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

• 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.

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

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

• The Korean Journal of Applied Statistics
• /
• v.23 no.4
• /
• pp.715-724
• /
• 2010

Recurrent event data occurs when a subject experience the event of interest several times and has been found in biomedical studies, sociology and engineering. Several diverse approaches have been applied to analyze the recurrent events (Cook and Lawless, 2007). In this study, we analyzed the YTOP(Young Traffic Offenders Program) dataset which consists of 192 drivers with conviction dates by speeding violation and traffic rule violation. We consider a subject-specific effect, frailty, to reflect the individual's driving behavior and extend to time-varying frailty effect. Another feature of this study is about the redefinition of risk set. During the study, subject may be under suspension and this period is regarded as non-risk period. Thus the risk variables are reformatted according to suspension and termination time.

• Communications for Statistical Applications and Methods
• /
• v.20 no.4
• /
• pp.283-290
• /
• 2013

Subjects can experience two types of recurrent events in a longitudinal study. In addition, there may exist intermittent dropouts that results in repeated observation gaps during which no recurrent events are observed. Therefore, theses periods are regarded as non-risk status. In this paper, we consider a special case where information on the observation gap is incomplete, that is, the termination time of observation gap is not available while the starting time is known. For a statistical inference, incomplete termination time is incorporated in terms of interval-censored data and estimated with two approaches. A shared frailty effect is also employed for the association between two recurrent events. An EM algorithm is applied to recover unknown termination times as well as frailty effect. We apply the suggested method to young drivers' convictions data with several suspensions.

• The Korean Journal of Applied Statistics
• /
• v.25 no.1
• /
• pp.115-123
• /
• 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 Biological Nursing Science
• /
• v.18 no.3
• /
• pp.185-191
• /
• 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
• /
• v.27 no.4
• /
• pp.380-387
• /
• 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 the Korea Convergence Society
• /
• v.13 no.2
• /
• pp.47-54
• /
• 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.