• 제목/요약/키워드: Frail elderly

검색결과 130건 처리시간 0.031초

노인물리치료를 위한 저항트레이닝 처방에 대한 탐색 (An Exploration on Prescription of Resistance Training for Geriatric Physical Therapy)

  • 신홍철;정동혁
    • The Journal of Korean Physical Therapy
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    • 제15권1호
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    • pp.61-81
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    • 2003
  • There can be little dissension that the ultimate goal of all physical therapy interventions with the elderly is to restore or maintain the highest level of function possible for the individual. Whenever physical therapists take on this challenge, they assist elders in maintaining their identities as competent adults. Advancing age is associated with profound changes in body composition, including increased fat mass, decreased fat-free mass(particularly muscle), decreased total body water and decreased bone density. Along with these changes in body compositions, and perhaps as a direct result of them, elderly people have lower energy needs, reduced strength and functional capacity and a greatly increased risk for such diseases as noninsulin-dependent diabetes mellitus and osteoporosis. Resistance training is considered a promising intervention for reversing the loss of muscle function and the deterioration of muscle structure that is associated with advanced age. This reversal is thought to result in improvements in functional abilities and health status in the elderly by increasing muscle mass, strength and power and by increasing bone mineral density. In the past couple of decades, many studies have examined the effects of Resistance training on risk factors for age-related diseases or disabilities. We have explored the positive and negative aspects of older adults' participation in resistance training programs. The benefits to older adults are reported to be increased strength, endurance, muscle capacity, and flexibility; more energy; and improved self-image and confidence. The negative aspects include some pain or stiffness and other nonspecific problems. The positive and negative aspects of resistance training are therefore very similar to those in younger populations. Scientific investigations over the past 10 years have demonstrated that resistance training can be safely and successfully implemented in older populations. Even the frail and very sick elderly can benefit and improve their quality of life. Proper design and progression of a resistance training program for older adults is vital to optimal benefits from resistance exercise. The results of data provided by this research on resistance training for health shows that there is enough existing evidence to conclude that resistance training, particularly when incorporated into a comprehensive fitness program, can offer substantial health benefits which can be obtained by persons of all ages. These benefits, including improvements in functional capacity, translate into an improved quality of life.

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노인시설 종사자의 업무스트레스, 업무만족, 치매 및 인간중심보호 인식 연구: 사회복지사, 간호사, 생활지도원의 비교 (A Study on Work Stress, Satisfaction, and Dementia Attitudes of Social Care Work Force of Dependent Elders)

  • 최희경
    • 한국사회복지학
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    • 제59권3호
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    • pp.175-199
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    • 2007
  • 이 연구에서는 부산과 대구 지역의 노인시설에 근무하는 사회복지사, 간호사, 생활지도원 502명을 대상으로, 노인보호 관련 종사자들의 업무특성을 반영하여 고안된 측정도구들을 활용하여 이들의 일반적인 특성과 업무 스트레스, 업무 만족, 치매 및 인간중심 보호와 관련된 인식과 태도를 조사하여 그 결과를 분석하였다. 분석 결과 노인시설 종사자들의 급여수준이 낮고 근무시간이 길며 업무 부담이 과중한 상태인 것으로 나타났다. 치매 및 인간중심 보호와 관련된 종사자들의 인식수준은 높은 편이었으나, 업무 만족 수준이 낮았고 노인에 대한 보호 제공 및 업무환경과 관련된 스트레스가 높게 나타났다. 노인장기요양보험제도 시행을 앞두고 노인에게 사회적 보호를 제공할 전문 인력의 원활한 수급과 전문성 향상, 보호의 질 제고를 위하여 노인시설 종사인력에 대한 처우 개선과 인력 확충, 중장년기 인력 활용, 노인시설 종사인력에 대한 전문적 훈련과 교육 강화, 노인시설에서의 인간중심 보호 방식의 도입과 실천이 필요함을 제시하였다.

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지역사회 거주 여성노인의 요실금 유무에 따른 허약정도와 허약 영향요인 (Frailty and its Related Factors in the Vulnerable Elderly Woman by Urinary Incontinence)

  • 박진경
    • 한국노년학
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    • 제37권4호
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    • pp.893-907
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    • 2017
  • 본 연구는 지역사회에 거주하는 여성 노인의 요실금 유무에 따른 허약정도와 허약에 영향을 미치는 요인을 파악하기 위하여, 2012년 S시 8개구의 보건소 방문건강관리사업 대상자 중 65세 이상 여성노인 3,251명의 자료를 이차 분석하였다. 요실금 유무별 여성노인의 체질량 지수, 허리둘레, 복합적 이동능력, 우울, 주관적 건강과 걷기운동, 유연성 운동 및 근력운동에 따른 허약의 차이를 파악하기 위하여 $x^2$-test, t-test, ANOVA를 실시하였으며, 사후검증은 Scheffe test를 실시하였다. 또한, 요실금 유무에 따른 제 변수별 상관관계는 Pearson's correlation을 실시하였고, 요실금 유무에 따른 허약에 가장 영향을 미치는 요인을 파악하고자 위계적 회귀분석을 수행하여 비교하였다. 연구결과, 요실금이 있는 여성노인의 허약에 가장 영향을 미치는 요인은 우울, 걷기 운동, 복합적 이동능력, 연령순으로 높게 나타났으며(F=38.321, p<.001), 이들 변수에 의해 허약이 36.6% 설명되었다. 요실금이 없는 집단에서 유의한 변인은 연령, 우울, 걷기 운동, 주관적 건강, 복합적 이동능력 순으로 높게 나타났으며(F=265.666, p<.001), 이들 변수에 의해 허약 정도가 설명되는 변량은 30.7%였다. 향후 지역사회에 거주하는 여성 노인, 특히 요실금을 갖고 있는 여성노인의 허약을 예방하기 위하여, 하루 10분 이상, 주 5일 이상의 규칙적인 걷기 운동 프로그램과 우울을 예방하고 관리하는 프로그램을 제언한다.

