Hypertension in postmenopausal Indonesian Women: fluctuating Body Mass Index as a potential predictor of decreasing blood pressure

Background: The burden of Hypertension (HT) [P1][YT2] in Indonesian postmenopausal women has increased over the past years. Obesity is the most prevalent risk of HT among postmenopausal women. Objective: This study evaluates the relationship of fluctuating BMI with BP in postmenopausal women in Bogor, Indonesia. Methods: This longitudinal study acquired secondary data from a previous study of the “Cohort Study of NCD’ Risk Factors” along with a two-year follow-up. Data were analyzed from a total of 888 postmenopausal women aged ≥ 25 years[P3][wr4]. BMI and BP fluctuations were calculated from baseline BMI at the first visit (T1) until the observation period (T7). The significance of panel analysis at p value < 0.05.[P5][wr6] Results: The fixed-effect model showed a significant correlation between BMI changes with the changes in SBP and DBP and fluctuating BMI with SBP. After adjustment for physical activity, 1 kg of weight gain will increase SBP and DBP in normotensive, controlled, and uncontrolled hypertensive individuals. After adjusting for smoking, BMI reduction by 1% would lower the SBP as much as 2-3 mmHg compared to a stable BMI. Conclusions: Fluctuating BMI was a predictor in decreasing BP in postmenopausal women, so it could be used to control HT. Keywords: Fluctuating; BMI; BP; Postmenopausal; Indonesia

Remember Me Film Festival : An Education Efforts to Increase Dementia Awareness in Young Generations

The role of film as one of the effective educational media is fundamental, especially in promoting awareness of the early symptoms of Alzheimer's disease. In Indonesia, there have not been many productions that specifically aim to escalate knowledge and awareness of Alzheimer's disease. The purpose of this activity was to increase public awareness of dementia and Alzheimer's, promote prevention and dementia risk reduction, produce short films on dementia and Alzheimer's with Indonesian cultural background as well as encouraging people toward elderly-friendly behavior. The event was held as a collaboration between FKIK Unika Atma Jaya, Alzheimer's Indonesia, and Eagle Institute titled Remember Me Film Festival (RMFF). In disseminating the information, The RMFF activities were publicized via YouTube and mass media. The aims of this study was to discuss the Remember Me Film Festival (RMFF) meetings as part of the tridharma institutions (community service), evaluation of benefits to the community, and qualitative assessment of the contents of dementia research for viewers on social media (YouTube) at three time points of observation (1 year after being downloaded on YouTube). The results of RMFF revealed that for each point of observation there was an increase in the number of views from September 2017 to October 2018. The RMFF activity can thus be employed as a model of increasing health promotion using digital/online platform for the younger generation

Two of Ten Elderly Have Dementia When Entering Age of 70 Years Old

Life expectancy of Indonesia has increased in the few decades; it has now reached the age of 70 years. As age increases, the risk of degenerative diseases, like dementia is also increasing. As many as 60-70% of dementia cases are Alzheimer\u27s disease. However, there is only limited information on the prevalence rate of dementia in Indonesia. Early detection of dementia and knowing its prevalence rate is very important especially, since in most progressive case of dementia, including the Alzheimer\u27s disease, there is no known cure

Trigliserida Sebagai Faktor Prognosis Untuk Hipertensi Tidak Terkendali Pada Wanita Pasca Menopause Di Kota Bogor, Tahun 2014

Further analysis aimed to determine the new cut-off correlation between blood triglyceride levels withuncontrolled hypertension among 888 postmenopausal women from two-year follow up of the cohort studyin Bogor. Uncontrolled hypertension was defined as the average of systolic and diastolic are >140mmHgand >90mmHg consecutively with no underlying diseases and systolic is >130mmHg with co-morbidityat the end of 2-year follow up. The covariate variables included demography, behavior and biologicalfactors. The new triglyceride\u27s cut off was determined by ROC curve with 65% sensitivity and 68%specificity. Data were analyzed with multiple logistic regression. Blood triglyceride level significantlycorrelated with uncontrolled hypertension (p=0.007) after adjusted with LDL, postprandial blood sugarand sodium intake. Triglyceride levels of 108-149mg/dl resulted in OR of 1.54 (95% CI 0.95 to 2.48),150-199mg/dl showed OR of 2.04 (95% CI 1.06 to 3.93) and level of >200 indicated an OR 2.1 (95% CI1.02 to 4.30) compared to normal level (<108mg/dl). Triglyceride level of 108mg/dl is a new cut-off todetermine uncontrolled hypertension in postmenopausal women in the study area. Blood triglyceride\u27slevel can be used as a prognostic factor for hypertensive patients to monitor blood pressure increment

