Author Guideliness – Nutrix Journal 1

RELATIONSHIP QUALITY SLEEP WITH COGNITIVE

FUNCTIONS IN THE ELDERLY IN BPSLUT
SENJA CERAH MANADO

Irene Hutagalung1, Priscillia Merylin Saluy2

1. Student, Faculty of Nursing, Klabat University, Jl. Arnold Mononutu, Minahasa Utara 95371, Indonesia
2. Lecturer, Faculty of Nursing, Klabat University, Jl. Arnold Mononutu, Minahasa Utara, 95371, Indonesia

E-mail: irenehutagalung22@gmail.com psaluy@yahoo.com

Abstract

The Elderly is someone who has reached the age of more than 60 years. At the attainment of old age, a
person will experience several changes, namely the process of slowly disappearing the ability of the tissue
to repair itself, while maintaining normal function so that it cannot survive infection and repair damage.
The purpose of this study was to determine whether there was a significant relationship between sleep
quality and cognitive function among the elderly at BPSLUT Manado. This research type is the
descriptive correlation with cross-sectional approach. 56 elderly as respondents in this study were
selected through purposive sampling. Data were collected using a questionnaire and analyzed using the
Spearmen Correlation test. After analyzing the data, it was found that the value of P-value = 0.172
(Pvalue> 0.05), so it could be concluded that there was no significant relationship between sleep quality
and cognitive function. The results of tests conducted on the elderly with good sleep quality (19.6%). For
cognitive function is (67.9%) had a poor memory decline. Based on the results of the study, it is
recommended that further researchers pay more attention to aspects that support improving cognitive
function in the elderly so that they do not decline.

Keywords: Sleep Quality, Cognitive Function, Elderly.

Abstrak

Lansia adalah seseorang yang telah mencapai usia lebih dari 60 tahun. Pada pencapaian usia lanjut ini
seseorang akan mengalami beberapa perubahan yaitu proses menghilangnya secara perlahan kemampuan
jaringan untuk memperbaiki diri, sekaligus mempertahankan fungsi normal sehingga tidak dapat bertahan
terhadap infeksi dan memperbaiki kerusakan. Tujuan dari penelitian ini adalah untuk mengetahui apakah
ada hubungan yang signifikan antara kualitas tidur dengan fungsi kognitif pada lansia di BPSLUT
Manado. Jenis penelitian ini adalah desktiptif korelasi dengan pendekatan cross sectional. 56 lansia
menjadi responden dalam penelitian ini yang dipilih melalui purposive sampling. Data dikumpulkan
menggunakan kuesioner dan dianalisis menggunakan uji Spearmen Correlation. Setelah dilakukan
analisis data didapatkan nilai Pvalue = 0,172 (Pvalue > 0,05) sehingga bisa disimpulkan bahwa tidak ada
hubungan yang signifikan antara kualitas tidur dengan fungsi kognitif. Hasil uji yang dilakukan pada
lansia dengan kualitas tidur baik yaitu (19.6%). Untuk fungsi kognitif yaitu (67,9%) memiliki penurunan
daya ingat yang buruk. Berdasarkan hasil penelitian, disarankan peneliti selanjutnya untuk lebih
memperhatikan aspek-aspek yang menunjang untuk meningkatkan fungsi kognitif pada lansia agar tidak
semakin menurun.

Kata Kunci: Kualitas Tidur, Fungsi Kognitif, Lansia.

