Malnutrisi Sebagai Faktor Risiko Pneumonia Nosokomial pada Usia Lanjut

Data Nutrition Examination Survey (NHANES) menunjukan 16% orang Amerika yang berusia 65 tahun mengonsumsi kurang dari 1000 kalori per hari sehingga memiliki risiko tinggi kekurangan gizi. Di Indonesia, prevalensi usia lanjut (usila) yang mengalami risiko malnutrisi di rumah sakit adalah 69,03% dan 41,4% mengalami malnutrisi. Usia lanjut dengan malnutrisi mempunyai risiko lebih tinggi mengalami infeksi bakterial dan virus akut, tingkat kematian akibat infeksi lebih tinggi tiga kali lipat pada usila, karena gangguan sistem imun. Malnutrisi geriatri diidentifikasi melalui skrining status gizi dengan alat penapisan, Mini Nutrional Assessment (MNA) merupakan alat penilaian status gizi paling baik memberikan prognosis untuk mendete-ksi malnutrisi populasi usila. Malnutrisi merupakan faktor terjadinya pneumonia nosokomial pada usia lanjut, lama masa rawat inap yang memanjang, peningkatan biaya perawatan rumah sakit, dan risiko tinggi kematian. Kata Kunci: Usila, Pneumonia Nosokomial, Malnutrisi./ Data from Nutrition Examination Survey (NHANES) showed that 16% of Americans age of 65, consume less than 1000 calories per day, therefore have a high risk of malnutrition. The prevalence in Indonesia of malnutrition in the elderly who are hospitalized is 69.03% at risk of malnutrition and 41.4% experiencing malnutrition. The aging process of the elderly with malnutrition, has a higher risk of experiencing acute bacterial and viral infections, the mortality rate due to infection is three times higher in the elderly, due to immune system disorders. Geriatric malnutrition is identified through nutritional status screening with a screening tool, the Mini Nutritional Assessment (MNA) is the best nutritional status assessment tool providing the best prognosis for detecting malnutrition in the elderly population. Malnutrition is one of the factors in the occurrence of nosocomial pneumonia in the elderly, which has a risk of long hospitalization, increased hospitalization costs, and a high risk of death. Keywords: Elderly, Nosocomial Pneumonia, Malnutritio

Indonesian Geriatrics Society Consensus on COVID-19 Management in Older Adults

More than 80% of death cases and 95% of severe COVID-19 occur in patients aged over 60 years. Atypical clinical manifestations with high morbidity and mortality further emphasize the importance of COVID-19 management in older adults. Some older patients may appear asymptomatic while other may present with acute respiratory distress syndrome and multi organ failure. Fever, higher respiratory rate and crackles may present. The most common chest x-ray finding is ground glass opacity. Other imaging modalities that are often used are pulmonary computed tomography scan and lung ultrasonography. COVID-19 management in older adults should be comprehensive, starting from oxygen, fluid, nutritional, physical rehabilitation, pharmacology and psychosocial therapy. In this consensus, we also discuss about management of older adults with special condition such as diabetes mellitus, kidney disease, malignancy, frailty, delirium, immobilization and dementia. In post COVID-19 phase, we believe that physical rehabilitation is important as it is done to improve fitness. keywords : COVID-19; older adults; consensus; managemen