Geriatric Assessment in Elderly People by Using ABCDE (Ability Balance Cognitive Diseases Emotion) Method at Posyandu for Elderly People

Nunik Sulistyaningsih(1*), Mora Claramita(2), I Dewa Putu Pramantara(3)

(1) Puskesmas Bener
(2) Department of Family and Community Medicine, Faculty of Medicine Yogyakarta
(3) Internal Medicine Science Departement, Dr. Sardjito Central Public Hospital, Yogyakarta, Indonesia
(*) Corresponding Author


Background: Elderly populations have increased in line with the increased life expectancy. Currently, the balance of disease burden on the elderly has shifted towards chronic disease. Cardiovascular disease, diabetes, cognitive impairment and depression are chronic diseases that cause suffering and death in elderly populations. Therefore, it is necessary to conduct a comprehensive and multidimensional health assessment as a preventive effort to reduce morbidity in the elderly.

Objective: The general objective of this research was to obtain a description of elderly health status at the Posyandu for the elderly using a geriatric assessment called the ABCDE (Ability, Balance, Cognitive, Diseases, Emotion) method.

Methods: This research used a cross-sectional design. The subjects were elderly persons ≥ 60 years old who participated in the Posyandu for the elderly and who had fulfilled inclusion and exclusion criteria. The estimated minimum sample size was 242 selected using stratified random sampling. The statistical analysis in this research employed univariate, and bivariate analysis using Chi square tests.

Results: Elderly participants had light dependency (34.2%) with average activities of daily living (ADL) value of 19.39 ± 1.32, positive Romberg test 3.7%, and Sharpened Romberg Test 50%. The prevalence of cognitive impairment was 43.4%, while the average score of Mini Mental State Examination was 23.31 ± 6.08, hypertension prevalence 73.14%, hypercholesterolemia 13.22%, and diabetes mellitus 10.33%. Elderly who had depression and probable depression were 12.81%, consisting of mild depression 11.57% and moderate depression 1.24%. Balance disorders had a statistically significant correlation with ADL (p = 0.012; Ratio Prevalence (RP) = 1.422: 95% CI), cognitive impairment (p = 0.039; RP = 1.31: 95% CI), and depression (p = 0.034; RP = 1.63: 95% CI).

Conclusion: The prevalences of hypertension, cognitive impairment, and balance disorder on sharpened Romberg test were high. There were statistically significant correlations between balance disorder and ADL, cognitive function, and depression. These findings support the application of geriatric assessment by using ABCDE which can be applied in primary care setting for elderly people.


