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The Analysis Study of Yoga and Cognitive in Older Adults: A Systematic Review and Metaanalysis Pretika Prameswari; Yudhi Hajianto Nugroho; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 12 No. 1 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ej9z7f37

Background: Yoga practices, focusing on mindfulness and meditation, have been found to positively impact cognitive function in older adults. These practices improve physical health, balance, flexibility, and cardiovascular function, while also promoting brain plasticity, neurogenesis, and stress-induced damage. The social aspect of yoga classes may also reduce isolation, thereby reducing cognitive decline. This study aims to provide a comprehensive analysis of existing research on the effects of yoga on cognitive function in older adults. Method: This systematic review was conducted in accordance with the PRISMA 2020 guidelines, focusing solely on full-text articles published in English between 2014 and 2024. To ensure the inclusion of high-quality, peer-reviewed sources, editorial pieces and review articles lacking a DOI were excluded. A comprehensive literature search was carried out across several reputable databases, including ScienceDirect, SpringerLink, PubMed, and SagePub, to identify pertinent studies that met the inclusion criteria. Result: The initial database search yielded over 1,000 relevant publications on the topic. Following a rigorous three-stage screening process, eight studies met the predefined inclusion criteria and were selected for in-depth analysis. Each study underwent a comprehensive critical evaluation, enabling a thorough examination of the relationship between psoriasis and hypertension. This systematic approach ensured that the analysis was grounded in high-quality evidence, closely aligned with the study's objectives, and capable of providing meaningful insights into this complex association. Conclusion: Yoga has been found to have beneficial effects on cognitive function in older adults, although methodological limitations and inconsistencies in intervention design need further investigation. Further research is needed to determine the true efficacy of yoga in promoting cognitive health among this age group.

Analysis Study of Geriatric Syndrome and Frailty Prevalence in Older Adults: A Systematic Review and Meta-Analysis Pretika Prameswari; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 12 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/swz60349

Background: Geriatric syndromes and frailty are major public health concerns associated with adverse health outcomes in aging populations worldwide. Frailty is a multifactorial condition characterized by increased vulnerability to stressors, leading to higher risks of morbidity, functional decline, hospitalization, and mortality. Objective: This meta-analysis aims to evaluate the prevalence, risk factors, and outcomes of frailty in older adults, as well as the effectiveness of various interventions in mitigating its impact. Methods: A systematic literature search was conducted across major databases to identify studies assessing frailty and geriatric syndromes. Studies were screened based on predefined eligibility criteria, and data were extracted for pooled analysis. Results: The findings indicate that frailty prevalence varies widely across different populations and is strongly associated with advanced age, comorbidities, malnutrition, and sedentary lifestyles. The pooled odds ratio for frailty versus robustness was 0.17 (95% CI: 0.16–0.18, p < 0.00001), indicating a strong negative association, with frail individuals being significantly more vulnerable to adverse health outcomes. However, substantial heterogeneity was observed across studies (I² = 100%), likely due to variations in frailty assessment tools, study populations, and geographic settings. Frailty prevalence ranged from 9.4% in rural Malaysia to 47.1% in Botswana, reflecting socioeconomic and healthcare disparities. Common risk factors included advanced age, female gender, chronic diseases, physical inactivity, and malnutrition. Conclusion: Addressing geriatric syndromes and frailty requires a holistic, multidisciplinary approach integrating early detection, prevention, and individualized interventions. Public health strategies and policy reforms should prioritize frailty screening, community-based support, and interdisciplinary care coordination to enhance the well-being of older adults and alleviate the burden on healthcare systems. Future research should focus on optimizing frailty management strategies and evaluating long-term outcomes in diverse populations.

