Lbm 5 Modul Tumbang

7/25/2019 Lbm 5 Modul Tumbang

1/26

LI LBM 5MODUL TUMBUH

KEMBANGNISITYA MAHISI URSAMAYORI

30101307024SGD 19


2/26

Fase ase !e"#aa"1) Fase subklinik (usia 25-35 tahun)

Ke$a"%a&a" '()*(" *#+a, *e"#)#" - .es.(s.e)("/ growth hormone (GH)/ a"es.)(e" e*$e".#&a" )a,&a+ $e$as/ %a" a!a. *e)#sa& se+ a" DNA*#+a, *e*!e"a)#', .#$#'/ se!e)., ,e. %a" $#)#&/ s.)ess/ !(+#s,/ !a!a)a"$e)+e$,'a" )a,as, #+.)a,(+e. a), *a.a'a), Ke)#sa&a" ,", $,asa"%a .,a&.a*!a& a), +#a) I",,# a&a" .a*!a& a" *e)asa "()*a+6 .a"!a .a"a a"

ea+a a), aginga.a# !e"%a&,. Ba'&a"/ !aa #*#*"%a )e".a" #s,a ,",,a"a! #s,a *#a a" "()*a+

2) Fase transisi (usia 35-45 tahun)

Se+a*a .a'a! ,", &aa) '()*(" *e"#)#" sa*!a, 25 !e)se" Ke',+a"a" *assa(.(. %a" *e"a&,$a.&a" &e',+a"a" &ea.a" a" e"e), se).a &(*!(s,s,+e*a& .#$#' %a" *e",", Keaaa" ,", *e"%e$a$&a" )es,s.e"s, ,"s#+,"/

*e","&a."%a )es,&( !e"%a&,. a".#"/ !e*$#+#' a)a'/ a" ($es,.as aa.a'a! ,", *#+a, *"8#+ ea+a &+,",s/ se!e)., !e"#)#"a" &e.aa*a" !e"+,'a.a"!e"e"a)a"/ )a*$#. !#.,' *#+a, .#*$#'/ e+as.,s,.a" a" !,*e".as, +,.*e"#)#"/ ()("a" se&s#a+ a" $a"&,.a" se&s#a+ *e"#)#" Te)a".#" a),a%a ',#!/ )a,&a+ $e$as *e)#sa& se+ e"a" 8e!a. se',"a ,",,# *#+a,*e)asa a" .a*!a& .#a Ra,&a+ $e$as *#+a, *e*!e"a)#', e&s!)es, e"/%a" *e"a, !e"%e$a$ a), $a"%a& !e"%a&,. aging/ .e)*as#& &a"&e)/arthritis/ &e',+a"a" a%a ,"a./ !e"%a&,. a).e), &()("a),a a" ,a$e.es


3/26

3) Fase Klinik (usia 45 tahun keatas)

O)a" *e"a+a*, !e"#)#"a" '()*(" %a" $e)+a"#./ .e)*as#& DHEA(dehydroepiandrosterone)/ *e+a.(","/ GH/ .es.(s.e)("/ es.)(e"/ a"'()*(" .,)(, Te)a!a. #a &e',+a"a" &e*a*!#a" !e"%e)a!a"

"#.),s,/ ,.a*,"/ a" *,"e)a+ se',"a .e)a, !e"#)#"a" e"s,.as.#+a"/ &e',+a"a" *assa (.(. se&,.a) 1 &,+()a* se.,a! 3 .a'#"/!e","&a.a" +e*a& .#$#' a" $e)a. $aa" D, a".a)a #s,a 40 .a'#" a"70 .a'#"/ se()a" !),a &e*#"&,"a" a!a. &e',+a"a" 20 !("(.(."%a/ %a" *e"a&,$a.&a" &e.,a&*a*!#a" #".#& *e*$a&a) :001000 &a+(), !e)'a), e"%a&,. &)(",s *e"a, sa"a. e+as .e)+,'a./ a&,$a.s,s.e* ()a" %a" *e"a+a*, &eaa+a" Ke.,a&*a*!#a" *e"a,

a&.() #.a*a #".#& *e",&*a., .a'#" e*as6 a" se),"&a+, aa"%a&e.,a&*a*!#a" #".#& *e+a&a" a&.,,.as see)'a"a a+a*&e',#!a" se'a),'a),"%a )ea+e"s, !e"%a&,. &)(",s a&a" *e","&a.se8a)a )a*a.,& se$aa, a&,$a. !e","&a.a" #s,a ;F(


