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Effect of cognitive stimulation therapy in combination with other intervention modalities on cognitive ability in elderly with cognitive impairment: a quasi-experimental study Turana, Yuda; Sani, Tara Puspitarini; Prasetya, Virginia Geraldine Hanny; Suswanti, Ika; Konny, Lisye; Halim, Magdalena Surjaningsih; Handajani, Yvonne Suzy
Universa Medicina Vol. 43 No. 1 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.13-19

Abstract

BackgroundCognitive stimulation therapy (CST) has been proven to be beneficial in improving cognition and quality of life in people with mild cognitive impairment (MCI) and mild dementia (MD). This study investigates the benefit of more frequent exclusively CST intervention compared to less-frequent CST-exercise combination on cognitive ability among elderly people with cognitive impairment. MethodsA quasi-experimental controlled study involving 22 subjects aged = 60 years with cognitive impairment. They were divided into three groups: group A (6 months, weekly CST + exercise sessions, n=13), Group B (3 months, twice-weekly CST-only sessions, n=5), group C (3 months, no intervention, n=4) as control. The Modified Mini Mental State Examination Indonesian Version was used for evaluating the cognitive ability of the elderly subjects. Data were analyzed using one-way Anova and Kruskal-Wallis tests ResultsAll participants completed the study, the majority being female with mean age of 70.43 ± 6.97 years and differences in education level distribution across the three groups. The scores before and after the intervention showed a significant difference in the registration and construction domains (p<0.005). However, there was a greater improvement of the mean difference in cognitive scores in groups A and B compared to the control group, although the difference was not statistically significant (p >0.05). ConclusionA twice-weekly CST-only intervention and a once-a-week CST-exercise combination provide better cognitive improvement than no intervention (control). Therefore, elderly people with cognitive impairment should be encouraged to engage in physical activities, brain training, and group activities for promoting the brain’s ability.
PREVALENSI DAN FAKTOR YANG MEMENGARUHI KEJADIAN HIPERTENSI TIDAK TERKONTROL: DATA SEKUNDER INDONESIAN FAMILY LIFE SURVEY 5 Suswanti, Ika; Turana, Yuda; Riyadina, Woro; Rohanah, Rohanah
Edu Dharma Journal :Jurnal penelitian dan pengabdian masyarakat Vol 9, No 2 (2025): Edu Dharma Journal: Jurnal Penelitian Dan Pengabdian Masyarakat
Publisher : Sekolah Tinggi Ilmu Kesehatan Widya Dharma Husada Tangerang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52031/edj.v9i2.1133

