ADDRESSING HYPERTENSION IS CRUCIAL TO MITIGATING COGNITIVE DECLINE AND IMPROVING PATIENTS' QUALITY OF LIFE

Dewi  Pangestuti; Adhayani Lubis; Adi Raja Brando Lubis; Amirul  Mukminin; Ira Aini Dania; Donalry Agus Saputra; Stenly Hely Sajow

doi:10.22437/jiituj.v9i1.34442

Authors

Dewi Pangestuti Universitas Islam Sumatera Utara
Adhayani Lubis Universitas Prima Indonesia
Adi Raja Brando Lubis Universitas Prima Indonesia
Amirul Mukminin Universitas Jambi
Ira Aini Dania Universitas Islam Sumatera Utara
Donalry Agus Saputra Universitas Sumatera Utara
Stenly Hely Sajow Auckland University of Technology

DOI:

https://doi.org/10.22437/jiituj.v9i1.34442

Keywords:

Cognitive Deficit, Elderly, Hypertension

Abstract

Hypertension, a condition characterized by persistent elevated blood pressure, often places individuals at risk of developing complications that can adversely impact their quality of life. One notable complication associated with hypertension is cognitive dysfunction. A study published in the Journal of Alzheimer's Disease (2020) demonstrated that individuals with long-standing hypertension exhibited an elevated risk of developing cognitive impairment and Alzheimer's disease. Preliminary research suggests that approximately 12.5 percent of hypertensive deaths may be attributable to underlying factors. Aims: This study aims to examine the cognitive deficits in patients with hypertension and summarise research on the relationship between hypertension and cognitive impairment. This analytical research study with a cross-sectional design, total sample of 84 individuals who suffer from hypertension, the ages of 60 and 79 years old. The sample selected using purposive sampling, instruments used in this study were medical record and Mini Mental State Examination (MMSE) questionnaire. The data was analyzed univariate and bivariate with the Chi Square statistical test. The MMSE cognitive function test revealed that out of 84 individuals with hypertension, 67.85% had normal cognitive function, while 32.14%) moderate cognitive impairment. The sample for the research consisted of 40 male individuals (47.61%) and 44 female individuals (52.38%). Hypertension can affect a person's cognitive function which has an impact on quality of life.

Downloads

Download data is not yet available.

Author Biographies

Adhayani Lubis, Universitas Prima Indonesia

Departement of Psychiatry, Faculty of Medicine, Universitas Prima Indonesia, Sumatera Utara, Indonesia

Adi Raja Brando Lubis, Universitas Prima Indonesia

Department of Family Medicine, Faculty of Medicine, Universitas Prima Indonesia, Sumatera Utara, Indonesia

Amirul Mukminin, Universitas Jambi

Doctoral School in Education, Graduate School, Universitas Jambi, Jambi, Indonesia

Ira Aini Dania, Universitas Islam Sumatera Utara

Departement of Psychiatry, Faculty of Medicine, Universitas Islam Sumatera Utara, Sumatera Utara, Indonesia

Donalry Agus Saputra, Universitas Sumatera Utara

Departement of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Sumatera Utara, Indonesia

Stenly Hely Sajow, Auckland University of Technology

Departement of Public Health, Auckland University of Technology, Auckland, New Zealand

References

Afrilia, L., Fitri, A., Sitanggang, H. D., Perdana, S. M., & Wisudariani, E. (2024). Faktor-Faktor yang Mempengaruhi Kenaikan Berat Badan Pada Pengguna Kontrasepsi Suntik di Wilayah Kerja Puskesmas Simpang IV Sipin Kota Jambi Tahun 2022. Jurnal Kesmas Jambi, 8(2), 101-109. https://doi.org/10.22437/jkmj.v8i2.35806.

Anto, E. J., Siagian, L. O., Siahaan, J. M., Silitonga, H. A., & Nugraha, S. E. (2019). The relationship between hypertension and cognitive function impairment in the elderly. Open Access Macedonian Journal of Medical Sciences, 7(9), 1440–1445. https://doi.org/10.3889/oamjms.2019.300.

Amare, F., Hagos, B., Sisay, M., & Molla, B. (2020). Uncontrolled hypertension in Ethiopia: A systematic review and meta-analysis of institution-based observational studies. BMC Cardiovascular Disorders, 20, 1–9. https://doi.org/10.1186/s12872-020-01414-3.

