The Effect of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Function in Frail Geriatrics

The Effect of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Function in Frail Geriatrics | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report The Effect of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Function in Frail Geriatrics Akhmad Ulil Albab, Fatichati Budiningsih, Yulyani Wediningsih, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6663721/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The geriatric population is experiencing significant growth, which has led to increased attention to health issues that arise with aging, one of which is frailty. Frailty in the elderly is associated with impaired stress tolerance due to the decline in the function of various body organs, including sarcopenia and cognitive decline. This study aims to investigate the effects of muscle strength, physical performance, and interleukin-6 (IL-6) levels on cognitive function in frail geriatrics. Methods: This observational study involved 41 geriatric patients over the age of 60 who met the pre-frail and frail criteria based on the Cardiovascular Health Study (CHS) score. Data were collected through handgrip strength measurements for muscle strength, 5 time stand chair test for physical performance, and blood IL-6 levels. Cognitive function was assessed using the MoCA-INA questionnaire. Result: The results showed a significant relationship between muscle strength, physical performance, and IL-6 levels with cognitive decline in frail geriatrics. Overall, the decline in muscle strength and physical performance, along with increased IL-6 levels, can exacerbate cognitive function in elderly individuals with frailty. Conclussion: This study suggests the need for interventions that integrate the improvement of muscle strength and physical performance to prevent or delay cognitive decline in frail geriatrics. muscle strength physical performance IL-6 cognitive function INTRODUCTION The geriatric population continues to increase globally, presenting major challenges for health service systems (Hamidi and Joseph, 2019 ). Frailty is one of the main issues faced by the elderly, characterized by reduced tolerance to physiological stress due to the decline in physiological reserves of various organs (Veronese, 2020). One of the main causes of frailty is sarcopenia, which can trigger cognitive decline (Chen et al., 2020 ). Chronic low-level inflammation, characterized by increased interleukin-6 (IL-6) levels, also worsens cognitive conditions (Papadopoulou, 2020 ). The decline in muscle strength and physical performance in the elderly is an important indicator in detecting the risk of cognitive disorders (Du et al., 2023 ). This study aims to analyze the effects of muscle strength, physical performance, and IL-6 levels on cognitive function in frail geriatrics. It is expected that the results of this study can contribute to the development of preventive and curative interventions to reduce the burden of cognitive disorders in the elderly population. METHODS a. Study Design This is an observational analytic study with a cross-sectional approach. The data were collected from samples selected based on inclusion and exclusion criteria. The samples were chosen using consecutive sampling, where each subject who met the inclusion and exclusion criteria was involved in the study, ensuring the required number of subjects. b. Population and Subject Study The target population for this study consists of frail geriatric patients. The accessible population consists of frail geriatric patients who visit the Geriatrics Clinic at Dr. Moewardi General Hospital, Surakarta. This study involved 41 subjects. All participants provided informed consent prior to inclusion in the study. The research was conducted in accordance with the ethical principles of the Declaration of Helsinki and was approved by the Ethics Commission of Dr. Moewardi Hospital / Faculty of Medicine, Universitas Sebelas Maret (UNS), Surakarta, Indonesia (Approval Number: 567/II/HREC/2024). Inclusion criteria: patients over 60 years old, patients meeting the pre-frail and frail criteria based on the Cardiovascular Health Study (CHS) score, and those who consented to participate. Exclusion criteria: patients with dementia, Alzheimer's disease, chronic diseases (malignancies, uncontrolled diabetes, chronic kidney failure, cirrhosis), severe physical mobility disorders, and acute infections. c. Variables The independent variables of this study include muscle strength, physical performance, and IL-6 levels. The dependent variable is cognitive function in frail geriatrics. Muscle strength was measured using handgrip strength, physical performance was measured by the 5 Times Chair Stand Test, and IL-6 levels were measured from venous blood samples. Cognitive function was evaluated using the MoCA-INA questionnaire (Montreal Cognitive Assessment Indonesia version). d. Statistical Analysis Statistical analysis was conducted using correlation and multiple linear regression to assess the relationships and effects of muscle strength, physical performance, and IL-6 levels on cognitive function. All analyses were performed with a significance level of p<0.05. RESULT AND DISCUSSION a. Basic Characteristic Data Univariate analysis was used to explain and describe the characteristics of each research variable. The characteristics of the research subjects can be seen in table 1.1 below. In the table, it can be seen that the highest number of patients in the age range of 71-80 years, as many as 23 (56.1%) consisting of 11 (26.8%) male patients and 30 (73.2%) female patients. The range of patient education varies but is dominated by patients with a bachelor's degree as many as 14 (34.1%) patients. From the body weight data, 12 (29.3%) patients were categorized as overweight. Some patients can still carry out daily activities independently as many as 29 (70.7%) patients. Patients who have a smoking habit are 5 (12.2%) patients. While patients who have comorbid hypertension are 29 (95.1%) patients and those who have comorbid diabetes mellitus are 15 (36.6%) patients. From the results of the study we got the average among respondents