Abstract

                                                     ABSTRACTBackground: Hypertension remains one of the main health problems in Indonesia. Low awareness, inadequate hypertension treatment, and increasing risk factors contribute to the rising incidence of uncontrolled hypertension in the country. This study aimed to determine the prevalence of uncontrolled hypertension and associated factors from the Indonesian Family Life Survey Wave 5. Methods: A cross-sectional study design using secondary data from the Indonesian Family Life Survey Wave 5, conducted in 9 provinces, involving 4,566 weighted subjects. Uncontrolled blood pressure was defined as individuals diagnosed with hypertension by a health worker but who still had high blood pressure based on the average of three blood pressure measurements, according to the JNC 8 guidelines. Demographic characteristics, mental health, lifestyle factors, and disease comorbidities were examined as independent variables. Data were analyzed using the chi-square test and multiple logistic regression to identify determinants of uncontrolled hypertension. Results: The prevalence of uncontrolled hypertension was 64.5%. In the multivariate analysis, older age, female gender, lack of formal education, smoking, depression, low physical activity, obesity, and the presence of comorbid diabetes mellitus and hypercholesterolemia were significantly associated with uncontrolled hypertension (p 0.05). Among these factors, obesity was identified as the most dominant risk factor (p 0.05; Odds Ratio: 1.844).Conclusion: Obesity was identified as the most dominant risk factor associated with the prevalence of uncontrolled hypertension.                                                  ABSTRAKLatar Belakang: Hipertensi masih menjadi salah satu masalah kesehatan utama di Indonesia. Rendahnya kesadaran, pengobatan hipertensi yang tidak memadai, dan meningkatnya faktor risiko berkontribusi terhadap meningkatnya insiden hipertensi yang tidak terkontrol di negara ini. Penelitian ini bertujuan untuk menentukan prevalensi hipertensi yang tidak terkontrol dan faktor-faktor terkait dari Survei Kehidupan Keluarga Indonesia Gelombang 5.Metode: Desain penelitian cross sectional menggunakan data sekunder Indonesian Family Life Survey 5, yang dilakukan di 9 provinsi, melibatkan 4.566 subjek tertimbang. Tekanan darah yang tidak terkontrol didefinisikan sebagai individu yang didiagnosis hipertensi oleh tenaga kesehatan tetapi masih memiliki tekanan darah tinggi berdasarkan rata-rata tiga pengukuran tekanan darah, menurut pedoman JNC 8. Karakteristik demografi, kesehatan mental, faktor gaya hidup, dan komorbiditas penyakit diperiksa sebagai variabel independen. Data dianalisis menggunakan uji chi-square dan regresi logistik ganda untuk mengidentifikasi determinan hipertensi yang tidak terkontrol. Hasil: Prevalensi hipertensi yang tidak terkontrol adalah 64,5%. Analisis multivariat menunjukkan usia lanjut, jenis kelamin perempuan, kurangnya pendidikan formal, merokok, depresi, aktivitas fisik rendah, obesitas, serta adanya komorbiditas diabetes melitus dan hiperkolesterolemia secara signifikan berhubungan dengan hipertensi yang tidak terkontrol (p 0,05). Di antara faktor-faktor tersebut, obesitas diidentifikasi sebagai faktor risiko paling dominan (p 0,05; Rasio Odds: 1,844). Kesimpulan: Obesitas diidentifikasi sebagai faktor risiko paling dominan yang berhubungan dengan prevalensi hipertensi yang tidak terkontrol.
Nutritional Status, Physical Activity, Oxidative Stress, and Cognitive Function in Pre Elderly and Elderly Dainy, Nunung Cipta; Kusharto, Clara Meliyanti; Madanijah, Siti; Nasrun, Martina Wiwie Setiawan; Turana, Yuda
Jurnal Gizi dan Pangan Vol. 13 No. 3 (2018)
Publisher : The Food and Nutrition Society of Indonesia in collaboration with the Department of Community Nutrition, IPB University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.238 KB) | DOI: 10.25182/jgp.2018.13.3.117-122

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This study aimed to analyse the relation of nutritional status, physical activity or oxidative stress with cognitive function of pre-elderly and elderly. A comparative cross-sectional study was conducted on 40 pre-elderly and 35 elderly subjects who were admitted to the Integrated Development Post Program (Posbindu) between September 2014 and January 2015. Anthropometric measurements (weight and height), physical activity, and biochemical data (oxidized low-density lipoprotein[Ox-LDL] and serum malondialdehyd [MDA]) were obtained. Nutritional status was assessed through body mass index (BMI), while the cognitive function was measured by Rey Osterrieth Complex Figure (ROCF) and Digit Span Backward. The data were analysed using an independent t-test and Spearman’s test with a confidence level of 95%. The study showed that the prevalence of malnutrition among the pre-elderly and elderly were 60.0% and 80.0%, respectively. Concerning physical activity, those who belonged to inactive-sedentary activity based on physical activity level (PAL) ratio were 55.0% and 45.7%, respectively. There were no significant differences in Ox-LDL, MDA levels and cognitive function (p>0.05). Significant negative correlations existed between Ox-LDL and immediate visual memory function (r=-0.289; p<0.05), as well as between Ox-LDL and delayed visual memory function (r=-0.288; p<0.05). The conclusion that visual memory function was only correlated with Ox-LDL.
Adaptasi Kultural dan Data Normatif Pemeriksaan Olfaktori pada Populasi Lansia Indonesia Martin, Juvenius; Chandra, Kenly; Vebriana, Gennesia; Putra, Aditya; Kristian, Kevin; Handajani, Yvonne Suzy; Turana, Yuda
Oto Rhino Laryngologica Indonesiana Vol. 55 No. 2 (2025): VOLUME 55, NO. 2 JULY - DECEMBER 2025
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v55i2.736