Amelia, F. F., Ningsih, N. A., & Hasmah, H. (2024). Penerapan Sistem Informasi Manajemen Puskesmas dengan Metode HOT-FIT di Puskesmas Wotu Kabupaten Luwu Timur. Jurnal Kesmas Jambi, 8(2), 111-119. https://doi.org/10.22437/jkmj.v8i2.36806.

Amir, A., Hidayati, F., Guspianto, G., & Putri, F. E. (2024). Hubungan Personal Hygiene dengan Gejala Dermatitis pada Narapidana di Lembaga Pemasyarakatan Kelas II A Jambi Tahun 2024. Jurnal Kesmas Jambi, 8(2), 94-100. https://doi.org/10.22437/jkmj.v8i2.35466.

Balwan, W. K., & Kour, S. (2021). A systematic review of hypertension and stress-the silent killers. Scholars Academic Journal of Biosciences, 6, 150–154. https://doi.org/10.36347/sajb.2021.v09i06.002.

Carey, R. M., & Whelton, P. K. (2020). Evidence for the universal blood pressure goal of <130/80 mm Hg is strong: Controversies in hypertension-pro side of the argument. Hypertension, 76(5), 1384–1390. https://doi.org/10.1161/HYPERTENSIONAHA.120.14647.

Carey, R. M., Wright, J. T., Taler, S. J., & Whelton, P. K. (2021). Guideline-driven management of hypertension: An evidence-based update. Circulation Research, 128(7), 827–846. https://doi.org/10.1161/CIRCRESAHA.121.318083.

Carey, R. M., Moran, A. E., & Whelton, P. K. (2022). Treatment of hypertension: A review. JAMA, 328(18), 1849–1861. https://doi.org/10.1001/jama.2022.19590.

Cheon, E.-J. (2022). Hypertension and cognitive dysfunction: A narrative review. Journal of Yeungnam Medical Science, 40(3), 225–232. https://doi.org/10.12701/jyms.2022.00605.

Commodore-Mensah, Y., Turkson-Ocran, R. A., Foti, K., Cooper, L. A., & Himmelfarb, C. D. (2021). Associations between social determinants and hypertension, stage 2 hypertension, and controlled blood pressure among men and women in the United States. American Journal of Hypertension, 34(7), 707–717. https://doi.org/10.1093/ajh/hpab011.

Dhakal, A., & Bobrin, B. D. (2023). Cognitive deficits. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK559052/.

De Menezes, S. T., Giatti, L., Brant, L. C. C., Griep, R. H., Schmidt, M. I., Duncan, B. B., ... & Barreto, S. M. (2021). Hypertension, prehypertension, and hypertension control: Association with decline in cognitive performance in the ELSA-Brasil cohort. Hypertension, 77(2), 672–681. https://doi.org/10.1161/HYPERTENSIONAHA.120.16080.

Di Chiara, T., Del Cuore, A., Daidone, M., Scaglione, S., Norrito, R. L., Puleo, M. G., ... & Tuttolomondo, A. (2022). Pathogenetic mechanisms of hypertension–brain-induced complications: Focus on molecular mediators. International Journal of Molecular Sciences, 23(5), 2445. https://doi.org/10.3390/ijms23052445.

Dunne, R. A., Aarsland, D., O’Brien, J. T., Ballard, C., Banerjee, S., Fox, N. C., ... & Burns, A. (2021). Mild cognitive impairment: The Manchester consensus. Age and Ageing, 50(1), 72–80. https://doi.org/10.1093/ageing/afaa228.

Ekaputri, T. W., Qur’ani, H. N., Maharani, C., Puspasari, A., Justitia, B., & Ayudia, E. I. (2024). Effects of Sub-acute Ethanol Extract Toxicity of Karamunting (Rhodomyrtus tomentosa) Leaves on Hematological Profile in Female White Rats. Journal of Medical Studies, 4(3), 120-125. https://doi.org/10.22437/joms.v4i3.38943.

Endra, K., & Villaflor, G. M. (2024). Integration of the POE Model and Metaphoral Thinking in Student Worksheets: Improving Mathematical Reasoning Abilities in the Modern Education Era. Journal of Educational Technology and Learning Creativity, 2(1), 41-53. https://doi.org/10.37251/jetlc.v2i1.981.

