• Journal of dental hygiene science
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• v.24 no.1
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• pp.1-8
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• 2024

Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

• Journal of the Korean Statistical Society
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• v.36 no.1
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• pp.129-148
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• 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.

• International Journal of Heart Failure
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• v.6 no.3
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• pp.107-116
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• 2024

Frailty is highly prevalent among patients with heart failure (HF) and independently predicts adverse outcomes. However, optimal frailty definitions, assessments, and management in HF remain unclear. Frailty is common in HF, affecting up to 80% of patients depending on population characteristics. Even pre-frailty doubles mortality risk versus robust patients. Frailty worsens HF prognosis through systemic inflammation, neurohormonal changes, sarcopenia, and micronutrient deficiency. Simple screening tools like gait speed and grip strength predict outcomes but lack HF-specificity. Comprehensive geriatric assessment is ideal but not always feasible. Exercise, nutrition, poly-pharmacy management, and multidisciplinary care models can help stablize frailty components and improve patient-centred outcomes. Frailty frequently coexists with and exacerbates HF. Routine frailty screening should guide supportive interventions to optimize physical, cognitive, and psychosocial health. Further research on HF-specific frailty assessment tools and interventions is warranted to reduce this dual burden.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• International Journal of Heart Failure
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• v.6 no.3
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• pp.93-106
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• 2024

Being commonly diagnosed in elderly women and associated with comorbidities as well as ageing-related cardio-vascular changes, heart failure with preserved ejection fraction (HFpEF) has been recently considered as a distinct cardiogeriatric syndrome. Frailty is another frequent geriatric syndrome. HFpEF and frailty share common underlying mechanisms, often co-exist, and represent each other's risk factors. A threshold of 65 years old is usually used to screen patients for both frailty and HFpEF in research and clinical settings. However, both HFpEF and frailty are very heterogenous conditions that may develop at younger ages. In this review we aim to provide a broader overview on the coexistence of HFpEF and frailty throughout the lifetime. We hypothesize that HFpEF and frailty patients' profiles (young, elderly, superaged) represent a continuum of the common ageing process modified by cumulative exposure to risk factors resulting to a presentation of HFpEF and frailty at different ages. We believe, that suggested approach might stimulate assessment of frailty in HFpEF assessment and vice versa regardless of age and early implementation of targeted interventions. Future studies of pathophysiology, clinical features, and outcomes of frailty in HFpEF by age are needed.

• Research in Community and Public Health Nursing
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• v.29 no.4
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• pp.429-439
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• 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.

• Korean Journal of Community Nutrition
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• v.26 no.5
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• pp.382-395
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• 2021

Objectives: This study examined the nutritional status according to frailty status in the elderly at home. Methods: The participants were a total of 76 elderly at home living in Seo-gu, Gwangju, Korea. The nutritional status and frailty status were analyzed using the Nutrition Quotient for Elderly (NQ-E) and the Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight Scale (K-FRAIL), respectively. Results: The distribution of frailty status was robust (17.1%), pre-frailty (38.2%) and frailty (44.7%), and its distribution was significantly different in genders, age groups and the number of medications. The mean NQ-E score was 47.0 for total subjects, indicating a low grade. The scores of balance, diversity and dietary behavior factors were within the low grade, while the score of the moderation factor was within the medium-high grade. According to the frailty status, pre-frailty and frailty showed significantly higher scores for sugar-added beverages intake in the moderation constructs than robust. Robust showed significantly higher scores for the exercise hours and perception level for one's health than pre-frailty and frailty. Conclusions: These results suggest that nutrition status is associated with frailty status. Regular nutrition education and visiting nutrition service should be established to improve the balance and diversity of food intake and improve the dietary behavior of the elderly at home.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.848-857
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• 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.

• Journal of Korean Academy of Rural Health Nursing
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• v.19 no.1
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• pp.66-74
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• 2024

Purpose: This study evaluates the effectiveness of providing frailty prevention services by living support workers through a case of community resource connection centered on living support workers to revitalize frailty prevention programs for vulnerable elderly people. Methods: This is a research study using secondary data from a neighborhood health-sharing project among the integrated health promotion projects of one public health center in Daegu Metropolitan City. To assess frailty effects pre-assessments were conducted in August, and post-assessments were conducted in November. Frailty was measured using a 20-item frailty instrument used in home healthcare projects. Data were analyzed using the chi-square, independent t-test, and paired t-test. Results: Preliminary measurements showed that older elderly had higher frailty scores than younger elderly. However, among the elderly aged 75 or older the total frailty score decreased statistically significantly from 5.97 points to 5.30 points (t=3.03, p=.003). Conclusion: The older elderly showed greater effect of frailty prevention than the younger elderly.

• Journal of the Korean Data and Information Science Society
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• v.24 no.4
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• pp.931-940
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• 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.