Introduction

Malaysia as a developing country will feel aging residents in the nearest future.
Malaysia's progress in achieving status old countries are faster than developed
countries. This is because the second demographic transition experienced applies in
context the development of sophisticated medical technology. Gold citizen on
Malaysia will double from 7% to 14% in the 28th term only years compared to
Sweden which has taken time for 112 years for the same changes (United Nations
Development (PBB), 2007). In this connection, Malaysia is not able to afford to dwell
on the issues related to aging population.
Following UN recommendations (2009), Malaysia will achieve the status
old country in 2030 if the population is 60 years old and upwards of 15% of the total
population. This is meaningful Malaysia will be an old country ahead of the Malaysia
Plan 14th. Recognizing this nature, the Kingdom has taken a step initial supplies to
deal with population aging issues with Publication of Dasar Warga Tua Negara in
1995..
"Constructive position" - a person who has such a position, as a rule, all his life is
calm, energetic and cheerful. They retain these characteristics in old age. They are
positive about the life they enjoy, and, at the same time, are able to reconcile
themselves with the approaching death, without fear. They are active, eager to help
others. They do not do tragedy for old age and their discomfort, they seek
entertainment and relationships with the public. People like this, most likely, live
safely throughout their lives.
1.Review of the video clip.

Communication Network Environment show the development of technology and its

use in various aspects of human life. This is explained based on the theory of
technology determinism which details how technology plays a role in facilitating the
daily affairs of society through the "idea of progress" or "doctorine of progress" which
shows technology offers solutions to "social problems" through "technological
advancement" that brings progress to human life ( Miller, Sarah, 1997).

The elderly and the development of communication technology are not new issues in
the study of social sciences and humanities (Prensky 2001). Although the majority of
studies on the implications of communication technology are often focused on
adolescents or youth, senior citizens are also associated with this phenomenon (Xie
2007).
This is because they are also in the digital communication network environment that
is happening at the moment. In fact, studies in this age category were also conducted
by researchers such as Furlong 1989; Wright 2000; Kanayama 2003 and Xie 2007 in
unraveling the issues behind technological developments. Various studies on the use
of media and technology were conducted to unravel the issues faced.
2.Advantages of Social Media

Easy to make connections

In fact, senior citizens who often browse social sites will have many contacts without
them realizing it. The social site accepts the registration of all senior members of any
restriction which causes anyone to contact any party they wish. It is this situation that
causes the senior citizen to have thousands of friends with just one touch of a finger.
In short, social sites can be used as a tool to gain more contacts in this world.
As we all know, the use of social sites can add new contacts from all over the world
as well as long-lost relationships can be re-established. Facebook, WhatsApp and
Telegram applications are suitable options for this scenario. We can select senior
citizens at any time either at our request or at the request of other partner account
owners. Comments on pictures of individual activities that are uploaded continuously
will strengthen the relationship among friends. This social site can be used as a main
vehicle to find old contacts who have been cut off. Through social media they can
find out the careers that have been pursued by friends and can interact with each other
and then tie their relationship like aur with a cliff. They can also convey information
such as holding a meeting somewhere by gathering friends as a 'reunion' activity. This
thing becomes easy because it can save time and energy by using the facilities that are
in front of the eyes. It is clear that in addition to being able to find old friends again,
social media can also add new and distant new contacts to senior citizens

Positive Thinking and Confident

Furthermore, social sites also provide space and opportunities for senior citizens to
share their voices depending on current issues that want to be highlighted. This can be
done among friends, the mass media and the public, artists and fans, even between
leaders and the people as a field of communication.
With this new communication medium such as the Twitter application, it indirectly
allows senior citizens such as video viewers to get to know their favorite artists more
closely when they have the opportunity to read any comments written by each artist
Increased enthusiasm and motivation
However, studies also prove that this social site has a positive impact such as being a
senior citizen to express their feelings. Modern day life is full of stress such as the
stress of material life and the pressure to succeed that affects the emotional health of
the individual. The existence of such a site makes it easier for senior citizens to write
about their anxiety and then cure the depression. So, senior citizens can find peace of
mind when expressing their feelings through writing on the social site.