4/26

Te)a,"%a !)(ses !e"#aa"#e$ri %&eneti' 'l$'k

Me"#a .+' .e)!)()a* se8 e"e.,& #.& s!es,es2 .e).e".# T,a! s!e8,es *e*!#"%a, , +* "#8+e,"%a s#a.# a* e"e.,& % .+' ,!#.a) *e"#)#.

s#a.# )e!+,&as, .e).e".# ?a* ,", a&a" *e"',.#" *,.(s,s @ *e"'e".,&a" )e!+,&as, se+ $,+a .& ,!#.a)/ a,

*e"#)#. &("se! ,", $,+a a* &,.a ,.# $e)'e"., *a&a a&a" *e","a+ #",a e"(".)(+a" e"e.,& #*#)/ )#!a"%a ,&(".)(+ a+a* .,"&a. se+#+e) e"e+,.,a" Ha%,8& *e"#"#&&a" $a'


5/26

Rusakn"a siste iun tubuh

M#.as, % $e)#+a" a.a# !e)#$a'a" !)(.e," !as8a.)a"s+as,/ !.*e"%e$a$&a" $e))a""%a &e*a*!#a" s,s. ,*#" .#$#' *e"e"a+,,),"%a se",), ;se+ )e8(",.,("=

?,&a *#.as, s(*a.,& *e"%e$a$&a" ."%a &e+a,"a" ! a".,e"!e)*#&aa" se+/ *a&a 'a+ ,", !. *e"%e$a$&a" s,s. ,*#" .#$#'*e"a"a! se+ % *e"a+a*, !e)#$a'a" .s$ s$ se+ as," @*e"'a"8#)&a""%a

Te(), *e"#a a&,$a. *e.a$(+,s*e Me"#)#. M8Ka%/ !e"#)a"a" ,".a&e &a+(), a&a" e*"'a*$a.

!e).#*$#'a" @ *e*!e)!a"a" #*#) e)!a"a"a" #*#) .s$ $e)as(s,as, " .e).#"a"%a !)(ses ee"e)as,Kerusakan akibat ra!ikal bebas

&. . !)(ses )es!,)as,/ (&s,e" % ,+,$a.&a" +* *e"#$a' $a'a"$a&a) * AT Me+a+#, e",*2 )es!,)as, +* *,.(&("),a/ *a&a )a,&a+$e$as ;RB= a&a" ,'as,+&a" s$ a. a".a)a

RB $e)s,a. *e)#sa&/ &)" sa"a. )ea&.,/ s' !. $e)ea&s, " DNA/!)(.e,"/ as+e*a& .a& e"#'/ se!e)., *e*$)a" se+

Ma&," +a"#. #s,a *a&," $%& RB .e)$e".#& s' !)(ses !e")#sa&a".e)#s .

R,B$e!hi ar$.$/ !kk,200,Buku .ar eriatri/ lu Kesehatan an.utUsia,Jakarta:FKU)


6/26

#e$ri ra!ikal bebas

)(#& 'as,+ *e.a$(+,s*e (&s,a., % sa"a. )ea&., ;RB= !.$e)ea&s, " $e)$aa, &(*!("e" se+#+a)/ .e)*as#& !)(.e,"/ DNA/ @+,!,/ @ * *(+e+2 % .& $e)#"s, "a*#" $e).a'a" +a*a @

*e"a"# #"s, se+ +a,""%a RB aa+a' se"%a


7/26

#e$ri &lik$silasi

)(ses +,&(s,+as, "("e",*a.,& % *e"'as,+&a" !e).a#.a" +#&(sa!)(.e," % ,se$#. s$ aa"8e +%8a.,(" e" !)(#8.s ;AGEs= !.

*e"%e$a$&a" !e"#*!#&a" !)(.e," @ *a&)(*(+e+ +a," %.e)*(,&as, s' *e"%e$a$&a" ,s#"s, ! *a"#s,a % *e"#a

)(.e," +,&as, *e"#"#&&a" !e)#$a'a" #"s,("a+/ *e+,!#.,*e"#)#""%a a&.,,.as e",* @ *e"#)#""%a e)aas, !)(.e,"a$"()*a+ Ke.,&a *a"#s,a *e"#a/ AGEs $e)a*#+as, , $e)$aa,a),"a"/ .e)*as#& &(+ae"/ H$/ +e"sa *a.a K)" *#a.a"

