Association between Disease Activity and Depression in Rheumatoid Arthritis Patients

Introduction. Rheumatoid Arthritis (RA) is a chronic, systemic disease that cause synovialinflammation and progressive destruction to cartilages and deformities. Prevalence of depressionin RA patients is 20 to 30%. Disease activity is considered to have association with depression. This study aims to identify the prevalence of depression in RA patients and the associationbetween disease activity index and depression in RA patients. Methods. A cross-sectional study of 145 RA patients that fulfilled the inclusion criteria was conducted in Rheumatology Outpatient Clinic at Cipto Mangunkusumo Hospital Jakarta from January to March 2017.Evaluation of Disease Activity Score - 28 (DAS 28) and Back Depression Inventory (BDI) was done to the patients. Statistical analysis was performed using SPSS version 20. Categorical variables were compared using chi-square test. Results. A total of 145 subjects were included in this study and most of them were female (90.3%). Median age of subjects was 55 years (range 19-83 years). Forty five subject (31%) were identified having psychosocial stressor. The proportion of depression in RA patients was 35.9% (95% CI 30-42%). Based on Disease Severity Score, it was found that subject with mild, moderate, and severe score were 24 (82.8%), 52 (66.7%), and 4 (23.5%), respectively. There was significant association between disease activity with depressionin rheumatoid arthritis patient (p= 0.001). Conclusion. The proportion of depression in RA patients at RSCM is 35,9 %. There was significant association between disease activity with depression in RA patients

Supplementary Material for: Malnutrition Prevalence and Nutrient Intakes of Indonesian Older Adults in Institutionalized Care Setting: A Systematic Review of Observational Studies

Introduction: Data on the prevalence of malnutrition and nutrient intakes among Indonesian older aduls in institutionalized care setting are scattered and scarce. Thus, we conducted a systematic review of published and grey literature to estimate (1) the prevalence of malnutrition, (2) the level and distribution of habitual energy and nutrient intakes, and (3) the prevalence of inadequacy of energy and nutrient intakes among hospitalized and institutionalized older adults in Indonesia. Methods: This systematic review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. The population of this review was Indonesian older adults in institutionalized care settings, including hospital ward, orphanages, nursing homes, residential facilities, and rehabilitation centers . Malnutrition was assessed using body mass index, the mini nutritional assessment (MNA) score, or the subjective global assessment (SGA) score. The dietary intakes (from food recalls, food records, or food frequency questionnaire) were compared with the Indonesian recommended daily allowances (RDAs) for people aged 65 to 80. The prevalence of inadequacy was calculated using two-thirds of the RDA as a proxy for the estimated average requirement (EAR). Results: The search yielded 330 studies from electronic databases, resulting in fifteen eligible studies. One report was obtained from an unpublished study. Based on the JBI criteria, most studies had low risk of bias and represented the target population. The prevalence of malnutrition in hospital, nursing home, and other institutionalized care ranged from 6.5%-48.3% in hospitals and 3.2%-61.0% in other institutionalized care units. In the hospital setting, there was a high prevalence of inadequacies for all nutrients, particularly protein (20%), calcium (more than 90%), and vitamin D intakes (more than 50%). In nursing homes, these proportions were exceptionally high for protein (66%) and calcium and vitamin D intakes (almost 100%). Conclusion: The high risk of malnutrition Indonesian older adults in institutionalized care setting is pronounced, along with poor intakes of macronutrients and micronutrients in both settings