• 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.

• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.380-387
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• 2016

Purpose: The purpose of this study was to examine the mediating and moderating effects of fall-related efficacy and social support on the relationship between frailty and health-related quality of life among rural community-dwelling elderly. Methods: A cross-sectional survey was conducted with a convenient sampling method, and data of 438 elderly residents living in a rural community was used. The structured questionnaire included items from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/ depression), fall-related efficacy and social support. Results: Analysis of the mediating effect of fall-related efficacy and social support showed that there was significant mediating influence of fall-related efficacy on the relationship between frailty and health-related quality of life. There were no moderating effects of fall-related efficacy and social support. Conclusion: The findings suggest that fall-related efficacy may play a role in reducing the effect of frailty on health-related quality of life and underscore the need to consider ways of enhancing fall-related efficacy in interventions for rural community-dwelling frail elderly.

• 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.

• 한국노년학
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• v.41 no.3
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• pp.295-308
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• 2021

This study is a descriptive study conducted to find out the predictive factors according to the level of the frailty of the communitydwelling older adult in a rural area. Data were collected from 400 older adults aged 65 years or older living in rural areas of Gyeongsangnam-do from October 2019 to March 2020. Data were analyzed using logistic regression to examine the predictive factors according to the level of frailty. The results showed that 27.8% for robust older adults, 30.9% for pre-frailty older adults, and 41.3% for frailty older adults. As a result of analyzing the predictive factors according to the level of frailty, the predictors from the robust stage to the pre-frailty stage were grip strength, nutritional status, and depression. The predictive factors for entering the pre-frailty stage into the frailty stage were gender, nutritional status, physical performance ability, and depression. Also, it was found that the predictive factors for entering from the robust stage to the frailty stage were sex, occupation, nutritional status, physical performance ability, and depression. Through this study, it was possible to understand the level of the frailty of the older adults living in rural communities and the effects of multidimensional variables. These results can be used as basic data necessary to find a way to prevent and manage the progression of frailty among older adults in rural areas.

• Journal of Korean Biological Nursing Science
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• v.18 no.3
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• pp.185-191
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• 2016

Purpose: The purpose of this study is to understand the effect of taking calcium/vitamin D supplements and performing Taekkyeon exercises on the frailty of the elderly targeting a vulnerable senior social group. Methods: A total of 124 people aged 65 and older consisting of 60 persons in the experimental group, and 64 persons in the control group participated in this study, and this study is a non-equivalent control group pre/post-test design quasi-experimental study. This study analyzed the homogeneity between the experimental group and the control group using a chi-square test and t-test while analyzing the difference in the degree of frailty and bone density with the practice of Taekkyeon and a calcium agent using t-test and GEE. Results: The study results showed that the frailty and bone density of the experimental group significantly improved. Conclusion: Through this study, it was confirmed that calcium/vitamin D intake and Taekkyeon exercises were an effective intervention which strengthened the elderly's physical condition.

• Research in Community and Public Health Nursing
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• v.30 no.2
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• pp.243-255
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• 2019

Purpose: The purpose of this study is to examine effects of a multifactorial program for preventing the frailty of older adults and effects of a follow-up program applying a capacity building strategy. Methods: A quasi-experimental pretest-posttest design was used for the nonequivalent control group. The follow-up group (n=75) and non-follow-up group (n=68) received the same multifactorial program comprising muscle strength exercise, cognitive training, and psychosocial programs for 12 weeks. After completion of multifactorial program, the follow-up group took follow-up programs applying the capacity building strategy for following 12 weeks. The data of physical function, cognitive function, and psychological function, and self-rated health were collected from both groups three times: before intervention, after intervention, and 12 weeks after intervention. The data were analyzed using $x^2$ test and t-test. Results: In comparison with the non-follow-up group, the scores of Timed Up & Go Test, and physical activities energy expenditure were significantly improved in the follow-up group. Conclusion: These results indicate that a multifactorial program with follow-up adapting the strategies of capacity building for the older adults group is feasible to prevent the physical frailty in community.

• 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.

• The Korean Journal of Applied Statistics
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• v.28 no.6
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• pp.1209-1216
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• 2015

Competing-risks events are often observed in a clustered clinical study such as a multi-center clinical trial. We propose a joint modelling approach via a shared frailty term for competing risks survival data from a cluster. For the inference we use the hierarchical likelihood (or h-likelihood), which avoids an intractable integration. We derive the corresponding h-likelihood procedure. The proposed method is illustrated via the analysis of a practical data set.

• The Korean Journal of Applied Statistics
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• v.25 no.1
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• pp.115-123
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• 2012

In animal tumorigenicity data, tumor onsets occur at several sites and onset times cannot be exactly observed. Instead, the existence of tumors is examined only at death time or sacrifice time of the animal. Such an incomplete data structure makes it difficult to investigate the effect of treatment on tumor onset times; in addition, such dependence should be considered when censoring due to death is related with tumor onset. A bivariate frailty effect is incorporated to model bivariate tumor onsets and to connect death with tumor. For the inference of parameters, EM algorithm is applied and a real NTP(National Toxicology Program) dataset is analyzed as an illustrative example.

• Journal of Korean Public Health Nursing
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• v.30 no.2
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• pp.247-258
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• 2016

Purpose: The purpose of this study was to evaluate the effects of a comprehensive exercise program for the prevention of urinary incontinence (UI), frailty, and depression, as well as the promotion of physical function in community-dwelling elderly female living alone. Methods: A nonequivalent control group pretest-posttest design was employed. The participants were 76 vulnerable elderly female with a mild-to-moderate urinary incontinence. The exercise group completed 12 weeks of a moderate intensity, comprehensive exercise program. Descriptive statistics, independent t-tests and ANCOVA were used for data analysis with SPSS. Results: Upon the completion of the 12-week exercise program, significant improvements for UI symptoms (p=.001), timed up and go (p<.001), frailty (p=.006), and depression (p<.001) were observed, but not for hand grip strength (p=.053). Conclusion: The findings of this study indicate that the 12-week comprehensive exercise program for the prevention of urinary incontinence had positive effects on improving UI symptoms, physical function, levels of frailty and depression in elderly women living alone. More prolonged exercise programs with other types of exercise should be developed for these vulnerable elderly women, and future studies are encouraged to confirm the effect of the comprehensive exercise program in other settings.