&(+ae""%a .,",/ *a&a a),"a" ,&a. * )a" e+as.,s @ &aK(",s, .s$ !. *e*!e"a)#', e+as.,s,.as ,"," !e*$#+#'a)a' AGEs !. $e),".e)a&s, " DNA @ *e"a&,$a.&a".e)a"#"%a &e*a*!#a" se+ #.& *e*!e)$a,&, !e)#$a'a" ! DNA

#e$ri 6 re+air

Me"#"#&&a" $a'


8/26

Fa&.() %a" *e*!e"a)#',!e"#aa"

1) Fakt$r lin&kun&an

a e"8e*a)a" +,""a" %a" $e)


9/26

3) Fakt$r &enetik

Ge"e.,& sese()a" sa"a. ,.e".#&a" (+e' e"e.,& ()a" .#a"%a Te.a!, a&.()

e"e.,& .e)"%a.a a!a. $e)#$a' &a)e"a ,"e&s, ,)#s/ )a,as,/ a" a. )a8#"a+a**a&a"a"C*,"#*a"C+,. %a" ,se)a! (+e' .#$#'4) Fakt$r +sikik

Fa&.() s.)es ,", .e)"%a.a *a*!# *e*a8# !)(ses a!(!.(s,s , $e)$aa,()a"Ca),"a" .#$#'5) Fakt$r $r&anik

Se8a)a #*#*/ a&.() ()a",& aa+a' - )e"a'"%a &e$#a)a"Ctness/ !(+a*a&a" )a" se'a./ !e"#)#"a" GH a" IGFI/ !e"#)#"a" .es.(s.e)("/!e"#)#"a" *e+a.("," se8a)a &("s.a" se.e+a' #s,a 30 .a'#" a" *e"%e$a$&a"a"#a" circandian clock ;),.*e 'a),a"= se+a"#."%a +,. a" )a*$#. a&a"$e))a" !,*e".as,"%a a" .e)a, !#+a a"#a" .,#)/ !e","&a.a"!)(+a&.," %a" sea+a" e"a" !e)#$a'a" e*(s, a" s.)ess/ !e)#$a'a" FollicleStimlating

Hormone ;FSH= a" !teini"ing Hormone ;LH=


10/26

Me"a!a *#a' .e)a.#' .e)#.a*a saa.##& +a+# $e),), ; a"#a"&ese,*$a"a" ,*a"a se+a," , (.a& =

$aa,*a"a !)(ses"%a !e"#)#"a" )a"e ( *(.,(";ROM= se", !e"#)#"a" &ea.a" (.(./ .e)#.a*a *e"%e$a$&a" &e+e*a'a" e&s.)e*,.as

$a


11/26

Me"a!a +,. .e)+,'a.&e"()

e"#)#"a" #*+a' $)($+as. % *"%e$a$&a" !e"#)#"a" #*+a' se)a. e+as.,"+e$,' s&+e)(.,& a" *e"e$a+ se',"a a),"a" &(+ae" *e"a, &e"() a"se)a$#. e+as.," &e',+a"a" a%a &e%a+"%a/ +,. *e"a, .,a& a!a. .ea" a")a" +e".#)

T#+a" a" (.(. *e"a, a.)(/ a),"a" +e*a& s#$.a" $e))a"/ +a!,sa" +,..,!,s se).a &e',+a"a" a%a &e"%a+"%a se',"a .e)$e".#& &e)#.a"2 a" a),s2+,.

K(".)a&s, (.(.2 *,*,& % .,a& ,., (+e' &(".)a&s, +,. % sesa#, se',"a*e"a&,$a.&a" a+#)2 &e),!#. ,ae)a'


12/26

Me"a!a .e)a, !e"+,'a.a" &a$#)a" a"#a" !e"e"a)a" se$#.&a" #"s, (.(. a&(*(as,

*a.aDe"a" $e).a*$a'"%a #s,a / $e".#& (.(. s,+,a),s a&a" $e)#$a' se*a&," .#a se)a. (.(. a" e"a" e*,&,a" *e","&a.&a"a),"a" (.(. *e",&a. *e"a, +e$,' .e$a+ / .e)#.a*a ,".e),() se.e+a' ,.# .e)a, ee"e)as, (.(. %a" *e"a+a*, a.)(

*e"%e$a$&a" !e"%#s#.a" a" ,!e)&,)a&a" #".#&*e*!e).a'a"&a" $e".#&/ e"a" #s,a +e$,' *a# a),!aas,+,a),s a.)( (.(. #a .e)a, *e"a+a", ',a+,",sas, De"a" $e).a*$a'"%a #s,a !e"#)#"a" a*!+,.#( a&(*(as,