respectively for muscle strength, physical performance, IL-6, and cognitive function of 16.38 kg, 18.07 seconds, 7.90 pg/mL, and a cognitive function score of 22.02 points. Table 1.1. Basic Characteristic Data No. Parameter Frek. (N=41) % 1. Age 60 – 70 y.o 16 39.0 71 – 80 y.o 23 56.1 >80 y.o 2 4.9 2. Sex Male 11 26.8 Female 30 73.2 3. Education Out of school 2 4.9 Elementary School 4 9.8 Junior High School 6 14.6 Senior High School 7 17.1 Diploma 7 17.1 Undergraduate/ Barchelor 14 34.1 Graduate 1 2.4 4. Body Mass Index (BMI) Underweight 4 9.8 Normal 10 24.4 Overweight 12 29.3 Obesitas I 10 24.4 Obesitas II 5 12.2 5. Comorbid Hipertension 39 95.1 Diabetes Melitus 15 36.6 Hipertension and Diabetes Melitus 15 36.6 6. Acivity Daily Living (ADL) Independent 29 70.7 Mild Dependency 10 24.4 Moderate Dependency 2 2.4 7. Smoking Habbit Yes 5 12.2 No 36 87.4 Table 1.2. Avarage Examination Result Score No. Parameter Min. Maks. Average Std. Deviation 1. Muscle Streght 6 30 16,38 5.72 2. Phisical Performance 9,04 41,19 18,07 7.45 3. IL-6 1,5 134,90 7,90 20.61 4. Cognitive Function 12 28 22,02 3.48 In the age range of 71-80 years, there is an increased prevalence of heart disease, hypertension, and diabetes mellitus (Rahman et al., 2020). Patients with a bachelor's degree are more likely to have access to better health services and lead a healthy lifestyle (Williams et al., 2022). Higher education is also associated with reduced incidence of chronic diseases, as individuals with higher education are often exposed to better health information (Hoffman & Stokes, 2019). According to research by Jones et al. (2021), obesity is a major risk factor for many age-related chronic diseases, including cardiovascular disorders, diabetes, and muscle and joint problems. Hypertension can affect heart and kidney function, while diabetes mellitus is associated with vascular damage and an increased risk of cognitive impairment. According to research by Singh et al. (2022), patients suffering from hypertension and diabetes mellitus often show impairments in their physical and cognitive functions. Bivariate analysis was performed using the Kolmogorov-Smirnov test to determine the normality of the data. From the analysis that has been done, the value of p = 0.439 (p>0.05) is obtained, so the data has a normal distribution. b. Effect of Muscle Strength on Cognitive Function Bivariate analysis showed a significance of p=0.045 (p<0.05) so that it can be said to have a relationship. This study shows that there is a significant negative relationship between muscle strength and cognitive function scores, where decreased muscle strength is associated with decreased cognitive ability. For example, Kobayashi-Cuya et al. (2018) suggested that decreased muscle strength may worsen blood flow to the brain, which in turn increases the risk of cognitive function decline (Kobayashi-Cuya et al., 2018). This is in line with findings from Kim and Kim (2022), who showed that lower hand strength is associated with decreased cognitive performance among older adults (Kim and Kim, 2022). Table 2. Statistical Analisis Result of The Effect of Muscle Strength on Cognitive Function Model Unstandardized Coeficients Standardized Coeficients t p B Std. Error Beta (constant) 18,805 1,643 11,443 <0,001 Muscle Streght 0,191 0,093 0,314 2,066 0,045 From the table it can be concluded that every increase of 1 score of muscle strength will increase cognitive function by 0.191. From the data analysis also obtained R 2 value of 0.099 which means that muscle strength affects cognitive function by 9.9%, statistically significant. c. Effect of Physical Performance on Cognitive Function Bivariate analysis showed a significance of p=0.010 (p<0.05) so that it can be said to have a relationship. Physical performance, as measured by the 5-time sit to stand test (5TSTS), showed a significant negative correlation with cognitive function in the elderly population. Decreased ability to perform simple physical tasks, such as standing up from a seated position, may reflect more profound motor and cognitive impairments. Alves et al. (2021) emphasized that limited physical performance in the elderly is often associated with faster cognitive decline, where individuals who have difficulty performing simple physical activities tend to have lower cognitive scores (Alves et al., 2021). Research by Dodds et al., (2021) also showed that poor performance in the 5TSTS test is associated with an increased risk of disability and decline in cognitive function, confirming the importance of physical performance measurement in the context of cognitive health (Dodds et al., 2021). Table 3. Statistical Analisis Result of The Effect of Physical Performance on Cognitive Function Model Unstandardized Coeficients Standardized Coeficients t p B Std. Error Beta (constant) 22,370 1,458 15,338 <0,001 Phisical Performance 0,019 0,075 0,041 2,256 0,010 From the table it can be concluded that every increase of 1 score of physical performance will increase cognitive function by 0.019. From the data analysis also obtained R 2 value of 0.002 which means that physical performance affects cognitive function by 0.2%, statistically significant. d. Effect of Interleukin-6 on Cognitive Function Bivariate analysis showed a significance of p=0.002 (p<0.05) so that it can be said to have a relationship. Interleukin-6 (IL-6) as an inflammatory biomarker has shown a significant association with cognitive function decline. Increased levels of IL-6 in the body are associated with decreased cognitive scores, which suggests that systemic inflammation can accelerate degenerative processes in the brain. Lin et al,. (2018) confirmed that high inflammation, reflected by elevated IL-6, may worsen cognitive ability in elderly individuals (Lin et al., 2018). Other studies have shown that IL-6 plays an important role in the mechanisms underlying cognitive decline, with evidence that high levels of IL-6 can trigger neuronal damage and accelerate the progression of cognitive impairment (İvecek, Şekerci and Sümbül Şekerci, 2024). Table 4. Statistical Analisis Result of The Effect of Interleukin-6 on Cognitive Function Model Unstandardized Coeficients Standardized Coeficients t p B Std. Error