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Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition characterized by severe inflammation and damage to the alveoli, leading to impaired oxygen exchange in the lungs. Older adults are particularly vulnerable to ARDS due to age-related physiological changes and the presence of comorbidities. This literature review aims to explore the risk factors, pathophysiology, and management strategies of ARDS in the elderly population. The review identifies key factors such as immunosenescence, decreased lung elasticity, and the presence of chronic conditions like hypertension, diabetes, and cardiovascular disease as contributing to the increased susceptibility to ARDS in older adults. Infections, especially pneumonia and sepsis, are found to be significant triggers for the onset of ARDS. Additionally, environmental factors, such as long-term exposure to air pollution and smoking, further elevate the risk. Prevention through vaccination and the management of comorbidities are highlighted as essential strategies for reducing the incidence of ARDS. The review also emphasizes the importance of lung-protective ventilation strategies in the treatment of ARDS in older adults. Overall, this paper underscores the need for comprehensive healthcare approaches, including early detection, vaccination, and integrated care for managing comorbid conditions to mitigate the impact of ARDS in the elderly. Further research is recommended to develop more effective and tailored treatment approaches for this vulnerable population. 

Insulin and glucagon, hormones secreted by the pancreas, regulate blood glucose, the main source of energy for cells. Insulin facilitates glucose uptake and glycogen synthesis, whereas glucagon increases blood glucose by stimulating glycogenolysis and gluconeogenesis in the fasting state. An increase in blood glucose above normal over a long period of time can cause diabetes mellitus. The prevalence of type 2 diabetes among the elderly in Indonesia is 6.2%, with a projected increase to 12 million cases by 2030. The causes include genetic factors, aging, unhealthy eating patterns, a lack of movement, and comorbidities such as obesity and hypertension. This activity uses the PDCA (Plan-Do-Check-Action) method, which aims to carry out blood glucose checks as an early detection of type 2 diabetes mellitus. The Hana Nursing Home in South Tangerang hosted this activity, which involved 61 participants. The results of the blood glucose examination showed that 15 people (24.58%) had diabetes and 33 people (54.1%) had pre-diabetes. Early detection and effective management are essential to prevent complications and maintain functional status.

Hypertension is a condition where systolic blood pressure is equal to or more than 140 mmHg and diastolic blood pressure is more than or equal to 90 mmHg. The cause of hypertension can be influenced by genetic factors, environmental factors or influenced by a combination of these two factors. From the causative factors, hypertension can be classified into 2, namely: primary or essential hypertension for which the cause is not known, and secondary hypertension which is hypertension arising from other diseases. According to the American Heart Association in 2019, there were about 4 billion people on the Asian continent, but levels of awareness, treatment and blood pressure control tend to be low. The Chinese population has a presentation of 47% of the population who are aware and check themselves for hypertension, 14% of whom are undergoing treatment. Singapore has 74% of people aware of hypertension and 69% undergoing treatment. In America, about 46% of adults have hypertension, about 40% of whom are African-American-non-Hispanic men and women. Women aged 20 to 34 years, 13% had hypertension; nearly 86% of the condition was in their mid-70s. Men at that age also had the same condition, increasing from about 26% to 80%.

Hypertension is an increase in blood pressure above 140/90 mmHg. One of the causes of hypertension that is difficult to control is stress which can worsen the client's condition so that it is needed to handle through stress management. Zikir relaxation therapy is one of the relaxation therapies with an elemental approach to spirituality that is useful for reducing stress. The purpose of this case study is to illustrate the application of Zikir Relaxation Therapy to stress on clients with essential hypertension in the area assisted by the Rowosari Health Center Semarang. This type of research is descriptive using the case study approach method. The subjects used were two respondents with the criteria of clients with essential hypertension, level I-II hypertension, and moderate stress levels. The form of intervention is the application of Zikir relaxation therapy 4 times in 2 weeks (twice a week). The analysis is used to determine the stress level using the DSS (Distress Symptom Scale) measuring instrument. The results showed a decrease in stress levels before and after the administration of Zikir therapy from moderate stress to mild stress for subject I with a decrease of 36 scores and from moderate stress to normal for subject II with a decrease in 40 scores. The average reduction in stress levels of the two subjects after Zikir relaxation from an average score of 63 to 38. From the results of these studies, the provision of zikir therapy can be used as an intervention to reduce stress levels in clients with essential hypertension.