Comparison of Functional Independence among Community-dwelling Older Adults in Rural Areas in South Korea and the United States

  • Lee, Jia (College of Nursing Science.East-West Nursing Research Institute, East-West Medical Research Institute, Kyung Hee University)
  • Received : 2012.06.19
  • Accepted : 2012.10.21
  • Published : 2012.10.31


Purpose: The purpose of the study was to compare level of functional independence and its correlates among community-dwelling older adults in rural areas between South Korea and the United Sates. Methods: The study employed a comparative and correlational design. Data were collected from 198 community-dwelling older adults in rural areas (South Korea=100, & US = 98). Functional independence, cognitive function, obesity and general characteristics were measured. Results: From both countries, approximately fifteen percent of older adults living independently had cognitive problems without any treatments. Among Korean older adults functional independence was associated with a number of chronic diseases and aging while in the United States the participants had a negative correlation with obesity and aging. Conclusion: For Korean older adults in rural areas, nurses should focus on monitoring older adults' abilities to manage chronic illness and designing self-management programs while in the United States the focus should be on healthy lifestyle programs about exercise and diet to increase functional independence.


  1. Brach, J. S., Simonsick, E. M., Kritchevsky, S., Yaffe, K., Newman, A. B., & Health, Aging and Body Composition Study Research Group. (2004). The association between physical function and lifestyle activity and exercise in the health, aging and body composition study. Journal of American Geriatric Society, 52 (4), 502-509.
  2. Cho, Y. H. (2007). A study on the related factors and status of body mass index in rural elderly. Journal of the Korean Gerontological Society, 27 (4), 897-912.
  3. Crum, R. M., Anthony, J. C., Bassett, S. S., & Folstein, M. F. (1993). Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA, 269 (18), 2386-2391.
  4. Daving, Y., Andren, E., Nordholm, L., & Grimby, G. (2001). Reliability of an interview approach to the Functional Independence Measure. Clinical Rehabilitation, 15 (3), 301-310. http://
  5. Erdfelder, E., Faul, F., & Buchner, A. (1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers, 28, 1-11.
  6. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12 (3), 189-198.
  7. Kim, C. Y. (2006). The cognitive function and activities of daily living of the aged with dementia in the medical and welfare facilities for aged. Unpublished master thesis Chung-Ang University, Seoul.
  8. Korean Statistical Information Service. (2010, December). National survey of Korean population 2010. Retrieved January 14, 2011 from
  9. Korean Statistical Information Service. (2011, January). Transition of Korean population 2010. Retrieved February 19, 2011 from
  10. Lang, I. A., Llewellyn, D. J., Alexander, K., & Melzer, D. (2008). Obesity, physical function, and mortality in older adults. Journal of American Geriatrics Society, 56 (8), 1474-1478.
  11. Luchsinger, J. A., Patel, B., Tang, M. X., Schupf, N., & Mayeux, R. (2008). Body mass index, dementia, and mortality in the elderly. The Journal of Nutrition, Health & Aging, 12 (2), 127-131.
  12. Ministry of Health and Welfare. (2010, December). Elderly policy. Retrieved March 1, 2011 from
  13. Ministry of Health and Welfare. (2011, September). Older adults with dementia. Retrieved October 12, 2011 from
  14. Mungas, D. (1991). In-office mental status testing: A practical guide. Geriatrics 46 (7), 54-56.
  15. Park, J. H., & Kwon, Y. C. (1990). Modification of the minimental state examination for use in the elderly in a non-Western society. Part I. Development of Korean version of minimental state examination. International Journal of Geriatric Psychiatrics, 5 (5), 381-387.
  16. Rejeski, W. J., Marsh, A. P., Chmelo, E., Prescott, A. J., Dobrosielski, M., Walkup, M. P., et al. (2009). The Lifestyle Interventions and Independence for Elders Pilot(LIFE-P): 2-year follow-up. The Journals of Gerontology. Series A, Biological Science and Medical Sciences, 64 (4), 462-467.
  17. Seok, J. E., & Yu, E. J. (2007). Income support and care for the elderly: The balancing of family obligation and state responsibility. Family Law Research, 21 (1), 31-56.
  18. Sharkey, J. R., Ory, M. G., & Branch, L. G. (2006). Severe elder obesity and 1-year diminished lower extremity physical performance in homebound older adults. Journal of American Geriatric Society, 54 (9), 1407-1413. j.1532-5415.2006.00842.x
  19. Simmons, S. F., & Schnelle, J. F. (2001). The identification of residents capable of accurately describing daily care: implications for evaluating nursing home care quality. Gerontologist, 41 (5), 605-611.
  20. Stuck, A. E., Walthert, J. M., Nikolaus, T., Bula, C. J., Hohmann, C., & Beck, J. C. (1999). Risk factors for functional status decline in community-living elderly people: A systematic literature review. Social Science Medicine, 48 (4), 445-469.
  21. Suh, H. J., & Kim, B. H. (2009). Comparison of self-living ability, obesity indices and nutrient intake according to physical fitness among the elderly in rural areas. The Korean Journal of Food and Nutrition, 22 (4), 577-586.
  22. Tierney, S., Elwers, H., Sange, C., Mamas, M., Rutter, M. K., Gibson, M., et al. (2011). What influences physical activity in people with heart failure?: A qualitative study. International Journal of Nursing Studies, 48, 1234-1243.
  23. U.S. Department of Health and Human Services. (2011, January). Medicare. Retrieved from February 20, 2011 from
  24. Uniform Data System for Medical Rehabilitation. (1990). Guide for the uniform data system for medical rehabilitation. buffalo. NY: State University of New York at Buffalo.