Evans, N. R., Todd, O. M., Minhas, J. S., Fearon, P., Harston, G. W., Mant, J., ... & Warburton, E. A. (2022). Frailty and cerebrovascular disease: Concepts and clinical implications for stroke medicine. International Journal of Stroke, 17(3), 251–259. https://doi.org/10.1177/17474930211034331.

Fatmawati, A., & Arimbi, D. (2024). Aplikasi Pendekatan Teori Virginia Henderson pada Pasien Close Fraktur Epifisis Radius Distal Dextra: Studi Kasus. Jurnal Ilmiah Ners Indonesia, 5(2), 90-100. https://doi.org/10.22437/jini.v5i2.35965.

Filippone, E. J., Foy, A. J., & Naccarelli, G. V. (2022). Controversies in hypertension II: The optimal target blood pressure. The American Journal of Medicine, 135(10), 1168–1177.e3. https://doi.org/10.1016/j.amjmed.2022.05.009.

Fitrianingsih, F., Ersa, C. B., Indriyani, D., & Wirdayanti, W. (2022). Gambaran Karakteristik Pasien HIV di Poli Rawat Jalan RSUD Raden Mattaher Jambi. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 6(2), 164–172. https://doi.org/10.22437/jiituj.v6i2.6131.

Fitriani, S., Ramadhani, N. R., Susanti, E., & Guspianto, G. (2024). Evaluation and Strategy to Strengthen the Implementation of Early Detection of Cervical Cancer Using the IVA Test Method . Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan, 12(2), 132-136. https://doi.org/10.22437/jmj.v12i2.30503.

Fitriana, H., & Waswa, A. N. (2024). The Influence of a realistic mathematics education approach on students’ mathematical problem solving ability. Interval: Indonesian Journal of Mathematical Education, 2(1), 29-35. https://doi.org/10.37251/ijome.v2i1.979.

Flack, J. M., & Adekola, B. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in Cardiovascular Medicine, 30(3), 160–164. https://doi.org/10.1016/j.tcm.2019.05.003.

Forte, G., & Casagrande, M. (2020). Effects of blood pressure on cognitive performance in aging: A systematic review. Brain Sciences, 10(12), 919. https://doi.org/10.3390/brainsci10120919.

Giovanni, A., Enrico, A., Aime, B., Michael, B., Marianne, B., Jonathan, C., ... & Mayowa, O. (2020). Global burden of cardiovascular diseases and risk factors, 1990–2019: Update from the GBD 2019 study. Journal of the American College of Cardiology, 76(25), 2982–3021. https://doi.org/10.1016/j.jacc.2020.11.010.

Gupta, A., Perdomo, S., Billinger, S., Beddhu, S., Burns, J., & Gronseth, G. (2020). Treatment of hypertension reduces cognitive decline in older adults: A systematic review and meta-analysis. BMJ Open, 10(11). https://doi.org/10.1136/bmjopen-2020-038971.

Gusnaini, E., Soviarni, S., & Herlina, D. . (2024). The relationship between diet compliance and changes in blood sugar levels of diabetes mellitus patients in the work area of hiang community health center in kerinci regency in 2024. Jurnal keperawatan universitas jambi, 9(1), 12-20.

Hanoum, N. A., Villaverde, K., Saputra, Y., Nuhuyeva, Aehla, & Ye, T. (2024). Design and development of tempe fermentation tool based on fuzzy method to determine tempe maturity level. Journal of Educational Technology and Learning Creativity, 2(2), 235-255. https://doi.org/10.37251/jetlc.v2i2.1418.

Harahap, H., Darmawan, A., Ekaputri, T. W., Kusdiyah, E., & Iskandar, M. M. (2024). Pre-Matrical Nutrition Counseling, Anthropometric and Hemoglobin Examination In Women Of Fertile Age. Journal of Medical Studies, 4(3), 126-130. https://doi.org/10.22437/joms.v4i3.38953.

Hegde, S., Ahmed, I., & Aeddula, N. (2023). Secondary hypertension. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK544305/

Huang, W. L. (2019). Energy alterations as the underlying cause of primary hypertension? Journal of Nephrology, 4(2), 33–44. https://doi.org/10.1038/s41598-019-55438-7.