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Background: The olfactory sense plays a vital role in well-being and cognitive health, particularly in the older adults. Olfactory dysfunction is linked to neurodegenerative diseases, and geriatric syndromes like frailty. Existing cognitive tests are education-biased, limiting their applicability. Cultural adaptation of olfactory tests enhances diagnostic accuracy, necessitating region-specific normative data for Indonesia. Purpose: To establish normative olfactory scores for Indonesia’s older adult population using a culturally adapted odor identification test. Method: A descriptive study was conducted on 205 healthy participants aged 60 and above, in Jakarta. Eight culturally familiar odors were used in a forced-choice identification test. Normative data were generated based on percentiles, with the 10th percentile serving as the cut off for hyposmia. Data were analyzed using Statistical Package for the Social Sciences (SPSS). Result: Olfactory function was found to decline with age. Hyposmia thresholds were determined: individuals aged 60-64 years were considered hyposmic if they identified fewer than five odors, while those aged 80+ were hyposmic if they identified fewer than two odors. No significant differences were found between education levels, as both groups shared the same hyposmia thresholds. Conclusion: The study provided normative olfactory data specific to the Indonesia’s older adult population. These results supported the use of culturally adapted tests in clinical practice to detect olfactory dysfunction, which might indicate early cognitive decline. Further research should include longitudinal studies to capture changes over time.
Association of Cognitive Function, Depression, and Social Engagement with Quality of Life among Community-Dwelling Elderly in West Jakarta, Indonesia Wijaya, Kenneth Noah; Suryakusuma, Linda; Handajani, Yvonne Suzy; Turana, Yuda
Althea Medical Journal Vol 12, No 4 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v12n4.4214

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Background: As Indonesia’s elderly population grows, quality of life (QoL) has become a critical indicator of healthy aging. Evidence regarding the influence of cognitive function, depression, and social engagement on QoL remains inconsistent and is often limited to institutionalized elderly. This study examined these associations among community-dwelling elderly in an urban setting.Methods: A cross-sectional study was conducted at PUSAKA Kebon Jeruk, West Jakarta, from March to November 2023. Ninety-eight participants aged ≥60 years were selected using simple random sampling. Cognitive function was assessed using the Montreal Cognitive Assessment–Indonesian version (MoCA-INA), depression using the Geriatric Depression Scale (GDS), social engagement using the Social Disengagement Index, and QoL using the WHO Quality of Life–Brief Version (WHOQOL-BREF). Data were analyzed using Chi-square, Fisher’s exact, and multivariate logistic regression.Results: Most respondents were female (71.4%), aged 60–74 years (74.5%). The majority demonstrated normal cognitive function (63.3%), good social engagement (90.8%), and no depression. Overall QoL satisfaction was high, particularly in the social relationship (71.4%) and environmental domains (90.8%). Bivariate analysis showed associations between education, cognitive function, social engagement, gender, depression and specific QoL domains (p<0.05). Multivariate analysis identified gender as the strongest predictor of the environmental QoL (OR=5.63, p=0.025), education for social relationship (OR=2.99, p=0.020), and depression for general health perception (OR=3.16, p=0.041).Conclusions: Cognitive function, depression, education, and social engagement are key determinants of QoL among community-dwelling elderly. Community-based interventions focusing on mental health, cognitive stimulation, and social participation may improve QoL and support healthy aging. 
HUBUNGAN PARAMETER KEBUGARAN FISIK DENGAN SINDROMA FRAILTY PADA LANSIA DI JAKARTA Rayner Abdiwijaya Hariyanto; Linda Suryakusuma; Yvonne Suzy Handajani; Yuda Turana
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 42 No 2 (2026): Volume 42, No 2 - Maret 2026
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: Frailty is a multifactorial geriatric syndrome resulting from the loss of the body's ability to cope with stressors due to aging. According to a study conducted by Asenso et al., the global prevalence of frailty is 13.6%. Aim: This study is aimed to understand the relationship between physical fitness parameters and frailty syndrome in the elderly. Methods: This study uses a cross-sectional involving 98 respondents aged 60 years and above. ADL was measured using the Barthel Index. Balance was measured using the Berg Balance Scale. Physical activity was measured using the SQUASH questionnaire with cutoffs based on the GPAQ. Frailty status was assessed using the Fried frailty phenotype. Results: From 98 respondents, the majority were female (71.4%), aged 60-74 years (74.5%), with a higher education level (51%). A total of 18.4% of the elderly experienced frailty. Chi-square analysis showed that significant factors were age (p<0.001; OR: 7.408), ADL (p=0.019; OR: 3.944), Balance (p=0.042; OR: 7,800), and physical activity (p=0.014; OR: 3.714). Multiple logistic regression showed that age is the most influential factor in frailty (p=0.002; OR: 6,209) and followed by physical activity (p=0.030; OR: 3.834). Discussion: Age, ADL, balance, and physical activity were found to have a significant relationship with frailty. Among these factors, age was identified as the most influencing factor. Keywords: ADL, age, balance, elderly, frailty, physical activity
Aktivitas Fisik Sebagai Penentu Frailty: Melampaui Indeks Massa Tubuh, Lingkar Pinggang, dan Body Fat Percentage. Fabian Sejati; Yuda Turana; Yvonne Suzy Handajani; Kevin Kristian
Bahasa Indonesia Vol 24 No 2 (2025): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v24i2.6138