Introduction age of more than 60 years. At the attainment of old

age, a person will experience several changes, namely
the process of slowly disappearing the ability of the
The Elderly is someone who has reached the tissue to repair itself, while maintaining normal
Author Guideliness – Nutrix Journal
function so that it cannot survive the infection
and repair the damage suffered (Maryam,
2012). World Health Organization (WHO)
there were 600 million elderly people in 2012
worldwide. The results of population data for
2010 show that the number of elderly people
in Indonesia will continue to increase by
around 450 thousand people per year (Badan
Pusat Statistik, 2015).
Based on their age, most of the elderly in
Indonesia are young elderly aged 60-69 with
a total of 10.75 million people. The number
of elderly people who are over 60 years old is
estimated to increase to 27.1 million in 2020,
and in 2025 to 33.7 million people, and most
recently in 2035 there will be 48.2 million
elderly people (Kemenkes, 2017).
An elderly person will experience various
changes that occur in him, one of which is
sleep patterns. The elderly will have
difficulty sleeping at night and they will
replace their nighttime sleep with sleeping
during the day (Sunaryo, 2013). Most elderly
who have problems starting to sleep, and are
often awake at night without cause, will feel
tired when they wake up in the morning
(Dewi, 2014). Sunaryo (2013) states that if
the fulfillment of sleep in the elderly is not
fulfilled, it will have an impact on disorders
such as physical fatigue and mental stress,
dull skin, depression, cardiovascular disease,
diabetes, and decreased cognitive abilities. In
this condition, it will worsen the cognitive
function of the elderly. Insufficient sleep
quality in the elderly will cause damage to
memory and cognitive abilities, so if this
continues to occur it will have an impact on
high blood pressure, stroke, heart attack, and
even psychological problems and even
depression (Potter & Perry, 2012).
Cognitive function is a mental process
experienced by a person in gaining
knowledge or abilities and intelligence
possessed by the elderly including memory,
thinking, understanding, planning,
implementation (Santoso & Ismail, 2009).
According to Wreksoatmodjo (2012) the
decline in cognitive function experienced by
the elderly usually begins with forgetfulness
memory (Forget Fulness), then goes to mild
cognitive impairment (Mild Cognitive
Impairment / MCI) and ends in the dementia
process.
The purpose of this study was to determine
2
the relationship between sleep quality and fungal
cognition at BPSLUT Senja Cerah Manado. In this
study, researchers took the nursing theory proposed by
Virginia Handerson.
The theory he put forward consists of 14
basic needs, but researchers only take one
basic need, namely sleep and rest.
Initial data collection was carried out on
September 11 2019, at the Social Service
Center for Displaced Aged Senja Cerah
Manado, there were 56 elderly, as well as 45
elderly who live in nursing homes. One of
the orphanage managers said that there were
elderly people who felt problems and
disturbances during sleep, some were taking
sleeping pills, and their memory function
was disturbed. In connection with the
previous problem statement, the researcher is
interested in conducting a study entitled
"The Relationship between Sleep Quality
and Cognitive Function".
Methods
The research method used is the descriptive
correlation with a cross-sectional approach,
namely research conducted by collecting
data on the independent variable and the
dependent variable simultaneously at a
certain time (Masturoh & Anggita, 2018).
The variables to be studied were classified
into two, namely the independent variable
(sleep quality) and the dependent variable
(cognitive function). The sample used in this
study was calculated based on the Slovin
formula, the number of samples in this study
was 56 elderly.
The instrument in this study was to use a
questionnaire to determine the sleep quality.
The questionnaire used by researchers in
data collection was adopted from the
Pittsburgh Sleep Quality Index (PSQI)
questionnaire developed by Buysee (1989)
consisting of 9 questions. The measurement
scale uses a rating scale, namely a score of 0-
3 with 0 = never in the last month, 1 = 1 time
a week, 2 = 2 times a week and 3 = more
than 3 times a week with the interpretation is
Bad: if the total score is> 5; Good: if the
score is ≤ 5. Whereas the second
questionnaire, namely the Mini-Mental State
Examination (MMSE), can be said to be
normal if the score reaches 24 to 30 points,
and if the score is <24 it can be said to be
impaired in cognitive function.
Author Guideliness – Nutrix Journal 3

