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Original Article
- Frailty and its related Factors in Vulnerable Elderly Population by Age Groups
- Eunok Park1, Mi Yu2
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Journal of Korean Academy of Nursing 2016;46(6):848-857.
DOI: https://doi.org/10.4040/jkan.2016.46.6.848
Published online: December 15, 2016
1College of Nursing, Jeju National University, Jeju
2College of Nursing·Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
1College of Nursing, Jeju National University, Jeju
2College of Nursing·Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Address reprint requests to : Yu, Mi College of Nursing, Gyeongsang National University, 816 beongil-15, Jinju-daero, Jinju, Gyeongnam 52727, Korea Tel: +82-55-772-8229 Fax: +82-55-772-8222 E-mail: yumi825@gnu.ac.kr
• Received: June 6, 2016 • Revised: September 8, 2016 • Accepted: September 29, 2016
Copyright © 2016 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium
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Abstract
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Purpose
- This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea.
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Methods
- In this secondary analysis, data were collected from records for 22,868 elders registered in the Visiting Health Management program of Public Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group.
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Results
- Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p<.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p<.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p<.001).
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Conclusion
- The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.
Table 1.Differences in Variables by Age Group (N=22,868)
Table 2.Frailty by Age Group
Table 3.Correlations among Variables
Table 4.Factors Affecting Frailty of Elders by Age Group
- 1. Statistics Korea. Percentage of elderly population [Internet]. Daejeon: Author; 2016.[cited 2016 February 16]. Available from:. http://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1YL0201&conn_path=I2
- 2. Min J. Effect of social engagement on self-rated health trajectory among Korean older adults. Health and Social Welfare Review. 2013;33(4):105–123. http://dx.doi.org/10.15709/hswr.2013.33.4.105Article
- 3. Kim JI. Levels of health-related quality of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Journal of Korean Academy of Community Health Nursing. 2013;24(1):99–109. http://dx.doi.org/10.12799/jkachn.2013.24.1.99Article
- 4. Lee I, Park YI, Park E, Lee SH, Jeong IS. Validation of instruments to classify the frailty of the elderly in community. Journal of Korean Academy of Community Health Nursing. 2011;22(3):302–314. http://dx.doi.org/10.12799/jkachn.2011.22.3.302Article
- 5. Whitson HE, Purser JL, Cohen HJ. Frailty thy name is . Phrailty? The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2007;62(7):728–730. http://dx.doi.org/10.1093/gerona/62.7.728PubMed
- 6. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdie-ner J, et al. Frailty in older adults: Evidence for a phenotype. The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2001;56(3):M146–M156. http://dx.doi.org/10.1093/gerona/56.3.M146ArticlePubMed
- 7. Morley JE, Haren MT, Rolland Y, Kim MJ. Frailty. The Medical clinics of North America. 2006;90(5):837–847. http://dx.doi.org/10.1016/j.mcna.2006.05.019ArticlePubMed
- 8. Ministry of Health & Welfare, Korea Health Promotion Foundation. 2012 Yearbook of home visiting health care. Seoul: Author; 2013.
- 9. Levers MJ, Estabrooks CA, Ross Kerr JC. Factors contributing to frailty: Literature review. Journal of Advanced Nursing. 2006;56(3):282–291. http://dx.doi.org/10.1111/j.1365-2648.2006.04021.xArticlePubMed
- 10. Park JK, Kim SL. Factors affecting the elderly’ frailty among the vulnerable social group. Journal of the Korean Gerontological Society. 2014;34(3):441–456.