Hubaybah, H., Azhary, M. R., Simatupang, N. A., Herwansyah, H., Amir, A., & Ningsih, V. R. (2024). KECERIA (Kegiatan Cerdaskan Remaja Putri dari Anemia): Menciptakan Sekolah Bebas Anemia. Jurnal Salam Sehat Masyarakat (JSSM), 6(01), 1-7. https://doi.org/10.22437/jssm.v6i01.36585.

Hyskaj, A., Ramadhanti, A., Farhan , H., Allaham, A., & Ismail, M. A. (2024). Analysis of the role of the flo application as a digital educational media for adolescent reproductive health in the technology era. Journal of Educational Technology and Learning Creativity, 2(1), 71-82. https://doi.org/10.37251/jetlc.v2i1.1414.

Iadecola, C., & Gottesman, R. F. (2019). Neurovascular and cognitive dysfunction in hypertension: Epidemiology, pathobiology, and treatment. Circulation Research, 124(7), 1025–1044. https://doi.org/10.1161/CIRCRESAHA.118.313260.

Indasari, R., Ayu, I. M., Situngkir, D., & Nitami, M. (2024). Faktor-Faktor yang Berhubungan dengan Kejadian Kecelakaan Lalu Lintas pada Pengendara Sepeda Motor di Daerah Mimika, Papua, Tahun 2022. Jurnal Kesmas Jambi, 8(2), 71-80. https://doi.org/10.22437/jkmj.v8i2.32422.

Jimenez-Balado, J., Riba-Llena, I., Abril, O., Garde, E., Penalba, A., Ostos, E., ... & Delgado, P. (2019). Cognitive impact of cerebral small vessel disease changes in patients with hypertension. Hypertension, 73(2), 342–349. https://doi.org/10.1161/HYPERTENSIONAHA.118.12090.

Kamid, K., Romalisa, Y., Rohati, R., Ningsih, R., & Nabilah, B. S. (2024). Cognitive psychology study and mathematical process skills on students' answers in mathematics learning in comparative material. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 8(2). https://doi.org/10.22437/jiituj.v8i2.37240.

Kelly, D. M., & Rothwell, P. M. (2020). Blood pressure and the brain: The neurology of hypertension. Practical Neurology, 20(2), 100–111. https://doi.org/10.1136/practneurol-2019-002269.

Kucmierz, J., Frak, W., Mylnarska, E., Franczyk, B., & Rysz, J. (2021). Molecular interactions of arterial hypertension in its target organs. International Journal of Molecular Sciences, 22(18), 9669. https://doi.org/10.3390/ijms22189669.

Li, Z., Wang, W., Sang, F., Zhang, Z., & Li, X. (2023). White matter changes underlie hypertension-related cognitive decline in older adults. NeuroImage: Clinical, 38(February), 103389. https://doi.org/10.1016/j.nicl.2023.103389.

Li, H., Wang, M., Qian, F., Wu, Z., Liu, W., Wang, A., & Guo, X. (2024). Association between untreated and treated blood pressure levels and cognitive decline in community-dwelling middle-aged and older adults in China: A longitudinal study. Alzheimer's Research & Therapy, 16(1), 104. https://doi.org/10.1186/s13195-024-01467-y.

Li, C., Zhu, Y., Ma, Y., Hua, R., Zhong, B., & Xie, W. (2022). Association of cumulative blood pressure with cognitive decline, dementia, and mortality. Journal of the American College of Cardiology, 79(14), 1321–1335. https://doi.org/10.1016/j.jacc.2022.01.045.

Lorenza, P. S. ., Mawarti, I., & Oktarina, Y. (2024). Description Of The Level Of Patient Satisfaction With Health Services In The Inpatient Unit Of Rsu Mayjen H.A Thalib Kerinci. Jurnal Keperawatan Universitas Jambi, 9(1), 7-11.

Ma, L. Y., He, F., Liu, S., Wang, X. D., Gao, Y., Shi, Z., Niu, J., & Ji, Y. (2022). The association between the prevalence, medication adherence, and control of hypertension and the prevalence of mild cognitive impairment in rural northern China: A cross-sectional study. Patient Preference and Adherence, 16, 493–502. https://doi.org/10.2147/PPA.S351588.