3. Discussion

The process of biological aging is inevitable and uncontrollable; often associated with
disease. However, there are many factors in your control to help prolong life and more
importantly ensure a high quality of life. Studies in the field of psychology have
concluded that aging is not necessarily the cause of disease, but rather the result of a
lack of a healthy lifestyle.
Although people can generally look forward to good health for many years, studies
have shown that three-quarters of adults aged 65 and over live with one or more
chronic diseases. This indicates that it is estimated that 3.9 million people (39% of
adults aged 65 and over). If preventive measures are not taken against diseases related
to this age, projections say that by 2030 there will be more than six million people
suffering from long-term illness or disability
In 2017, a study on life expectancy in adults has concluded that a healthy lifestyle can
increase the life expectancy of men over 65 years with 8 years and a woman over 65
years with 10 years.
Early Signs of Decreased Health in Older Adults
If you are concerned about the health of aging you like, the first step is to measure the
following symptoms:

Weight / Weight
Hearing loss
Decreased Vision
Weak mobility
Depression
Memory Loss / Dementia
If you notice any of these symptoms, the first step is to consult a physician.

Healthy Lifestyle for Older Adults - physical, mental and social well-being
Healthy aging is associated with more than just improving physical health. The role of
social and mental well-being in older adults is often considered less important to lead
a high quality life.

The healthy aging process involves increasing life expectancy and improving the
quality of life of the elderly as well as optimizing opportunities for greater and
healthier participation in the community and socializing with family and friends. In
many cases, lack of social support has proven to be a negative influence on the well-
being of the elderly.

Physical
Healthy diet and nutrition: A balanced diet along with adequate water intake is a
reliable measure of negative health effects, including weight gain, the development of
insulin resistance, digestive problems or atherosclerosis. Research shows that a diet
high in fiber and low in saturated fat and added sugars - like the Mediterranean diet -
are good choices for most.
Physical activity: Physical Exercise for older adults helps maintain strength, mobility
and balance, resulting in improved physical health and lower risk of falls. In cases
where parents have limited mobility, leisurely walks in the park can be beneficial.
Quality sleep: Researchers have found that sleep-deprived adults are prone to
cardiovascular disease, increased levels of inflammatory blood markers, and a
weakened immune system. Lack of sleep can cause fatigue, affecting the physical and
mental health of individuals.

Physical health
Physical health plays an active role in leading a healthy lifestyle and is a conscious
effort taken daily.

Mental and Social Health

Your brain training: The most effective brain activity for older adults is to engage in
meaningful activities, such as engaging in volunteering or hobbies such as gardening,
sewing and painting. Cultivating these skills enhances their thinking ability,
benefiting their psychological health.
Stay in touch with loved ones: Communicating with loved ones brings a sense of
belonging and reduces the chances of loneliness and depression. Building connections
in community programs, old connective groups and other social activities can combat
social isolation. Involvement in social activities also lowers the risk of decreased
cognitive ability
Relation between the clip and three topics from module.

4.1 The Aging Process

4.1.1 Definition
The aging process is a process of slowly disappearing
network ability to improve or replace oneself and
maintain its normal structure and function so that it can not withstand the impact
(including infection) and repair the damage suffered (Darmojo, 1994).

The aging process is defined as time-related changes, which are universal, intrinsic,
progressive and detrimental. Such conditions can lead to a lack of ability to adapt to
the environment to survive (Nugroho, 2008)
Advanced Age Limits
Old age restrictions based on various literature have not been provided
satisfactory answer, so it seems there is no definite limitation. In summary from
various expert opinions, the elderly are people aged 65 and over
Here are some expert opinions on age restrictions:
According to WHO, there are four stages namely:
a) Middle age (middle age): 45-59 years
b) Elderly: 60-74 years
c) Old age: 75-90 years
d) Very old age: over 90 years
According to Prof.Dr.Koesoemanto Setyonregoro, Sp.KJ
a) Elderly adulthood: 18 / 20-25 years
b) Full age (middle years): 25-60 / 65 years
c) Advanced age (geriatric age, over 65/70 years)
divided into:
i. Age 70-75 years old (young old)
ii. Age 75-80 years old (old)
iii. Age over 80 years (very old)
3. According to Burnside (1979), there are four stages of aging:
a) Young old (age 60-69 years)
b) Middle age old (age 70-79 years)
c) Old-old (80-89 years old)
d) Very old old (age 90 and above)