- 11. St. John PD, Tyas SL, Montgomery PR. Depressive symptoms and frailty. International Journal of Geriatric Psychiatry. 2013;28(6):607–614. http://dx.doi.org/10.1002/gps.3866ArticlePubMed
- 12. Yang F, Gu D, Mitnitski A. Frailty and life satisfaction in Shanghai older adults: The roles of age and social vulnerability. Archives of Gerontology and Geriatrics. 2016;67:68–73. http://dx.doi.org/10.1016/j.archger.2016.07.001ArticlePubMed
- 13. Zheng Z, Guan S, Ding H, Wang Z, Zhang J, Zhao J, et al. Prevalence and incidence of frailty in community-dwelling older people: Beijing longitudinal study of aging II. Journal of the American Geriatrics Society. 2016;64(6):1281–1286. http://dx.doi.org/10.1111/jgs.14135PubMed
- 14. Gu D, Dupre ME, Sautter J, Zhu H, Liu Y, Yi Z. Frailty and mortality among Chinese at advanced ages. The Journals of Gerontology Series B Psychological Sciences and Social Sciences. 2009;64(2):279–289. http://dx.doi.org/10.1093/geronb/gbn009ArticlePubMedPMC
- 15. Park BJ, Lee YJ. Integrative approach to elderly frailty. Korean Journal of Family Medicine. 2010;31(10):747–754. http://dx.doi.org/10.4082/kjfm.2010.31.10.747Article
- 16. Sunwoo D, Oh YH, Lee SH, Oh JS, Lee SG. The future policy issues for health of the elderly: Construction of functional independence promotion system of everyday living activity. Seoul: Korea Institute for Health and Social Affairs; 2009.Report No.: Research 2009-22.
- 17. Buchman AS, Boyle PA, Wilson RS, Tang Y, Bennett DA. Frailty is associated with incident Alzheimer’s disease and cognitive decline in the elderly. Psychosomatic Medicine. 2007;69(5):483–489. http://dx.doi.org/10.1097/psy.0b013e318068de1dArticlePubMed
- 18. Burke KE, Schnittger R, O’Dea B, Buckley V, Wherton JP, Lawlor BA. Factors associated with perceived health in older adult Irish population. Aging & Mental Health. 2012;16(3):288–295. http://dx.doi.org/10.1080/13607863.2011.628976Article
- 19. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care. The Journals of Gerontology Series A Biological Sciences and Medical Sciences. 2004;59(3):255–263.ArticlePubMed
- 20. Yesavage JA, Sheikh JI. 9/Geriatric depression scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist. 1986;5(1-2):165–173. http://dx.doi.org/10.1300/J018v05n01_09Article
- 21. Kee BS. A preliminary study for the standardization of geriatric depression scale short form-Korea version. Journal of Korean Neuropsychiatric Association. 1996;35(2):298–307.
- 22. Imai Y, Hasegawa K. The revised Hasegawa’s dementia scale (HDS-R): Evaluation of its usefulness as a screening test for dementia. Journal of the Hong Kong College of Psychiatrists. 1994;4(2):20–24.
- 23. Yang DW, Kim BS, Shim DS, Chung SW, Lee KS, Han SH, et al. Reliability and validity of the Korean version of revised form of hasegawa dementia scale (K-HDS). Journal of the Korean Neurological Association. 2004;22(4):315–321.
- 24. Djernes JK. Prevalence and predictors of depression in populations of elderly: A review. Acta Psychiatrica Scandinavica. 2006;113(5):372–387. http://dx.doi.org/10.1111/j.1600-0447.2006.00770.xArticlePubMed
- 25. Lee G, Ma RW. A study on the perceived health status among the elderly in local communities. Journal of the Korean Gerontological Society. 2013;33(4):881–893.
- 26. Birditt KS. Age differences in emotional reactions to daily negative social encounters. The Journals of Gerontology Series B Psychological Sciences and Social Sciences. 2014;69(4):557–566. http://dx.doi.org/10.1093/geronb/gbt045ArticlePubMed
- 27. Kim HR. Prevalence and risk factors of osteoarthritis among women and men elderly people in Korea. Journal of the Korean Gerontological Society. 2013;33(4):805–820.
- 28. Chimeddamba O, Peeters A, Walls HL, Joyce C. Noncommunicable disease prevention and control in Mongolia: A policy analysis. BMC Public Health. 2015;15:660http://dx.doi.org/10.1186/s12889-015-2040-7ArticlePubMedPMCPDF
- 29. Kramer AF, Erickson KI, Colcombe SJ. Exercise, cognition, and the aging brain. Journal of Applied Physiology. 2006;101(4):1237–1242. http://dx.doi.org/10.1152/japplphysiol.00500.2006ArticlePubMed
- 30. Lee Y, Lee YS, Han A, Kim SY. Effects of silverobics exercise on metabolic syndrome risk factors, bone mineral density and living fitness of elderly women. The Korean Journal of Sports Science. 2012;21(1):1155–1164.
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XML DownloadFrailty and its related Factors in Vulnerable Elderly Population by Age Groups
Frailty and its related Factors in Vulnerable Elderly Population by Age Groups
Differences in Variables by Age Group (N=22,868)
| Characteristics | Categories | n | 65~74 yr (n=9,032) | 75~84 yr (n=11,530) | Over 85 yr (n=2,306) | χ2 | p |
|---|---|---|---|---|---|---|---|
| n (%) | n (%) | n (%) | |||||
| Gender | Male | 4,809 | 1,987 (22.0) | 2,380 (20.6) | 442 (19.2) | 10.98 | .004 |
| Female | 18,059 | 7,045 (78.0) | 9,150 (79.4) | 1,864 (80.8) | |||
| Smoking | No | 21,132 | 8,325 (92.8) | 10,665 (93.2) | 2,142 (93.7) | 2.91 | .233 |
| Yes | 1,573 | 649 (7.2) | 780 (6.8) | 144 (6.3) | |||
| Alcohol consumption | No Yes | 18,714 4,154 | 7,179 1,853 (79.5) (20.5) | 9,536 1,994 (82.7) (17.3) | 1,999 307 (86.7) (13.3) | 75.98 | ＜.001 |
| Physical activity | No Yes | 21,889 979 | 8,545 487 (94.6) (5.4) | 11,084 446 (96.1) (3.9) | 2,260 46 (98.0) (2.0) | 61.41 | ＜.001 |
| Skipping breakfast | No | 22,664 | 8,947 (99.1) | 11,429 (99.1) | 2,288 (99.2) | 0.60 | .740 |
| Yes | 204 | 85 (0.9) | 101 (0.9) | 18 (0.8) | |||
| No. of diseases | None 1~2 | 2,110 17,559 | 980 6,827 (10.9) (75.6) | 937 8,871 (8.1) (76.9) | 193 1,861 (8.4) (80.7) | 73.09 | ＜.001 |
| ≥3 | 3,199 | 1,225 (13.6) | 1,722 (14.9) | 252 (10.9) | |||
| Hypertension | No Yes | 8,684 14,184 | 3,724 5,308 (41.2) (58.8) | 4,129 7,401 (35.8) (64.2) | 831 1,475 (36.0) (64.0) | 67.26 | ＜.001 |
| Diabetes mellitus | No | 18,395 | 7,053 (78.1) | 9,317 (80.8) | 2,025 (87.8) | 112.41 | ＜.001 |
| Yes | 4,473 | 1,979 (21.9) | 2,213 (19.2) | 281 (12.2) | |||
| CVA | No Yes | 21,457 1,411 | 8,460 572 (93.7) (6.3) | 10,783 747 (93.5) (6.5) | 2,214 92 (96.0) (4.0) | 21.25 | ＜.001 |
| Arthritis | No Yes | 7,810 15,058 | 3,477 5,555 (38.5) (61.5) | 3,687 7,843 (32.0) (68.0) | 646 1,660 (28.0) (72.0) | 138.68 | ＜.001 |
| Urinary incontinence | No | 22,344 | 8,845 (97.9) | 11,246 (97.5) | 2,253 (97.7) | 3.49 | .175 |
| Yes | 524 | 187 (2.1) | 284 (2.5) | 53 (2.3) | |||
| Depression | No | 13,339 | 5,651 (62.6) | 6,469 (56.1) | 1,219 (52.9) | 141.89 | ＜.001 |
| Mild | 8,765 | 3,156 (34.9) | 4,642 (40.3) | 967 (41.9) | |||
| Severe | 764 | 225 (2.5) | 419 (3.6) | 120 (5.2) | |||
| Cognitive condition | Normal | 18,534 | 7,866 (87.1) | 9,159 (79.4) | 1,509 (65.4) | 600.00 | ＜.001 |
| Dementia | 4,334 | 1,166 (12.9) | 2,371 (20.6) | 797 (34.6) | |||
| Frailty | Not frail | 18,765 | 8,104 (89.7) | 9,222 (80.0) | 1,439 (62.4) | 999.50 | ＜.001 |
| Frail | 4,103 | 928 (10.3) | 2,308 (20.0) | 867 (37.6) | |||
| Variables | Range | M±SD | M±SD | M±SD | F | p | |
| Frailty | 0~20 | 2.21a±3.02 | 3.30b±3.55 | 5.08c±4.44 | 692.78 | ＜.001 | |
| Depression | 0~15 | 4.24a±2.11 | 4.57b±2.27 | 4.84c±2.37 | 90.41 | ＜.001 | |
| Cognitive condition | 0~30 | 22.55a±4.67 | 20.82b±4.81 | 18.78c±5.14 | 684.41 | ＜.001 |
a, b, c: post-hoc (Scheffé) comparison results for ANOVA. Different letters present that mean difference is significant with other groups.