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Pendahuluan: Proses penuaan meningkatkan risiko seseorang untuk mengalami masalah kesehatan, salah satunya adalah frailty. Sebuah penelitian studi potong lintang oleh Setiati, et al. di Indonesia pada tahun 2020, didapatkan prevalensi sebesar 66,20% pre-frail dan 18,70% frail. Tujuan: Mendapatkan gambaran mengenai frailty pada lansia dan faktor risikonya di Pusaka Kebon Jeruk, Jakarta Barat. Metode: Penelitian ini menggunakan metode potong lintang dan terdiri dari 100 subjek dengan usia ≥60 tahun yang telah memenuhi kriteria penelitian. Pengambilan data dilakukan melalui wawancara menggunakan instrumen yang sudah divalidasi. Hasil: Dari 100 responden, sebagian besar berusia 60-74 tahun (75%), perempuan (71%), pendidikan ≥12 tahun (90%). Terdapat 18% lansia yang mengalami frailty. Analisis bivariat menunjukkan faktor yang memiliki hubungan bermakna adalah usia (p<0,001; RO=7,633; 95%CI=2,519–23,127) dan aktivitas fisik (p=0,011; RO=3,857; 95%CI=1,308–11,370). Simpulan: Frailty memiliki hubungan bermakna dengan usia dan aktivitas fisik. Usia menjadi faktor yang paling memengaruhi dan meningkatkan risiko frailty pada lansia.
Pengaruh Fungsi Kognitif Spesifik terhadap Risiko Frailty pada Lansia Carissa Marvella Budhy; Yuda Turana; Yvonne Suzy Handajani; Kevin Kristian
Bahasa Indonesia Vol 24 No 3 (2025): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v24i3.6155