Physiological Changes in the Elderly

The older a person gets, the more likely it is that there will be a negative and
functional decrease in his or her organs. The introduction of the 1% law states that
organ function will decrease by one percent each year after the age of 30 years. Signs
of aging are not on the appearance of organs or organisms at rest, but on how
organisms can adapt to external stress (Kane et al, 1994).
According to Boedhi Darmodjo (2004) old age is not a disease or illness, but is an
increase in sensitivity or decreased adaptation ability often known as geriatric giant,
where the elderly will experience 13 i, namely:
1. Immobilization
2. Instability (easy to fall)
3. Disturbed intellectuality (dementia)
4. Isolation (depression)
5. Incontinence
6. Impotence
7. Immunodeficiency
8. Infections are easy to occur
9. Impaction (constipation)
10. Iatrogenesis (error diagnosis)
11. Insomnia
12. Impairment of (impaired vision,
hearing, tasting, olfactory, communication
and skin integrity
13. Inaniation (malnutrition).
Here are the changes that occur in the elderly in various
body organ system:
4.1.4.1 Sensory System
Morphological changes occur in the eyes, ears, nose, sensory nerves in the tongue and
in the skin. These changes have an impact on functional anatomy in the various five
sense organs both in the function of seeing, hearing, balance or taste and touch.
Older people generally suffer from presbyopia due to the reduced elasticity of the lens
so that they cannot see the distance clearly. In the elderly there is also a decrease in
sensitivity to color and a decrease in the ability to see objects at a low level of
illumination (Maryam et al, 2008).
Older people also experience a loss of ability to hear high-frequency tones as a result
of degeneration of cortical organs (hair cells) and loss of neurons in the cochlea
(Darmojo, 2014).
Taste system, there is a decrease in the sensitivity of the speaker papillus, especially
to the sweet and salty taste. This occurs due to the cessation of the growth of
seasoning buds located on the tongue and on the inner surface of the cheeks. While in
the olfactory system. Elderly olfactory capacity also decreases with increasing age
due to the growth of cells in the nose stopsor because of the thickness of the hair
follicles in the nostrils. While in the elderly it is often found that the skin becomes
drier and harder so that the sense of touch on the skin becomes more sensitive.

4.1.4.2 Intestinal Gastro System

Physiological changes in the elderly in the gastrointestinal system are atrophic
changes in the jaw until younger teeth are removed. Atrophic changes also occur in
the mucosa, glands and digestive muscles. These morphological changes will cause
functional changes to pathological changes, including urinary and swallowing
disorders as well as changes in appetite.
4.1.4.3 Cardiovascular System
The elderly experience a decrease in the ability to pump blood
thus decreasing its contraction and volume. This condition is compounded by a
decrease in elasticity as well as an increase in peripheral vascular resistance so that
the average blood pressure in the elderly increases.

4.1.4.4 Respiratory System

The strength of the respiratory muscles decreases, the elasticity of the lungs
decreasing, residual capacity increases so that breathing is heavier
4.2. Cognitive in the Elderly
Cognitive Definition
Cognitive comes from the Latin cognosere (meaning “for
knowing ”or“ to recognize ”) refers to the ability to process information, apply
knowledge and change tendencies (Nehlig, 2010). Cognitive Function is a mental
process performed by a person to regulates information such as obtaining input from
the environment (perception), selecting (attention), representing (understanding), and
storing (memory) information and ultimately guiding behavior (reasoning and
coordination of motor output). (Briton and Marmot, 2003).
4.2.1 Cognitive Domain
a. Attention
Attention is the ability to follow a specific stimulus without being disturbed by
external stimuli. Attention is the result of the relationship between brain stem, limbic
activity and cortex activity so that it is able to focus on specific stimuli and ignore
irrelevant stimuli (PERDOSSI 2008). While concentration is the ability to maintain
attention for a certain period of time. Attention and concentration disorders can affect
other cognitive functions such as memory, language and executive function.
Aspects of attention consist of (Bahrudin, 2011):
 Selective attention: Ability to select stimuli.
 Maintain attention or alertness: Ability to maintain attention in a given time.
Divided attention: Ability to react to multiple stimuli at one time.
 Alternative attention: Able to move from one situation to another.