Beta (constant) 22,054 0,591 37,340 <0,001 IL-6 -0,004 0,027 0,022 3,137 0,002 From the table it can be concluded that every increase of 1 IL-6 score will reduce cognitive function by 0.004. From the data analysis also obtained R 2 value of 0.001 which means IL-6 affects cognitive function by 0.1%, statistically significant. e. Effects of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Functioning Multivariate analysis showed that the significance value of p<0.05 so that it can be said that there is a relationship between muscle strength, physical performance, IL-6 on cognitive function. A decrease in muscle strength and physical performance, along with an increase in IL-6, can increase the risk of cognitive decline. Research by (Zhang et al., 2020) found that increasing muscle strength and physical performance can reduce inflammation, which in turn slows the decline in cognitive function in the elderly (Zhang et al., 2020). Furthermore, Park and Kim (2022) emphasized that regular physical activity serves as a protective factor against frailty and cognitive decline (Park and Kim, 2022). The link between inflammation, muscle strength, and cognitive function is also reinforced by research showing that high IL-6 levels are associated with cognitive decline, and that increasing muscle strength can reduce IL-6 levels (Liu et al., 2018). Table 5. Statistical Analisis Result of The Effects of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Functioning Variabel b (regression coeff.) p CI 95% Upper Margin Lower Margin Constanta 18,289 Muscle Streght 0,201 0,040 -10,600 -3,782 Phisical Performance 0,017 0,030 -1,65117 8,85420 IL-6 -0,006 0,037 -10,69331 18,94749 N observation 41 Adjusted R 2 0,029 p model <0,03 The results of this study indicate that each increase in 1 score of muscle strength will increase cognitive function by 0.201 (p=0.040), statistically significant. Every increase of 1 physical performance score will increase cognitive function by 0.017 (p=0.030), statistically significant. Every 1 increase in IL-6 score will decrease cognitive function by 0.006 (p=0.037), statistically significant. Muscle strength, physical performance, and IL-6 together affect cognitive function by 2.9%, the remaining 97.1% is influenced by other factors not examined in this study. CONCLUSSION AND SUGGESTION This study concluded that there is a significant influence between muscle strength, physical performance, and interleukin-6 levels on cognitive function in geriatrics with frailty. Decreased muscle strength and physical performance and increased IL-6 were associated with worsening cognitive function. The suggestion from this study is the importance of a multifactorial intervention program that includes structured physical exercise and inflammation control to prevent or slow the decline in cognitive function in the elderly with frailty. Future research is recommended to use a longitudinal design with a larger sample size to confirm the causal relationship. Declarations Ethics Approval and consent to participate: This study was conducted after obtaining ethical approval from the Ethics Commission of Dr. Moewardi Hospital / Faculty of Medicine, Universitas Sebelas Maret (UNS), Surakarta, Indonesia (Number: 567/II/HREC/2024). The study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent to participate was obtained from all participants involved in the study. Consent for publication Not applicable. Data Availability Data described in the manuscript, code book, and analysis code will be available upon request and approval. Competing interests The authors declare no competing interests. Funding There is no funding. Acknowledgements We would like to thank all who participated in this study. References Alves JFN et al. (2021) ‘Association between physical functioning with cognition among community-dwelling older adults: a cross-sectional study’. Geriatr Gerontol Aging, 15. Chen LK, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300–e3072. Dodds RM, et al. Prevalence and factors associated with poor performance in the 5-chair stand test: findings from the Cognitive Function and Ageing Study II and proposed Newcastle protocol for use in the assessment of sarcopenia. J Cachexia Sarcopenia Muscle. 2021;12(2):308–18. Du H, et al. Association between sarcopenia and cognitive function in older Chinese adults: Evidence. from the China health and retirement longitudinal study’; 2023. Hamidi M, Joseph B. Changing Epidemiology of the American Population. Clin Geriatr Med. 2019;35(1):1–12. Hoffman JA, Stokes R. Education level and its impact on health outcomes in chronic disease management. J Health Educ Res Dev. 2019;37(2):125–36. İvecek H, Şekerci A, Sümbül Şekerci B. IL-6 Levels And Cognitive Complications In Patients With Type 2 Diabetes Mellitus: A Cross Sectional Study. Ankara Universitesi Eczacilik Fakultesi Dergisi. 2024;48(3):24–24. Jones SE, et al. Obesity and chronic diseases: A study on elderly populations. Int J Obes. 2021;45(5):1042–50. Kim K, Kim H. Handgrip Strength and Cognitive Function among Elderly Koreans: Insights from the Korean Longitudinal Study of Ageing. Int J Environ Res Public Health. 2022;19(9):5262. Kobayashi-Cuya KE, et al. Observational Evidence of the Association Between Handgrip Strength, Hand Dexterity, and Cognitive Performance in Community-Dwelling Older Adults: A Systematic Review. J Epidemiol. 2018;28(9):373–81. Lin T et al. (2018) ‘Systemic Inflammation Mediates Age-Related Cognitive Deficits’. Front Aging Neurosci, 10. Liu Z, et al. Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes. J Am Med Dir Assoc. 2018;19(4):304–e3092. Papadopoulou SK. (2020) ‘Sarcopenia: A Contemporary Health Problem among Older Adult Populations’. Park D, Kim H-S. The Factors Affecting Frailty among the Elderly in Korea: A Study Using the Frailty Cohort. Int J Environ Res Public Health. 2022;20(1):670. Rahman MS, et al. Age-related prevalence of chronic diseases in elderly populations. J Gerontol. 2020;75(3):406–13. Singh SR, et al. Diabetes and hypertension: Effects on physical and cognitive functions in older adults. J Clin Med. 2022;11(4):899. Williams RM, et al. Higher education and health literacy in chronic disease management. J Health Communication. 