DOI. 10.5281/zenodo.

3365503
Suhari, et.al. International Conference of Kerta Cendekia Nursing Academy.
Copyright © 2019 September; 1: 57-62
Accepted: July 11, 2019
http://ejournal-kertacendekia.id/index.php/ICKCNA/

© 2019 INTERNATIONAL CONFERENCE OF KERTA CENDEKIA NURSING ACADEMY

ORIGINAL RESEARCH E-ISSN:

BRAIN GYM IMPROVES COGNITIVE FUNCTION FOR ELDERLY

WITH DEMENSIA

Suhari1*, Anggia Astuti1, Primasari Mahardhika Rahmawati1, Musviro1

1
Diploma 3 Program of Nursing, Jember University

*Correspondence:
Suhari
Email: kanghari_doktor@unej.ac.id

ABSTRACT
Background: Dementia is a combine of clinical symptoms caused by various background diseases and is characterized by loss of short-
term memory, global disorders, mental functions (including language functions), withdrawal of abstract thinking skills, difficulty in caring
for himself, behavioral changes, emotional instability and loss of time recognition and place. Brain gym is one of the exercises to improve
cognitive performance on elderly with dementia.
Objectives: This study was to determine the effect of brain gym on cognitive performance on elderly with dementia in Social Service Unit
Tresna Werdha Jember.
Methods: A Quasy Experimental design was done to conduct 30 elderly with dementia were recruited using purposive sampling divided
into 2 groups, experimental and control group. The independent variable of research this study was brain gym and the dependent variable
was cognitive function at elderly. Data were collected by using MMSE score and then analyzed using Wilcoxon Signed Rank Test with
level of significance α ≤ 0.05.
Results: The results identified a significant influence between the implementation of Brain Gym to improve cognitive function in the
elderly with dementia.
Conclusion: Brain gym increase cognitive performance on elderly with dementia.

Key words: Elderly, brain gym, cognitive function, dementia.

INTRODUCTION estimated that in 2017 there will be 23.66

The neurological system, especially million elderly people in Indonesia
the brain, is a major factor in adaptive (9.03%). It is predicted that the number of
aging. This aging process occurs in a elderly people in 2020 (27.08 million),
degenerative manner which affects changes 2025 (33.69 million), 2030 (40.95 million)
in the elderly, one of which is a change in and 2035 (48.19 million).
cognitive function. Changes in cognitive The cognitive function of the elderly is
function can affect daily activities and even influenced by age, regeneration ability in
daily dysfunction in elderly people who the brain, vascularity inadequacy to the
have dementia (Nugroho, 2008). brain and hormones. In addition, risk
There are 47 million people suffering factors that can affect the decline in
from Alzheimer's dementia in the world, cognitive function are the offspring of the
and as many as 22 million of them are in family, education level, brain injury,
Asia. Based on population projection data poisons, not doing physical activity, and
of the Indonesian Ministry of Health's data chronic diseases such as Parkinson's, heart
and information center (2017), it is disease, stroke and diabetes (Sauliyusta &
INTERNATIONAL CONFERENCE OF KERTA CENDEKIA NURSING ACADEMY-2019 57
Rekawati, 2016). Dementia is progressive, dependent variable is the cognitive function
where the structure and chemistry of the of the elderly.
brain becomes more damaged over time.
The ability of the elderly to remember, Instruments
understand, communicate and reason Data collection and collection during
gradually decreases. This condition results the research was obtained through a direct
in the disfunction of everyday life. observation process to respondents. The
Brain gym is one method of improving instrument for assessing cognitive function
cognitive function in the elderly. According in this study was using the Mini Mental
to Munir (2015), this exercise can stimulate State Examination (MMSE) instrument.
good physical and brain activity. Dennison Ah. Yusuf, Indarwati and Jayanto (2016)
(2008), states that the brain gymnastic explained that there were five domains of
movement activates the neural relationship cognitive functions assessed in the MMSE
between the body and the brain, so that the instrument, namely orientation,
flow of electromagnetic energy throughout registration, attention and counting, recall,
the body becomes good. This is consistent and language skills described in 11 question
with the study of Yusuf, Ah, et al. (2010) items. The interpretation of the results in
which states that there is an influence of the MMSE instrument is that if the MMSE
brain gymnastics on improving cognitive value is in the range of 27-30 then it is
function in the elderly. The difference with included in the category of good cognitive
previous research is that this study was function, if the MMSE value is in the score
conducted on elderly people who range of 22-26 it is included in the category
experience dementia. Brain gym of sufficient cognitive function, and if the
interventions are expected to improve MMSE value is less than or equal score 21
cognitive function in elderly people who then included in the category of cognitive
experience dementia. function is less. The instrument used as a
reference in the implementation of brain
METHODS gymnastics (Brain Gym) is to use the
Study Design Standard Operating Procedure (SOP) of
The design used in this study is a brain gymnastics. Giving brain gymnastics
quasy-experiment pre-posttest control in the intervention group was 4 times a
group design. week for 1 month with the duration of each
meeting 15-20 minutes. The
Setting implementation of group brain exercises
This research was conducted at UPT was aimed at 15 respondents in the
PSTW Jember from October to November intervention group. The researcher led the
2018. way of brain gymnastics which was
accompanied by a homestead companion at
Research Subject UPT PSTW Jember. Post-tests were
The samples used in this study were 30 conducted after 1 month to determine
elderly with purposive sampling with the differences in cognitive function in the
criteria of elderly aged 60–80 years and intervention group.
physically and mentally healthy. The
independent variable in this study is brain Data Analysis
gymnastic method (Brain Gym), while the The data analysis process in this study
used SPSS through the Wilcoxon signed

