Mangunkusumo and Dharmais Cancer Hospital between 2022 and 2023. Patients were followed up for 12 months, and RUNX1 mutations within exons 4, 5, 7, and 8 were detected using polymerase chain reaction (PCR)-Sanger sequencing.
Results:
This study found RUNX1 mutations in 18.4% of the patients, predominantly in exons 4 and 5. Significant differences in leukocyte counts were observed between patients with and without RUNX1 mutations (p = 0.004). However, no significant association was observed between RUNX1 mutations and hyperleukocytosis or thrombocytosis.Survival analysis revealed that Individuals with RUNX1 mutations had notably lower survival rates (hazard ratio = 6.024, p = 0.014, 95% CI = 1.436–25.279).
Conclusion
In conclusion, RUNX1 mutations may be associated with poor survival outcomes in Indonesian AML patients. Further studies involving larger cohorts and comprehensive molecular analyses are required to confirm the prognostic significance of these findings.
3.In-hospital malnutrition among adult patients in a national referral hospital in Indonesia
Dyah PURNAMASARI ; Nur Chandra BUNAWAN ; Dwi SUSENO ; Ikhwan RINALDI ; Drupadi HS DILLON
Nutrition Research and Practice 2023;17(2):218-227
BACKGROUND/OBJECTIVES:
Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors.
SUBJECTS/METHODS:
This was a prospective study involving hospitalized adult patients aged 18–59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m2 ), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio;NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay.
RESULTS:
Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019).
CONCLUSIONS
We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.


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