2022;27(4):334–41. Zhang Y, et al. Development of frailty subtypes and their associated risk factors among the community-dwelling elderly population. Aging. 2020;12(2):1128–40. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6663721","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":464461923,"identity":"4288ae24-43da-408f-a8ae-b9d7668d744e","order_by":0,"name":"Akhmad Ulil Albab","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYDACHh4gwcYgw8bOwPgAxOcjVgsPGzMDswGIz0a0FgZmBjYJBjCbAODvOXt0w4+ywzx8zMzPKr/m2MmwMTA/fHQDjxaJs31pN3vOHQY6jM3stuy2ZKDD2IyNc/BZc57H7AZvG0gLg9ltyW3MPCB/SePTIg/UcvMvWAv7t2LJbfWEtRic7TG7DbGFx4zx47bDhLUYnjljdlvmXDpIS7E047bjIE/h94vcmRyzm2/KrOXk29s3fvy5rdqen7354WO83kcGzDxgkljlIMD4gxTVo2AUjIJRMGIAAAPsPpCZyEy9AAAAAElFTkSuQmCC","orcid":"","institution":"Sebelas Maret University","correspondingAuthor":true,"prefix":"","firstName":"Akhmad","middleName":"Ulil","lastName":"Albab","suffix":""},{"id":464461924,"identity":"f98cb35c-8d4f-4655-867f-7165efc21677","order_by":1,"name":"Fatichati Budiningsih","email":"","orcid":"","institution":"Sebelas Maret University","correspondingAuthor":false,"prefix":"","firstName":"Fatichati","middleName":"","lastName":"Budiningsih","suffix":""},{"id":464461926,"identity":"2f216cc7-1786-4db3-bdad-4820b98f8c30","order_by":2,"name":"Yulyani Wediningsih","email":"","orcid":"","institution":"Sebelas Maret University","correspondingAuthor":false,"prefix":"","firstName":"Yulyani","middleName":"","lastName":"Wediningsih","suffix":""},{"id":464461928,"identity":"b30f7ed8-a749-4e1f-a4c7-241f25289452","order_by":3,"name":"Agus Joko Susanto","email":"","orcid":"","institution":"Sebelas Maret University","correspondingAuthor":false,"prefix":"","firstName":"Agus","middleName":"Joko","lastName":"Susanto","suffix":""},{"id":464461929,"identity":"0f0559de-f050-49a1-a594-8cb17680da1c","order_by":4,"name":"Eti Poncorini Pamungkasari","email":"","orcid":"","institution":"Sebelas Maret University","correspondingAuthor":false,"prefix":"","firstName":"Eti","middleName":"Poncorini","lastName":"Pamungkasari","suffix":""}],"badges":[],"createdAt":"2025-05-14 11:38:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6663721/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6663721/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85203639,"identity":"9ae4f038-39c3-4607-a6cd-fcc256a0f0c4","added_by":"auto","created_at":"2025-06-23 11:02:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":847891,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6663721/v1/9fa2c743-bce7-431c-b3bc-c3fe72976ebd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eThe Effect of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Function in Frail Geriatrics\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe geriatric population continues to increase globally, presenting major challenges for health service systems (Hamidi and Joseph, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Frailty is one of the main issues faced by the elderly, characterized by reduced tolerance to physiological stress due to the decline in physiological reserves of various organs (Veronese, 2020). One of the main causes of frailty is sarcopenia, which can trigger cognitive decline (Chen et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Chronic low-level inflammation, characterized by increased interleukin-6 (IL-6) levels, also worsens cognitive conditions (Papadopoulou, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The decline in muscle strength and physical performance in the elderly is an important indicator in detecting the risk of cognitive disorders (Du et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study aims to analyze the effects of muscle strength, physical performance, and IL-6 levels on cognitive function in frail geriatrics. It is expected that the results of this study can contribute to the development of preventive and curative interventions to reduce the burden of cognitive disorders in the elderly population.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003ea.\u0026nbsp; \u0026nbsp;Study Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is an observational analytic study with a cross-sectional approach. The data were collected from samples selected based on inclusion and exclusion criteria. The samples were chosen using consecutive sampling, where each subject who met the inclusion and exclusion criteria was involved in the study, ensuring the required number of subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb.\u0026nbsp; \u0026nbsp;Population and Subject Study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe target population for this study consists of frail geriatric patients. The accessible population consists of frail geriatric patients who visit the Geriatrics Clinic at Dr. Moewardi General Hospital, Surakarta. This study involved 41 subjects. All participants provided informed consent prior to inclusion in the study. The research was conducted in accordance with the ethical principles of the Declaration of Helsinki and was approved by the Ethics Commission of Dr. Moewardi Hospital / Faculty of Medicine, Universitas Sebelas Maret (UNS), Surakarta, Indonesia (Approval Number: 567/II/HREC/2024).\u003c/p\u003e\n\u003cp\u003eInclusion criteria: patients over 60 years old, patients meeting the pre-frail and frail criteria based on the Cardiovascular Health Study (CHS) score, and those who consented to participate. Exclusion criteria: patients with dementia, Alzheimer\u0026apos;s disease, chronic diseases (malignancies, uncontrolled diabetes, chronic kidney failure, cirrhosis), severe physical mobility disorders, and acute infections.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec.\u0026nbsp; \u0026nbsp;Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe independent variables of this study include muscle strength, physical performance, and IL-6 levels. The dependent variable is cognitive function in frail geriatrics. Muscle strength was measured using handgrip strength, physical performance was measured by the 5 Times Chair Stand Test, and IL-6 levels were measured from venous blood samples. Cognitive function was evaluated using the MoCA-INA questionnaire (Montreal Cognitive Assessment Indonesia version).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ed.\u0026nbsp; \u0026nbsp;Statistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analysis was conducted using correlation and multiple linear regression to assess the relationships and effects of muscle strength, physical performance, and IL-6 levels on cognitive function. All analyses were performed with a significance level of p\u0026lt;0.05.\u003c/p\u003e"},{"header":"RESULT AND DISCUSSION","content":"\u003cp\u003e\u003cstrong\u003ea.\u0026nbsp; \u0026nbsp;Basic Characteristic Data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnivariate analysis was used to explain and describe the characteristics of each research variable. The characteristics of the research subjects can be seen in table 1.1 below. In the table, it can be seen that the highest number of patients in the age range of 71-80 years, as many as 23 (56.1%) consisting of 11 (26.8%) male patients and 30 (73.2%) female patients. The range of patient education varies but is dominated by patients with a bachelor\u0026apos;s degree as many as 14 (34.1%) patients. From the body weight data, 12 (29.3%) patients were categorized as overweight. Some patients can still carry out daily activities independently as many as 29 (70.7%) patients. Patients who have a smoking habit are 5 (12.2%) patients. While patients who have comorbid hypertension are 29 (95.1%) patients and those who have comorbid diabetes mellitus are 15 (36.6%) patients.\u003c/p\u003e\n\u003cp\u003eFrom the results of the study we got the average among respondents respectively for muscle strength, physical performance, IL-6, and cognitive function of 16.38 kg, 18.07 seconds, 7.90 pg/mL, and a cognitive function score of 22.02 points.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.1.\u003c/strong\u003e Basic Characteristic Data\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"551\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFrek. (N=41)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 \u0026ndash; 70 y.o\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e71 \u0026ndash; 80 y.o\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;80 y.o\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e73.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOut of school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eElementary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eJunior High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSenior High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUndergraduate/ Barchelor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBody Mass Index (BMI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOverweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eObesitas I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eObesitas II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eComorbid\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHipertension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDiabetes Melitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHipertension and Diabetes Melitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcivity Daily Living\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(ADL)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIndependent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMild Dependency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate Dependency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSmoking Habbit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.2.\u003c/strong\u003e Avarage Examination Result Score\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"548\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eParameter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMin.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMaks.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAverage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMuscle Streght\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16,38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhisical Performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9,04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41,19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18,07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIL-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1,5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e134,90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7,90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.61\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCognitive Function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22,02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn the age range of 71-80 years, there is an increased prevalence of heart disease, hypertension, and diabetes mellitus (Rahman \u003cem\u003eet al.,\u003c/em\u003e 2020). Patients with a bachelor\u0026apos;s degree are more likely to have access to better health services and lead a healthy lifestyle (Williams \u003cem\u003eet al.,\u003c/em\u003e 2022). Higher education is also associated with reduced incidence of chronic diseases, as individuals with higher education are often exposed to better health information (Hoffman \u0026amp; Stokes, 2019). According to research by Jones \u003cem\u003eet al.\u003c/em\u003e (2021), obesity is a major risk factor for many age-related chronic diseases, including cardiovascular disorders, diabetes, and muscle and joint problems. Hypertension can affect heart and kidney function, while diabetes mellitus is associated with vascular damage and an increased risk of cognitive impairment. According to research by Singh \u003cem\u003eet al.\u003c/em\u003e (2022), patients suffering from hypertension and diabetes mellitus often show impairments in their physical and cognitive functions.\u003c/p\u003e\n\u003cp\u003eBivariate analysis was performed using the Kolmogorov-Smirnov test to determine the normality of the data. From the analysis that has been done, the value of p = 0.439 (p\u0026gt;0.05) is obtained, so the data has a normal distribution.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eb.\u0026nbsp; \u0026nbsp;Effect of Muscle Strength on Cognitive Function\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBivariate analysis showed a significance of p=0.045 (p\u0026lt;0.05) so that it can be said to have a relationship. This study shows that there is a significant negative relationship between muscle strength and cognitive function scores, where decreased muscle strength is associated with decreased cognitive ability. For example, Kobayashi-Cuya \u003cem\u003eet al.\u003c/em\u003e (2018) suggested that decreased muscle strength may worsen blood flow to the brain, which in turn increases the risk of cognitive function decline (Kobayashi-Cuya \u003cem\u003eet al.,\u003c/em\u003e 2018). This is in line with findings from Kim and Kim (2022), who showed that lower hand strength is associated with decreased cognitive performance among older adults (Kim and Kim, 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Statistical Analisis Result of The Effect of Muscle Strength on Cognitive Function\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"94%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eModel\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUnstandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003et\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eB\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStd. Error\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003e(constant)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e18,805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1,643\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e11,443\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eMuscle Streght\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e2,066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e0,045\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFrom the table it can be concluded that every increase of 1 score of muscle strength will increase cognitive function by 0.191. From the data analysis also obtained R\u003csup\u003e2\u003c/sup\u003e value of 0.099 which means that muscle strength affects cognitive function by 9.9%, statistically significant.\u003cstrong\u003e\u003cbr\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ec. \u0026nbsp; Effect of Physical Performance on Cognitive Function\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBivariate analysis showed a significance of p=0.010 (p\u0026lt;0.05) so that it can be said to have a relationship. Physical performance, as measured by the 5-time sit to stand test (5TSTS), showed a significant negative correlation with cognitive function in the elderly population. Decreased ability to perform simple physical tasks, such as standing up from a seated position, may reflect more profound motor and cognitive impairments. Alves \u003cem\u003eet al.\u003c/em\u003e (2021) emphasized that limited physical performance in the elderly is often associated with faster cognitive decline, where individuals who have difficulty performing simple physical activities tend to have lower cognitive scores (Alves \u003cem\u003eet al.,\u003c/em\u003e 2021). Research by Dodds \u003cem\u003eet al.,\u003c/em\u003e (2021) also showed that poor performance in the 5TSTS test is associated with an increased risk of disability and decline in cognitive function, confirming the importance of physical performance measurement in the context of cognitive health (Dodds \u003cem\u003eet al.,\u0026nbsp;\u003c/em\u003e2021).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Statistical Analisis Result of The Effect of Physical Performance on Cognitive Function\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"96%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eModel\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUnstandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003et\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eB\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStd. Error\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003e(constant)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e22,370\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1,458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e15,338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003ePhisical Performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,075\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,041\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e2,256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e0,010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFrom the table it can be concluded that every increase of 1 score of physical performance will increase cognitive function by 0.019. From the data analysis also obtained R\u003csup\u003e2\u003c/sup\u003e value of 0.002 which means that physical performance affects cognitive function by 0.2%, statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ed. \u0026nbsp; Effect of Interleukin-6 on Cognitive Function\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBivariate analysis showed a significance of p=0.002 (p\u0026lt;0.05) so that it can be said to have a relationship. Interleukin-6 (IL-6) as an inflammatory biomarker has shown a significant association with cognitive function decline. Increased levels of IL-6 in the body are associated with decreased cognitive scores, which suggests that systemic inflammation can accelerate degenerative processes in the brain. Lin \u003cem\u003eet al,.