!)es$,(!, !e"#)#"a" a*!+,.#( a&(*(as, ,&a,.&a"

e"a" !e)#$a'a" a+a* se)a. +e"sa *e"a, )a" !aa.a" &a!s#+ e+as.,s / se',"a +e"sa )a" *a*!#*e"%es#a,&a" $e".#&"%a Fa&.()a&.() %a" *e*!e"a)#', !e)#$a'a" as.,*a. -&(".)a& &()"ea &a)e"a !e)#$a'a" ',)as, &()"ea / !)(ses!e"#aa" &()"ea

( Buku teks Geriatri# $"Boedhi Darmo%o , obat &"&adi 'artono )


13/26

,.' a,"/ ea) s.)#8.#)es e.e),()a.e T'e ea))#* (.e" .',8&e"sa" .'e ,""e) ea) $("es a" (.'e) s.)#8.#)es a)e ae8.e


14/26

Y(#) ea)s 'ae .


15/26

e)#$a'a" s,& a" !s,&(+(,s!aa !e"#aa" ; QS A+A'&a - 15 =


16/26

7erubahan-+erubahan Fisik

1 Se+ Le$,' se,&,. #*+a'"%a Le$,' $esa) #)a""%a Be))a""%a #*+a' 8a,)a" .#$#' a" $e))a""%a 8a,)a" ,".)ase+#+e) Me"#)#""%a !)(!()s, !)(.e," , (.a&/ (.(./ ,"a+/ a)a'/ a" 'a., ?#*+a' se+ (.a& *e"#)#" Te)a"#"%a *e&a",s*e !e)$a,&a" se+ O.a& *e"a, a.)(s $e)a."%a $e))a" 5102 S,s.e* e)sa)aa" Be)a. (.a& *e"#)#" 1020 ;Se.,a! ()a" $e))a" se+ sa)a (.a&"%a a+a* se.,a! 'a),"%a= Pe!a."%a *e"#)#" '#$#"a" !e)sa)aa" La*$a. a+a* )es!(" a"


17/26

5 S,s.e* Ka),(as+e) E+as.,s,.as ,"," a().a *e"#)#" Ka.#! a".#" *e"e$a+ a" *e"a, &a Ke*a*!#a" a".#" *e*(*!a a)a' *e"#)#"/ 'a+ ,", *e"%e$a$&a" *e"#)#""%a &(".)a&s, a" (+#*e"%a Ke',+a"a" e+as.,s,.as !e*$#+#' a)a'/ )a""%a ee&.,,.as !e*$#+#' a)a' !e),e) #".#& (&s,e",sas,/

e)#$a'a" !(s,s, a), .,#) &e ##& a.a# a), ##& &e $e),), $,sa *e"%e$a$&a" .e&a"a" a)a' *e"#)#"/

*e"a&,$a.&a" !#s," *e"aa& Te&a"a" a)a' *e",", a&,$a. *e","&a."%a )es,s.e"s, !e*$#+#' a)a' !e),e)

S,s.e* e"a.#)a" Te*!e)a.#) T#$#' Te*!e)a.#) .#$#' *e"#)#" ; ',!(.e)*,a = se8a)a s,(+(,s a&,$a. *e.a$(+,s*e %a" *e"#)#" Ke.e)$a.asa" )ee&s *e",,+ a" .,a& a!a. *e*!)(#&s, !a"as a&,$a."%a a&.,,.as (.(. *e"#)#"

7 S,s.e* Res!,)as, O.(.(.(. !e)"aasa" &e',+a"a" &ea.a" a" *e"a, &a Me"#)#""%a a&.,,.as a), s,+,a a)#!a)# &e',+a"a" e+as.,s,.as/ *e"a),& "aas +e$,' $e)a./ &a!as,.as !e)"aasa" *a&s,*#* *e"#)#"/ a"

&ea+a*a" $e)"aas *e"#)#" A+e(+, #)a"%a *e+e$a) a), $,asa a" #*+a'"%a $e))a" Ke*a*!#a" #".#& $a.#& $e))a" Ke*a*!#a" &ea.a" (.(. !e)"aasa" a&a" *e"#)#" se,)," e"a" !e).a*$a'a" #s,a: S,s.e* Gas.)(,".es.,"a+ Ke',+a"a" ,, a&,$a. e),((".a+ ,sease/ &ese'a.a" ,, %a" $#)#& a" ,, %a" $#)#& I"e)a !e"e8a! *e"#)#"/ ',+a""%a se"s,.,,.as sa)a !e"e8a! , +,a' .e)'aa! )asa *a",s/ as,"/ asa*/

a" !a',. E(se!'a#s *e+e$a) Rasa +a!a) *e"#)#"/ asa* +a*$#" *e"#)#" e),s.a+.,& +e*a' a" $,asa"%a .,*$#+ &("s.,!as,