INTERNATIONAL CONFERENCE OF KERTA CENDEKIA NURSING ACADEMY-2019 58

rank test statistical test to determine the Level of Cognitive Function of the Elderly
differences in the scores of the pre-test and
post-test level of cognitive function of the Table 2. Level of Cognitive Function of the
intervention group and the control group Elderly Aged 60-80 Years at UPT PSTW
with a significance level of α ≤ 0.05. Jember in October-November 2018 (n = 30)

Ethical Consideration Control Intervention

This research has gone through an pre post pre post
Mean 7.00 7.00 5.50 8.62
ethical test from the Jember University and p=0.802 p= 0.013
obtained permission from UPT PSTW
Jember. Distribution of cognitive function
levels in the elderly intervention group
RESULTS before being given brain gymnastics (pre-
Characteristic of Respondents test) as many as 13 elderly (86.67%) had
less cognitive function levels, 13.33%
Table 1. Characteristics of Elderly elderly with sufficient cognitive function
Respondents Aged 60–80 Years at UPT and 0% elderly with good cognitive
PSTW Jember in October-November 2018 function. The results of the pre-test level of
(n = 30) cognitive function in the control group also
found that most of the elderly had a level of
Characteristics of Respondents n % cognitive function that is less than 9 elderly
Male 8 26,67 (60%), 40% of the elderly with sufficient
Gender cognitive function and 0% of the elderly
Female 22 73,33
Did not finish with good cognitive function.
elementary 22 73,33 The results showed an increase in
school cognitive function of the elderly in the
Educational Finish
intervention group after being given
history elementary 7 23,33
school treatment in the form of brain exercise for 1
Finish Junior month. The number of elderlies with
1 0,33
High School sufficient cognitive function increased to
Work Work 21 70,00 33.33%, 0.67% of the elderly experienced
employment
Not working 9 30,00 an increase in cognitive function to be good
status
and there was a decrease in the number of
elderlies with less cognitive function i.e.
Based on table 1 above, it can be seen
86.67% decreased to 53.33%. The post test
that the majority of respondents are female,
results in the control group showed an
the education status does not complete
increase in the number of elderlies with less
elementary school (SD) and the majority
cognitive function i.e. 60% to 66.67%,
have a history of work.
33.33% to the elderly with less cognitive
function and 0% to elderly with good
cognitive function.
The results of the Wilcoxon signed
rank test statistical test data calculation
showed that there were differences in
cognitive function scores between the
intervention groups given brain gymnastics
INTERNATIONAL CONFERENCE OF KERTA CENDEKIA NURSING ACADEMY-2019 59
which were indicated by a significance center can be alerted again with brain
value of p = 0.013. whereas in the control gymnastics (Pratiwi, 2016).
group there was a significance value of p> This fun motion exercise in brain
0.005 which is the value of p = 0.802 so that gymnastics is the core of educational
it can be said that there was no significant kinesiology, abbreviated as Edu-
difference between the scores of cognitive Kinesthetic (Edu-K), a method developed
functions before and after the control by Paul E. Dennison, an educator in
group. America and director of the Word Remedial
Valley 4 Word Learning Center. education
DISCUSSION comes from the Latin word educate which
Aging and being elderly for some means to pull out, while kinesiology comes
people can be a burden. Elderly people will from the Greek kinesis which means
begin to lose independence, both physically movement. Education Kinesiology is a way
such as limited mobility, and to pull out or display potential in a student
psychologically such as cognitive damage. of any age that was originally locked,
Elderly people will experience a decline in through these simple movements believed
cognitive and psychomotor functions. to be able to stimulate all parts of the brain
Cognitive functions include the process of so that they can open parts of the brain that