Angka Prevalensi Demensia, Perlu Perhatian Kita Semua

Kurang dari empat tahun Indonesia akan memiliki struktur penduduk yang tua, yaitu persentase penduduk yang berusia 60 tahun atau lebih paling tidak 10%. Seiring dengan peningkatan jumlah penduduk lanjut usia terjadi juga peningkatan jumlah penduduk dengan penyakit degeneratif seperti demensia. Sebanyak 60-70 % demensia, merupakan demensia Alzheimer. Demensia Alzheimer (pikun) merupakan penyakit degeneratif dimana terjadinya penurunan fungsi otak yang mempengaruhi emosi, daya ingat, pengambilan keputusan, perilaku dan fungsi otak lainnya hingga mengganggu aktivitas sehari-hari. Pada saat ini belum diketahui secara pasti berapa banyak lanjut usia di Indonesia yang mengalaminya. Pengetahuan masyarakat tentang demensia Alzheimer (pikun) sebagai sebuah penyakit juga masih kecil. Sebagian besar masyarakat menganggap demensia Alzheimer (Pikun) sebagai bagian dari proses penuaan yang sifatnya alami. Di sisi lain penyakit demensia alzheimer belum ada obatnya sehingga deteksi dini sangat perlu dilakukan, termasuk angka prevalensi pada masyarakat perlu diketahui untuk mengetahui beban dari komunitas dan pelayanan kesehatan. Salah satu tujuan dari survei demensia di D I Yogyakarta yang dilakukan oleh SurveyMETER pada tahun 2016 dengan support dari Knowledge Sector Initiative DFAT adalah untuk mendapatkan prevalensi demensia. Survey ini dibangun dari hasil studi Demensia di Jakarta dan juga dari Survei Kehidupan Rumah Tangga Indonesia (SAKERTI) atau Indonesia Family Life Survey (IFLS). DI Yogyakarta merupakan provinsi dengan persentase jumlah lanjut usia terbanyak di Indonesia. Persentase lanjut usia Indonesia 15 tahun lagi terlihat di D I Yogyakarta sekarang. Angka prevalensi demensia dari survei demensia di D I Yogyakarta menunjukan nilai yang lebih tinggi dibandingkan dengan angka prevalensi pada tingkat internasional. Seberapa besar lebih tingginya tingkat prevalensi demensia pada setiap kelompok umur, tempat tinggal dan implikasinya dipaparkan dalam policy brief ini

Adaptation of the STRiDE dementia survey into the Indonesian context in North Sumatra

Background: North Sumatra is one of two provinces in Indonesia in which the prevalence and costs of care of dementia has been completed as part of the STrengthening Responses to dementia In Developing countries (STRiDE) program. The toolkit used in the study was developed in English and thus needed to be cross-culturally adapted into Bahasa Indonesia. Part of this process involved pre-testing as a way to maximize the cultural appropriateness of the toolkit, especially in a multiethnic province like North Sumatra. Here we report the adaptation process. Methods: The translated toolkit consisted of measures needed within the prevalence survey in North Sumatra. This included cognitive, functional and quality of life measures aimed at older adults and their informants (i.e., family member). The interviewer asked each component of the toolkit in full, making notes on certain questions or items that need to be clarified or rephrased for the participants. Any specific difficulty in understanding the translated sentence or any items that were culture inappropriate were also noted. Data included observation, interviews, verbatim quotes which were constructed in the form of field-notes. Results: Several questions and items needed to be paraphrased to achieve greater clarity and make sure that they were in line with the original meanings. This was mainly due to the translatability of the word from the source language to the target language with errors that could be linguistic or cultural. Translating a text from English to Bahasa Indonesia and vice versa may be affected because of the different ways of ellipsis, which is a phenomenon of missing phrasal components, operated in both languages. Although the respondents belonged to different ethnic groups, cultural background did not affect the way they responded to the questions. Conclusion: Cross-cultural adaptation and pre-testing process played an important role to ensure the toolkit measured and was interpreted as it was originally intended. The STRIDE toolkit was generally accepted and understood, although several items need further explanation or examples

Comprehensive measurement of the prevalence of dementia in low- and middle-income countries: STRiDE methodology and its application in Indonesia and South Africa

Background A core element of the Strengthening Responses to Dementia in Developing Countries (STRiDE) programme was to generate novel data on the prevalence, cost and impact of dementia in low- and middle-income countries, to build better health policy. Indonesia and South Africa are two middle-income countries in need of such data. Aims To present the STRiDE methodology and generate estimates of dementia prevalence in Indonesia and South Africa. Method We conducted community-based, single-phase, cross-sectional studies in Indonesia and South Africa, randomly sampling participants aged 65 years or older in each country. Dementia prevalence rates for each country were generated by using the 10/66 short schedule and applying its diagnostic algorithm. Weighted estimates were calculated with national sociodemographic data. Results Data were collected between September and December 2021 in 2110 people in Indonesia and 408 people in South Africa. The adjusted weighted dementia prevalence was 27.9% (95% CI 25.2–28.9) in Indonesia and 12.5% (95% CI 9.5–16.0) in South Africa. Our results indicate that there could be >4.2 million people in Indonesia and >450 000 people in South Africa who have dementia. Only five participants (0.2%) in Indonesia and two (0.5%) in South Africa had been previously diagnosed with dementia. Conclusions Despite prevalence estimates being high, formal diagnosis rates of dementia were very low across both countries (<1%). Further STRiDE investigations will provide indications of the impact and costs of dementia in these countries, but our results provide evidence that dementia needs to be prioritised within national health and social care policy agendas

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk