What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study

Kim, Sun‐Young; Jung, Hee-Won; Won, Chang Won

doi:10.3904/kjim.2019.097

Cited by 9 publications

(5 citation statements)

References 58 publications

(74 reference statements)

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“…In acute care settings, performing comprehensive geriatric assessments (CGAs) for older patients is less feasible as CGAs frequently take > 30 minutes for a single patient. To address this unmet need, several screening measures of frailty for older adults have been developed and validated [11][12][13][14]. Among these instruments, the ones requiring physical performance assessments might be less applicable for acute hospital settings where patients experience sudden deconditioning due to acute illnesses.…”

Section: Introductionmentioning

confidence: 99%

Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic

Jung

Jang

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et al. 2021

Korean J Intern Med

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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.Conclusions: 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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Section: Introductionmentioning

confidence: 99%

Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic

Jung

Jang

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et al. 2021

Korean J Intern Med

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“…This could be due to lack of provision of proper healthcare resources to older adults with multiple comorbidities. Furthermore, Kim et al reported in their study that older Korean adults had about an average of 2.4 comorbidities, and that only certain diseases such as hypertension, diabetes, and arthritis were linked to frailty 27 .…”

Section: Discussionmentioning

confidence: 99%

Impact of frailty on mortality and healthcare costs and utilization among older adults in South Korea

Nari,

Park,

Nam

et al. 2023

Sci Rep

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Frailty has become increasingly relevant in a rapidly aging society, highlighting the need for its accurate identification and exploring associated clinical outcomes. Using a multidimensional framework to estimate frailty in a sample of community dwelling older adults, its effect on mortality, incurred healthcare costs and utilization were investigated. We obtained data from the 2008–2018 Korean Longitudinal Study of Aging (KLoSA). After excluding individuals aged < 65 years and those with missing data, a total of 3578 participants were included in our study. Cox proportional hazard analysis was conducted to investigate the impact of frailty on all-cause mortality by generating hazard ratios (HRs) and population attributable risks (PARs). Healthcare utilization and out-of-pocket costs incurred by frailty were examined using the Generalized Linear Mixed Model (GLMM). Subgroup analyses were conducted according to frailty components. Among 3578 older adults, 1052 individuals died during a 10-year follow up period. Compared to the low risk frailty group, the moderate risk group (HR: 1.52, 95% CI:1.37–1.69) and severe risk group (HR: 3.10, 95% CI: 2.55–3.77) had higher risks for all-cause mortality. 27.4% (95% CI: 19.0–35.3%) of all-cause mortality was attributable to frailty, and the PARs ranged from 0.5 to 22.6% for individual frailty components. Increasing frailty levels incurred higher total healthcare costs and cost per utilization, including inpatient and outpatient costs. Frailty also increased likelihood of inpatient use, longer length of stay and more frequent outpatient visits. Among the frailty components, Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) in particular were linked to elevated mortality, higher incurred healthcare costs and utilization. Frailty-tailored interventions are of utmost relevance to policy makers and primary caregivers as frailty threatens the ability to maintain independent living and increases risk of detrimental outcomes such as mortality and increased utilization and out-of-pocket costs of healthcare in older adults.

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“…15) The standardized CGA used for the FI can comprise assessments in Frailty is also known to be highly associated with hypertension, diabetes mellitus, cancer (other than minor skin cancers), chronic lung disease, heart attacks, congestive heart failure, angina, asthma, arthritis, stroke, and kid ney disease. 16,17) If frailty is caused by any disease, it is sometimes called secondary frailty. Otherwise, it is called primary frailty.…”

Section: Frailty Indexmentioning

confidence: 99%

“…Frailty is also known to be highly associated with hypertension, diabetes mellitus, cancer (other than minor skin cancers), chronic lung disease, heart attacks, congestive heart failure, angina, asthma, arthritis, stroke, and kidney disease [ 16 , 17 ].…”

Section: Diagnosis Of Frailtymentioning

confidence: 99%

Diagnosis and Management of Frailty in Primary Health Care

Won

2020

Korean J Fam Med

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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, psycho logical, 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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What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study

Cited by 9 publications

References 58 publications

Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic

Validity of the Clinical Frailty Scale in Korean older patients at a geriatric clinic

Impact of frailty on mortality and healthcare costs and utilization among older adults in South Korea

Diagnosis and Management of Frailty in Primary Health Care

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