Sains Malaysiana 38(6)(2009): 953–958

Hubungan Anemia dengan Status Kognitif dan

Kefungsian Warga Tua di Rembau, Negeri Sembilan

(Relationship of Anaemia with Cognitive and Functional Status of Elderly in Rembau, Negeri Sembilan)

Norliyana Aris & Suriah Abdul Rahman*

Pusat Pengajian Sains Kimia dan Teknologi Makanan

Fakulti Sains dan Teknologi, Universiti Kebangsaan Malaysia

43600 UKM Bangi, Selangor, D.E., Malaysia

Norshazila Shahidan

Jabatan Teknologi Makanan, Fakulti Bioteknologi dan Pertanian

Universiti Darul Iman, Terengganu, Malaysia

Diserahkan: 13 Januari 2009 / Diterima: 27 April 2009

ABSTRAK

Prevalens anemia dan status pemakanan telah dinilai di kalangan 88 warga tua Melayu yang berumur 60 hingga 85 tahun (min umur 69.8 ± 6.0 tahun) dari empat buah kampung di daerah Rembau, Negeri Sembilan. Selain itu, hubungan antara hemoglobin dengan nutrien, status kognitif dan status fungsi turut dinilai. Subjek ditemubual untuk mendapatkan maklumat demografi dan pengambilan makanan. Status kognitif dinilai menggunakan Elderly Cognitive Assessment Questionnaire (ECAQ) manakala status fungsi dinilai menggunakan Instrumental Activity Daily Living (IADL) dan ujian kekuatan genggaman tangan. Aras hemoglobin ditentukan dengan menggunakan kaedah HemoCue. Hasil kajian menunjukkan prevalens anemia bagi kajian ini adalah sebanyak 22.7%. Prevalens anemia bagi subjek lelaki adalah sebanyak 30.0% dengan min hemoglobin 11.7 ± 1.0 g/dL manakala 20.6% subjek perempuan mengalami anemia dengan min hemoglobin 11.2 ± 0.5 g/dL. Ujian ECAQ menunjukkan 21.6% subjek mengalami gangguan kognitif dengan prevalens yang tinggi bagi subjek kumpulan umur tua-tua (57.9%) berbanding kumpulan umur tua-muda (11.6%). Hasil penilaian status fungsian pula mendapati purata skor IADL subjek adalah 11 ± 3 dengan skor IADL adalah lebih rendah di kalangan subjek kumpulan umur tua-tua (9 ± 4) berbanding subjek kumpulan umur tua-muda (12 ± 2). Sementara itu, purata kekuatan genggaman tangan keseluruhan subjek adalah 16.8 ± 8.7 kg (14.2 ± 8.4 kg purata kekuatan genggaman tangan bagi kumpulan umur tua-tua dan 17.6 ± 8.7 kg bagi kumpulan umur tua-muda). Hasil analisis pengambilan makanan menunjukkan purata pengambilan kalori bagi subjek lelaki (1310 ± 448 kcal/hari) dan subjek perempuan (1180 ± 300 kcal/hari) tidak memenuhi Saranan Pengambilan Nutrien Malaysia (RNI). Walaupun pengambilan kalori tidak mencapai RNI, pengambilan nutrien seperti ferum, niasin dan vitamin A didapati melebihi RNI. Korelasi antara hemoglobin dengan nutrien hanya ditunjukkan dengan kalori (r=0.486, p=0.048). Selain itu, tidak wujud korelasi antara hemoglobin dengan skor ECAQ dan IADL namun wujud korelasi dengan kekuatan genggaman tangan (r=0.265, p=0.013). Sebanyak 22.7% kes anemia dilaporkan dalam kajian ini. Walau bagaimanapun, korelasi hanya berlaku di antara hemoglobin dengan pengambilan kalori dan kekuatan genggaman tangan. Anemia di kalangan warga tua akan meningkatkan ketakupayaan fizikal warga tua untuk hidup dengan lebih bebas.

Kata kunci: Anemia; status fungsi; status kognitif; warga tua

ABSTRACT

The prevalence of anaemia and nutritional status was evaluated among 88 Malay elderly (20 men and 68 women) aged 60 to 85 years (mean age 69.8 ± 6.0 years) from four villages in Rembau district, Negeri Sembilan. In addition, the relationship between hemoglobin with nutrient intake, cognitive and functional status of the elderly were also investigated. Subjects were interviewed to obtain information on demographic and nutrient intake. Cognitive status was assessed using Elderly Cognitive Assessment Questionnaire (ECAQ) while functional status was measured using Instrumental Activity Daily Living (IADL) and hand grip measurement. Hemoglobin level was determined using HemoCue method. The findings indicated that the prevalence of anaemia was 22.7%. Prevalence of anaemia for male subject was 30.0% with mean of hemoglobin as 11.7 ± 1.0 g/dL while 20.6% of female subject was anaemic with mean of hemoglobin was 11.2 ± 0.5 g/dL. As much as 21.6% of the subjects have cognitive impairment with the prevalence is high in old-old age group (57.9%) compared to the young-old age group (11.6%). Results from functional assessment showed that mean for IADL score as 11 ± 3. The IADL score was lower in old-old age group (9 ± 4) compared to the young-old age group (12 ± 2). For hand grip measurement, overall mean was 16.8 ± 8.7 kg (14.2 ± 8.4 kg for old-old age group and 17.6 ± 8.7 kg for young-old age group). Nutrient analysis showed that the mean calorie intake for men (1310 ± 448 kcal/day) and women (1180 ± 300 kcal) were lower than the RNI. However, only intakes of iron, niacin and vitamin A achieved the Malaysian Recommended Nutrient Intake (RNI). Correlation between hemoglobin and nutrients was only showed with calorie intake (r=0.486, p=0.048) and not with other nutrients. Besides that, there was no correlation between hemoglobin with ECAQ and IADL scores but hemoglobin was correlated with hand grip strength (r=0.265, p=0.013). As a conclusion, 22.7% case of anaemia was reported in this study. However, correlations were only formed between hemoglobin with calorie intake and hemoglobin with hand grip. Anaemia in elderly increases the inability of the elderly to live independently.

Keywords: Anemia; cognitive status; elderly; functional status

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*Pengarang untuk surat-menyurat; email: sar@ukm.my