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Pendahuluan: Penuaan populasi menyebabkan beban kesehatan meningkat, salah satunya adalah frailty. Berdasarkan systematic review dan meta-analysis pada 2023 prevalensi frailty pada lansia di Indonesia adalah 26,8%, sedangkan 55,5% mengalami pre-frail. Penelitian ini bertujuan untuk memeroleh gambaran tentang frailty serta faktor risikonya di Pusaka Kebon Jeruk, Jakarta Barat. Metode: Penelitian ini menggunakan rancangan potong-lintang dan melibatkan 100 responden berusia ≥60 tahun. Pengumpulan data dilakukan melalui wawancara dengan menggunakan, seperti Fried Fraily Index, MoCA-Ina, dan CERAD-NB. Analisis data dilakukan dengan metode chi-square dan multiple logistic regression. Hasil: Dari 100 responden, terdapat 75 (75% subjek) berusia 60-74 tahun dengan rerata usia 70,13 tahun, perempuan (71%), durasi pendidikan ≥12 tahun (90%). Terdapat 18 (18% subjek) lansia yang mengalami frailty. Analisis bivariat menunjukkan bahwa faktor yang memiliki hubungan signifikan adalah usia (p: <0,001; RO: 7,633; 95%CI: 2,519 – 23,127) dan constructional praxis (p: 0,037; RO: 3,162; 95%CI: 1,032 – 9,685). Simpulan: Frailty memiliki hubungan bermakna dengan usia dan fungsi kognitif constructional praxis. Dengan usia menjadi faktor yang paling memengaruhi dan meningkatkan risiko frailty pada lansia.
THE ROLE OF FUNCTIONAL ABILITY, MULTIMORBIDITY, AND DEPRESSION TO QUALITY OF LIFE OF INDONESIAN OLDER ADULTS Yvonne Suzy Handajani; Thania Vinsalia; Elisabeth Schröder-Butterfill; Yuda Turana
The Indonesian Journal of Public Health Vol. 20 No. 3 (2025): THE INDONESIAN JOURNAL OF PUBLIC HEALTH
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijph.v20i3.2025.538-551

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Introduction: Multimorbidity significantly affects older adults' quality of life (QoL). Its prevalence among adults aged ≥60 years ranges from 24% to 83%, increases with age and is closely linked to progressive physical and functional decline. A|ims: To investigate the determinants of QoL among community-dwelling older adults in urban Jakarta, Indonesia. Methods: A cross-sectional study was conducted in several community-based home care centers in West Jakarta, Indonesia, in 2023. From a database of 2,000 older adults, 600 individuals were selected using simple random sampling for screening. After applying inclusion and exclusion criteria, 501 older adults aged ≥60 years were included in the analysis. Sociodemographic and health-related data were collected using structured interviews and direct measurements. Mult|ivar|iate log|ist|ic regress|ion analysis was performed to identify factors associated with QoL. Results: A total of 501 older adults were analyzed; most were female (67.1%) and had multimorbidity (85.6%). The mean WHOQOL-BREF scores exceeded 60, with the highest score in the psychological domain (66.8). Physical health was significantly associated with multimorbidity (OR=2.08; p=0.013), exercise (OR=1.51; p=0.029), IADL (OR=3.54; p=0.007), ADL (OR=1.69; p=0.021), and balance (OR=1.92; p=0.044). Exercise increased the likelihood of better QoL (OR=1.47; p=0.037), while depression predicted poorer quality of life (OR=1.75; p=0.020). Conclusion: Multimorbidity, functional disability, balance impairment, depression, age, and exercise were significantly associated with QoL. Improving chronic disease management, maintaining independence, promoting regular exercise, and supporting mental health can enhance older adults’ well-being. Community-based programs encouraging active lifestyles and balance training may further improve QoL in this population.
PENDIDIKAN SEBAGAI FAKTOR PROTEKTIF TERHADAP GANGGUAN FUNGSI KOGNITIF PADA LANSIA: Education as a Protective Factor of Cognitive Impairment in the Elderly Devina Audrey; Linda Suryakusuma; Yvonne Suzy Handajani; Yuda Turana
Bahasa Indonesia Vol 25 No 2 (2026): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v25i2.5690