How Do Comprehensive Geriatric Assessment Approaches Impact Functional Status And Quality Of Life For Older Adults With Multiple Geriatric Syndromes? Dodi Novriadi; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 12 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/m656qp44

Introduction: The global aging population has led to an increased prevalence of multiple geriatric syndromes such as frailty, multimorbidity, cognitive impairment, and functional decline. Comprehensive Geriatric Assessment (CGA) is a multidimensional, multidisciplinary diagnostic process designed to evaluate medical, psychological, and functional capabilities of older adults to develop coordinated treatment and follow-up plans. CGA aims to improve functional status, quality of life (QoL), and reduce adverse outcomes like falls and hospital readmissions. Methods: This systematic review analyzed studies involving older adults aged 65 years and above, focusing on CGA interventions compared to standard care. Data were extracted from randomized controlled trials and observational studies conducted in various healthcare settings including hospitals, community, and ambulatory units. Functional status and QoL outcomes were assessed using validated tools such as the Short Physical Performance Battery (SPPB) and EQ-5D. Results: CGA interventions demonstrated significant improvements in physical function, with SPPB scores increasing by up to 3.18 points at six months post-intervention. Quality of life measures also showed positive changes in both physical and mental health domains. Secondary outcomes included reductions in falls, frailty scores, and improvements in nutritional status and depressive symptoms. Discussion: The evidence supports CGA as an effective approach to managing complex health needs in older adults. Despite resource requirements, CGA offers long-term benefits by enhancing functional independence and overall well-being. Integration of tele-rehabilitation and digital monitoring may further improve accessibility and efficiency. Conclusion: Comprehensive Geriatric Assessment significantly improves functional status and quality of life in elderly populations. Continued efforts to standardize CGA protocols and train multidisciplinary teams are essential to maximize its global impact.

What is the comparative effectiveness of cognitive behavioral therapy versus medical treatment in improving sexual function for women with sexual dysfunction? Yunike Putri Nurfauzia; I Made Adi Saputra Wijaya; Mutia Juliana; Yahya Nurlianto
The International Journal of Medical Science and Health Research Vol. 12 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/sndsqr62

Introduction: This review investigates the comparative effectiveness of Cognitive Behavioral Therapy (CBT) versus medical treatments in improving sexual function among adult women diagnosed with sexual dysfunction. Sexual dysfunctions studied include provoked vestibulodynia (PVD), hypoactive sexual desire disorder (HSDD), vaginismus, and related conditions. Methods: Fifteen studies, primarily randomized clinical trials, were analyzed. Interventions included various forms of CBT (couple-based, group-based, mindfulness-based) and medical treatments such as lidocaine, sildenafil, bupropion, and topical steroids. Outcomes measured were sexual function, pain, sexual satisfaction, psychological distress, and relational factors. Results: CBT consistently showed significant improvements in sexual function, psychological well-being, and relationship satisfaction. For example, one study reported a 66% improvement in sexual performance after 12 weeks of CBT, and another showed an 18-point increase in sexual function scores at six months follow-up. Medical treatments provided rapid relief of physiological symptoms like pain and lubrication deficits, with effect sizes sometimes comparable to CBT. However, CBT was more effective in addressing psychological and relational aspects. Discussion: CBT’s holistic approach addresses both physiological and psychological factors, offering longer-lasting benefits and skill development for patients. Medical treatments are advantageous for quick symptom relief and ease of administration. Combined approaches may optimize outcomes. Conclusion: Both CBT and medical treatments are effective, but CBT offers broader and potentially more durable improvements in sexual health. Treatment choice should be individualized based on patient needs and dysfunction type.

What is The Association Between Low Serum Vitamin A Levels and The Risk of Developing Gestational Trophoblastic Disease Yunike Putri Nurfauzia; I Made Adi Saputra Wijaya; Mutia Juliana; Yahya Nurlianto
The International Journal of Medical Science and Health Research Vol. 12 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/cbg2nb15

