BACKGROUND: In spite of widespread knowledge of importance of functional assessment for optimal care for the elderly patient, there was rare national survey for the level of ADL and JADL of community dwelling elderly in Korea. For correspondence of expanding home care for the elderly, this study aimed to assess and find standard level of ADL and IADL of the elderly residents in community. METHODS: For gencralization in Korean medical environment of the results, randomized sampling was done among districts of Korea by numbers of elderly residents. 2,000 elderly persons are surveyed in this study, and data were collected by face-to-face interview with home resident elderly by community health nurses and medical students. ADL and IADL were assessed with Korean version of Katz ADL and modified Lawton IADL instruments. RESULTS: Though mean scores of functional assessments for Korean elderly were 16.2/ 18 in ADL and 9.9/ 12 in JADL, and they were nstilted in highly shifted distribution to high levels of function, 38% of community dwelling elderly are dependent with ADL and 49.7% are dependent with IADL. ADL and IADL scores were significantly related to various demographic factors, that is, gender, age, economic status, living with spouse, perception of health. Especially, the elderly living alone is at risk for functional decline. CONCLUSION: Korean elderly has worst function in bathing(29.2% of respondents) with ADL items, but many elderly complained of dysfunction for in-door transfer(26.7%) and continence(18.6%). With JADL items, the function of long-distance transfer using public vehicles(subway or bus) is most highly affected(4l.9%).
Activities of Daily Living* ; Aged* ; Demography ; Home Care Services ; Humans ; Korea ; Nurses, Community Health ; Spouses ; Students, Medical ; Surveys and Questionnaires

No abstract available.
Aged* ; Humans ; Mass Screening*

The use of self reported height and weight is very common in epidemiologic studies and clinical settings. In this study we assessed the accuracy of selfreported weight, height and body mass index by comparing with measured data. Data were obtained from 1065 persons(657 men, 358 women) who visited a health care center for routine medical check-up during the period September 1994-February 1995. The correlation between reported and measured height and weight was very strong. There were some discrepancies between two data, however, and men and women differ ed somewhat in their pattern of misreporting. Weight was overestimated by 0.27kg in men and underestimated by 0.09kg in wo men whereas height was overestimated in men(0.88cm) and women(2.15cm). These misreported data resulted in an underestimation of body mass index and low sensitivity for diagnosing overweight in men and women. The size of error was larger in women than in men. So it suggests that the self reported height and weight data could be used as a continuous variable with little error, but misclassification could be occured when the self reported data were used as a categorical variable. Errors in self reported weight and height, BMI were related to a person's over-weight status. The more people overweighed the more they underestimated their weight. Educational level and age, exercise, marri age had no relationship with the accuracy of self reported data. In conclusion, the use of self reported weight and height in epidemiologic studies and clinical settings could result underestimation of obesity, especially in obese female group.
Body Mass Index ; Delivery of Health Care ; Epidemiologic Studies ; Female ; Humans ; Male ; Obesity ; Overweight ; Self Report

Cardiovascular disease (CVD) is the one of the leading causes of death in Korea. Aspirin, well known for its antiplatelet function, has been used for the secondary prevention of CVD during the first few several decades. However, whether or not to have a protective effect on the primary prevention of CVD in apparently healthy people is still controversial. In addition, accumulating data suggest aspirin may have a favorable possibility on cancer incidence and mortality. We reviewed the literature, focusing on new evidence on the benefits and risks of aspirin for the prevention of CVD and cancer. Aspirin modestly decreases the risk of non-fatal myocardial infarction and cancer incidence in patients without overt CVD and at average cancer risk, but increase the risk of major bleeding. Several guidelines on the use of aspirin for the primary prevention of CVD stated the need for the prudent assessment of individual CVD risks in the target population. Currently there's no CVD risk assessment tools based on domestic data available in Korea. Also the bleeding risk and relatively high incidence of hemorrhagic stroke in Koreans make a difficult decision. Clinicians should give the patients a balanced information and discuss the effects or harms of taking aspirin on the prevention of CVD and cancer according to the updated evidence. Patient education for the prevention of CVD is more important and life style change including smoking cessation, weight reduction, and a healthy diet should be emphasized before considering aspirin.
Aspirin* ; Cardiovascular Diseases* ; Cause of Death ; Diet ; Health Services Needs and Demand ; Hemorrhage ; Humans ; Incidence ; Korea ; Life Style ; Mortality ; Myocardial Infarction ; Patient Education as Topic ; Primary Prevention ; Risk Assessment ; Secondary Prevention ; Smoking Cessation ; Stroke ; Weight Loss

No abstract available.
Aged* ; Drug Therapy* ; Drug-Related Side Effects and Adverse Reactions ; Humans

BACKGROUND: The gaitaids are helpful for the patients of gait disturbance, but there was no study about the quantitative assessment of the effectiveness of gaitaids of several different types. But proper use of gaitaids is important for the disabled who is suffered from falls with or without trauma. The appropriate prescription of gaitaids is coming from the objective assessment for gaitaids. METHODS: We evaluated the 'balance index(BI)', which is originally suggested assessment scale by author, for the five different gaitaids :mono-cane, quad-cane, forearm crutch, axillary crutch, walker We assessed the difference of B.1 with or without using each gaitaids examined by 50 healthy adults and 20 stroke patients. RESULTS: The BI in the normal adult was 34.5+/-2.7, and 21.0+/-6.9 in the stroke patients. The balance index o( walker user was 37.6+/-1.4, which was the highest score. The BI of quad-cane was 30.1 +/-4.8, which was the next highest score and the BI of mono-cane, forearm crutch, axillary crutch were 25.5+/-5.6, 25.5+/-5.7, 25.5+/-5.4, which were lower than that of quad-cane. CONCLUSION: It can be suggested that the walker is the most effective for the support balance on gait and the quad-cane is more effective than mono-cane or crutches for balance support.
Adult ; Canes ; Crutches ; Forearm ; Gait ; Humans ; Prescriptions ; Stroke ; Walkers