Malhotra, S. (2020). Parietal and occipital lobe syndromes. In Examining biological foundations of human behavior (pp. 136–148). IGI Global. https://doi.org/10.4018/978-1-7998-2860-0.ch009.

Maudia, N., Awodeyi, A. F., & Mohammed, A. S. (2024). Enhancing pedagogical content knowledge in mathematics teachers through collaborative professional development. Interval: Indonesian Journal of Mathematical Education, 2(1), 36-49. https://doi.org/10.37251/ijome.v2i1.1342.

Maulidiyah, D. D. ., Murtaqib, M., & A’la, M. Z. . (2024). Hubungan Fatigue dengan Kualitas Hidup pada Pasien Gagal Ginjal Kronik yang Menjalani Hemodialisis di RSD dr. Soebandi Jember. Jurnal Ilmiah Ners Indonesia, 5(2), 81-89. https://doi.org/10.22437/jini.v5i2.35531.

Members, W. C., Ommen, S. R., Ho, C. Y., Asif, I. M., Balaji, S., Burke, M. A., ... & Ferrari, V. A. (2024). 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 83(23), 2324–2405. https://doi.org/10.1016/j.jacc.2024.02.014.

Merdekawati, D. ., Dasuki, D., & Aguspairi, A. (2024). Validity of Blood Pressure Measurement in Hypertention Patients. Jurnal Ilmiah Ners Indonesia, 5(2), 101-109. https://doi.org/10.22437/jini.v5i2.36305.

Miharja, M. A., Bulayi, M., & Triet, L. V. M. (2024). Realistic mathematics education: Unlocking problem-solving potential in students. Interval: Indonesian Journal of Mathematical Education, 2(1), 50-59. https://doi.org/10.37251/ijome.v2i1.1344.

Mulyani, D. T., Mulyani, S., & Yuliana, Y. (2024). Literature study the relationship between pregnant women’s knowledge about nutrition and the incidence of chronic energy deficiency (ced). Jurnal keperawatan universitas jambi, 9(1), 21-38.

Muntner, P., Shimbo, D., Carey, R. M., Charleston, J. B., Gaillard, T., Misra, S., ... & Wright, J. T. (2019). Measurement of blood pressure in humans: A scientific statement from the American Heart Association. Hypertension, 73(5), e35–e66. https://doi.org/10.1161/HYP.0000000000000087.

Munthomimah, R., Yamin, M., & Rusdi, M. (2022). Exploring physics: Engaging Inquiry-Based labs for sman 1 Muaro Jambi’s Class X. Tekno - Pedagogi : Jurnal Teknologi Pendidikan, 12(2), 10-19. https://doi.org/10.22437/teknopedagogi.v12i2.32523.

Nes, A., Sundberg, K., & Watzl, S. (2023). The perception/cognition distinction. Inquiry, 66(2), 165–195. https://doi.org/10.1080/0020174X.2021.1926317.

Nurhusna, & Oktarina, Y. (2024). Effectiveness Of Bundle Care In Preventing Pressure Ulcer In Patients Using Mechanical Ventilation Assistants In The Intensive Care Unit. Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan, 12(2), 118-124. https://doi.org/10.22437/jmj.v12i2.25321.

Oktavia, R., Lanita, U., Siregar, S. A., & Perdana, S. M. (2024). Efektivitas Edukasi Kesehatan Tentang Polycystic Ovary Syndrome (PCOS) Melalui Media Sosial Terhadap Pengetahuan dan Sikap Remaja Putri di Madrasah Aliyah Laboratorium Jambi. Jurnal Kesmas Jambi, 8(2), 81-93. https://doi.org/10.22437/jkmj.v8i2.32755.

Oliveros, E., Patel, H., Kyung, S., Fugar, S., Goldberg, A., Madan, N., & Williams, K. A. (2020). Hypertension in older adults: Assessment, management, and challenges. Clinical Cardiology, 43(2), 99–107. https://doi.org/10.1002/clc.23303.

Ostchega, Y., Fryar, C. D., Nwankwo, T., & Nguyen, D. T. (2020). Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. NCHS Data Brief. https://doi.org/https://stacks.cdc.gov/view/cdc/87559.

Putra, R. P., Ramadhanti, A., & Darmawan, H. (2023). Male or female, who is the highest? Life optimism in cardiovascular disease patients. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 7(1), 11–21. https://doi.org/10.22437/jiituj.v7i1.26618.