Introduction: Gestational Trophoblastic Disease (GTD) comprises a group of disorders characterized by abnormal trophoblastic proliferation, including hydatidiform mole and gestational trophoblastic neoplasia (GTN). Vitamin A, known for its role in cellular differentiation and immune modulation, has been studied for its potential association with GTD risk and treatment outcomes. Methods: A systematic review of recent studies was conducted, focusing on serum vitamin A levels in GTD patients and the effects of vitamin A supplementation on treatment response. Included studies ranged from cross-sectional analyses to randomized controlled trials involving human subjects diagnosed with various GTD subtypes. Results: Ferraz et al. (2020) reported normal serum vitamin A levels (0.3–0.7 mg/dL) in patients with complete hydatidiform mole, indicating no association between low vitamin A levels and GTD risk. Conversely, Hidayat et al. (2020) demonstrated that vitamin A supplementation (6,000 IU/day) combined with methotrexate chemotherapy in low-risk GTN patients led to a more rapid decline in beta-human chorionic gonadotropin (β-hCG) levels and reduced chemotherapy resistance compared to chemotherapy alone. Discussion: While low serum vitamin A does not appear to predispose to GTD, supplementation may enhance chemotherapy efficacy, possibly through antioxidant and immunomodulatory mechanisms. However, limited sample sizes and study heterogeneity warrant further research. Conclusion: Vitamin A supplementation shows promise as an adjunct therapy in GTD treatment, improving outcomes in select patients, though it is not linked to disease risk. Larger, controlled studies are needed to confirm these findings

What Are The Most Effective Non-Pharmacological Interventions For Preventing Osteoporosis And Sarcopenia In Adults Over 65 Years Old? Calista Giovani; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 17 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/e6em4w32

Introduction: Osteoporosis and sarcopenia are prevalent conditions among older adults, particularly those over 65, leading to increased fracture risk and functional decline. Understanding effective non-pharmacological strategies for prevention is crucial as the global population ages. This study evaluates the efficacy of exercise and dietary modifications in preventing these conditions. Methods: This systematic review adhered to PRISMA guidelines, focusing on randomized controlled trials that evaluated non-pharmacological interventions in adults aged 65 and older. Eligible studies were screened for their focus on primary prevention, intervention type, and outcome measures related to bone mineral density, muscle mass, and physical performance. Results: A total of 39 studies were included, revealing that high-intensity resistance training significantly improved bone mineral density and muscle strength. Nutritional interventions, particularly protein supplementation, enhanced the effects of exercise on muscle mass and functional performance. Multicomponent exercise programs integrating balance, aerobic, and resistance training also showed positive outcomes in reducing fall risk. Discussion: The findings underscore the importance of structured exercise programs and dietary modifications in preventing osteoporosis and sarcopenia. Community-based interventions demonstrated higher adherence rates, while home-based programs offered flexibility for older adults. Conclusion: Non-pharmacological interventions, particularly high-intensity resistance training combined with dietary support, are effective strategies for preventing osteoporosis and sarcopenia in older adults. Future research should focus on enhancing long-term adherence to these interventions to improve health outcomes in this vulnerable population.

How Do Medication Management Interventions Reduce Polypharmacy- Related Risks In Older Adults With Multiple Chronic Conditions? Calista Giovani; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 17 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/20sx4161

Introduction: Polypharmacy, defined as the concurrent use of five or more medications, is prevalent among older adults with multiple chronic conditions, increasing the risk of adverse drug events and diminished quality of life. Addressing these risks through effective medication management has become a critical healthcare priority. Methods: This systematic review evaluated 40 studies, primarily randomized controlled trials (RCTs), focusing on medication management interventions such as structured medication reviews, deprescribing protocols, and electronic decision support systems. The inclusion criteria targeted older adults aged 65 years and above, taking five or more medications. Results: The review revealed that medication management interventions significantly reduced the number of medications and potentially inappropriate medications (PIMs). Notably, 10 out of 14 studies reported a decrease in medication counts, and 5 out of 8 studies showed reductions in PIMs. Clinical benefits included improved quality-adjusted life years and fewer hospital admissions. Discussion: A multidisciplinary approach, involving pharmacists, physicians, and nurses, was essential for the success of these interventions. The integration of technology and patient-centered strategies enhanced medication adherence and safety. However, challenges such as time constraints and resource intensity hindered broader implementation. Conclusion: Medication management interventions effectively reduce polypharmacy-related risks in older adults. Continued focus on multidisciplinary collaboration, technology integration, and addressing implementation barriers is crucial for optimizing medication safety and health outcomes.