\u003c/em\u003e (2018) confirmed that high inflammation, reflected by elevated IL-6, may worsen cognitive ability in elderly individuals (Lin \u003cem\u003eet al.,\u003c/em\u003e 2018). Other studies have shown that IL-6 plays an important role in the mechanisms underlying cognitive decline, with evidence that high levels of IL-6 can trigger neuronal damage and accelerate the progression of cognitive impairment (İvecek, Şekerci and S\u0026uuml;mb\u0026uuml;l Şekerci, 2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u003c/strong\u003e Statistical Analisis Result of The Effect of Interleukin-6 on Cognitive Function\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"553\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eModel\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eUnstandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStandardized Coeficients\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003et\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eB\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eStd. Error\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eBeta\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cem\u003e(constant)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e22,054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e37,340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eIL-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0,004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,027\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e3,137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0,002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFrom the table it can be concluded that every increase of 1 IL-6 score will reduce cognitive function by 0.004. From the data analysis also obtained R\u003csup\u003e2\u003c/sup\u003e value of 0.001 which means IL-6 affects cognitive function by 0.1%, statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ee.\u0026nbsp; \u0026nbsp;Effects of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Functioning\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMultivariate analysis showed that the significance value of p\u0026lt;0.05 so that it can be said that there is a relationship between muscle strength, physical performance, IL-6 on cognitive function. A decrease in muscle strength and physical performance, along with an increase in IL-6, can increase the risk of cognitive decline. Research by (Zhang \u003cem\u003eet al.,\u003c/em\u003e 2020) found that increasing muscle strength and physical performance can reduce inflammation, which in turn slows the decline in cognitive function in the elderly (Zhang \u003cem\u003eet al.,\u003c/em\u003e 2020). Furthermore, Park and Kim (2022) emphasized that regular physical activity serves as a protective factor against frailty and cognitive decline (Park and Kim, 2022). The link between inflammation, muscle strength, and cognitive function is also reinforced by research showing that high IL-6 levels are associated with cognitive decline, and that increasing muscle strength can reduce IL-6 levels (Liu \u003cem\u003eet al.,\u003c/em\u003e 2018).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u003c/strong\u003e Statistical Analisis Result of The Effects of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Functioning\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"95%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariabel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eb\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;(regression coeff.)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCI 95%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper Margin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower Margin\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eConstanta\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18,289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eMuscle Streght\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-10,600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-3,782\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003ePhisical Performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-1,65117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8,85420\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eIL-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0,006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-10,69331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18,94749\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eN observation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eAdjusted R\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0,029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003ep model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0,03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe results of this study indicate that each increase in 1 score of muscle strength will increase cognitive function by 0.201 (p=0.040), statistically significant. Every increase of 1 physical performance score will increase cognitive function by 0.017 (p=0.030), statistically significant. Every 1 increase in IL-6 score will decrease cognitive function by 0.006 (p=0.037), statistically significant. Muscle strength, physical performance, and IL-6 together affect cognitive function by 2.9%, the remaining 97.1% is influenced by other factors not examined in this study.\u003c/p\u003e"},{"header":"CONCLUSSION AND SUGGESTION","content":"\u003cp\u003eThis study concluded that there is a significant influence between muscle strength, physical performance, and interleukin-6 levels on cognitive function in geriatrics with frailty. Decreased muscle strength and physical performance and increased IL-6 were associated with worsening cognitive function.\u003c/p\u003e\n\u003cp\u003eThe suggestion from this study is the importance of a multifactorial intervention program that includes structured physical exercise and inflammation control to prevent or slow the decline in cognitive function in the elderly with frailty. Future research is recommended to use a longitudinal design with a larger sample size to confirm the causal relationship.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and consent to participate: \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted after obtaining ethical approval from the Ethics Commission of Dr. Moewardi Hospital / Faculty of Medicine, Universitas Sebelas Maret (UNS), Surakarta, Indonesia (Number: 567/II/HREC/2024). The study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent to participate was obtained from all participants involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData described in the manuscript, code book, and analysis code will be available upon request and approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank all who participated in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlves JFN et al. (2021) \u0026lsquo;Association between physical functioning with cognition among community-dwelling older adults: a cross-sectional study\u0026rsquo;. Geriatr Gerontol Aging, 15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen LK, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300\u0026ndash;e3072.