OBJECTIVES: Recently, there are many studies that highlights the importance of the systolic blood pressure and pulse pressure as a better prognostic factor than diastolic blood pressure especially in older persons. In this study, we investigated the prevalence of isolated systolic hypertension in the elderly aged more than 60 years old who visit to hospital for routine health exam. METHODS: This study was done in one university hospital in a mid-sized city in Kyungki-provine of Korea, during one year from Feb. 1st, 2005. The study participants were people aged 60-yr-old or over who came to hospital for taking routine health examination offered by Korea's national health insurance corporation. We investigated the proportion of the isolated systolic hypertension among untreated hypertension by double-checked blood pressure. Besides we got information about eating habits, drinking and smoking status, exercise and stress, fasting blood glucose, serum total cholesterol, proteinuria and hematuria by standardized questionnaire and blood and unine test. RESULTS: The total number of participants were 2,480. Among them, 1,181 persons (47.6%) were males, 1,299 persons females (52.4%). 1,706 persons (68.8%) were in their sixties, 774 persons (31.2%) in their seventies or more. In males, 494 (41.8% of total males) had hypertension. Among 211 males with untreated hypertension, 109 (51.7%) had isolated systolic hypertension (ISH). In females, 551 (42.4% of total temales) had hypertension. Among 201 females with untreated hypertension, 132 (65.7%) had ISH. In male, body mass in dex (BMI), fasting blood gulcose and total cholesterol were significantly associated with ISH. In female BMI, age, drinking status were significant. In female, drinking status was a protective factor. CONCLUSIONS: In Korea older people aged 60 or more, isolated systolic hypertension is occupying most part of hypertension. As Korea is entering into a rapidly aging society, from now on, older persons with isolated systolic hypertension is expected to increase rapidly. In the future, The more studies and more active treatment for isolated systolic hypertension is to be required.
Aged ; Aging ; Blood Glucose ; Blood Pressure ; Cholesterol ; Drinking ; Eating ; Fasting ; Female ; Hematuria ; Humans ; Hypertension* ; Korea* ; Male ; Middle Aged ; National Health Programs ; Prevalence* ; Proteinuria ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking

PURPOSE: To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people. METHODS: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP). RESULTS: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410). CONCLUSION: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.
Activities of Daily Living ; Aged ; Aged, 80 and over ; *Case Management ; Cognition ; Demography ; Depression ; Female ; Geriatric Assessment ; *Health Services for the Aged ; *Home Care Services ; Humans ; Male ; Pain Measurement

The Korean healthcare system is ill-equipped to manage geriatric diseases, even though we are on the verge of becoming a super-aged society.Current Concepts: In Korea’s delivery of healthcare system, which is centered on subspecialty care from primary to tertiary care, older adults with multiple chronic diseases are forced to receive fragmented care from multiple doctors. In medical education and residency programs, even the most fundamental concepts of geriatrics are misunderstood, and geriatricians receive inadequate training. Consequently, along with the rapidly growing elderly population, elderly patients with complex health problems, frailty, and dysfunction are deprived of the opportunity to achieve healthy aging by taking multiple medications and suffering from geriatric syndromes caused by fragmented medical care.Discussion and Conclusion: Establishing a system for training geriatricians and strengthening geriatric education is necessary to ensure existing specialists can assign them the role of primary care geriatricians. Additionally, person-centered, integrated geriatric care that requires appropriate management of various complex diseases, as well as maintenance of function and frailty prevention, will be possible by establishing a geriatric healthcare system that ranges from frailty prevention, polypharmacy management, and home visits in primary healthcare to multidisciplinary geriatric care and transitional care in tertiary healthcare. Implementing this strategy as early as possible will help older adults age well and reduce the caregiving burden in later life. This could also ease concerns regarding physician shortages induced by the rapidly growing elderly population.

BACKGROUND: Job description for Korean family physicians needs to be verified in a representative sample for practicing family physicians to establish generalizability and popularity. This study was conducted to evaluate the responses of Korean family physicians in their job description by method independently developed by an expert panel and the results were compared with the panelists' consensus. METHODS: For each of the 129 tasks, the importance, the difficulty, and the frequency were checked along the 4-point scale and requirement for entry level was ticked along the binominal response. Sixty eight family physicians completed the questionnaire and the response rate was 20% of 350 eligible family physicians. RESULTS: Forty six percent of the tasks were rated as "moderately important" and 54% as "little important". One hundred eight tasks (84%) were recognized as competencies necessary for the entry level. Though the general tendency was similar to the consensus of the past job analysis, a few tasks were desired to be excluded (eg., extraction of bronchial secretion) or newly included (e.g., operation for infertility). Nineteen tasks (15%) were rated as less important ones in both groups. Fifteen tasks (12%) were commonly suggested to be excluded from the required tasks in both groups. CONCLUSION: As the job description for Korean family physicians has been recognized as a valid one among the representative practicing family physicians, it can be used in general for developing or modifying the curricula of residents and students and continuing education.
Consensus ; Curriculum ; Education, Continuing ; Humans ; Job Description* ; Physicians, Family* ; Task Performance and Analysis ; Ticks ; Surveys and Questionnaires