How Do Early Screening Interventions For Frailty Impact The Prevention Of Delirium In Older Adult Patients? Calista Giovani; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 17 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/57w91833

Introduction: Frailty and delirium are common and interrelated conditions affecting older adults, especially those undergoing hospitalization or surgery. Early screening for frailty has been proposed as a strategy to identify vulnerable patients and implement preventive measures to reduce the incidence of delirium. Methods: This review analyzed interventional studies published within the last decade that assessed the impact of early frailty screening combined with individualized care plans on delirium prevention in older adults. Studies included randomized controlled trials, quasi-experimental designs, and prospective interventions involving patients aged 65 years or older across various healthcare settings. Frailty screening tools and delirium assessment methods were evaluated alongside intervention timing and types. Results: Multiple studies demonstrated significant reductions in delirium incidence following early frailty screening and targeted interventions. For example, delirium rates decreased from 10.0% to 3.3% in vascular surgery patients after geriatric comanagement, and from 29.2% to 11.3% in colorectal surgery patients receiving comprehensive geriatric assessment. Interventions ranged from preoperative cognitive exercises and multimodal prehabilitation to in-hospital multidisciplinary care models. Some studies reported improved functional and cognitive outcomes, while a few noted no significant changes in longer-term results. Discussion: Early frailty screening enables proactive identification of at-risk older adults, facilitating the delivery of personalized, multidisciplinary interventions that effectively reduce delirium incidence. The timing of intervention—particularly preoperative assessments—plays a crucial role in optimizing outcomes. Multidisciplinary collaboration and individualized care plans are common success factors. However, challenges such as patient non-compliance, small sample sizes, and external factors like the COVID-19 pandemic may limit effectiveness in some contexts. Conclusion: Early screening for frailty combined with tailored, multidisciplinary care is an effective approach to delirium prevention in older adults. Continued research is needed to refine screening tools, intervention protocols, and implementation strategies to enhance patient outcomes and broaden applicability across healthcare settings.

The Association of Preoperative Malnutrition with Delayed Wound Healing and Related Postoperative Complications: A Systematic Review Pretika Prameswari; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 19 No. 2 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/jpfdb756

Introduction: Preoperative malnutrition is a prevalent and modifiable risk factor in surgical patients, yet its full impact on postoperative recovery remains a critical area of clinical investigation. The objective of this systematic review is to comprehensively synthesize the existing evidence linking preoperative malnutrition to delayed wound healing and a broad spectrum of other adverse postoperative outcomes. Methods: A systematic search of the PubMed, EMBASE, and Cochrane Library databases was conducted to identify relevant observational studies and meta-analyses. Studies were selected if they investigated the association between a defined measure of preoperative malnutrition and postoperative outcomes in adult surgical patients. The methodological quality and risk of bias of included studies were rigorously assessed using the Cochrane "Risk Of Bias In Non-randomized Studies - of Interventions" (ROBINS-I) tool. Data were extracted for a minimum of 15 distinct outcomes, with a primary focus on wound healing complications. Results: Twenty-five studies, encompassing a wide range of surgical specialties and patient populations, met the inclusion criteria. The analysis revealed a consistent and statistically significant association between various markers of malnutrition—including hypoalbuminemia, low Prognostic Nutritional Index (PNI), and high Nutritional Risk Screening 2002 (NRS-2002) scores—and adverse postoperative events. Malnourished patients demonstrated significantly increased rates of surgical site infections (Odds Ratio range: 1.97 to 4.12), wound dehiscence (OR up to 3.24), and anastomotic leakage. Furthermore, malnutrition was strongly correlated with prolonged length of hospital stay (mean difference up to 5.58 days), increased 30-day mortality (OR up to 3.61), higher readmission rates, and a greater incidence of systemic complications such as pulmonary, cardiac, and renal events. Discussion: The synthesized evidence underscores the systemic impact of malnutrition on the physiological response to surgical stress and subsequent recovery. The findings suggest that nutritional deficiencies impair fundamental biological processes, including immune function and tissue synthesis, which are critical for uncomplicated wound healing. The clinical implications are significant, highlighting the necessity of integrating nutritional screening into routine preoperative assessment to identify at-risk patients who may benefit from targeted nutritional optimization. Conclusion: Preoperative malnutrition is a robust and independent predictor of delayed wound healing and a wide array of associated postoperative complications. The integration of routine nutritional assessment and appropriate intervention into standard preoperative care pathways is strongly recommended to improve surgical outcomes, reduce healthcare utilization, and enhance patient safety.

