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Baek JY, Na SH, Lee H, Jung HW, Lee E, Jo MW, Park YR, Jang IY. Implementation of an integrated home internet of things system for vulnerable older adults using a frailty-centered approach. Sci Rep 2022; 12:1922. [PMID: 35121795 PMCID: PMC8817027 DOI: 10.1038/s41598-022-05963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/20/2022] [Indexed: 11/09/2022] Open
Abstract
Although integrated home internet of things (IoT) services can be beneficial, especially for vulnerable older adults, the hurdle of usability hinders implementation of the technology. This study aimed to evaluate the practical usability of home IoT services in older adults, by frailty status, and to determine the potential obstacles. From August 2019 to July 2020, we randomly selected 20 vulnerable older adults (prefrailty group [n = 11], and frailty group [n = 9]) who had already been identified as needing home IoT services in a community-based prospective cohort study, the Aging Study of the Pyeongchang Rural Area. Integrated home IoT services were provided for 1 year, and a face-to-face survey evaluating usability and satisfaction of each service was conducted. The usability of the integrated home IoT services declined gradually throughout the study. However, prefrail participants showed higher usability than frail older adults (difference-in-difference = - 19.431, p = 0.012). According to the frailty status, the change in usability for each service type also showed a different pattern. During the 12-month study period, the service with the highest satisfaction converged from various service needs to light control by remote control (77.8%) in the prefrailty group and automatic gas circuit breaker (72.7%) in the frailty group. For wider implementation of home IoT services, organizing services expected to have high usability and satisfaction based on user's frailty status is crucial. Also, providing education before service implementation might help older adults coping with digital literacy.
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Affiliation(s)
- Ji Yeon Baek
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Se Hee Na
- Department of Biomedical System Informatics, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Heayon Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of College of Medicine, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical System Informatics, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Park J, Lee Y, Won CW. CEND1 and MIR885 methylation changes associated with successful cognitive aging in community-dwelling older adults. Exp Gerontol 2022; 160:111704. [DOI: 10.1016/j.exger.2022.111704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/14/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
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Kim M, Won CW. Cut Points of Chair Stand Test for Poor Physical Function and Its Association With Adverse Health Outcomes in Community-Dwelling Older Adults: A Cross-Sectional and Longitudinal Study. J Am Med Dir Assoc 2021; 23:1375-1382.e3. [PMID: 34883057 DOI: 10.1016/j.jamda.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/17/2021] [Accepted: 11/06/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To identify the optimal cutoff points for poor physical function [measured by a 5-times sit-to-stand (5-STS) test] associated with slowness in community-dwelling older adults and to validate the 5-STS cut points by determining whether they predicted future slowness and clinically relevant health outcomes over a 2-year-follow-up period. DESIGN Cross-sectional and longitudinal analyses of a cohort study. SETTING AND PARTICIPANTS We conducted cross-sectional (n = 2977) and prospective 2-year follow-up analyses (n = 2515) among participants aged 70-84 years enrolled in the nationwide Korean Frailty and Aging Cohort Study (KFACS). METHODS Classification and regression tree (CART) analysis was used to identify the 5-STS cut points for poor performance in terms of slowness (eg, gait speed ≥1.0 m/s, gait speed >0.8 m/s and <1.0 m/s, gait speed ≤0.8 m/s) at baseline. Multinomial logistic regression models were used to evaluate the prevalence and incidence of slowness and clinical outcomes according to the three 5-STS categories (normal, intermediate, and poor) in the cross-sectional and longitudinal analyses. RESULTS The overall prevalence of slowness in our study sample was 9.0% for a gait speed of ≤0.8 m/s and 32.1% for a gait speed of <1.0 m/s. The CART model identified 5-STS cut points of 10.8 seconds and 12.8 seconds for intermediate and poor physical function, respectively. In the adjusted model, the cut point of 12.8 seconds had a significantly increased likelihood of incident slowness and clinically relevant health outcomes (ie, mobility limitation, disability, frailty, sarcopenia risk, and falls) over the 2-year-follow-up period (all, P < .05). CONCLUSIONS AND IMPLICATIONS Our study established 5-STS test cutoff points for poor physical function. Thresholds of 10.8 and 12.8 seconds (intermediate and poor physical function, respectively) for a 5-STS test might help identify individuals at risk of physical function impairments and, thus, help design preventive interventions in community health care settings.
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Affiliation(s)
- Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea; Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea.
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Won CW. Implications of frailty interventions from Korean frailty and aging cohort study. Aging Med (Milton) 2021; 4:247-249. [PMID: 34964004 PMCID: PMC8711215 DOI: 10.1002/agm2.12188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Chang Won Won
- Department of Family MedicineCollege of Medicine, Kyung Hee UniversitySeoulKorea
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Ki S, Yun JH, Lee Y, Won CW, Kim M, Kim CO, Son KY, Park H, Park S, Lee KE, Son SJ, Kim K, Kim MK, Kim J. Development of Guidelines on the Primary Prevention of Frailty in Community-Dwelling Older Adults. Ann Geriatr Med Res 2021; 25:237-244. [PMID: 34837935 PMCID: PMC8749035 DOI: 10.4235/agmr.21.0072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background Despite the increasing number of older adults as the population ages, there is a lack of frailty prevention guidelines for community-dwelling older adults. The Korean Frailty and Aging Cohort Study conducted systematic review on contributors to frailty and developed guidelines on the primary prevention of frailty in community-dwelling older adults. Methods This study updated a previous systematic review of contributors to frailty by adding the most recent articles. Based on this updated systematic review, experts in geriatrics and gerontology developed guidelines for preventing frailty using the Delphi method. Results These guidelines categorized the recommendations into physical activity, resilience, oral health, management of non-communicable diseases, involvement in society, smoking cessation, and eating various kinds of food. Conclusion Unlike previous frailty-related guidelines, this study developed evidence-based frailty prevention guidelines based on a systematic review. The guidelines are expected to contribute to the healthy aging of community-dwelling older adults by the primary prevention of frailty.
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Affiliation(s)
- Seungkook Ki
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.,Home Doctor Preventive Medicine Clinic, Suwon, Korea
| | - Ji-Hye Yun
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
| | - Chang-Won Won
- Department of Family Medicine, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, East-West Medical Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
| | - Chang-O Kim
- Institute of Social Welfare, Sungkonghoe University, Seoul, Korea
| | - Ki Young Son
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Health Care Science, Dong-A University, Busan, Korea
| | | | - Kyung-Eun Lee
- Major of Food and Nutrition, Seoul Women's University, Seoul, Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan, Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
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Lee D, Kim M, Won CW. Common and different characteristics among combinations of physical frailty and sarcopenia in community-dwelling older adults: The Korean Frailty and Aging Cohort Study. Geriatr Gerontol Int 2021; 22:42-49. [PMID: 34816568 DOI: 10.1111/ggi.14314] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/21/2021] [Accepted: 11/02/2021] [Indexed: 12/15/2022]
Abstract
AIM Physical frailty and sarcopenia are geriatric syndromes associated with adverse health outcomes. However, the common and different conditions associated with physical frailty and sarcopenia remain unclear. This study aimed to compare the clinical characteristics of older adults with physical frailty and sarcopenia. METHODS This cross-sectional study analyzed 2028 community-dwelling older adults, aged 70-84 years (mean age 75.9 ± 4.0 years; 50.1% men). Physical frailty was defined using the Fried frailty phenotype, whereas sarcopenia was defined using the Asian Working Group for Sarcopenia 2014 and 2019 criteria. RESULTS The prevalence of physical frailty was 5.5%, whereas that of sarcopenia, using the Asian Working Group for Sarcopenia 2014 and 2019, was 9.1% and 17.5%, respectively. The concordance of physical frailty with sarcopenia was higher in the Asian Working Group for Sarcopenia 2019 criteria than in 2014. Frail-only participants had a higher incidence of disability, cognitive dysfunction, poor self-perceived health, and depressive symptoms than the sarcopenic-only participants. Frail-and-sarcopenic participants showed a lower body mass index (≥23 kg/m2 ) than frail-only participants. Furthermore, in frail-and-sarcopenic participants, recurrent falls (16.9% vs 5.5%) were higher than in the neither-frail-nor-sarcopenic participants; falls with fracture (11.5% vs 1.7%) and fear of falling (59.0% vs 36.7%) were higher in frail-and-sarcopenic participants than in sarcopenic-only participants. CONCLUSIONS This study showed significant differences between physical frailty and sarcopenia among community-dwelling older adults. Older adults with physical frailty and sarcopenia were more likely to have higher fall-related outcomes than the others. Geriatr Gerontol Int 2021; ••: ••-••.
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Affiliation(s)
- Daehyun Lee
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.,Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Moon JH, Huh JS, Won CW, Kim HJ. Living and eating alone on depressive symptoms by physical frailty status: A cross-sectional study based on the Korean Frailty and Aging Cohort Study. Arch Gerontol Geriatr 2021; 98:104570. [PMID: 34773874 DOI: 10.1016/j.archger.2021.104570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND General health conditions in older adults, including their mental health, differ greatly based on their physical health conditions rather than age. Thus, we evaluated how lifestyle factors, which included eating and living, affected depressive symptoms in older adults based on their physical frailty status. METHODS We included older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS). Based on their eating and living patterns, we classified them into four groups: "lived and ate with others," "lived alone yet ate with others," "lived with others yet ate alone," and "lived and ate alone." Depressive symptoms and physical frailty were measured using the Korean version of the Geriatric Depression Scale and modified version of the Cardiovascular Health Study (CHS) Frailty Index, respectively. RESULTS A total of 2,702 participants, 11.4% lived with others yet ate alone, and 19.7% lived and ate alone. For robust older adults, after adjusting for variables, the "ate alone" group was significantly related with depressive symptoms, and the "lived and ate alone" group showed a higher risk of depressive symptoms. In the prefrail to frail participants, the "lived and ate alone" group was at a higher risk of depressive symptoms. CONCLUSION Eating and living alone are key risk factors for depressive symptoms in community-dwelling older adults regardless of their physical frailty status. Therefore, social interventions are needed for both physically frail and healthy older adults to support their eating patterns and increase opportunities for social interaction.
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Affiliation(s)
- Ji Hyun Moon
- Department of Family Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea; Department of Family Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Jung Sik Huh
- Department of Urology, Jeju National University College of Medicine, Jeju, Republic of Korea; Department of Urology, Jeju National University Hospital, Jeju, Republic of Korea
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea; Department of Family Medicine, Jeju National University Hospital, Jeju, Republic of Korea.
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Roh E, Hwang SY, Yoo HJ, Baik SH, Cho B, Park YS, Kim HJ, Lee SG, Kim BJ, Jang HC, Kim M, Won CW, Choi KM. Association of plasma FGF21 levels with muscle mass and muscle strength in a national multicentre cohort study: Korean Frailty and Aging Cohort Study. Age Ageing 2021; 50:1971-1978. [PMID: 34591968 DOI: 10.1093/ageing/afab178] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND despite of the beneficial effects of fibroblast growth factor (FGF) 21 in several metabolic diseases, the association of plasma FGF21 with muscle mass and muscle strength is still unclear. METHODS a total of 386 community-dwelling older adults aged 70-84 years were analysed. Appendicular skeletal muscle mass was measured using dual-energy X-ray absorptiometry and normalised to the square of height (ASM/ht2). Muscle strength was assessed using the hand grip strength (HGS) test. The definitions of low muscle mass (LMM) and low muscle strength (LMS) were based on the Asian Working Group for Sarcopenia. RESULTS plasma FGF21 was significantly lower in participants with LMM than in those with normal muscle mass (289.7 [192.4-448.3] vs. 345.6 [238.6-503.2] pg/ml, P = 0.008). In contrast, the LMS group had a significantly higher plasma FGF21 level than the normal muscle strength group (369.7 [244.4-591.1] vs. 309.7 [205.3-444.8] pg/ml, P = 0.006). In the partial correlation analysis, following adjustment for age, sex and body mass index, FGF21 levels had no significant association with ASM/ht2, but were negatively associated with HGS (r = -0.112, P = 0.029). Furthermore, after multivariate adjustment for confounding variables, the odds ratio for the risk of LMS was 2.32 (95% confidence interval 1.20-4.46) when comparing the highest with the lowest FGF21 quartile. CONCLUSIONS circulating FGF21 levels are negatively associated with muscle strength but are not independently correlated with muscle mass.
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Affiliation(s)
- Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Soon Young Hwang
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Belong Cho
- Department of Family Medicine, Center for Health Promotion and Optimal Aging, Seoul National University College of Medicine & Hospital, Seoul, Republic of Korea
| | - Yong Soon Park
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Sam-Gyu Lee
- Department of Physical & Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bong Jo Kim
- Department of Psychiatry, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Shin HE, Kim M, Won CW. Association between plasma procollagen type III N-terminal peptide (P3NP) levels and physical performance in elderly men: The Korean Frailty and Aging Cohort Study (KFACS). Exp Gerontol 2021; 154:111523. [PMID: 34425203 DOI: 10.1016/j.exger.2021.111523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Physical performance decline associated with aging is clinically important in the development of disability in the older population. More recently, procollagen type III N-terminal peptide (P3NP) and synaptosomal-associated protein of 25 kDa (SNAP25) have been suggested as potential biomarkers for physical performance decline. OBJECTIVE The objective of this pilot study was to examine plasma P3NP and SNAP25 levels in relation to muscle mass, strength, and performance status, and to investigate the association of plasma P3NP and SNAP25 levels with sarcopenia components. METHODS Seventy-nine community-dwelling elderly men (mean age: 78.1 ± 3.5 years) were randomly selected and matched by age from the Korean Frailty and Aging Cohort Study. The sample was classified into the "normal," "low muscle mass only," "sarcopenia," and "low physical performance only" groups according to the criteria of the Asian Working Group for Sarcopenia 2019. Estimates and 95% confidence intervals (CIs) of log P3NP and log SNAP25 levels by muscle mass, strength, and performance status were obtained using a generalized linear model. Pearson correlations and multiple linear regression analyses were used to assess the association of log P3NP and log SNAP25 levels with appendicular skeletal muscle mass (ASM) index, handgrip strength, and physical performance. RESULTS Log P3NP levels tended to be associated with low physical performance compared with the normal group (estimate = 0.54; 95% CI = -0.05, 1.14; p = 0.072). Log P3NP levels were inversely associated with physical performance (short physical performance battery and five-times sit-to-stand test) after adjusting for potential confounders (all p < 0.05) and tended to have an inverse association with gait speed (p = 0.078). Log P3NP levels tended to have a positive correlation with the ASM index (r2 = 0.042; p = 0.070), but not with handgrip strength (r2 = 0.0009; p = 0.795). However, no significant association between plasma SNAP25 levels and physical performance was observed. CONCLUSION Plasma P3NP levels might be a potential biomarker for decreased physical performance in elderly men. Further studies with larger sample sizes are needed to confirm our findings.
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Affiliation(s)
- Hyung Eun Shin
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Republic of Korea.
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea.
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Kim Y, Won CW, Kim S, Kim B, Kim M, Jeong E, Yang J, Lee H. Perceived Recovery Time from Common Cold as a Possible Indicator of Physical Resilience. Ann Geriatr Med Res 2021; 25:204-209. [PMID: 34496548 PMCID: PMC8497944 DOI: 10.4235/agmr.21.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background Resilience refers to the ability to recover function after encounter with stressors. While psychological resilience refers to the ability to cope with psychological stress, physical resilience refers to functional restoration after biomedical challenges. However, there is no gold standard to assess physical resilience. Accordingly, we explored whether the perceived recovery time from common cold could be used to represent physical resilience. Methods We analyzed data of individuals aged 72–86 years who had participated in the Korean Frailty and Aging Cohort Study in 2019. Among the 1,455 survey participants, 594 with asthma and chronic obstructive pulmonary disease and missing data were excluded. The remaining 861 participants were divided into three groups according to the number of days required for recovery from common cold (Group 1, 1–4 days; Group 2, 5–7 days; and Group 3, ≥8 days). The relationship between recovery time and psychological resilience scale (Brief Resilience Scale [BRS]) score, physical frailty (Fried’s physical frailty phenotype and the Korean Frailty Index for Primary Care [KFI-PC]), and frailty outcome was investigated. Results Group 3 comprised individuals more likely to be women, sleep less, be less physically less active, fall more often, and have a low EuroQol visual analogue scale score. BRS scores differed significantly among the three groups (Group 1, 13.29; Group 2, 14.32; Group 3, 15.22; p<0.001). In multivariate analysis, post-hoc analysis with the Bonferroni method revealed significant differences in BRS between Groups 1–2 and Groups 1–3. However, the KFI-PC and number of falls did not differ significantly. Conclusions Longer days of recovery from cold were associated with worse BRS scores. However, neither frailty nor the number of falls was related.
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Affiliation(s)
- Yoonki Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea.,Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - ByungSung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, East-West Medical Research Institute, Kyung Hee University College of Medicine, Seoul, Korea
| | - Eunjin Jeong
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jisoo Yang
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyona Lee
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Korea
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Jung HW, Jang IY, Back JY, Park S, Park CMI, Han SJ, Lee E. Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic. Korean J Intern Med 2021; 36:1242-1250. [PMID: 34503320 PMCID: PMC8435494 DOI: 10.3904/kjim.2020.652] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/22/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS We aimed to assess the validity of the Korean translated version of the Clinical Frailty Scale (CFS) in determining the frailty status in geriatric outpatients. METHODS The records of 123 ambulatory outpatients who had undergone CFS and comprehensive geriatric assessments (CGAs) including measurements for the Cardiovascular Health Study (CHS) frailty scale and the frailty index (CGA-FI) were analyzed. Correlations between CFS, CHS frailty scale, and CGA-FI were assessed. The ability of CFS to classify frailty status was calculated using the CHS frailty scale and CGA-FI as references. RESULTS The mean CFS score was 3.2 in the study population, with a mean age of 77.49 years (45.5% men). Individuals with higher CFS scores were older, had a greater burden of chronic diseases, and worse daily functions and cognitive performance. CFS scores positively correlated with CGA-FI (B = 0.78, p < 0.001) and CHS frailty scale (B = 0.67, p < 0.001) scores. For CFS, C-statistics to classify frailty by CGA-FI and CHS scale were 0.905 and 0.826, respectively. The cut-off value of CFS ≥ 4 maximized Youden's J to classify frailty by both the CHS scale and CGAFI. CONCLUSION The CFS is a valid screening tool to assess the frailty status in outpatients of a geriatric clinic in Korea. As a simple and quick measure, the CFS may facilitate frailty assessments in real-world clinical practice.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yeon Back
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seunghyun Park
- Department of Health Promotion and Management, National Health Insurance Service, Wonju, Korea
| | - Chan MI Park
- Department of Family Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Seung Jun Han
- Department of Internal Medicine, Hospital Medicine Center, Seoul National University Hospital, Seoul, Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Eunju Lee, M.D. Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3308 Fax: +82-2-2045-4268 E-mail:
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Shin HR, Choi EY, Kim SK, Lee HY, Kim YS. Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7918. [PMID: 34360213 PMCID: PMC8345707 DOI: 10.3390/ijerph18157918] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 11/17/2022]
Abstract
Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70-84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.
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Affiliation(s)
- Hye-Ri Shin
- Department of Gerontology, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
| | - Eun-Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA;
| | - Su-Kyung Kim
- AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
| | - Hee-Yun Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Young-Sun Kim
- AgeTech-Service Convergence Major, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Korea;
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63
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Kim M, Walston JD, Won CW. Associations between elevated growth differentiation factor-15 and sarcopenia among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 77:770-780. [PMID: 34255062 DOI: 10.1093/gerona/glab201] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized. METHODS We conducted cross-sectional (n = 929) and two-year prospective analyses (n = 788) among participants aged 70-84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of <60 mL/min/1.73 m 2 were excluded. Appendicular lean mass was measured using dual-energy X-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm. RESULTS At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs. 1019 pg/mL, p<0.001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16-3.33) than the lowest tertile (<885 pg/mL). During the two-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p>0.05). CONCLUSIONS Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.
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Affiliation(s)
- Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Jeremy D Walston
- Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. USA.,Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
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Choi SJ, Lee MS, Kang DH, Ko GJ, Lim HS, Yu BC, Park MY, Kim JK, Kim CH, Hwang SD, Kim JC, Won CW, An WS. Myostatin/Appendicular Skeletal Muscle Mass (ASM) Ratio, Not Myostatin, Is Associated with Low Handgrip Strength in Community-Dwelling Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147344. [PMID: 34299795 PMCID: PMC8307565 DOI: 10.3390/ijerph18147344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023]
Abstract
Background/Aims: Elevated levels of serum myostatin have been proposed as a biomarker for sarcopenia. Recent studies have shown that elevated level of serum myostatin was associated with physical fitness and performance. This study aimed to examine the significance of myostatin in the association between muscle mass and physical performance in the elderly. Methods: This cross-sectional study is based on the Korean Frailty and Aging Cohort study involving 1053 people aged 70 years or over. Anthropometric, physical performance, and laboratory data were collected. Results: The mean age of the participants was 75.8 years, and 50.7% of them were female. Serum myostatin levels in men (3.7 ± 1.2 vs. 3.2 ± 1.1 ng/mL, p < 0.001) were higher compared with that in women. Serum myostatin level was associated with appendicular skeletal muscle mass (ASM) index and eGFR by cystatin C. Serum myostatin/ASM ratio was associated with handgrip strength in women. Conclusion: Higher serum myostatin levels were related with higher muscle mass and better physical performances in the elderly. Serum myostatin/ASM ratio may be a predictor for physical performance rather than myostatin.
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Affiliation(s)
- Soo Jeong Choi
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Min Sung Lee
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea; (M.S.L.); (D.-H.K.)
| | - Duk-Hee Kang
- Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea; (M.S.L.); (D.-H.K.)
| | - Gang Jee Ko
- Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul 08308, Korea;
| | - Hee-Sook Lim
- Department of Food Sciences and Nutrition, Yeonsung University, Anyang 14011, Korea;
| | - Byung Chul Yu
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Moo Yong Park
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Jin Kuk Kim
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Chul-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14854, Korea;
| | - Seung Duk Hwang
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon 14584, Korea; (S.J.C.); (B.C.Y.); (M.Y.P.); (J.K.K.); (S.D.H.)
| | - Jun Chul Kim
- Division of Nephrology, Department of Internal Medicine, CHA University School of Medicine, Gumi 39295, Korea;
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul 02447, Korea
- Correspondence: (C.W.W.); (W.S.A.)
| | - Won Suk An
- Division of Nephrology, Department of Internal Medicine, Dong-A University College of Medicine, Busan 49201, Korea
- Correspondence: (C.W.W.); (W.S.A.)
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65
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Seo Y, Kim M, Shin H, Won C. Perceived Neighborhood Environment Associated with Sarcopenia in Urban-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6292. [PMID: 34200703 PMCID: PMC8296063 DOI: 10.3390/ijerph18126292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/07/2021] [Accepted: 06/09/2021] [Indexed: 11/17/2022]
Abstract
Sarcopenia is associated with adverse health outcomes among older individuals. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and perceived neighborhood environmental factors among community-dwelling older adults aged 70-84 years. We analyzed 1778 participants (mean age of 75.9 ± 3.8 years; 54.0% women) who lived in urban areas and underwent dual-energy X-ray absorptiometry from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 definition. Perceived neighborhood environmental factors were assessed using the Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). In the multivariate analysis, compared to the fifth quintile of the IPAQ-E score, the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia in the first, second, third, and fourth quintiles were 2.13 (1.40-3.24), 1.72 (1.12-2.64), 1.75 (1.15-2.66), and 1.62 (1.06-2.47), respectively. These neighborhood environmental characteristics were linked with an increased likelihood of sarcopenia: no public transportation access (OR = 2.04; 95% CI = 1.19-3.48), poor recreational facilities access (OR = 1.39; 95% CI = 1.01-1.90), absence of destination (OR = 1.53; 95% CI = 1.06-2.20), many hill hazards (OR = 1.36; 95% CI = 1.03-1.78), and lack of traffic safety (OR = 1.35; 95% CI = 1.02-1.78). Thus, better neighborhood environmental strategies may help prevent sarcopenia among urban-dwelling older adults.
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Affiliation(s)
- Yuri Seo
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Korea; (Y.S.); (H.S.)
| | - Miji Kim
- Department of Biomedical Science and Technology, East-West Medical Research Institute, College of Medicine, Kyung Hee University, Seoul 02447, Korea
| | - Hyungeun Shin
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Korea; (Y.S.); (H.S.)
| | - Changwon Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea
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66
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Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115754. [PMID: 34071957 PMCID: PMC8198611 DOI: 10.3390/ijerph18115754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022]
Abstract
Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.
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Jang AR, Won CW, Sagong H, Bae E, Park H, Yoon JY. Social factors predicting improvement of frailty in community-dwelling older adults: Korean Frailty and Aging Cohort Study. Geriatr Gerontol Int 2021; 21:465-471. [PMID: 33864343 DOI: 10.1111/ggi.14160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/28/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
AIM The study aimed to identify social factors predicting improvement of frailty in community-dwelling older adults after 2 years using a population-based cohort study. METHODS We analyzed data from the 2016 and 2018 Korean Frailty and Aging Cohort Study. The participants of this study were 1428 community-dwelling older adults aged 70-84 years who were recruited from 10 medical centers across different regions. Frailty was measured using the five-item FRAIL scale, which evaluates fatigue, resistance, ambulation, illness and weight loss. Multilevel logistic regression analysis was used to examine baseline social factors that predict frailty improvement after 2 years by frailty status. RESULTS In frail older adults, higher participation in social activities (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.02-1.34) was significantly associated with frailty improvement. In pre-frail older adults, there were no significant social factors predicting the improvement of frailty status; however, other modifiable factors such as high and moderate levels of physical activity (OR 1.17, 95% CI 1.07-1.28, OR 1.13, 95% CI 1.03-1.25, respectively) and low depressive symptoms (OR 0.88, 95% CI 0.84-0.91) were associated with pre-frail improvements. High levels of physical activity (OR 1.16, 95% CI 1.02-1.33) were also associated with improvements of frailty. CONCLUSIONS Different strategies depending on the level of frailty are necessary to improve frailty status. Timely and appropriate interventions can promote frailty improvement and prevent negative health outcomes in community-dwelling older adults. Geriatr Gerontol Int 2021; 21: 465-471.
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Affiliation(s)
- Ah Ram Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae Sagong
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Eunjung Bae
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Hyena Park
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Ju Young Yoon
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, Republic of Korea.,College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
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Lim J, Park H, Lee H, Lee E, Lee D, Jung HW, Jang IY. Higher frailty burden in older adults with chronic constipation. BMC Gastroenterol 2021; 21:137. [PMID: 33765938 PMCID: PMC7995705 DOI: 10.1186/s12876-021-01684-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/10/2021] [Indexed: 12/04/2022] Open
Abstract
Background Despite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults. Methods This is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype. Results In the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity. Conclusions Frailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-021-01684-x.
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Affiliation(s)
- Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hyungchul Park
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Heayon Lee
- Divison of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Jingwan-dong, Eunpyeong-gu, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Danbi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,PyeongChang Health Center and County Hospital, 11 Noseong-ro, Pyeongchang-gun, Gangwon-do, Republic of Korea.
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Dietary Patterns and Frailty in Older Korean Adults: Results from the Korean Frailty and Aging Cohort Study. Nutrients 2021; 13:nu13020601. [PMID: 33673185 PMCID: PMC7918700 DOI: 10.3390/nu13020601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022] Open
Abstract
There are few studies on dietary patterns and frailty in Asians, and the results are controversial. Therefore, this study examined the association between dietary patterns and frailty in older Korean adults using the Korean Frailty and Aging Cohort Study (KFACS). The sample consisted of 511 subjects, aged 70–84 years, community-dwelling older people from the KFACS. Dietary data were obtained from the baseline study (2016–2017) using two nonconsecutive 24-h dietary recalls, and dietary patterns were extracted using reduced rank regression. Frailty was measured by a modified version of the Fried Frailty Phenotype (FFP) in both the baseline (2016) and the first follow-up study (2018). A logistic regression analysis was used to examine the association between dietary patterns and frailty status in 2018. The “meat, fish, and vegetables” pattern was inversely associated with pre-frailty (OR = 0.41, 95% CI = 0.21–0.81, p for trend = 0.009) and exhaustion (OR = 0.41, 95% CI = 0.20–0.85, p for trend = 0.020). The “milk” pattern was not significantly associated with frailty status or the FFP components. In conclusion, a dietary pattern with a high consumption of meat, fish, and vegetables was associated with a lower likelihood of pre-frailty.
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Symptom Profiles, Health-Related Quality of Life, and Clinical Blood Markers among Korean Community-Dwelling Older Adults Living with Chronic Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041745. [PMID: 33670149 PMCID: PMC7916875 DOI: 10.3390/ijerph18041745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/26/2022]
Abstract
Older adults suffer from multiple symptoms, which negatively affects their health-related quality of life. The single-symptom management approach has been less than effective. The data of 2362 Korean community-dwelling older adults aged 70 and above were analyzed in the Korean Frailty and Aging Cohort Study (KFACS) study. A cluster analysis, correlation analysis, and logistic regression were used to analyze the data. We found three symptom clusters: high symptom burden (HSB, n = 1032); pain and fatigue group (PAF, n = 566); and the sleep deprivation group (SDP, n = 764). Participants in the HSB group are more likely to be of old age (OR = 1.1), be female (OR = 2.4), live in a rural area (OR = 1.4), have low physical activity (OR = 0.9), and have multiple chronic conditions (OR = 1.5). The clinical blood markers analysis showed a negative relationship among the physical health, free T4 (r = -0.083, p < 0.01) and insulin (r = -0.084, p < 0.01). The sex-specific blood markers analysis showed differences among three clusters. While free testosterone (male: r = 0.124, female: r = 0.110, p < 0.05) and dehydroepiandrosterone (DHEA) (male: r = 0.352 and female: r = 0.134, p < 0.05) were associated with physical health in the HSB group, only free testosterone was associated with mental health (male: r = -0.093, and female: r = -0.116, p < 0.05) in the SDP group. These findings suggest the potential role of the patient's sex and sex hormones in symptoms of Korean community-dwelling older adults. Understanding the symptom profiles and impact of biopsychosocial factors may enhance precision symptom management.
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Sagong H, Jang AR, Kim DE, Won CW, Yoon JY. The Cross-Lagged Panel Analysis between Frailty and Physical Activity among Community-Dwelling Older Adults by Age Groups. J Aging Health 2021; 33:387-395. [PMID: 33517827 DOI: 10.1177/0898264320987365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study was to investigate the reciprocal relationship between frailty and physical activity among older adults by age group (middle-old: 70-79 years; oldest-old: 80-84 years) within 2 years using cross-lagged panel analysis. Methods: The study data were derived from the Korean Frailty and Aging Cohort Study, and a total of 1092 participants were included. Results: Frailty and high physical activity had significant reciprocal relationships in the middle-old group, which indicates that frailty was associated with less high physical activity, and high physical activity predicts less frailty after 2 years. In the oldest-old group, there was no statistically significant reciprocal relationship between frailty and any level of physical activity reference to low physical activity and vice versa after 2 years. Discussion: Further studies on the relationship between frailty and physical activity of the oldest-old population and specific physical activity guidelines for older adults are needed.
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Affiliation(s)
- Hae Sagong
- College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Ah Ram Jang
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Da Eun Kim
- Research Institute of Nursing Science, College of Nursing, 34986Kyungpook National University, Daegu, Korea
| | - Chang Won Won
- College of Medicine, 26723Kyung Hee University, Seoul, Korea
| | - Ju Young Yoon
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea.,Research Institute of Nursing Science, 26725Seoul National University, Seoul, Korea
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72
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Kang S, Oh TJ, Cho BL, Park YS, Roh E, Kim HJ, Lee S, Kim BJ, Kim M, Won CW, Jang HC. Sex differences in sarcopenia and frailty among community-dwelling Korean older adults with diabetes: The Korean Frailty and Aging Cohort Study. J Diabetes Investig 2021; 12:155-164. [PMID: 32627923 PMCID: PMC7858110 DOI: 10.1111/jdi.13348] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/11/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to examine the prevalence of sarcopenia and frailty in Korean older adults with diabetes compared with individuals without diabetes. MATERIALS AND METHODS We analyzed the data of 2,403 participants aged 70-84 years enrolled in the Korean Frailty and Aging Cohort Study. Sarcopenia was defined using the Asian Working Group for Sarcopenia and the Foundation for the National Institutes of Health. Frailty was assessed by the Cardiovascular Health Study frailty phenotype criteria. RESULTS The mean age of the participants was 76.0 ± 3.9 years, and 47.2% were men. The prevalence of diabetes was 30.2% in men and 25.8% in women. Adults with diabetes showed a lower muscle mass index (appendicular skeletal muscle mass/body mass index) and handgrip strength in both sexes, but only the women showed decreased physical performance. Women with diabetes presented a higher prevalence of sarcopenia diagnosed by the Foundation for the National Institutes of Health criteria, and frailty compared with participants without diabetes (sarcopenia 14.7% vs 8.5%, P = 0.001; frailty 9.5% vs 4.9%, P = 0.003). Men in the high and middle tertiles for homeostatic model assessment of insulin resistance presented a significantly higher prevalence of sarcopenia, compared with men in the low tertile homeostatic model assessment of insulin resistance (high tertile 16.6%, middle tertile 13.3%, low tertile 8.6%). CONCLUSIONS In older adults with diabetes, muscle mass index and muscle strength were lower than in those without diabetes. However, the prevalence of sarcopenia and frailty was higher and physical performance was lower only in women with diabetes.
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Affiliation(s)
- Sunyoung Kang
- Department of Internal MedicineSeoul National University HospitalSeoulKorea
- Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
| | - Tae Jung Oh
- Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
- Department of Internal MedicineSeoul National University Bundang HospitalSeongnamKorea
| | - Be Long Cho
- Department of Family MedicineSeoul National University HospitalSeoulKorea
| | - Yong Soon Park
- Department of Family MedicineChuncheon Sacred Heart HospitalChuncheonKorea
| | - Eun Roh
- Department of Internal MedicineKorea University Guro HospitalSeoulKorea
| | - Hyeon Ju Kim
- Department of Family MedicineJeju National University HospitalJejuKorea
| | - Sam‐Gyu Lee
- Department of Physical & Rehabilitation MedicineChonnam National University HospitalGwangjuKorea
| | - Bong Jo Kim
- Department of PsychiatryGyeongsang National University HospitalJinjuKorea
| | - Miji Kim
- Department of Biomedical Science and TechnologyKyung Hee UniversitySeoulKorea
| | - Chang Won Won
- Department of Family MedicineKyung Hee University HospitalSeoulKorea
| | - Hak Chul Jang
- Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
- Department of Internal MedicineSeoul National University Bundang HospitalSeongnamKorea
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Park J, Won CW, Saligan LN, Kim YJ, Kim Y, Lukkahatai N. Accelerated Epigenetic Age in Normal Cognitive Aging of Korean Community-Dwelling Older Adults. Biol Res Nurs 2021; 23:464-470. [PMID: 33406883 DOI: 10.1177/1099800420983896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Epigenetic age acceleration has been studied as a promising biomarker of age-related conditions, including cognitive aging. This pilot study aims to explore potential cognitive aging-related biomarkers by investigating the relationship of epigenetic age acceleration and cognitive function and by examining the epigenetic age acceleration differences between successful cognitive aging (SCA) and normal cognitive aging (NCA) among Korean community-dwelling older adults (CDOAs). METHODS We used data and blood samples of Korean CDOAs from the Korean Frailty and Aging Cohort Study. The participants were classified into two groups, SCA (above the 50th percentile in all domains of cognitive function) and NCA. The genome-wide DNA methylation profiling array using Illumina Infinium MethylationEPIC BeadChip was used to calculate the following: the DNA methylation age, universal epigenetic age acceleration, intrinsic epigenetic age acceleration (IEAA), and extrinsic epigenetic age acceleration (EEAA). We also used Pearson correlation analysis and independent t-tests to analyze the data. RESULTS Universal age acceleration correlated with the Frontal Assessment Battery test results (r = -0.42, p = 0.025); the EEAA correlated with the Word List Recognition test results (r = -0.41, p = 0.027). There was a significant difference between SCA and NCA groups in IEAA (p = 0.041, Cohen's d = 0.82) and EEAA (p = 0.042, Cohen's d = 0.78). CONCLUSIONS Epigenetic age acceleration can be used as a biomarker for early detection of cognitive decline in Korean community-dwelling older adults. Large longitudinal studies are warranted.
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Affiliation(s)
- Jongmin Park
- College of Nursing, 34996Pusan National University, Gyeongsangnam-do, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, 26723Kyung Hee University, Seoul, Republic of Korea
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Youn-Jung Kim
- College of Nursing Science, 26723Kyung Hee University, Seoul, Republic of Korea
| | - Yoonju Kim
- College of Nursing Science, 26723Kyung Hee University, Seoul, Republic of Korea
| | - Nada Lukkahatai
- School of Nursing, 1466Johns Hopkins University, Baltimore, MD, USA
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Shin J, Kim M, Choi J. Development and Validation of a Multidimensional Frailty Scale for Clinical Geriatric Assessment. J Nutr Health Aging 2021; 25:938-943. [PMID: 34409975 DOI: 10.1007/s12603-021-1652-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study aims to develop a multidimensional frailty assessment tool including physical, psychological, and social frailty and to examine its psychometric property in a clinical setting. METHODS Through a literature review and gathered expert perspectives, the Korean Frailty Scale (KFS, 0-6 points) was developed with six questions about weight loss, self-assessment of health status, energy loss, fatigue, social network, and support. The psychometric property was then validated in community-dwelling older adults using the Korean Frailty and Aging Cohort Survey (2016-2019). Receiver operator characteristic (ROC) analyses determined optimal cutoff scores for frail, pre-frail, and robust. The predictive validity for mortality, hospitalization, fall events, and disability, such as declines in activities of daily living (ADL) and instrumental activities of daily living (IADL) was assessed after adjusting for age, sex, education level, household income, body-mass index, smoking status, alcohol consumption, physical activity, marital status, current employment, and residence. RESULTS The 2,923 participants (mean age: 76.0±3.9 years, female: 52.2%) were categorized into frail (≥3 points, 21.1%), pre-frail (1-2 points, 50.2%) and robust (0 points, 28.7%) groups. Sensitivity (88.3%), specificity (91.6%), and the area under the ROC curve (0.730) for the frail group were sufficient to be accepted as a new frailty scale. The frail group had increased risk of falling (relative risk [RR]: 1.810, 95% confidence interval: 1.354-2.420), mortality (hazard ratio, 6.596, 1.802-24.137), and IADL decline (RR, 1.638, 1.231-2.178). CONCLUSION The KFS is a new multidimensional frailty scale for clinical geriatric assessment that was confirmed as effective for predicting adverse health outcomes in Korean community-dwelling older adults.
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Affiliation(s)
- J Shin
- Jaekyung Choi, Department of Family Medicine, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea, Tel: +82-2-2030-7683; Fax: +82-2-2030-7748; E-mail:
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Shin HE, Walston JD, Kim M, Won CW. Sex-Specific Differences in the Effect of Free Testosterone on Sarcopenia Components in Older Adults. Front Endocrinol (Lausanne) 2021; 12:695614. [PMID: 34630322 PMCID: PMC8493256 DOI: 10.3389/fendo.2021.695614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/06/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The association of free testosterone (FT) with sarcopenia and its components is well known in men but incompletely understood in women. We examined the association of baseline FT with the prevalence and incidence of sarcopenia and its components in community-dwelling older adults. DESIGN Cross-sectional and longitudinal analysis from the prospective population-based Korean Frailty and Aging Cohort Study. METHODS A total of 1,879 community-dwelling older adults aged 70-84 years were enrolled for cross-sectional analysis and 1,583 subjects who participated in the 2-year follow-up survey were included for longitudinal analysis. Baseline FT levels was measured by radioimmunoassay. Skeletal muscle mass, handgrip strength, and physical performance tests were measured at baseline and after 2-year follow-up. Sarcopenia was defined by the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). RESULTS Continuous FT levels was positively associated with the prevalence of sarcopenia in men (odds ratio [OR]=0.95; 95% confidence interval [CI]=0.89-1.00)] and women (OR=0.64, 95% CI=0.42-0.99) after adjusting for multiple confounders. In prospective analysis, low FT levels was associated with a decrease in handgrip strength in women (β=-0.61; p=0.010) and a reduction in Timed "Up and Go" (TUG) test (β=0.53; p=0.008) in men after 2 years. No significant correlations were found between FT levels and the incidence of sarcopenia. CONCLUSIONS Low levels of FT may be a significant determinant of decreases in muscle strength in women and declines in physical performance in men after 2 years. Low FT do not predict loss of muscle mass in both men and women.
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Affiliation(s)
- Hyung Eun Shin
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Jeremy D. Walston
- Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, South Korea
- *Correspondence: Miji Kim, ; Chang Won Won,
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, South Korea
- *Correspondence: Miji Kim, ; Chang Won Won,
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Kim KJ, Choi J, Shin J, Kim M, Won Won C. Consensus on Components of Frailty Using the Delphi Method: Korean Frailty and Aging Cohort Study. J Nutr Health Aging 2021; 25:242-247. [PMID: 33491040 DOI: 10.1007/s12603-020-1523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The concept of frailty has been suggested to comprise physical, mental, and social phenotypes. However, there is no general consensus about the appropriate components for assessing frailty. OBJECTIVES The purpose of this study was to reach consensus on components of frailty assessment using the Delphi process. METHODS To achieve consensus on the definition of frailty, a modified Delphi method was used. Geriatric and gerontologic experts were selected from various fields. The detailed components of frailty were composed of data from the Korean Frailty and Aging Cohort Study. Establishing consensus and collecting opinions from experts were conducted using a modified Delphi method. RESULTS Overall, nine domains with 14 components of frailty assessment were accepted. There was consensus on the necessity of a broad phenotype including physical, mental, and social frailty. CONCLUSIONS Consensus on the components of a frailty assessment in a clinical setting is achieved through the Delphi process to establish a new tool of frailty assessment.
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Affiliation(s)
- K J Kim
- Jaekyung Choi, MD, PhD, Department of Family Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea, ORCID: https://orcid.org/0000-0002-0875-7505, Tel: +82-2-2030-7683, Fax: +82-2030-5009, E-mail:
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Jung HW, Kim S, Jang IY, Shin DW, Lee JE, Won CW. Screening Value of Timed Up and Go Test for Frailty and Low Physical Performance in Korean Older Population: The Korean Frailty and Aging Cohort Study (KFACS). Ann Geriatr Med Res 2020; 24:259-266. [PMID: 33296961 PMCID: PMC7781966 DOI: 10.4235/agmr.20.0072] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/21/2020] [Indexed: 11/29/2022] Open
Abstract
Background We evaluated the validity of the Timed Up and Go test (TUG) to screen for physical frailty and low physical performance in a nationwide community-dwelling Korean older population. Methods We used baseline records of 3,010 ambulatory participants with TUG data from the Korean Frailty Aging Cohort Study from 2016 to 2017. The population-specific distribution of TUG was assessed. Physical frailty was defined as ≥3 positive items in the 5-item Cardiovascular Health Study (CHS) frailty scale, and low physical performance was assessed as Short Physical Performance Battery (SPPB) scores ≤9 (ranging from 0 to 12). Results In men (n=1,429) and women (n=1,581), the mean TUG times were 10.3±2.7 seconds and 10.2±3.0 seconds, respectively. The cut-off TUG times for the worst quintile were 11.8 seconds in men and 12.5 seconds in women. The TUG time was correlated with both the CHS frailty scale score (standardized beta [B]=0.36, p<0.001) and SPPB total score (B=-0.22, p<0.001) in the linear regression analysis adjusted for age and sex. In the receiver operating characteristic analysis, the performance of TUG in identifying physical frailty, calculated as the area under the curve (AUC), was 0.87, while the AUC of TUG in identifying low physical performance according to SPPB was 0.86. Conclusion In the Korean older population, TUG can be a simple measure to identify physical frailty and low physical performance so as to identify populations that may benefit from in-depth geriatric assessments.
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Affiliation(s)
- Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Eun Lee
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
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Seo Y, Kim M, Shim H, Won CW. Differences in the Association of Neighborhood Environment With Physical Frailty Between Urban and Rural Older Adults: The Korean Frailty and Aging Cohort Study (KFACS). J Am Med Dir Assoc 2020; 22:590-597.e1. [PMID: 33221166 DOI: 10.1016/j.jamda.2020.09.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We examined the difference in the relationship between perceived neighborhood environments and physical frailty between urban and rural older adults. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Urban and rural community in South Korea; a total of 2593 community-dwelling older adults aged 70-84 years (mean age: 76.0 years, 51.0% women) in the Korean Frailty and Aging Cohort Study (KFACS). METHODS The neighborhood environment was assessed using the 17-item Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). The IPAQ-E had 7 environmental factors (residential density, access to destinations, neighborhood infrastructure, neighborhood safety, social environment, aesthetic qualities, and street connectivity). Physical frailty was defined using the Fried frailty criteria with modified cutoffs. RESULTS The number of participants residing in urban and rural areas was 1902 and 691, respectively. The prevalence of frailty was 5.3% and 12.0% in urban and rural areas, respectively. In urban areas, frailty was associated with the total IPAQ-E score (β = -0.007, P = .009) after adjusting for confounding factors. There was no association in the rural areas (β = -0.003, P = .535). In urban older adults, logistic regression showed that absence of destination [odds ratio (OR) 2.58, 95% confidence interval (CI) 1.36-4.90] and no crime safety at night (OR 2.00, 95% CI 1.12-3.57) were associated with a higher risk of frailty. In rural older adults, poor access to recreational facilities (OR 2.17, 95% CI 1.07-4.40) and no aesthetics (OR 2.49, 95% CI 1.22-5.10) were associated with frailty. CONCLUSIONS AND IMPLICATIONS Our study indicated that the presence of destination and crime safety at night was significantly associated with physical frailty among older adults living in urban areas, whereas aesthetics and recreational facilities were significantly associated with physical frailty in rural older adults.
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Affiliation(s)
- Yuri Seo
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea.
| | - Hayoung Shim
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Jang IY, Park JH, Kim JH, Lee S, Lee E, Lee JY, Park SJ, Kim DA, Hamrick MW, Kim BJ. The association of circulating kynurenine, a tryptophan metabolite, with frailty in older adults. Aging (Albany NY) 2020; 12:22253-22265. [PMID: 33188590 DOI: 10.18632/aging.104179] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/05/2020] [Indexed: 06/11/2023]
Abstract
Despite the accumulating evidence from in vitro and animal experiments supporting the role of kynurenine (a tryptophan metabolite) in a number of degenerative age-related changes, the relationship between kynurenine and frailty in older adults is not well understood. We collected blood samples from 73 participants who underwent a comprehensive geriatric assessment, measuring kynurenine levels using liquid chromatography-tandem mass spectrometry. We assessed the phenotypic frailty and the deficit accumulation frailty index using widely validated approaches proposed by Fried et al. and Rockwood et al., respectively. After adjusting for sex, age, and body mass index, the frail participants presented 52.9% and 34.3% higher serum kynurenine levels than those with robustness and prefrailty, respectively (P = 0.005 and 0.014, respectively). Serum kynurenine levels were positively associated with the frailty index, time to complete 5 chair stands, and patient health questionnaire-2 score and inversely associated with grip strength and gait speed (P = 0.042 to <0.001). Furthermore, the odds ratio per increase in serum kynurenine level for phenotypic frailty was approximately 2.62 (95% confidence interval = 1.22-5.65, P = 0.014). These data provide clinical evidence that circulating kynurenine might be a potential biomarker for assessing the risk of frailty in humans.
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Affiliation(s)
- Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mark W Hamrick
- Department of Cell Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Kong JY, Kim JS, Kang MH, Hwang HS, Won CW, Jeong KH. Renal dysfunction is associated with decline of cognitive function in community-dwelling older adults: Korean frailty and aging cohort study. BMC Geriatr 2020; 20:462. [PMID: 33172388 PMCID: PMC7654158 DOI: 10.1186/s12877-020-01862-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/31/2020] [Indexed: 11/20/2022] Open
Abstract
Background Cognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population. Methods A cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery. Results The mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4. Conclusion In older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01862-8.
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Affiliation(s)
- Ji Yoon Kong
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jin Sug Kim
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Min Hye Kang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kyung Hwan Jeong
- Division of Nephrology, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Jung H, Kim M, Lee Y, Won CW. Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217883. [PMID: 33121159 PMCID: PMC7662797 DOI: 10.3390/ijerph17217883] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023]
Abstract
Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70-84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8-8.9%) and 47.0% (95% CI, 45.1-48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.
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Affiliation(s)
- Heeeun Jung
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (M.K.); (C.W.W.); Tel.: +82-2-958-2840 (M.K.); +82-2-958-8700 (C.W.W.); Fax: +82-2-958-2836 (M.K.); +82-2-958-8699 (C.W.W.)
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (M.K.); (C.W.W.); Tel.: +82-2-958-2840 (M.K.); +82-2-958-8700 (C.W.W.); Fax: +82-2-958-2836 (M.K.); +82-2-958-8699 (C.W.W.)
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Jang IY, Lee S, Kim JH, Lee E, Lee JY, Park SJ, Kim DA, Hamrick MW, Park JH, Kim BJ. Lack of association between circulating apelin level and frailty-related functional parameters in older adults: a cross-sectional study. BMC Geriatr 2020; 20:420. [PMID: 33087053 PMCID: PMC7579806 DOI: 10.1186/s12877-020-01837-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/15/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Apelin, an active endogenous peptide, has been recently receiving great attention as a promising target for antiaging intervention, primarily based on results from genetically altered mice. To validate previous experimental data and investigate the possible role of apelin in humans, in this study, we examined serum apelin level in relation to frailty and its associated parameters in a cohort of ambulatory, community-dwelling older adults. METHODS Blood samples were collected from 80 participants who underwent a comprehensive geriatric assessment, and apelin level was measured using an enzyme immunoassay kit. Phenotypic frailty and deficit-accumulation frailty index (FI) were assessed using widely validated approaches, proposed by Fried and Rockwood groups, respectively. RESULTS After adjustment for sex, age, and body mass index, serum apelin level was found to be not significantly different according to phenotypic frailty status (P = 0.550) and not associated with FI, grip strength, gait speed, time to complete 5 chair stands, and muscle mass (P = 0.433 to 0.982). To determine whether the association between serum apelin level and frailty has a threshold effect, we divided the participants into quartiles according to serum apelin level. However, there were no differences in terms of frailty-related parameters and the risk for frailty among the quartile groups (P = 0.248 to 0.741). CONCLUSIONS The serum apelin level was not associated with both phenotypic frailty and functional parameters in older adults, despite its beneficial effects against age-related physiologic decline in animal models. Further large-scale longitudinal studies are necessary to understand the definite role of circulating apelin in frailty risk assessment.
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Affiliation(s)
- Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seungjoo Lee
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Jeoung Hee Kim
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Da Ae Kim
- Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Mark W Hamrick
- Department of Cell Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Jin Hoon Park
- Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
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Lee Y, Kim S, Kim M, Kim BS, Jeong E, Shim H, Won CW. A later menopausal age is associated with a lower prevalence of physical frailty in community-dwelling older adults: The Korean Frailty and Aging Cohort Study (KFACS). Arch Gerontol Geriatr 2020; 91:104243. [PMID: 32916429 DOI: 10.1016/j.archger.2020.104243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/04/2020] [Accepted: 08/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether age at menopause is associated with physical frailty. METHODS This was a cross-sectional study that included 1264 women (70-84 years) from the Korean and Aging Cohort Study (KFACS) who had records of their ages at menarche and their ages at menopause and had experienced a natural menopause. We used Fried criteria to assess physical frailty status. The ages at menopause and menarche were collected using self-reported questionnaires. RESULTS The prevalence of physical frailty decreased by 5.3 % with each year of increase in age at menopause after adjusting for age, marital status, years of education, diabetes mellitus, hypertension, polypharmacy, hospitalizations, falls, and hormone replacement therapy (p = 0.005). The prevalence of frailty significantly decreased by 4.1 % when the reproductive span increased by a year (p = 0.019). CONCLUSIONS This study found that a later menopausal age was associated with a lower risk of frailty using Fried criteria. In addition, it showed that a longer reproductive span was associated with a lower prevalence of frailty.
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Affiliation(s)
- Y Lee
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - S Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - M Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - B S Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - E Jeong
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - H Shim
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - C W Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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84
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Yun JH, Ki SK, Kim J, Chon D, Shin SY, Lee Y. Relationships between cognitive function and frailty in older Korean adults: The moderating effect of the number of teeth. Arch Gerontol Geriatr 2020; 91:104213. [PMID: 32805701 DOI: 10.1016/j.archger.2020.104213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cognitive function and physical frailty are known to be closely related. Among older adults with dementia, those who wear dentures have a higher mortality rate than those who do not wear them. This suggests the possibility that oral health may affect the cognitive-frailty relationship. This study aims to investigate whether the number of teeth present, acts as a moderating variable in the cognitive function-frailty relationship. METHODS Data were obtained from the cross-sectional baseline study of the Korean Frailty Aging Cohort Study (2016-2017). Cognitive function was assessed using the Mini-Mental State Examination. Frailty score was based on the Cardiovascular Health Study Index. Oral condition was evaluated by the number of teeth present and analyzed using categories of 0-9 teeth, 10-19 teeth, and ≥20. The moderation effect was analyzed using the ordinary least squares (OLS) regression. RESULTS Data on 2,310 older adults (1,110 men; mean age 75.9 ± 3.9 years) was analyzed. Adjusting for age, sex, income, education, alcohol drinking, body mass index, and number of comorbidities, cognitive function and frailty showed a negative association (B=-.030, p = .011). In the 10-19 teeth category, compared to the 0-9 teeth category, a negative association with frailty was found (B=-.152, p = .026). A significant interaction effect between the number of teeth and cognitive function was detected (p = .007). CONCLUSION The number of teeth may modify the degree of the association between cognitive function and frailty. For effective frailty management of older persons, cognitive function management and oral management should be considered and performed together.
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Affiliation(s)
- Ji-Hye Yun
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Seung-Kook Ki
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
| | - Doukyoung Chon
- Department of Preventive Medicine, School of Medicine, Korea University, Seoul, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Republic of Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea.
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85
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Won CW. Diagnosis and Management of Frailty in Primary Health Care. Korean J Fam Med 2020; 41:207-213. [PMID: 32713174 PMCID: PMC7385295 DOI: 10.4082/kjfm.20.0122] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022] Open
Abstract
Disability in older adults has become a significant burden, both individually and socially, due to the rapidly aging population in Korea. It is important to manage both frailty and chronic diseases to delay disability. Frailty, which is considered to be a transition phase between healthy status and disability, is defined as a significant decline in functional reserves of multiple organ systems and the resultant extreme vulnerability to stressors, leading to a higher risk of adverse health-related outcomes. The frailty phenotype and frailty index are the most commonly used methods to diagnose frailty. Frailty is related to physical, psychological, cognitive, and social dysfunction, and is sometimes caused by chronic disease. Therefore, primary care providers are ideally situated to incorporate the concept of frailty into their practice, as they are champions in comprehensive care. Although the identification and treatment of frailty is not yet standard practice in primary care, primary care physicians must use the electronic frailty index to identify frailty in all the patients aged ≥65 years in the United Kingdom. In Canada, some insurance companies and governments are using a similar program, which is called the Community Actions and Resources Empowering Seniors model. The clinical practice guidelines of the International Conference of Frailty and Sarcopenia Research, as well as some additional references, will be introduced. Here, we review the current literature on how to diagnose and manage frailty in primary care.
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Affiliation(s)
- Chang Won Won
- Department of Family Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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86
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Spousal Concordance of Physical Frailty in Older Korean Couples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124574. [PMID: 32630401 PMCID: PMC7344744 DOI: 10.3390/ijerph17124574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
Marital status is an important risk factor for physical frailty. However, there are limited data on spousal concordance of physical frailty among married couples. Here, we evaluate the spousal concordance of frailty as defined by the Fried frailty phenotype and specific phenotype components that contribute to this association. Data on 315 married couples (630 individuals) aged between 70 and 84 years were obtained from the Korean Frailty and Aging Cohort Study (KFACS). Multivariate logistic regressions were used for the analysis. After adjusting for covariates (age, body mass index, education, house ownership, comorbidity, cognition, depressive symptoms, cohabitation with adult children for both partners), a husband’s frailty was positively associated with his wife’s frailty (odds ratio (OR) 3.34, 95% confidence interval (CI) 1.04–10.73, p < 0.05), and a wife’s frailty was significantly associated with her husband’s frailty (OR 4.62, 95% CI 1.31–16.33, p < 0.05), indicating a greater effect of the frailty status of the spouse among women than among men. Among the five components of the Fried frailty phenotype, weight loss, slowness, and exhaustion were the main contributing factors to the spousal association for frailty. In conclusion, having a frail spouse is a strong and independent risk factor for frailty among community-living older adults.
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Shim H, Kim M, Won CW. Motoric Cognitive Risk Syndrome Using Three-Item Recall Test and Its Associations with Fall-Related Outcomes: The Korean Frailty and Aging Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3364. [PMID: 32408653 PMCID: PMC7277733 DOI: 10.3390/ijerph17103364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 01/07/2023]
Abstract
Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older Korean adults reported SCCs, thereby, it may not be discriminative to define MCR in Korea. We adopted the three-item recall (3IR) test, instead of SCCs, to define MCR. This cross-sectional analysis included 2133 community-dwelling older adults aged 70-84 years, without dementia or any dependence in activities of daily living from the Korean Frailty and Aging Cohort Study. The newly attempted criteria of MCR using 3IR were met by 105 participants (4.9%). MCR using 3IR showed synergistic effects on fall-related outcomes, whereas the conventional definition of MCR using SCCs was not superior to SG only. MCR using 3IR was associated with falls (odds ratio [OR]: 1.92; 95% confidence interval (CI): 1.16-3.16), recurrent falls (OR: 2.19; 95% CI: 1.12-4.32), falls with injury (OR: 1.98; 95% CI: 1.22-3.22), falls with fracture (OR: 2.51; 95% CI: 1.09-5.79), fear of falling (OR: 3.00; 95% CI: 1.83-4.92), and low activities-specific balance confidence (OR: 3.13; 95% CI: 1.57-6.25). We found that MCR using 3IR could be useful in predicting fall-related outcomes in a cultural background reporting more SCCs, such as Korea.
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Affiliation(s)
- Hayoung Shim
- Department of Biomedical Science and Technology, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul 02447, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul 02447, Korea
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