• Journal of Yeungnam Medical Science
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• v.37 no.4
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• pp.296-301
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• 2020

The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of preoperative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.

• Journal of Korean Society for Quality Management
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• v.26 no.4
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• pp.111-123
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• 1998

We consider the problem of modeling count data where the observation period is determined by the life time of the system under study. We assume random effects or a frailty model to allow for a possible association between the death times and the counts. We assume that, given a random effect or a frailty, the death times follow a Weibull distribution with a hazard rate. For the counts, given a frailty, a Poisson process is assumed with the intensity depending on time. A gamma distribution is assumed for the frailty model. Maximum likelihood estimators of the model parameters are obtained. A model for the time to death and the number of failures system received is constructed and consequences of the model are examined.

• International Journal of Advanced Culture Technology
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• v.11 no.3
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• pp.131-141
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• 2023

This study aimed to identify the determinants of physical frailty among the old-old adults in rural Korean communities. A total of 191 individuals aged 75 and older were included in the study, with the majority being female. Participants were classified into healthy (n=47), pre-frail (n=54), and frail (n=90) groups. Significant differences were found across these groups in terms of age, gender, education level, depression, and nutritional status. Multiple logistic regression analysis revealed that age (OR=1.16), depression (OR=0.21), malnourishment (OR=10.85), and short physical performance ability (OR=0.70) were significant predictors of physical frailty. These findings underscore the multifaceted nature of physical frailty among old-old adults in urban-rural complex communities and highlight the need for comprehensive and integrated interventions. Such interventions should consider not only physical factors but also broader health conditions and socio-demographic influences impacting the elderly. Further research is needed to develop and evaluate interventions that address these determinants and promote health equity among the elderly population in urban-rural complex communities

• Communications for Statistical Applications and Methods
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• v.25 no.5
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• pp.471-488
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• 2018

In this paper, we propose extending proportional hazards frailty models to allow a discrete distribution for the frailty variable. Having zero frailty can be interpreted as being immune or cured. Thus, we develop a new survival model induced by discrete frailty with zero-inflated power series distribution, which can account for overdispersion. This proposal also allows for a realistic description of non-risk individuals, since individuals cured due to intrinsic factors (immunes) are modeled by a deterministic fraction of zero-risk while those cured due to an intervention are modeled by a random fraction. We put the proposed model in a Bayesian framework and use a Markov chain Monte Carlo algorithm for the computation of posterior distribution. A simulation study is conducted to assess the proposed model and the computation algorithm. We also discuss model selection based on pseudo-Bayes factors as well as developing case influence diagnostics for the joint posterior distribution through ${\psi}-divergence$ measures. The motivating cutaneous melanoma data is analyzed for illustration purposes.

• Nutrition Research and Practice
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• v.17 no.5
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• pp.1007-1018
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS: Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ² test to validate the test. RESULTS: There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS: The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

• 한국노년학
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• v.38 no.4
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• pp.891-903
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• 2018

This study investigated the relation between frailty, social support, and health-related quality of life to provide basic data to improve the health-related quality of life of old-old elderly who are a high risk group for frailty. For this descriptive study, one-on-one interviews with structured questionnaires were conducted for elderly aged 75 years or older at elderly welfare facilities in K county from March 01 to 31 in 2016, and a total of 211 elderly were interviewed. The collected data were analyzed by t-test, Pearson's correlation coefficient, and path analysis using SPSS/WIN and AMOS 18.0 program. For the differences between the age groups, those aged over 80 years had a significantly higher frailty (t=-2.51, p=.013) and a lower health-related quality of life than those aged below 80 years (t=3.29, p=.001); however, there was no significant difference in social support (t=1.28, p=.201). The correlation between frailty, social support and health-related quality of life showed that as frailty became higher, social support (r=-.21, p=.003) and health-related quality of life (r=-.65, p<.001) were significantly lower, and health-related quality of life was significantly higher with a higher social support (r=.18, p=.010). As a result of investigating the mediating effects of frailty between social support and health-related quality of life, social support had a significant direct effect on frailty (${\beta}=-.21$, p=.016) and frailty had a significant direct effect on health-related quality of life (${\beta}=-.06$, p=.004); however, social support had no significant direct effect on health-related quality of life (${\beta}=.00$, p=.562). Social support had a significant indirect effect on health-related quality of life and a mediating effect on frailty (${\beta}=.01$, p=.012); therefore, the full mediation effect of frailty between social support and health-related quality of life was verified. Social support prevents frailty, and improving frailty enhances health-related quality of life. Therefore, it is necessary to develop a multifactorial frailty prevention program that includes age-specific social support strategies to improve the health-related quality of life in old-old elderly.