Frailty by Age Group
| Characteristics | Categories | 65~74 yr (n=9,032) | 75~84 yr (n=11,530) | Over 85 yr (n=2,306) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| M ±SD | t | p | M ±SD | t | p | M ±SD | t | p | ||
| Smoking | No | 2.24 ±3.04 | 2.98 | .003 | 3.29 ±3.55 | -0.07 | .945 | 5.09 ±4.43 | -0.22 | .829 |
| Yes | 1.90 ±2.75 | 3.30 ±3.45 | 5.17 ±4.68 | |||||||
| Alcohol | No | 2.33 ±3.15 | 8.10 | ＜.001 | 3.39 ±3.63 | 6.87 | ＜.001 | 5.20 ±4.49 | 3.55 | ＜.001 |
| consumption | Yes | 1.78 ±2.42 | 2.85 ±3.09 | 4.32 ±3.99 | ||||||
| Physical activity | No | 2.26 ±3.03 | 6.39 | ＜.001 | 3.36 ±3.55 | 9.68 | ＜.001 | 5.13 ±4.45 | 5.86 | ＜.001 |
| Yes | 1.43 ±2.78 | 1.85 ±3.22 | 2.63 ±2.82 | |||||||
| Skipping breakfast | No | 2.22 ±3.02 | 2.07 | .041 | 3.29 ±3.55 | -1.54 | .127 | 5.07 ±4.42 | -1.07 | .301 |
| Yes | 1.67 ±2.42 | 3.94 ±4.22 | 6.67 ±6.34 | |||||||
| Hypertension | No | 2.17 ±3.02 | -1.12 | .261 | 3.19 ±3.55 | -2.55 | .011 | 5.19 ±4.67 | 0.85 | .398 |
| Yes | 2.24 ±3.02 | 3.36 ±3.55 | 5.02 ±4.31 | |||||||
| Diabetes mellitus | No | 2.17 ±2.97 | -2.57 | .010 | 3.26 ±3.52 | -2.11 | .035 | 5.12 ±4.45 | 1.06 | .288 |
| Yes | 2.37 ±3.18 | 3.45 ±3.70 | 4.82 ±4.39 | |||||||
| CVA | No | 2.11 ±2.92 | -9.57 | ＜.001 | 3.20 ±3.48 | -8.98 | ＜.001 | 5.05 ±4.42 | -1.68 | .097 |
| Yes | 3.73 ±3.97 | 4.65 ±4.30 | 5.91 ±4.87 | |||||||
| Arthritis | No | 1.85 ±3.06 | -8.90 | ＜.001 | 2.73 ±3.53 | -11.91 | ＜.001 | 4.51 ±4.46 | -3.88 | ＜.001 |
| Yes | 2.44 ±2.97 | 3.57 ±3.53 | 5.31 ±4.41 | |||||||
| Urinary | No | 2.19 ±3.00 | -4.10 | ＜.001 | 3.27 ±3.53 | -4.57 | ＜.001 | 5.05 ±4.44 | -2.28 | .023 |
| incontinence | Yes | 3.30 ±3.69 | 4.40 ±4.13 | 6.45 ±4.17 | ||||||
Frailty range; 0~20 score. CVA=Cerebrovascular accident.
