• Journal of agricultural medicine and community health
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• v.46 no.1
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• pp.23-31
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• 2021

Objectives: Frailty and sarcopenia are recent important concepts in elder health care. Sarcopenia is the most important factor influencing frailty, and exercise and nutritional status are known to affect sarcopenia. The purpose of this study was to identify the relationship between nutritional status, sarcopenia, and frailty. Methods: This study was a cross-sectional design. The subjects of this study were 411 elderly people aged 65 or older from 10 villages in Gyeongnam. The survey tools were the K-FRAIL for frailty, the GDS-SF for depression, the SARC-F questionnaire for sarcopenia, and the DETERMINE for nutritional status. Frequency analysis, the chi-square test, and multiple logistic regression analysis were performed using the SPSS 25.0 program. Results: As a result of the chi-square test, there was a significant difference in the nutritional status and the frailty proportion (p<0.001), and there was a significant difference between frailty and suspected sarcopenia (p<0.001). After adjustment, nutritional status was significantly associated with sarcopenia (OR=2.946, p<0.001). In addition, nutritional status was significantly associated with frailty (OR=2.958, p<0.001), and sarcopenia also had a significant effect on frailty (OR=5.898, p<0.001). Finally, even after including sarcopenia, nutritional status had a significant effect on frailty (OR=2.246, p=0.002). Conclusions: Nutritional status can have both a direct effect on frailty and an indirect effect through sarcopenia, and it was found that sarcopenia also affects frailty. Therefore, it is necessary to evaluate sarcopenia and nutritional status and to evaluate their levels in the elderly and to take appropriate interventions.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.206-215
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• 2017

Purpose: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. Methods: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. Results: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. Conclusion: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.

• 한국체육학회지인문사회과학편
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• v.58 no.4
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• pp.423-433
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• 2019

The purpose of this review is to summarize current knowledge regarding animal sarcopenia and frailty models and their diagnosis indexes. In addition, we introduce the effects of exercise interventions on sarcopenia and frailty syndrome. Data collection and analysis (fifteen published articles from 2005~2017) were conducted by using keywords' sarcopenia index, frailty index, exercise and mice, and so on' in academic search engines such as Google scholar and Pubmed. Sarcopenia and frailty are the representative syndromes in elderly peoples which those symptoms can be effectively prevented or delayed by extremely adjusted long term exercise interventions (The combined oxidative and resistant exercise program might be ideal.).

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.229-242
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• 2023

Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

• Annals of Geriatric Medicine and Research
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• v.20 no.3
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• pp.114-117
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• 2016

A research project, the "Construction of Frailty Cohort for Elderly and Intervention Study," funded by the Ministry of Health and Welfare, has been ongoing since December 2015. The Korean Frailty and Aging Cohort Study (KFACS) aims to identify risk factors for adverse outcomes associated with frailty in community-dwelling older adults, as well as means of prevention. KFACS is a multicenter, longitudinal study, with the baseline survey being conducted in 2016-2017. The sample (n=3,000) consists of those aged 70-84 years, stratified by age and gender, recruited from urban and rural regions nationwide. An in-person interview and health examination are performed every 2 years. This project is also conducting many intervention studies. Project interventions focus on nutrition and exercise. The nutritional intervention study compares the effects of 1.2 g/kg versus 1.5 g/kg daily protein intake on sarcopenia and frailty in older Koreans. The exercise trial examines the effectiveness of an information and communication technology-based program in preventing or reducing frailty.

• Journal of the Korean Data and Information Science Society
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• v.27 no.5
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• pp.1389-1397
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• 2016

Semi-parametric frailty model with nonparametric baseline hazards has been widely used for the analyses of clustered survival-time data. The frailty models can be fitted via an auxiliary Poisson hierarchical generalized linear model (HGLM). For the inferences of the frailty model marginal likelihood, which gives MLE, is often used. The marginal likelihood is usually obtained by integrating out random effects, but it often requires an intractable integration. In this paper, we propose to obtain the MLE via Laplace approximation using a Poisson HGLM approach for semi-parametric frailty model. The proposed HGLM approach uses hierarchical-likelihood (h-likelihood), which avoids integration itself. The proposed method is illustrated using a numerical study.

• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.562-574
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• 2017

Purpose: This study attempts to explore the subjective experience of frailty among elderly individuals in Korea. Methods: From June to August in 2014, 11 elderly persons who had experienced frailty in a community were interviewed. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' frailty process was structured in seven categories: (a) 'natural phenomenon with ageing,' (b) 'life force comes to an end,' (c) 'the light in my heart turns off,' (d) 'unavoidable situation,' (e) 'continuous and connected vicious cycle,' (f) 'the limit of recovery energy already passes,' and (g) 'life is supported by someone's help.' Conclusion: The frailty experience in the participants is a natural process of aging, which cause vicious cycle acting with each other among physical, psychological, and social health. It is said that the cycle of frailty was started from weight loss and insufficient sleep, and boostered by pain. The participants from repetition of the vicious cycle become exhausted and pass the threshold of their recovery energy at some points. If they meet with sudden accidents such as falling, traffic accident and so on, they become to live a dependent life supported by someone's help in a moment. To prevent frailty and worsening conditions in Korean elderly individuals, it is recommended to provide a interventional programs using this study's results.

• Journal of Korean society of Dental Hygiene
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• v.20 no.3
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• pp.347-357
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• 2020

Objectives: The purpose of the study was to investigate the relationship between frailty and oral health among some elderly community residents. Methods: A self-reported questionnaire was completed by 240 elderly in the Gwangju-Jeonnam area from October 1, 2019, to November 30, 2019, based on convenience sampling. The questionnaire consisted of general characteristics of the subjects, frailty level (Kihon checklist), and Geriatric Oral Health Assessment Index. Results: There were 66 (27.5%) frail elderly, and the GOHAI group with a score less than 45 constituted 187 (77.9%), which was higher than the group with a score of 45 or higher. The distribution of the frail elderly was indicated to be higher in the people with older age (p<0.05), lower educational level (p<0.01), current economic inactivity (p<0.05), living alone (p<0.01), more chronic diseases (p<0.01), and GOHAI score below 45 (p<0.01). Compared to those with a good oral health-related quality of life, those with a poor quality of life showed a 3.03 times higher risk of frailty (95% CI=1.291-7.107)(p<0.05). Conclusions: By recognizing the need for oral health care of the elderly through these results and by identifying the relationship between frailty and oral health, it is possible to consider oral health as a predictor of frailty.

• The Journal of the Korean life insurance medical association
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• v.26
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• pp.3-12
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• 2007

Frailty는 노인에서 장애와 사망의 주된 원인이 되는데 근육 감소증, 근력 약화, 에너지/화동력/보행속도의 감소, 염증성 싸이토카인의 증가를 특징으로 한다. 비타민 D의 결핍 또는 저항증은 근육기능과 단백질 합성에 대한 효과, 염증성 싸이토카인의 표현 조절, 혈관계에 대한 영향, 중추신경계에 대한 영향을 통해 Fraity syndrome에 대한 원인인자가 될 수 있다. 따라서 만약 비타민 D 결핍이 이 증후군의 중요한 요인이라면 비타민 D 투여는 안전하고도 비용-효과적인 Frailty syndrome에 대한 예방 및 치료 방법이 될 수 있는 것이다.

• Journal of the Korean Data and Information Science Society
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• v.17 no.3
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• pp.999-1007
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• 2006

The semiparametric gamma frailty models have been often used for multivariate survival analysis because they give an explicit marginal likelihood. The commonly used estimation procedure is the profile likelihood method based on marginal likelihood, which provides the same parameter estimates as the EM algorithm. In this paper we show in finite samples the standard profile-likelihood method can lead to an underestimation of parameters, particularly for the frailty parameter. To overcome this problem, we propose an adjusted profile-likelihood method. For the illustration a numerical example and a small-sample simulation study are presented.