Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area

Abstract

Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.

Comparison Between Korean Version of Physical Activity Scale for the Elderly and International Physical Activity Questionnaire-Short Form in Evaluation of Frailty Phenotype

“…The participation rate was 95%, and the characteristics of ASPRA participants were comparable with those of a nationally representative sample of the Korean rural population 7,15) , except that a higher proportion of ASPRA participants were working in agriculture and had a little formal education.…”

“…Detailed information on study design, target population, and measurements in ASPRA were published previously 7) . People were eligible for the study if they were (1) age 65 years or older, (2) registered in the Community Healthcare Service, (3) ambulatory with or without an assistive device, (4) living at home, and (5) able to provide informed consent.…”

“…Trained nurses determined the existence of common geriatric conditions using the following instruments: the Korean version of the Mini-Mental State Examination (K-MMSE) for cognitive function, handgrip strength and usual gait speed for physical performance, the Korean version of the Center for Epidemiological Studies Depression (CES-D) scale for depressive mood, the Mini-Nutritional Assessment-Short Form (MNA-SF) score for malnutrition, and the Korean activities of daily living (ADL) and Korean instrumental ADL for dependence, with the previously validated cutoff points 7) . Sarcopenia was defined according to the Asian Working Group on Sarcopenia (AWGS) 20) criteria, based on bioimpedance analysis (Inbody 620; Inbody, Seoul, Korea), usual gait speed, and handgrip strength (T.K.K.…”

“…In general, most tools can be categorized as either a phenotype model or an accumulationof-deficit model 2,3,6) . Many clinical and preclinical studies used the Cardiovascular Health Study (CHS) frailty phenotype as a reference standard method [7][8][9][10] . As the construct validity and predictive validity of the CHS frailty phenotype have also been demonstrated in older Koreans 5) , the CHS frailty phenotype is widely used for varying purposes in Korea 8,11) .…”

Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight questionnaire versus the Modified Kihon Checklist for Frailty Screening in Community‐Dwelling Older Adults: The Aging Study of PyeongChang Rural Area

“…The Aging Study of PyeongChang Rural Area (ASPRA) is a community-based, prospective cohort study of frailty and geriatric syndromes in older Koreans living in rural areas. 15 The design and method in which it was carried out have been described elsewhere. 15 Briefly, we enrolled 382 older adults in two communities of Pyeongchang County, Gangwon Province, Korea, which is located 180 km east of Seoul.…”