Faktor yang mempengaruhi fungsi kognitif pada pasien diabetes melitus tipe 2 di Rumah Sakit Siloam Karawaci

Solansa, Tracy (2020) Faktor yang mempengaruhi fungsi kognitif pada pasien diabetes melitus tipe 2 di Rumah Sakit Siloam Karawaci. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Latar belakang: Fungsi kognitif merupakan kemampuan untuk memahami dan bereaksi, memproses dan memahami, menyimpan dan mengambil informasi, membuat keputusan dan menghasilkan tanggapan yang sesuai. Penurunan fungsi kognitif dapat disebabkan dari berbagai hal, salah satunya adalah kondisi hiperglikemia kronis. Hiperglikemia kronis menyebabkan terjadinya resistensi insulin yang mengakibatkan terjadinya penurunan plastisitas neuron, peningkatan stres oksidatif, dan neurofibrillary tangle. Prevalensi mild cognitive impairment di Asia mencapai 17,1%. Sedangkan prevalensi di Indonesia belum jelas, namun pada usia lanjut ditemukan sekitar 32,4%. Tujuan penelitian: Mengetahui hubungan tingkat kadar HbA1c dengan fungsi kognitif pada pasien diabetes melitus tipe 2. Metode penelitian: Penelitian ini menggunakan metode potong lintang (cross sectional) dengan jumlah responden minimal sebanyak 201 orang pada populasi diabetes melitus tipe 2 di Rumah Sakit Siloam Karawaci. Sampel diambil dengan metode non-randomized purposive sampling. Pengambilan data dilakukan mulai bulan Januari 2020 hingga bulan Maret 2020 menggunakan data rekam medis untuk kadar HbA1c dan kuesioner MoCA-Ina untuk menguji fungsi kognitif. Uji statistika dilakukan dengan aplikasi Statistical Package for the Social Sciences (SPSS) versi 25.0 dengan analisis bivariat menggunakan chi-square dan analisis variabel kovariat menggunakan multivariat regresi logistik. Hasil Penelitian: Terdapat hubungan yang signifikan antara kadar HbA1c dengan fungsi kognitif (OR=5,98; CI 95% 2,25-15,85; p=0,000). Usia dewasa menengah dan tingkat pendidikan yang tinggi pada pasien diabetes melitus tipe 2 dengan kadar glukosa yang tidak terkontrol meningkatkan probabilitas terjadinya penurunan fungsi kognitif. Kesimpulan: Kadar HbA1c yang tidak terkontrol pada pasien diabetes melitus tipe 2 berhubungan dengan penurunan fungsi kognitif./Background: Cognitive functions are solutions for understanding and comprehending, processing and solving, storing and retrieving information, making decisions and producing appropriate responses. Decreasing of cognitive function can be caused by various factors, chronic hyperglycemic state is one of the factor. Chronic hyperglycemia causes insulin resistance which results in decreased neuronal plasticity, increased oxidative stress, and neurofibrillary tangle. The prevalence of mild cognitive impairment in Asia reaches 17.1%. The prevalence of mild cognitive impairment in Indonesia is unclear, but in elderly is found around 32,4%. Objective: To investigate the relationship of HbA1c levels with cognitive function in patients with type 2 diabetes mellitus. Methods: This research will use a cross sectional study with minimum sample of 201 type 2 diabetes mellitus patients at Siloam Hospital Karawaci through a non- randomized purposive sampling method. Data collection will be taken starting January 2020 to March 2020 using medical record data for HbA1c levels and MoCA-Ina questionnaire to evaluate the cognitive function. Statistical test will be calculated using Statistical Package for the Social Sciences (SPSS) version 25.0 with bivariate analysis using chi-square and multivariate analysis covariate variables using logistic regression. Result: The study showed a significant relationship between HbA1c levels with cognitive function (OR=5,98; CI 95% 2,25-15,58; p=0,000). Adults in middle age and high level of education in patients with type 2 diabetes mellitus with uncontrolled glucose levels increase the probability of cognitive decline. Conclusion: Uncontrolled HbA1c levels in patients with type 2 diabetes mellitus are associated with decreased cognitive function.

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