The Relationship Between Nutritional Status and Chemotherapy Toxicity in Patients with Cervical Cancer: A Systematic Review Bangar Parlinggoman Tua; Yahya Nurlianto; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 20 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/tcw7d817

Introduction: Cervical cancer imposes a significant global health burden, disproportionately affecting low- and middle-income countries where malnutrition is also endemic. Antineoplastic therapy, particularly concurrent chemoradiotherapy (CCRT) with platinum-based agents, is the standard of care but is associated with severe toxicities. This systematic review investigates the central hypothesis that poor nutritional status—defined by a range of anthropometric, serological, and body composition metrics—is an independent and significant predictor of increased chemotherapy-related toxicity in cervical cancer patients. Methods: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A systematic search of PubMed, Scopus, and the Cochrane Library was performed to identify studies evaluating the relationship between nutritional status and chemotherapy toxicity in cervical cancer patients. Eligibility criteria were based on the Population (cervical cancer patients), Exposure (malnutrition), Comparison (well-nourished), and Outcome (toxicity) framework. Methodological quality was appraised using the Cochrane Risk-of-Bias 2 (RoB 2) tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale (NOS) for observational studies. Results: A total of 16 studies (2 RCTs and 14 observational cohorts) met the inclusion criteria. The results demonstrate a consistent and statistically significant association between malnutrition and increased treatment toxicity. Specifically, poor nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) was an independent predictor of both Grade 3+ toxicity and Toxicity-Induced Modification of Treatment (TIMT). Sarcopenia (low Skeletal Muscle Index, SMI) was significantly associated with higher rates of treatment interruption due to toxicity (p=0.024) and was a determining factor for Grade 3+ adverse events. Low Body Mass Index (BMI < 18.5 kg/m²) was linked to severe Grade 3/4 gastrointestinal complications, including bowel obstruction (p<0.001). A low Prognostic Nutritional Index (PNI) correlated with increased severity of fatigue, nausea, and diarrhea (p<0.05). Nutritional interventions, such as omega-3 supplementation, were shown in an RCT to significantly reduce the incidence of chemotherapy toxicity. Discussion: The evidence converges to confirm that malnutrition is a critical determinant of chemotherapy tolerance. The mechanisms are multifactorial. Pharmacokinetic alterations, such as hypoalbuminemia, increase the free, active fraction of protein-bound drugs, leading to toxicity. Pharmacodynamic failures, particularly in sarcopenic patients, result in a relative overdose from standard Body Surface Area (BSA)-based dosing due to a smaller volume of distribution. Malnutrition also impairs the host's ability to repair healthy tissue (e.g., gut mucosa, bone marrow) damaged by chemotherapy. Conclusion: Nutritional status is a powerful, modifiable predictor of severe chemotherapy-related toxicity in cervical cancer patients. These findings mandate the integration of nutritional screening (e.g., PG-SGA) and objective assessment (e.g., CT-based SMI) into routine oncological practice. Such screening can risk-stratify patients and trigger pre-emptive nutritional interventions to improve treatment tolerance, reduce toxicity-related interruptions, and optimize clinical outcomes

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