Results
Research that has been done at BPSLUT
Manado:
Discussion
Table 1. Distribution of Sleep Quality
In table 1, it can be seen that the results of the
Sleep Cumulative study show that most of the elderly at BPSLUT
F Percent Manado have good sleep quality. Because it is
Quality Percent
well known that the elderly at BPSLUT Manado
Poor 1 1.8 100.0 has a good environment and sports activities are
Good 11 19.6 19.6 held every Friday morning so that it helps the
Total 56 100.0 elderly to feel comfortable. This is also
supported by research from Nofiyanto (2015)
where the study states that improving the quality
Table 1 shows that the good sleep quality of sleep in the elderly is influenced by a
experienced by the elderly at BPSLUT Manado comfortable living environment for the elderly,
is 11 (19.6%), and those who experience poor appropriate room temperature, and also good
sleep quality are 1 (1.8%). This data shows that lighting can improve sleep quality for the better.
most of the elderly at BPSLUT Senja Cerah
Manado have good sleep quality. Table 2 shows that the majority of the elderly at
BPSLUT Manado has severe dementia, namely
Table 2. Distribution according to cognitive
function. 38 (67.9%) measured using the Mini-Mental
State Examination (MMSE) questionnaire. The
same results were obtained from research. The
Cognitiv
Cumulative same results were obtained from the research of
e F Percent
Percent Ningsih et al. (2017), showing that 71.4% of the
Function
elderly have severe dementia, which is mostly
Normal 7 12.5 12.5 experienced by the elderly aged 60-74 years.
Moderate 11 19.6 32.1 Older age will experience deterioration in
Weight 38 67.9 100.0 cognitive thinking, decreased power. remember
(memory), and decreased intelligence. The
Total 56 100.0
memory deterioration experienced by the elderly
can affect cognitive function so that they
Table 2 shows that 38 elderly (67.9%) with experience impairment. According to Prabowo
severe dementia and 11 (19.6%) elderly with (2014), Dementia usually starts slowly and gets
moderate dementia, and for normal dementia 7 worse over time, so that this situation is not
(12.5%). This data shows that most of the elderly realized at first. There is a decrease in memory,
in BPSLUT Senja Cerah Manado have severe the ability to recognize people, places, and
memory impairment. objects. Ida's research (2015) states that the older
you get, the dementia rate in the elderly gets
Table 3. Relationship between Sleep Quality and
Cognitive Function.
heavier.

Table 3 shows the results of the analysis of the

Variable P-value Interpretation
relationship between sleep quality and cognitive
function in the elderly at BPSLUT Manado. The
Sleep Quality 0,172 No connection result of the Spearmen Correlation test is 0.172>
Cognitive 0.05, which indicates that there is no significant
Function relationship between sleep quality and cognitive
function in the elderly at BPSLUT Manado.
Based on table 3, it can be seen that the p-value Research conducted by Hanifa (2016) at the
of the relationship between sleep quality and Margaguna Social Institution in South Jakarta
cognitive function is 0.172 which indicates more with a significant value of 1,000> 0.05, so it is
than 0.05. These results indicate that there is no concluded that there is no relationship between
significant relationship between sleep quality and sleep quality and cognitive function. The
cognitive function at BPSLUT Senja Cerah percentage results show that good quality sleep
Manado. will result in 100% good cognitive function,
while poor sleep quality results in 80% good
cognitive function. So that sleep quality is not a
major factor in the influence of cognitive
Author Guideliness – Nutrix Journal 4

function. The existence of other factors such as

recent education, marital status, gender, also
plays a role in the influence of cognitive function
in the elderly. This is inversely proportional to
the research conducted by Pramardika (2014) in
the work area of the Bengkuring Community
Health Center, Samarinda City, East Kalimantan
Province, that the elderly with suspected
cognitive impairment is 47.7%, indicating a
relationship between sleep quality and cognitive
function.

Conclusions

The study concluded that most of the elderly in

BPSLUT Manado (19.6%) experienced good
sleep quality. There are 38 (67.9%) elderly who
have a severe cognitive function. There is no
significant relationship between sleep quality and
cognitive function at BPSLUT Senja Cerah
Manado.
It is suggested to BPSLUT Senja Cerah Manado
to pay more attention to aspects that support
improving cognitive function in the elderly so
that they do not decline. For example, discussing
what has been watched on TV, for example
news. Because the news that is watched will be
more useful than entertainment to stimulate brain
activity to think again. For further researchers it
is recommended to use additional methods other
than interviews with the elderly, researchers can
also use teaching aids so that the aims and
objectives of the research are clearer. Also,
researchers can review potential sources that
cause memory decline in the elderly and can
make the results of this study as a reference for
further research.