• Therapeutic Science for Rehabilitation
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• v.10 no.3
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• pp.43-56
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• 2021

Objective : The objective of this study was to present the components of frailty by organizing the definitions of frail elderly and analyzing the tools used to screen them. Methods : This study searched for articles at involved frailty screening assessments in the elderly. Databases including CINAHL, Embase, Medline Complete, and PubMed were searched. The search terms were "assess" AND "frailty" AND "screening" AND ("frail elderly" OR "elderly"). Results : A total of 539 articles were identified by the search and 11 articles were selected. Frailty occurs due to the depressed function of multidimensional factors, and a frail elderly person is defined as one at high risk of health degeneration, functional impairment, and occurrence of disability, and having a high level of threat to life. Seven tools were selected from 11 articles. The most frequently used tool was the frailty phenotype, which was used in five articles (45.4%). The identified components of frailty were physical, activity participation, nutrition, psychological, social, overall health, and age. Conclusion : The results confirmed the definition and components of frailty. This study is expected to contribute to the future development of standardized evaluation tools for screening frail elderly individuals and intervention programs for the management of the frail elderly.

• Health Policy and Management
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• v.34 no.2
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• pp.156-162
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• 2024

Background: This study aimed to explore the relationship between frailty and Area Deprivation Index (ADI) among older adults in Korea. Methods: We used data from the Korea National Health and Nutrition Examination Survey from 2014 to 2019, focusing on individuals aged 65 years and older. Frailty was assessed using Fried phenotype of frailty criteria. A multiple logistic regression analysis was conducted to assess the relationship between frailty and ADI adjusted for all covariates. Results: Among 9,825 older adults, those who lived in an area with a high ADI had a 1.2-fold higher risk of frailty compared to those who lived in an area with a low ADI (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.09-1.37). Particularly, married individuals living in areas with a high ADI had an approximately 1.4-fold higher risk of frailty compared to those living in areas with a low ADI (OR, 1.35; 95% CI, 1.16-1.57). Conclusion: This study reveal a significant relationship between frailty and the ADI among older adults. In particular, married individuals who live in areas with a high ADI were found more vulnerable to frailty than those who live in areas with a low ADI. Therefore, policy intervention should be implemented to reduce health inequalities among older people, especially those living in the most deprived areas groups.

• Journal of the Korea Convergence Society
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• v.13 no.2
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• pp.47-54
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• 2022

The purpose of this study was to analyze the effect of masticatory ability on frailty in the elderly. General characteristics, subjective and objective masticatory ability, and frailty level were investigated in 224 elderly. The major findings were as; There were differences in masticating ability according to age, education level, employment status, living arrangement, and maxillary & mandibular dentures. The masticatory ability of the non-frail elderly was significantly higher than the frail elderly. The risk ratio of frailty was 2.33 times higher in subjects with poor mastication compared to subjects with good mastication ability. Also, as a result of adjusting for age, the risk ratio of frailty in the poor group was 2.30 times higher than in the group with good mastication ability. Through this, it is thought that the masticatory ability of the elderly is one of the predictors of frailty, and efforts to achieve healthy aging by preventing senescence through oral health management at the community level are thought to be necessary.

• Korean Journal of Exercise Nutrition
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• v.24 no.1
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• pp.37-45
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• 2020

[Purpose] The purpose of this study was to examine the effects of elastic band exercises and nutritional education, as well as to identify the factors influencing frailty, strength, and nutritional intake of elderly women. [Methods] The subjects in this study were 30 elderly women who were divided into four groups. All groups agreed to participate in four programs: health education only (HE), elastic band exercises only (EX), nutritional education only (NU), and elastic band exercises plus nutritional education (EX+NU). Frailty was evaluated by measuring the frailty factors according to Fried et al. Leg strength was measured using a leg-extension machine. Nutritional intake was assessed by the 24-hour recall method and food records. Nutritional intake was analyzed by CAN Pro 5.0 program. [Results] After three months, the prevalence of frailty significantly decreased in the EX+NU group (P=0.013) compared with that of the HE group (P=0.088). There was significant improvement in leg strength in both the EX (P=0.012) and EX+NU groups (P=0.003) compared with that of the HE group (EX, P=0.005; EX+NU, P=0.002). The nutritional intake significantly decreased in the EX group compared with that of the HE group (P<0.05, P<0.05). [Conclusion] The combination of elastic exercises and nutrition education had positive effects on frailty and leg strength, while having negative effects on total calories, carbohydrate, sodium, and iron intake in elderly women. Elastic exercises only had positive effects on leg strength while having negative effects on nutritional intake in elderly women.