Da%a a$s()$s, *e+e*a'


18/26

Me"a!a !e"e),.a .,a&*e"s.)#as, sea& 5 .a'#"

+a+#


19/26

Me"a!a


20/26

'%s,(+(,8a+ 8'a"es ," .'e )e#+a.,(" ( (( ,".a&e .a&e !+a8e/ ee" ," .'e!)ese"8e ( .'e ,"8)ease $(% a. a" .'e ,"8)ease )a.es ( ($es,.% .'a.(88#)


21/26

Me"a!a


22/26

@hen balan'e is i+aire!/ a" ,",,#a+ 'as ,8#+.% *a,".a,"," #!),'.(),e".a.,(" F() ea*!+e/ a" ,",,#a+ *a% "(. $e a$+e .(


23/26

Baa,*a"a 8a)a*e*!e)+a*$a. !e"#aa"

Se+a+# a&., Da+a* 'a+ ,", #sa'a&a" #".#& .,a& se)," ##& .e)+a+# +a*a $a,& ,.# , e!a" &(*!#.e) a.a#*e"(".(" a8a)a .e+e,s, %a" a"a s#&a, A"a a!a. *e*#+a,"%a e"a" *e"#)a",


24/26

Me"# *a&a"a" *e"a"#" a. ,, se,*$a" @ $e)a),as,H,"a), !a!a)a" .(,8 !)((&s,a" ; )a,&a+ $e$as =S#!+e*e" a".,(&s,a" -,. B12 - s,s.,* s%a)a @ (.a&

Asa* (+a. - *e)a"sa" *e.a$(+,s*e '(*(s,s.e," aa) .& * !+a& , a).e),Be.a&a)(.e" - se+ &e&e$a+a" ; se+ T/ +,*(s,. =/ *e"8ea' (&s,as, LDL&(+es.e)(+/ *e"8ea' !e"%a&,. a".#" @ s.)(&e

,. E - *e"8ea' (&s,as, LDL &(+es.e)(+/ *e"#)#"&a" a.e)(s&+e)(s,s,. P - *e"'a*$a. se+ &a"&e)/ *e","&a.&a" HDL &(+es.e)(+/ *e"#)#"&a"

.e&a"a" a)a'/ *e*!e)a. !e*$#+#' a)a'/ *e)e*aa&a" se+ a)a'

!#.,'/ *e*$e".#& a".,(&s,a" e"(e" +#.a.,("Pa - *e"8ea' (&s,as, LDL &(+es.e)(+ @ *e"#)#"&a" .e&a"a" a)a'M - s,s.es,s AT/ s.a$,+,s,sas, DNA/ RNA/ *e"#)#"&a" .e&a"a" a)a'/

*e"8ea' )es,s.e"s, ,"s#+,"/ *e"8ea' 8a),a8 a))es.Se - a. &e*(!)ee".,/ !e*$e.#& a".,(&s,a" e"(e" e",* !e)(&s,ase

+#.a.,("

P) - *e","&a.&a" &e)a ,"s#+,"/ *e"8ea' DM" - *e"a&.,&a" &e+e"a) .',*#s #".#& !)(#&s, a".,$(,/ !e*$e.#&a".,(&s,a" e"(e" e",* s#!e)(&s,a ,s*#.ase ; SOD =

M" - !e*$e.#& a".,(&s,a" e"(e" e",* s#!e)(&s,a ,s*#.ase ; SOD =P# - !e*$e.#& a".,(&s,a" e"(e" e",* s#!e)(&s,a ,s*#.ase ; SOD =K(e",* Q 10 - *e"8ea' (&s,as, LDL &(+es.e)(+


25/26

Y(# 8a". 8'a"e e"e.,8s/ $#. %(# 8a" *a&e 'ea+.'% +,es.%+e 8'(,8es .( e+a% a," () )e#8e .'e(!!().#",.% () ,++ 'ea+.' A(, .($a88( !)(#8.s a" a+8('(+ a$#se P'((se .( ea. 'ea+.'% a""#.),.,(#s ((s a" s.a% .

D),"& +(.s (


26/26

e"%a&,) a!a saa %a",se$a$&a" !e"#aa"

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