Putri, F. E., Hubaybah, H., Lesmana, O., Putra, A. N., & Fitri, A. (2024). Pelatihan Pembuatan Kompos pada Facility Care untuk Mengurangi Jumlah Sampah Organik di Fakultas Kedokteran dan Ilmu Kesehatan Universitas Jambi. Jurnal Salam Sehat Masyarakat (JSSM), 6(01), 8-20. https://doi.org/10.22437/jssm.v6i01.37359.

Quzwain, F., Shafira, N. N. A., Aryanty, N. ., & Raudhoh, S. (2024). Interprofessional Learning Development In Indonesia Health Study Program. Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan, 12(2), 112-117. https://doi.org/10.22437/jmj.v12i2.37316.

Rahmat, A. A., Siregar, S. A., Perdana, S. M., & Prasetyo, Y. (2024). FKIK Bebas Sampah Plastik: Pengembangan Media Promosi Kesehatan pada Tatanan Khusus dalam Mewujudkan Kampus Sehat. Jurnal Salam Sehat Masyarakat (JSSM), 6(01), 21-29. https://doi.org/10.22437/jssm.v6i01.37911.

Risnawati, R., Ramadan, M., Baba, K., Hammad, S., & Rustaminezhad, M. A. (2024). The impact of Augmented Reality-Based learning media on students’ digital literacy skills: A study on junior high school students. Journal of Educational Technology and Learning Creativity, 2(1), 63-70. https://doi.org/10.37251/jetlc.v2i1.1415.

Santisteban, M. M., Iadecola, C., & Carnevale, D. (2023). Hypertension, neurovascular dysfunction, and cognitive impairment. Hypertension, 80(1), 22–34. https://doi.org/10.1161/HYPERTENSIONAHA.122.18085

Saputra, A., Musonda, A., & Nikolantonakis, K. (2024). Transformation of Character Assessment through ICT Technology: A Study of the Use of Web-Based Platforms. Interval: Indonesian Journal of Mathematical Education, 2(1), 60-68. https://doi.org/10.37251/ijome.v2i1.1345.

Shera, S. D., Hakam, M., & Widayati, N. (2024). Hubungan Pemberdayaan Diri dengan Kecerdasan Emosional Pasien Diabetes Mellitus Tipe 2 di RSD dr. Soebandi Jember. Jurnal Ilmiah Ners Indonesia, 5(2), 110-119. https://doi.org/10.22437/jini.v5i2.36311.

Sholikhah, D. U., Puspita, E., & Mardiah, A. (2024). The effect of puzzle game therapy on fine motor development in children 3-5 years in play group aisyiyah 27 surabaya. Jurnal keperawatan universitas jambi, 9(1), 1-6.

Soares, A., Sari, P. I., Maulana, M. R. I., & Ariesti, A. D. (2024). Trends and Issues in Medication Management in Home Care for Gouty Arthritis Patients: Literature Review. JURNAL KEPERAWATAN UNIVERSITAS JAMBI, 9(1), 39-45.

Solihin, S., & Triana, W. (2024). Edukasi Monopoli Anemia (GEMOMIA) pada Remaja Putri di SMAN 01 Kabupaten Muaro Jambi. Jurnal Salam Sehat Masyarakat (JSSM), 6(01), 45-52. https://doi.org/10.22437/jssm.v6i01.37552.

Susanti, M., Dania, I. A., & Ibarra, F. (2024). Self-Efficacy Reduces Relapse In Drug Abuse With Cognitive Behaviour Therapy. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 8(2). https://doi.org/10.22437/jiituj.v8i2.34358.

Susanti, S. N., Sukarmin, S., Jauhar, M. ., Tiara, N., & Lasmini, L. (2024). Efikasi Diri, Dukungan Sosial, dan Self-Care Management Klien Hipertensi. Jurnal Ilmiah Ners Indonesia, 5(2), 62-80. https://doi.org/10.22437/jini.v5i2.37546.

Streit, S., Poortvliet, R. K. E., Den Elzen, W. P. J., Blom, J. W., & Gussekloo, J. (2019). SBP and cognitive decline in older adults with HTN. Annals of Family Medicine, 17(2), 100–107. https://doi.org/10.1370/afm.2367.