learning, orientation, understanding, were previously blocked (As'adi, 2011)
understanding and attention. This will Scientists have conducted research and
cause the reaction and behavior of the concluded that people who experience a
elderly to be slower (Joseph, 2010). decline in cognitive function must make top
Elderly people can remain active in priority to improve quality of life. Having a
various ways according to their level of higher level of education accompanied by
education and social background. The brain being in a higher social stratum is assumed
that is rarely used will decrease its function, to reduce cognitive decline (Ahmad, 2006).
therefore maintaining the potential of the Based on demographic data on the results
brain in the aging process is very important. of the study indicate that the elderly who
Learning and continuing to do activities is have a history of graduating education have
the key to stimulation of the brain, if this an MMSE value that is better than the
stimulation is given continuously it can elderly who have a history of not
improve human intelligence until the age of completing education.
80-90 years (Denniso, 2006 in Pratiwi, Lesmana (2006) in Yusuf (2010) states
2016). that work experience had an impact on the
Brain gymnastics (brain gym) is one of quality of the elderly thinking process. The
the stimulations to optimize, stimulate brain results of the study of the majority of the
function to be more relevant to the elderly, elderly have a work history as farm laborers
facilitate blood flow and oxygen to the and coolies. They fall into the category of
brain. Brain gymnastics (brain gym) is a heavy cognitive function, while those who
series of simple movements that are fun and have a work history of traders, farmers,
are used to improve learning skills by using tailors have good cognitive functions. The
the whole brain. Brain gymnastics is useful author assumes that good cognitive
to raise awareness and reflex of the elderly function seen from the history of work is
who have been lost. RAS (reticular associated with the habits of the elderly
activating system) or someone's alertness thinking and counting which is an activity
of training the brain.

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 Brain gym provides a stimulus for Brain gymnastics can activate three
repair of the fibers in the corpus collosum dimensions of the brain. The concentration
which provides many two-way neural dimension can increase blood flow to the
connections between the cortical areas of brain, and increase oxygen reception. The
both brain hemispheres, including the lateral dimension will stimulate the
hippocampus and amygdale. The brain coordination of the two hemispheres of the
gymnastic movement reactivates the neural left brain and right brain (improve
connections between the body and the brain breathing, stamina, release tension and
so as to facilitate the flow of reduce fatigue). Focusing dimensions to
electromagnetic energy throughout the help release focus barriers from the brain
body. This movement supports electrical (improve lack of attention and lack of
and chemical changes that take place on all concentration).
mental and physical events (Joseph, 2010).
The role of the hippocampus in CONCLUSION
consolidation as a cross-reference system, Routine brain gymnastics (brain gym)
which links certain aspects of memory can improve cognitive function of the
stored in separate parts of the brain so as to elderly with dementia.
increase nucleic acids in changes in
neuronal memory. Synapse affects the SUGGESTION
processing of information or data received With the results of this study, it is
so that people will store information in their expected that health workers can make the
memory. Repair of synapse function can results of this study as input in providing
affect the performance of the cerebral services to the elderly to improve the
cortex involved in the process of new cognitive function of the elderly by
information as a pathway to the cortex for providing routine brain gymnastics.
permanent memory storage. The cerebral
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