• Title, Summary, Keyword: Frailty

Search Result 132, Processing Time 0.037 seconds

Discrepancies in the Prevalence of Known Frailty Scales: Korean Frailty and Aging Cohort Study

  • Kim, Kyoung Jin;Shin, Jinyoung;Choi, Jaekyung;Won, Chang Won
    • Annals of Geriatric Medicine and Research
    • /
    • v.22 no.3
    • /
    • pp.137-144
    • /
    • 2018
  • Background: The identification of frailty is considered an effective means of enhancing healthy aging. The definition of frailty affects its prevalence and associated institutionalization and mortality. This study aimed to identify the prevalence of frailty among community-dwelling older Korean adults according to different frailty scales. Methods: This cross-sectional study based on the Korean Frailty and Aging Cohort Study represents a population of 1,318 people aged 70 years and older. Discrepancies in the prevalence of frailty were evaluated among six validated assessment tools. Multivariate logistic regression analysis was used to evaluate the prevalence of frailty according to its predictors (age, sex, and socioeconomic status). Results: The mean age of the participants was 76.1 (standard deviation, 3.9) years, and females comprised 51.0%. The prevalence of frailty varied from 2.5% to 12.4% using the Study of Osteoporotic Fracture frailty index and the Korean version of the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight scale, respectively. The prevalence of frailty was higher among women and frailty rates increased with age on all scales. The risks of prefrailty and frailty were increased among participants with a low education level after adjusting for age, sex, residence, and income level. Conclusion: In this study, the prevalence of frailty was found to vary depending on the scale used. Efforts aimed at screening and providing intervention for frailty and frail adults at risk, respectively, are needed to improve health outcomes considering the characteristics of each frailty scale and the determined prevalence.

BAYESIAN MODEL AVERAGING FOR HETEROGENEOUS FRAILTY

  • Chang, Il-Sung;Lim, Jo-Han
    • Journal of the Korean Statistical Society
    • /
    • v.36 no.1
    • /
    • pp.129-148
    • /
    • 2007
  • Frailty estimates from the proportional hazards frailty model often lead us to conjecture the heterogeneity in frailty such that the variance of the frailty varies over different covariate groups (e.g. male group versus female group). For such systematic heterogeneity in frailty, we consider a regression model for the variance components in the proportional hazards frailty model, denoted by the MLFM. However, in many cases, the observed data do not show any statistically significant preference between the homogeneous frailty model and the heterogeneous frailty model. In this paper, we propose a Bayesian model averaging procedure with the reversible jump Markov chain Monte Carlo which selects the appropriate model automatically. The resulting regression coefficient estimate ignores the model uncertainty from the frailty distribution in view of Bayesian model averaging (Hoeting et al., 1999). Finally, the proposed model and the estimation procedure are illustrated through the analysis of the kidney infection data in McGilchrist and Aisbett (1991) and a simulation study is implemented.

Co-occurrence Network Analysis of Keywords in Geriatric Frailty

  • Kim, Youngji;Jang, Soong-nang;Lee, Jung Lim
    • Journal of Korean Academy of Community Health Nursing
    • /
    • v.29 no.4
    • /
    • pp.429-439
    • /
    • 2018
  • Purpose: The aim of this study is to identify core keyword of frailty research in the past 35 years to understand the structure of knowledge of frailty. Methods: 10,367 frailty articles published between 1981 and April 2016 were retrieved from Web of Science. Keywords from these articles were extracted using Bibexcel and social network analysis was conducted with the occurrence network using NetMiner program. Results: The top five keywords with a high frequency of occurrence include 'disability', 'nursing home', 'sarcopenia', 'exercise', and 'dementia'. Keywords were classified by subheadings of MeSH and the majority of them were included under the healthcare and physical dimensions. The degree centralities of the keywords were arranged in the order of 'long term care' (0.55), 'gait' (0.42), 'physical activity' (0.42), 'quality of life' (0.42), and 'physical performance' (0.38). The betweenness centralities of the keywords were listed in the order of depression' (0.32), 'quality of life' (0.28), 'home care' (0.28), 'geriatric assessment' (0.28), and 'fall' (0.27). The cluster analysis shows that the frailty research field is divided into seven clusters: aging, sarcopenia, inflammation, mortality, frailty index, older people, and physical activity. Conclusion: After reviewing previous research in the 35 years, it has been found that only physical frailty and frailty related to medicine have been emphasized. Further research in psychological, cognitive, social, and environmental frailty is needed to understand frailty in a multifaceted and integrative manner.

Frailty and its related Factors in Vulnerable Elderly Population by Age Groups (취약계층 노인의 연령별 허약정도와 관련 요인)

  • Park, Eunok;Yu, Mi
    • Journal of Korean Academy of Nursing
    • /
    • v.46 no.6
    • /
    • pp.848-857
    • /
    • 2016
  • Purpose: This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea. Methods: In this secondary analysis, data were collected from records for 22,868 elders registered in the Visiting Health Management program of Public Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group. Results: Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p <.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p <.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p <.001). Conclusion: The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.

A visualizing method for investigating individual frailties using frailtyHL R-package

  • Ha, Il Do;Noh, Maengseok
    • Journal of the Korean Data and Information Science Society
    • /
    • v.24 no.4
    • /
    • pp.931-940
    • /
    • 2013
  • For analysis of clustered survival data, the inferences of parameters in semi-parametric frailty models have been widely studied. It is also important to investigate the potential heterogeneity in event times among clusters (e.g. centers, patients). For purpose of this analysis, the interval estimation of frailty is useful. In this paper we propose a visualizing method to present confidence intervals of individual frailties across clusters using the frailtyHL R-package, which is implemented from h-likelihood methods for frailty models. The proposed method is demonstrated using two practical examples.