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDodds RM, et al. Prevalence and factors associated with poor performance in the 5-chair stand test: findings from the Cognitive Function and Ageing Study II and proposed Newcastle protocol for use in the assessment of sarcopenia. J Cachexia Sarcopenia Muscle. 2021;12(2):308\u0026ndash;18.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDu H, et al. Association between sarcopenia and cognitive function in older Chinese adults: Evidence. from the China health and retirement longitudinal study\u0026rsquo;; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHamidi M, Joseph B. Changing Epidemiology of the American Population. Clin Geriatr Med. 2019;35(1):1\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoffman JA, Stokes R. Education level and its impact on health outcomes in chronic disease management. J Health Educ Res Dev. 2019;37(2):125\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eİvecek H, Şekerci A, S\u0026uuml;mb\u0026uuml;l Şekerci B. IL-6 Levels And Cognitive Complications In Patients With Type 2 Diabetes Mellitus: A Cross Sectional Study. Ankara Universitesi Eczacilik Fakultesi Dergisi. 2024;48(3):24\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones SE, et al. Obesity and chronic diseases: A study on elderly populations. Int J Obes. 2021;45(5):1042\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim K, Kim H. Handgrip Strength and Cognitive Function among Elderly Koreans: Insights from the Korean Longitudinal Study of Ageing. Int J Environ Res Public Health. 2022;19(9):5262.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKobayashi-Cuya KE, et al. Observational Evidence of the Association Between Handgrip Strength, Hand Dexterity, and Cognitive Performance in Community-Dwelling Older Adults: A Systematic Review. J Epidemiol. 2018;28(9):373\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin T et al. (2018) \u0026lsquo;Systemic Inflammation Mediates Age-Related Cognitive Deficits\u0026rsquo;. Front Aging Neurosci, 10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu Z, et al. Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes. J Am Med Dir Assoc. 2018;19(4):304\u0026ndash;e3092.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePapadopoulou SK. (2020) \u0026lsquo;Sarcopenia: A Contemporary Health Problem among Older Adult Populations\u0026amp;#8217.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePark D, Kim H-S. The Factors Affecting Frailty among the Elderly in Korea: A Study Using the Frailty Cohort. Int J Environ Res Public Health. 2022;20(1):670.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRahman MS, et al. Age-related prevalence of chronic diseases in elderly populations. J Gerontol. 2020;75(3):406\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh SR, et al. Diabetes and hypertension: Effects on physical and cognitive functions in older adults. J Clin Med. 2022;11(4):899.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilliams RM, et al. Higher education and health literacy in chronic disease management. J Health Communication. 2022;27(4):334\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang Y, et al. Development of frailty subtypes and their associated risk factors among the community-dwelling elderly population. Aging. 2020;12(2):1128\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"muscle strength, physical performance, IL-6, cognitive function","lastPublishedDoi":"10.21203/rs.3.rs-6663721/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6663721/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e The geriatric population is experiencing significant growth, which has led to increased attention to health issues that arise with aging, one of which is frailty. Frailty in the elderly is associated with impaired stress tolerance due to the decline in the function of various body organs, including sarcopenia and cognitive decline. This study aims to investigate the effects of muscle strength, physical performance, and interleukin-6 (IL-6) levels on cognitive function in frail geriatrics.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e This observational study involved 41 geriatric patients over the age of 60 who met the pre-frail and frail criteria based on the Cardiovascular Health Study (CHS) score. Data were collected through handgrip strength measurements for muscle strength, 5 time stand chair test for physical performance, and blood IL-6 levels. Cognitive function was assessed using the MoCA-INA questionnaire.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResult: \u003c/strong\u003e\u003c/em\u003e\u003cem\u003eThe results showed a significant relationship between muscle strength, physical performance, and IL-6 levels with cognitive decline in frail geriatrics. Overall, the decline in muscle strength and physical performance, along with increased IL-6 levels, can exacerbate cognitive function in elderly individuals with frailty.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclussion:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e This study suggests the need for interventions that integrate the improvement of muscle strength and physical performance to prevent or delay cognitive decline in frail geriatrics.\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"The Effect of Muscle Strength, Physical Performance, and Interleukin-6 on Cognitive Function in Frail Geriatrics","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-03 21:05:10","doi":"10.21203/rs.3.rs-6663721/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a1afce17-a1e9-4c6d-87f1-ce56fe518270","owner":[],"postedDate":"June 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-23T10:53:57+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-03 21:05:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6663721","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6663721","identity":"rs-6663721","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}