b. Language
Language is a basic tool of communication and a basic modality that
develop cognitive functioning skills. In speaking there are six modality
the language is:
1) Fluency
Fluency refers to the ability to produce sentences
with normal length, rhythm, melody. The inspection method is with
assess the patient's fluency in speaking spontaneously.
2) Understanding
Comprehension is the ability to understand a question or
order and proved by doing the command.
3) Repetition
The ability of a person to repeat a statement or
sentences spoken by someone.
4) Naming
Refers to a person's ability to name an object and its parts.
5) Written Reading Examination
A major contributor to cognitive change is decline
entire central nervous system. Decreases associated with aging are shown in speed,
short-term memory, working memory and long-term memory (Papalia, Olds &
Feldman, 2008).
4.2.2 Factors Affecting Elderly Cognitive
1. Gender
Women are more at risk of cognitive decline. That thing
due to the role of endogenous sex hormones where estrogen receptors are found in
areas of the brain that play a role in learning and memory functions such as the
hypochampus. Estradiol is thought to protect neurons (neuroprotective) and may limit
damage due to oxidative stress.Low estradiol levels are associated with decreased
general cognitive function and verbal memory (Yaffe et al.
2007 in Myers 2008).

2. Age
Increased age goes hand in hand with decreased cognitive function. The older (> 60
years) the lower the cognitive function (Erickson, 2010)

3. Education Status
According to Monginsidi's research (2013) it is explained that a person who
undergoes education for more than nine years or more than basic education (SPM,
Diploma a or undergraduate) has the result of cognitive function which is considered
normal.

4. Health Status
One that affects cognitive function is hypertension, angina pectoris, myocardial
infarction and heart disease as well as other vascular diseases. In the case of
hypertension, an increase in chronic blood pressure can increase the effects of aging
on brain structure including reduction of alba substance and grise substance in the
prefrontal lobe, decreased hypochampus and hyperintensity of alba substance in the
frontal lobe (Briton and Marmot, 2003).
4.2.3 Cognitive Function Examination
In assessing the function of global cognition, examination using Mini Mental State
Examination (MMSE) is performed. MMSE since 1975 has been validated and widely
used in clinical practice and research.
MMSE serves as a medium to detect cognitive impairment in the elderly, inpatients
and community members (Bahrudin, 2011).

Mini Mental State Examination (MMSE) is a structured measuring instrument

consisting of 30 points and grouped into 7 categories:
 Orientation to place (country, province, city, building, floor)
 Orientation to time (year, season, month, day and date)
 Registration (quickly repeats 3 words)
 Attention and concentration (sequentially subtracting 7, starting from the number
100, or spelling the word REVELATION in reverse)
 Recall (recall 3 words that have been repeatedbefore)
 Language (naming 2 objects, repeating sentences, reading aloud and understanding
a sentence, writing sentences and following 3-step instructions)
 Visual construction (copying images)

4.3 Personality

According to WHO, More than 20% of adults aged 65 years have been diagnosed
with a mental state that requires treatment. These include dementia, moodiness, and
indecision. Under home care settings, more than 50% of the population experiences
some type of cognitive impairment that may worsen other health conditions.
Early symptoms of mental illness
Memory problems
Memory problems are not considered a normal part of the aging process by most
people, leading to mental illness often going unrecognized and severe. Memory
problems may be a warning sign of mental illnesses such as Alzheimer's and dementia
in golden citizens. Signs of memory loss may include misplacing items, repeatedly
asking for the same information or forgetting important dates.

Change in self-care
Often times, someone with mental health problems will stop adhering to their
personal care routine. A ketara change in appearance may indicate that a person is not
successful at adhering to a routine regarding personal appearance. Although he will
appear different to everyone, a change in personal appearance may be a sign of mental
illness including forgetting to shower or skipping pre-defined standard personal care
duties, such as grooming.

Social activities
Individuals with mental illness often become less sociable. If you notice your loved
ones are losing interest in activities they enjoy or are avoiding frequent social
inclusion, it may be because they are experiencing mental health problems which
make these things difficult.

Mood changes
Mood changes often accompany mental illness, such as moodiness and Alzheimer's.
Your beloved can be free from anxiety, excitement to depression, or believe in wrong.
If the mood swings last longer than a few weeks, there may be a more serious cause
for their personality change.
Diagnosis
To determine the diagnosis and check the associated complications, you may have:

Physical examination.
The doctor will try to dismiss any physical problems that may be causing the
symptoms.

The final exam. For example, tests of thyroid function or tests for alcohol and drugs.

Psychological assessment.
A doctor or mental health provider talks to you about your symptoms, thoughts,
feelings and behavior patterns. You may be asked to fill out research questions to help
answer these questions.

Management/Treatment
Mental illness, like most chronic illnesses, requires ongoing treatment. With advances
in the treatment of mental illness, many mental states can be treated impressively with
one or a combination of the following therapies:
-medication
-Psychotherapy
- Group therapy
-Daily care or care for part of the hospital
-Special therapy, such as cognitive behavioral therapy and behavior modification

Other treatments include:

Alternative therapies, such as water therapy, massage and biofeedback
Creative therapy, such as art therapy, music therapy, or play therapy
Hypnotherapy.
Electroconvulsive Therapy (ECT).
Vagus nerve stimulation (VNS).
Transcranial magnetic stimulation (TMS) is a new therapy.
Conclusion

Psychological well-being is one of the most important elements for senior citizens,
so it is important for the community to have awareness and try to apply the practice of
pure values to strengthen the community's relationship with the citizens. The country
and society must educate the younger generation on the importance and responsibility
of caring for their parents
Reference

1. Bahrudin, Moch. 2011. Pemeriksaan Klinis di Bidang Penyakit Syaraf. Malang:

UMM Press. Bab 4. Pemeriksaan status mental. Bab 4. Pemeriksaan status mental
(neurobehavior/fungsi luhur).Pp. 31-33
2. Boedhi Darmojo, R.B. (2009). Buku Ajar Geriatri (Ilmu Kesehatan Lanjut Usia)
edisi ke-4. Jakarta: FKUI. hal: 175.
3. Briton and Marmot, 2003 Perspectives in Biology and Medicine 46(3):S9-S2
Researchgate
4. Darmojo, R. (2011).Buku Ajar Geriatic (IlmuKesehatanLanjutUsia) edisike –
4.Jakarta :BalaiPenerbit FKUI
5. Jabatan Kebajikan Masyarakat. (1995). Dasar Warga Tua Negara.
6. Erickson, F. (2010). Culture in society and in educational practices. In J.A. Banks
and C.A. McGee (Eds.), Multicultural Education: Issues and Perspectives (7th
ed., pp. 33–58). Indianapolis, IN: Jossey-Bass.
7. Furlong, Frederick T. 1989. “Commodity Prices as a Guide for Monetary Policy.”
Federal Reserve Bank of San Francisco Economic Re - view 1, pp. 21–38
8. Kanayama 2003 Online Ethnographic Research on the Experience of Japanese
Elderly People
9. Mihalca, L., and Miclea, M. (2007). Current trends in educational technology
research. Cognition, Brain, Behavior, 9(1), 115–129.
10. Maryam, R.Sitti et al. (2008). Mengenal Usia Lanjut dan Perawatannya,
Jakarta:Salemba Medika.
11. Nehlig A (1999) Are we dependent upon coffee and caffeine?A review on human
and animal data. Neurosci

12. Perhimpunan Dokter Spesialis Saraf Indonesia (PERDOSSI). , 2008. 5. ...

ource/docs/clinicalguidelines
13. Papalia, Olds & Feldman, 2008). Experience human development ,Publisher Mc
Grawhill company UK
14. Xie 2007 ,Using for Offline Relations https://doi.org/10.1177/089443930729762