Taufiqurrahman, F. (2024). The Overview of Ureteral Colic in Ureterolithiasis Patients Based on the Location of Stones Observed on Urographic CT-scan. Journal of Medical Studies, 4(3), 111-119. https://doi.org/10.22437/joms.v4i3.38942.

Taurusi, T., Septi, S. E., & Osma, U. S. (2024). Discovery learning model to improve creative thinking skills and ability to understand concepts in ohm’s law material: Meta analysis. EduFisika: Jurnal Pendidikan Fisika, 9(1), 104-116. https://doi.org/10.59052/edufisika.v9i1.32640.

Triyasmina, T., Rusdi, M., Asyhar, R., Dachia, H. A., & Rukondo, N. (2022). Chemistry learning revolution: Interactive multimedia E-Learning with a problem based learning approach. Tekno - Pedagogi : Jurnal Teknologi Pendidikan, 12(2), 1-9. https://doi.org/10.22437/teknopedagogi.v12i2.32521.

Tumanggor, S., Dewi, H., Gading, P. W., Enis, R. N., & Shafira, N. N. A. (2024). Overview of Learning Motivation and Learning Strategies of Students In The Medical Study Program. Journal of Medical Studies, 4(3), 131-137. https://doi.org/10.22437/joms.v4i3.38958.

Vanika, N., Yuliawati, Y., & Sani, F. . (2024). Consumable Medical Materials Related To The Treatment Of Covid And Multivitamins During The Pandemic . Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan, 12(2), 137-144. https://doi.org/10.22437/jmj.v12i2.17734.

Wardlaw, J. M., Benveniste, H., & Williams, A. (2022). Cerebral vascular dysfunctions detected in human small vessel disease and implications for preclinical studies. Annual Review of Physiology, 84(1), 409–434. https://doi.org/10.1146/annurev-physiol-060821-014521.

Widiasta, A., Ilman, M., & Rachmadi, D. (2024). The Art of Management of Children with Steroid-Resistant and Cyclophosphamide-Resistant Nephrotic Syndrome in Indonesia. Jambi Medical Journal : Jurnal Kedokteran Dan Kesehatan, 12(2), 125-131. https://doi.org/10.22437/jmj.v12i2.29348.

Wolska-Bulach, A., Wierzowiecka, M., Niklas, K., Tykarski, A., & Niklas, A. (2022). Cognitive dysfunctions in patients with hypertension—pathogenesis and treatment. arterial hypertension, 26(2), 45-59. https://doi.org/10.5603/AH.a2022.0007.

Wollesen, B., Wildbredt, A., Schooten, K. S. V., Lim, M. L., & Delbaere, K. (2020). The effects of cognitive-motor training interventions on executive functions in older people: A systematic review and meta-analysis. European Review of Aging and Physical Activity, 17(9), 1–22. https://doi.org/10.1007/s40279-020-01370-0.

World Health Organization. (2021). Ageing. World Health Organization. Retrieved from https://www.who.int/health-topics/ageing#tab=tab_1

Wulandari, M., Rodriguez, E. V. ., & Afrianda, S. (2024). Analysis of high school students’ creativity ability in solving physics problems. EduFisika: Jurnal Pendidikan Fisika, 9(1), 117-122. https://doi.org/10.59052/edufisika.v9i1.29637.

Yahya, F. B., Hassan, H. C., Panduragan, S. L., & Mat, S. (2024). Quality of life: The spirituality and spiritual wellbeing of elderlies in Malaysia. Jurnal Ilmiah Ilmu Terapan Universitas Jambi, 8(2). https://doi.org/10.22437/jiituj.v8i2.34273.

Zakiyah, Z., Boonma, K., & Collado, R. (2024). Physics learning innovation: Song and Animation-Based media as a learning solution for mirrors and lenses for junior high school students. Journal of Educational Technology and Learning Creativity, 2(2), 183-191. https://doi.org/10.37251/jetlc.v2i2.1062.

Zhang, W., Zhang, S., Deng, Y., Wu, S., Ren, J., Sun, G., ... & Cai, J. (2021). Trial of intensive blood-pressure control in older patients with hypertension. New England Journal of Medicine, 385(14), 1268–1279. https://doi.org/10.1056/nejmoa2111437.