Abstract

Pendahuluan: Gangguan fungsi kognitif merupakan masalah yang sering ditemukan pada lansia dan dapat memengaruhi kemandirian serta kualitas hidup. Berbagai faktor biologis dan sosiodemografis diduga berhubungan dengan fungsi kognitif. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berhubungan dengan gangguan fungsi kognitif pada lansia. Metode: Penelitian observasional dengan desain potong lintang ini melibatkan 99 responden berusia ≥60 tahun di PUSAKA Kebon Jeruk, Jakarta Barat. Variabel sosiodemografis meliputi usia, jenis kelamin, dan tingkat pendidikan, sedangkan faktor biologis meliputi hipertensi, diabetes melitus, dan indeks massa tubuh. Fungsi kognitif dinilai menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-INA). Analisis bivariat dilakukan menggunakan uji Chi-square, dilanjutkan dengan regresi logistik multivariat. Hasil: Sebanyak 65,7% responden mengalami gangguan fungsi kognitif. Tingkat pendidikan berhubungan secara bermakna dengan gangguan fungsi kognitif pada analisis bivariat (p=0,014; OR=2,943; IK95% 1,231–7,035). Tidak terdapat hubungan bermakna antara usia, jenis kelamin, hipertensi, diabetes melitus, maupun indeks massa tubuh dengan gangguan fungsi kognitif. Pada analisis multivariat, tingkat pendidikan tetap berhubungan secara bermakna dengan gangguan fungsi kognitif (p=0,029; OR=2,685; IK95% 1,109–6,501). Simpulan: Tingkat pendidikan berhubungan secara independen dengan gangguan fungsi kognitif pada lansia. Lansia dengan tingkat pendidikan lebih rendah memiliki odds gangguan fungsi kognitif yang lebih tinggi dibandingkan lansia dengan tingkat pendidikan lebih tinggi.
Co-Authors Abigail Madeline Aditya Putra, Aditya Arieska Ann Soenarta Bambang Widyantoro Barus, Jimmy Fransisco Abadinta Beatus Bibang Budiharsana, Meiwita Paulina Budiyanti, Ecie Carissa Marvella Budhy Chandra, Kenly Clara Meliyanti Kusharto D. Y. Suharya David Reinaldo Sebastian Gunawan Devina Audrey Dhanasari Vidiawati Dian Purnomo Ebtehal Salman Eka Harmeiwaty Elisabeth Schröder-Butterfill Elsiandi, Caroline Alvina Fabian Sejati Frederica Jovianti Giovanny, Audrey Carissa Gunawan, David Reinaldo Sebastian Halim, Magdalena Surjaningsih Hardi, Nicholas Ika Suswanti Jessica Alysia Jimmy Barus Jimmy Fransisko Abadinta Barus Julia Rahadian Kevin Kristian Konny, Lisye Kristian, Kevin Latasya, Chelsea Destania Linda Suryakusuma Linda Suryakusuma Linda Suryakusuma Linda Suryakusuma Linda Suryakusuma Magistra Cylvia Margaretha Maria Dara Novi Handayani, Maria Dara Novi Martin, Juvenius Martina Wiwie Setiawan Nasrun Nelly Tina Widjaja Nelly Tina Widjaja Nelly Tina Widjaja Nelly Tina Widjaja Nicholas Andrian Singgih Noriko Matsushita Nunung Cipta Dainy Nur Rizqiyah Muhandis Piustan, Mas Eaufrat Prasetya, Virginia Geraldine Hanny Pricilya H. Wangi Rahmadanty, Nadiya Kamila Rarsari Soerarso Rayner Abdiwijaya Hariyanto Rohanah, Rohanah Rr Josephine Retno Widayanti Sagita Pratiwi Sugiyono sandy Ayu Monica Silalahi Sani, Tara Puspitarini Sasmita, Poppy Sasmita, Poppy K. Shalim, Christina Permata Siti Madanijah Sudharta, Harvey Suryakusuma, Linda Suwito, Michelle Margaretha Tanuwijaya, Melyana Thania Vinsalia Thiantoro, Benedicta Ann Clarabelle Tonny Sundjaya Tunggul Diapari Situmorang Vebriana, Gennesia Vidya Gani Wijaya Widyadharma, I Putu Wijaya, Kenneth Noah William William Woro Riyadina Yuliana Yosephine Yvonne S Handayani Yvonne Suzy Handajani Yvonne Suzy Handajani Yvonne Suzy Handajani Yvonne Suzy Handajani Yvonne Suzy Handajani Yvonne Suzy Handajani Yvonne Suzy Handajani