ABCDE Method, Elderly, Geriatric Assessment, Posyandu

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  1. Murtagh J. General Practice (fifth edition). New South Wales: McGraw Hill; 2011.
  2. Jiang S, Li P. Current development in elderly comprehensive assessment and research methods. BioMed Research International. 2016; 2016.
  3. Cigolle CT, Langa KM, Kabeto MU, Tian Z, Blaum CS. Geriatric conditions and disability: the health and retirement study. Annals of Internal Medicine. 2007;147(3):156-64.
  4. Elsawy B, Higgins KE. The geriatric assessment. American Family Physician. 2011;83(1):48-56.
  5. Sin CK, Fu SN, Tsang CS, Tsui WW, Chan FH. Prevention in primary care is better than cure: the Hong Kong reference framework for preventive care for older adults-translating evidence into practice. Hong Kong Med J. 2015;21(4):353-9.
  6. Ministry of Health, Republic of Indonesia. Regulation of the Minister of Health National Action Plan for Elderly Health No. 25. Jakarta: Ministry of Health, Republic of Indonesia, 2016; p.15-16.
  7. Karolina P, Agnieszka P, Barbara SA, Jerzy C, Alicja KR, Aleksandra S, et al. Clustering of geriatric deficits emerges to be an essential feature of ageing-results of a cross-sectional study in Poland. Aging (Albany NY). 2016;8(10):2437.
  8. Senn N, Monod S. Development of a comprehensive approach for the early diagnosis of geriatric syndromes in general practice. Frontiers in Medicine. 2015;2:78.
  9. Barkhausen T, Junius-Walker U, Hummers-Pradier E, Mueller CA, Theile G. “It’s MAGIC”-development of a manageable geriatric assessment for general practice use. BMC Family Practice. 2015;16(1):1-0.
  10. Ministry of Health, Republic of Indonesia. Training for competency improvement of health intelligence personnel in the elderly, center for health intelligence. Jakarta: Ministry of Health, Republic of Indonesia, 2014; p. 29-41.
  11. Bueno-Cavanillas A, Padilla-Ruiz F, Jiménez-Moléon JJ, Peinado-Alonso CA, Gálvez-Vargas R. Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes. European Journal of Epidemiology. 2000;16(9):849-59.
  12. Widjaja TN. Problems of the elderly in one community order in Jakarta Barat in 2011, geriatric syndrome in the elderly in the community. Jakarta: Atmajaya University, 2011; p. 83-114.
  13. Velázquez-Brizuela IE, Ortiz GG, Ventura-Castro L, Árias-Merino ED, Pacheco-Moisés FP, Macías-Islas MA. Prevalence of dementia, emotional state and physical performance among older adults in the metropolitan area of Guadalajara, Jalisco, Mexico. Current Gerontology and Geriatrics Research. 2014;2014.
  14. Hoi LV, Thang P, Lindholm L. Elderly care in daily living in rural Vietnam: need and its socioeconomic determinants. BMC Geriatrics. 2011;11(1):1-0.
  15. Wu MS, Lan TH, Chen CM, Chiu HC, Lan TY. Socio-demographic and health-related factors associated with cognitive impairment in the elderly in Taiwan. BMC Public Health. 2011;11(1):1-8.
  16. Hughes TF. Promotion of cognitive health through cognitive activity in the aging population. Aging Health. 2010;6(1):111-21.
  17. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World Journal of Cardiology. 2012;4(5):135.
  18. Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults. Diabetes Care. 2012;35(12):2650-64.
  19. William AB, Changs A. Current diagnosis and treatment, 2nd edition. New South Wales: McGrawHill, 2014; p. 24-28.
  20. Félix-Redondo FJ, Grau M, Fernández-Bergés D. Cholesterol and cardiovascular disease in the elderly. Facts and gaps. Aging and Disease. 2013;4(3):154-169.
  21. Sözeri-Varma G. Depression in the elderly: clinical features and risk factors. Aging and Disease. 2012;3(6):465-471.
  22. Prata MG, Scheicher ME. Correlation between balance and the level of functional independence among elderly people. Sao Paulo Medical Journal. 2012;130:97-101.
  23. Bortoli CG, Piovezan MR, Piovesan EJ, Zonta MB. Balance, falls and functionality among elderly persons with cognitive function impairment. Revista Brasileira de Geriatria e Gerontologia. 2015;18(3):587-97.
  24. Tangen GG, Engedal K, Bergland A, Moger TA, Mengshoel AM. Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and alzheimer disease. Physical Therapy. 2014;94(8):1123-34.
  25. Alsalaheen BA, Whitney SL, Marchetti GF, Furman JM, Kontos AP, Collins MW, et al. Relationship between cognitive assessment and balance measures in adolescents referred for vestibular physical therapy after concussion. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine. 2016;26(1):46-52.
  26. Iaboni A, Flint AJ. The complex interplay of depression and falls in older adults: a clinical review. The American Journal of Geriatric Psychiatry. 2013;21(5):484-92.
  27. Setiati S, Laksmi PW. Impaired balance falls and fractures. Textbook of Internal Medicine. Jakarta: Faculty of Medicine, University of Indonesia, 2016; p. 3646-3757.
  28. Agrawal Y, Carey JP, Hoffman HJ, Sklare DA, Schubert MC. The modified Romberg Balance Test: normative data in US adults. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2011;32(8):1309-1311.
  29. Nakagawa HB, Ferraresi JR, Prata MG, Scheicher ME. Postural balance and functional independence of elderly people according to gender and age: cross-sectional study. Sao Paulo Medical Journal. 2017;135:260-5.
  30. Acar S, Demırbüken İ, Algun C, Malkoç M, Tekın N. Is hypertension a risk factor for poor balance control in elderly adults?. Journal of Physical Therapy Science. 2015;27(3):901-4.


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