Correlations among Variables
| Variables | 65~74 yr (n=9,032) | 75~84 yr (n=11,530) | Over 85 yr (n=2,306) | |||
|---|---|---|---|---|---|---|
| Frailty | Depression | Frailty | Depression | Frailty | Depression | |
| r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | |
| Depression | .26 (＜.001) | 1 | .28 (＜.001) | 1 | .26 (＜.001) | 1 |
| Cognitive condition | -.23 (＜.001) | -.14 (＜.001) | -.29 (＜.001) | -.16 (＜.001) | -.41 (＜.001) | -.25 (＜.001) |
Factors Affecting Frailty of Elders by Age Group
| Variables | 65~74 yr | 75~84 yr | Over 85 yr | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| b | SE | ß | t | p | b | SE | ß | t | p | b | SE | ß | t | p | |
| Intercept | |||||||||||||||
| Smoking* | -0.22 | 0.12 | .02 | -1.86 | .062 | ||||||||||
| Alcohol consumption* | -0.32 | 0.07 | .04 | -4.24 | ＜.001 | -0.22 | 0.08 | .02 | -2.73 | .006 | -0.37 | 0.25 | .03 | 2.20 | .138 |
| Physical activity* | -0.69 | 0.13 | .05 | -5.24 | ＜.001 | -1.26 | 0.16 | .07 | -8.05 | ＜.001 | -1.94 | 0.59 | .06 | 10.66 | .011 |
| Skipping breakfast* | -0.53 | 0.31 | .02 | -1.74 | .082 | ||||||||||
| No. of disease | 0.22 | 0.08 | .03 | 2.83 | .005 | ||||||||||
| Hypertension* | |||||||||||||||
| Diabetes mellitus* | 0.19 | 0.07 | .03 | 2.62 | .009 | 0.15 | 0.09 | .02 | 1.71 | .087 | |||||
| CVA* | 1.35 | 0.12 | .11 | 10.94 | ＜.001 | 1.11 | 0.13 | .08 | 8.65 | ＜.001 | 1.09 | 0.42 | .05 | 6.57 | .010 |
| Arthritis* | 0.48 | 0.06 | .08 | 7.73 | ＜.001 | 0.59 | 0.07 | .08 | 8.26 | ＜.001 | 0.40 | 0.19 | .04 | 4.57 | .033 |
| Urinary incontinence* | 0.72 | 0.21 | .03 | 3.45 | .001 | 0.59 | 0.20 | .03 | 2.99 | .003 | |||||
| Depression | 0.31 | 0.01 | .22 | 21.91 | ＜.001 | 0.36 | 0.01 | .23 | 26.56 | ＜.001 | 0.30 | 0.04 | .16 | 68.53 | ＜.001 |
| Cognitive condition | -0.12 | 0.01 | .19 | -18.93 | ＜.001 | -0.18 | 0.01 | .24 | -27.4 | ＜.001 | -0.31 | 0.02 | .36 | 349.39 | ＜.001 |
| F (p) | 135.66 (＜.001) | 245.40 (＜.001) | 96.48 (＜.001) | ||||||||||||
| R2 | 0.13 | 0.17 | 0.20 | ||||||||||||
*Dummy variables (no=0, yes=1); Smoking, drinking alcohol, physical activity, skipping breakfast, hypertension, diabetes mellitus, cerebrovascular accidents, arthritis, urinary incontinence; CVA=C erebrovascular accide ents.
Table 1. Differences in Variables by Age Group (N=22,868)
a, b, c: post-hoc (Scheffé) comparison results for ANOVA. Different letters present that mean difference is significant with other groups.
Table 2. Frailty by Age Group
Frailty range; 0~20 score. CVA=Cerebrovascular accident.
Table 3. Correlations among Variables
Table 4. Factors Affecting Frailty of Elders by Age Group
*Dummy variables (no=0, yes=1); Smoking, drinking alcohol, physical activity, skipping breakfast, hypertension, diabetes mellitus, cerebrovascular accidents, arthritis, urinary incontinence; CVA=C erebrovascular accide ents.
