• 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.).

• 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.

• Journal of the Korean Data and Information Science Society
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• v.20 no.1
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• pp.203-209
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• 2009

Frailty models are useful for the analysis of correlated and/or heterogeneous survival data. However, the inferences of fixed parameters, rather than random effects, have been mainly studied. The prediction (or estimation) of random effects is also practically useful to investigate the heterogeneity of the hospital or patient effects. In this paper we propose how to extend the prediction method for random effects in HGLMs (hierarchical generalized linear models) to log-normal semiparametric frailty models with nonparametric baseline hazard. The proposed method is demonstrated by a simulation study.

• Journal of the Korean Data and Information Science Society
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• v.20 no.5
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• pp.895-903
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• 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.

• Research in Community and Public Health Nursing
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• v.26 no.4
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• pp.405-414
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• 2015

Purpose: The purposes of this study were to examine the effects of home visit healthcare using a complex program on community-dwelling frail elders' physical strength, frailty, and depression and to compare the effects among three regions. Methods: This study was conducted as a quasi-experimental study using one-group pretest-posttest design. A total of 86 subjects were sampled from three regions (metropolis, small city, and rural area). The program was applied for 14 weeks. This program consisted of disease management by a visiting nurse, exercise with a visiting nurse, self exercise, telephone monitoring, health education, counseling, providing handbook, and incentive. Physical strength was measured by balance, upper-limb, and lower-limb muscle strength. Frailty was measured by the Korean Frail Scale and depression was measured by the Geriatric Depression Scale. Paired t-test and ANCOVA were used to analyze the effects. Results: Physical strength, frailty, and depression were significantly improved after applying the complex program. There were not differences among the regions. Conclusion: Home visit healthcare using a complex program was effective in improving frail elders' physical strength, frailty, and depression. There were not differences among the regions. Therefore, home visit healthcare using a complex program needs to be expanded to other regions.

• Journal of Korean Medical Science
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• v.33 no.51
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• pp.332.1-332.8
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• 2018

Background: The trend of aging society is occurring globally, and with it, one of the health problems that is emerging is frailty. Efforts are being made to account for the increasing prevalence of frailty, and various modifiable factors are being considered in regards to frailty. Because social contact has shown beneficial effects in terms of health in previous studies, it is increasingly being considered in relation to frailty. The purpose of this study was to assess the association of different types of social contact with frailty status. Methods: A total of 1,200 Korean elders aged 70-84 years old were included in the study. Using Fried's Cardiovascular Health Study index to categorize the frailty status, the relationship between frailty status and frequency of contact (i.e., with family members, friends, or neighbors) was analyzed using multinomial logistic regression accounting for confounders. Results: Adjusting for all covariates, frequency of contact with friends was the most statistically significant. Less frequent contact was associated with a significantly higher odds of pre-frailty: monthly (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.27-3.20), and rarely (OR, 1.87; 95% CI, 1.17-2.99), with daily contact group as reference. Also, those contacting friends monthly (OR, 5.04; 95% CI, 2.29-11.08) or rarely (OR, 3.23; 95% CI, 1.58-6.61) were more likely to be frail compared to the daily group. Conclusion: Frequency of social contact, especially with friends, is strongly associated with 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.

• 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.23 no.2
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• pp.201-211
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• 2012

Purpose: The purpose of this study is to evaluate the effects of a local community based multi-factorial program for high-risk younger and older elderly people. Methods: The quasi-experimental research design (pretest-post test) was employed. Participants were recruited in Seoul and a total of 98 elders completed an 8-week multi-factorial program for preventing frailty. Descriptive statistics, $x^2$-test and GLM were used in the data analysis with SPSS/WIN 15.0. Results: The high-risk elderly people in the younger and older stages showed differences in IADL, TUG and BMI, and after being provided with the multi-factorial program for preventing frailty, some effects were shown on improving the total score of frailty, a physical function, TUG, BMI, depression, subjective feeling of health, and social interaction. Conclusion: The 8-week multi-factorial program for preventing frailty had positive effects on improving physical, emotional and social functions of the high-risk elderly people. It is necessary to evaluate the effects after individual intervention as well as group intervention and to evaluate the effects of the program by setting a control group in the future.