The Association between Frequency of Social Contact and Frailty in Older People: Korean Frailty and Aging Cohort Study (KFACS)

  • Chon, Doukyoung;Lee, Yunhwan;Kim, Jinhee;Lee, Kyung-eun
    • Journal of Korean Medical Science
    • /
    • v.33 no.51
    • /
    • pp.332.1-332.8
    • /
    • 2018
  • Background: The trend of aging society is occurring globally, and with it, one of the health problems that is emerging is frailty. Efforts are being made to account for the increasing prevalence of frailty, and various modifiable factors are being considered in regards to frailty. Because social contact has shown beneficial effects in terms of health in previous studies, it is increasingly being considered in relation to frailty. The purpose of this study was to assess the association of different types of social contact with frailty status. Methods: A total of 1,200 Korean elders aged 70-84 years old were included in the study. Using Fried's Cardiovascular Health Study index to categorize the frailty status, the relationship between frailty status and frequency of contact (i.e., with family members, friends, or neighbors) was analyzed using multinomial logistic regression accounting for confounders. Results: Adjusting for all covariates, frequency of contact with friends was the most statistically significant. Less frequent contact was associated with a significantly higher odds of pre-frailty: monthly (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.27-3.20), and rarely (OR, 1.87; 95% CI, 1.17-2.99), with daily contact group as reference. Also, those contacting friends monthly (OR, 5.04; 95% CI, 2.29-11.08) or rarely (OR, 3.23; 95% CI, 1.58-6.61) were more likely to be frail compared to the daily group. Conclusion: Frequency of social contact, especially with friends, is strongly associated with frailty.

Modified Criteria for Diagnosing "Cognitive Frailty"

  • Won, Chang Won;Lee, Yunhwan;Kim, Sunyoung;Yoo, Jinho;Kim, Miji;Ng, Tze-Pin;Kim, Haena;Son, Sang Joon
    • Psychiatry investigation
    • /
    • v.15 no.9
    • /
    • pp.839-842
    • /
    • 2018
  • The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer's disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.

Is Frailty a Modifiable Risk Factor of Future Adverse Outcomes in Elderly Patients with Incident End-Stage Renal Disease?

  • Lee, Sung Woo;Lee, Anna;Yu, Mi-Yeon;Kim, Sun-wook;Kim, Kwang-il;Na, Ki Young;Chae, Dong-Wan;Kim, Cheol ho;Chin, Ho Jun
    • Journal of Korean Medical Science
    • /
    • v.32 no.11
    • /
    • pp.1800-1806
    • /
    • 2017
  • Little is known about the clinical significance of frailty and changes of frailty after dialysis initiation in elderly patients with end-stage renal disease (ESRD). We prospectively enrolled 46 elderly patients with incident ESRD at a dialysis center of a tertiary hospital between May 2013 and March 2015. Frailty was assessed by using a comprehensive geriatric assessment protocol and defined as a multidimensional frailty score of ${\geq}10$. The main outcome was the composite of all-cause death or cardiovascular hospitalization, as determined in June 2016. The median age of the 46 participants was 71.5 years, and 63.0% of them were men. During the median 17.7 months follow-up, the rate of composite outcome was 17.4%. In multivariate logistic regression analysis, after adjusting for age, sex, diabetes, body mass index (BMI), and time of predialytic nephrologic care, female sex, and increased BMI were associated with increased and decreased odds of frailty, respectively. In multivariate Cox proportional hazards analysis, after adjusting for age, sex, diabetes, BMI, and time of predialytic nephrologic care, frailty was significantly associated with the composite adverse outcome. In repeated frailty assessments, the multidimensional frailty score significantly improved 12 months after the initiation of dialysis, which largely relied on improved nutrition. Therefore, frailty needs to be assessed for risk stratification in elderly patients with incident ESRD.

The Concept of Frailty: A Review of the Literature (노인허약에 대한 고찰)

  • Choi, Kyung-Won;Lee, In-Sook
    • The Korean Journal of Rehabilitation Nursing
    • /
    • v.11 no.2
    • /
    • pp.67-73
    • /
    • 2008
  • Purpose: The purpose of this study was to review and identify the meaning and components of the concept, Frailty. Method: We conducted literature review of studies that concluded the word of 'frail' or 'frailty between 1980 and 2008, and used MEDLINE, CINAHL database to select the articles. Results: Frailty is defined as a concept with multidomains, which are physical, cognitive, psychological, social. Critical characteristics of Frailty include multidominal deficiency, combined accumulation, diminished ability to keep up the independence of daily living, states beyond one's reserve capacity, dynamic relativity, proximity to adverse health outcome, aggregated symptoms. Frailty is caused by decreased physical activity, loss of sensory function, Chronic symptoms or signs, relationship with Caregiver, social isolation. Moreover, Frail elderly is at risk of falls and institutionalization. Conclusion: Frailty is very useful concept, because it has the potential to identify the elderly population at risk of adverse health outcomes. Based on this results, the appropriate tool for screening Korean Frail elderly and Nursing intervention for them needs to be developed.

  • PDF

A correction of SE from penalized partial likelihood in frailty models

  • Ha, Il-Do
    • Journal of the Korean Data and Information Science Society
    • /
    • v.20 no.5
    • /
    • pp.895-903
    • /
    • 2009
  • The penalized partial likelihood based on restricted maximum likelihood method has been widely used for the inference of frailty models. However, the standard-error estimate for frailty parameter estimator can be downwardly biased. In this paper we show that such underestimation can be corrected by using hierarchical likelihood. In particular, the hierarchical likelihood gives a statistically efficient procedure for various random-effect models including frailty models. The proposed method is illustrated via a numerical example and simulation study. The simulation results demonstrate that the corrected standard-error estimate largely improves such bias.

  • PDF