Acknowledgements

The researcher would like to thanks to Ns.

Debby D Pontoh, S.Kep as leader of Nursing at
Panti Werdha BPSLUT Senja Cerah Manado,
and Elderly who were respondents at the time of
the study. The researcher would special thanks to
Mrs. Priscillia Saluy, BSN.,MSN., Ms. Ellen
Padaunan, S.Kep., Ns., M.Kep. Ns. Frendy
Fernando Pitoy, S.Kep., MSN., research families
and friends for their advice, guidance, support,
and patience during this research project.

References

Buyse, D. e. (1989). The Pittsburgh Sleep Quality Index (PSQI) : A New Instrument for Psychiatric
Practice and Research Pittsburgh. Elsevier Scientific Publisher Ireland. doi:10.1016/0165-
1781(89)90047-4
Author Guideliness – Nutrix Journal 5

Badan Pusat Statistik. (2015). Statistik Penduduk Lanjut Usia.

https://www.bps.go.id/website/pdf_publikasi/Statistik-Penduduk-Lanjut-Usia-2015--.pdf.
Dewi, S. R. (2014). Buku Ajar Keperawatan Gerontik. Yogyakarta; Deepublish
Hanifa, A. (2016). Hubungan Kualitas Tidur dan Fungsi Kognitif Pada Lanjut Usia Di Panti Sosial
Margaguna. Skripsi. Jakarta: Program Studi Ilmu Keperawatan Fakultas Kedokteran dan Ilmu
Kesehatan Universitas Islam Negeri Syarif Hidayatullah.
http://repository.uinjkt.ac.id/dspace/handle/123456789/33433
Ida Untari. (2015). Kajian Tingkat Demensia Pada Lansia di Panti Werdha Dharma Bakti Surakarta.
Jurnal Kesehatan Muhammadiyah, Vol. 3, No.2.
Kemenkes, R. (2017). Lansia Di Indonesia. Jakarta: Pusat data dan informasi kementrian kesehatan RI.
Maryam. (2012). Mengenal Lanjut Usia dan Perawatannya. Jakarta: Salemba Medika
Masturoh, I, & Anggita, N. (2018). Metode Penelitian Kesehatan. Jakarta: Pusat Pendidikan Sumber
Daya Manusia Kesehatan Pendidikan Sumber Daya Manusia Kesehatan.
Nofiyanto, M (2015). Pengaruh Aromaterapi Mawar Terhadap Kualitas Tidur Lansia di Panti Sosial
Tresna Werdha Unit Budi Luhur Kasongan Bantul. Yogyakarta. doi:
https://doi.org/10.30989/mik.v5i1.140
Potter, A., & Perry, A. (2012). Fundamental Keperawatan, Ed 7. Jakarta
Prabowo, E. (2014). Buku Ajar Keperawatan Jiwa. Yogyakarta: Nuha Medika
Pramardika. (2014). Hubungan antara Kualitas Tidur dengan Fungsi Kognitif di Wilayah Kerja UPTD
Puskesmas Kalimantan Timur. Universitas Widya Gama Mahakam Samarinda. Jurnal Fakultas
Kesehatan Masyarakat. http://www.academia.edu/31935892/ pdf.
Sari, C. M., Ningsih, E. F., & Pratiwi, S. H. (2018). Description of Dementia in the elderly status in the
work area health center ibrahim adjie bandung. Indonesia Contemporary Nursing Journal
(ICON Journal) hassanudin University. website
Santoso, H., & Ismail, A. (2009). Memahami Krisis Lanjut Usia. Jakarta: Gunung Mulia.
Sunaryo, (2013). Asuhan Keperawatan Gerontik. Yogyakarta: Andi
Wreksoatmodjo, (2012). Pemeriksaan Status Mental Mini pada Usia Lanjut. Jakarta: Salemba Medika.