고령화사회 관련 정보제공 전·후의 노후상황별 주거선호 특성 (Characteristics of Housing Preference for Each Aging Situation before and after Providing Information of Aging Society)

  • 이연숙;신화경;이동주;윤혜경;이준민;유혜정
    • KIEAE Journal
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    • 제11권5호
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    • pp.119-127
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    • 2011
  • The aging population has been increasing in Korea so that it is difficult for people to understand the change of the future society. This study aimed to analyze the characteristics of preliminary retiree's alternative housing preference by providing an accurate information about residential current issues and the seriousness brought by the aging society. It explained the visual information about the aspect of the residential change due to the aging society to 104 preliminary retirees who live in the apartment in Seoul. It surveyed the characteristics of the alternative housing preference following 4 situations of the Old age type(couple/healthy, couple/ill, single/healthy, single/ill). It analyzed the difference of housing preference before and after providing information. The results are as follows: First, a previous apartment is not enough to prepare the aging society and UIBS(unit insertion building system) for the elderly was expected to be a great help to the frail after 2026. Second, the preference of UIBS was increased after providing information of the aging society. Third, in the case of the illness, a big city with medical facilities was preferred not to move in the suburb. Fourth, after providing information, a small size of apartment was preferred but the preferred change of housing ownership was not founded. Last, there was considerable difference before and after providing information under 4 situation of Old age type. These results showed the feasibility of coping with more accurate future society only if a survey should be taken with providing sufficient information about the aging society.

레크리에이션병합 체조프로그램이 후기 여성노인의 체력, 우울, 인지기능 및 삶의 질에 미치는 효과 (Effects of a Recreational Combination Gymnastics Program for Old-old Women)

  • 최연희;이춘지
    • 대한간호학회지
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    • 제42권6호
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    • pp.843-852
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    • 2012
  • Purpose: In this study a recreational combination gymnastics program was provided for women 75 years of age or older and the effects on physical fitness (grip strength, static balance, ability to do complex movement), depression, cognitive function and quality of life were examined. Methods: A quasi-experimental study employing a nonequivalent control group, pre-post design was conducted. Participants included 53 women elders whose cognitive function was within the normal range. The women were assigned to an experimental group (27) or a control group (26). The intervention was conducted twice a week for a period of 12 weeks. Chi-square test, t-test, paired t-test, Wilcoxon rank sum test and Wilcoxon signed rank test were used for data analysis. Results: Following completion of the program, left grip strength (t=2.17, p=.035), right grip strength (t=2.04, p=.046), static balance (t=-2.18, p=.030), depression (z=-2.88, p=.004), cognitive function (t=3.96, p<.001), and quality of life (t=-3.19, p=.002) were significantly better in the experimental group. Conclusion: Findings from this study indicate that recreational combination gymnastics programs are effective in enhancing physical fitness, cognitive function, and quality of life and in decreasing depression for female elders and could therefore be regarded as positive programs for promotion of physical and mental health for older women.

The Association Between the Number of Natural Remaining Teeth and Appendicular Skeletal Muscle Mass in Korean Older Adults

  • Kim, Sunyoung;Min, Jin-Young;Lee, Hong Soo;Kwon, Kung-Rock;Yoo, Jinho;Won, Chang Won
    • Annals of Geriatric Medicine and Research
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    • 제22권4호
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    • pp.194-199
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    • 2018
  • Background: The aim of this study was to examine the correlation between the number of remaining natural teeth (NRT) and the appendicular skeletal muscle mass index (SMI) in older adults. Methods: This study was based on data from the 2008-2010 Korea National Health and Nutritional Examination Surveys. The participants were 2,378 older participants (984 men and 1,394 women) aged over 65 years. Survey dentists conducted oral health examinations, and ASM was measured using dual-energy X-ray absorptiometry. Results: The participants with $NRT{\geq}20$ had more ASM and SMI than those with NRT<20 in both sexes. SMI was correlated with NRT in men (r=0.018, p<0.001) and in women (r=-0.007, p<0.001). The positive correlation between the NRT and SMI remained significant in men even after adjusting for age, marital status, income, smoking, drinking, physical activity, protein intake, energy intake, calcium intake, body mass index, fasting blood glucose level, medications, and prostheses (${\beta}=0.011$, p=0.001). In women, the correlation disappeared after adjustment for smoking, alcohol, physical activity, protein intake, energy intake, calcium intake, marital status, income, fasting basal glucose, medication administration, and prostheses. Conclusion: This study showed a correlation between NRT and SMI in those ${\geq}65$ years of age in Korea. The relationship persisted in men, but not in women, even after adjusting for confounders.

아이덴티티를 표현하는 노인가정의 소유물 배치패턴 사례연구 (A Case Study of Possession Display Pattern as a Mean of Self-identity Expression in Older People's Households)

  • 최정신
    • 한국주거학회논문집
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    • 제18권5호
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    • pp.65-72
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    • 2007
  • What is the meaning of home to older people? How much is home significant for older people? How do they express self-identity through decorating their own homes? These are the new subjects that scholars in the West are involved in lately in terms of micro-perspective (George, 1998; Kellett, Gilroy & Jason, 2005; Gilroy & Kellett, 2006). It is evident that home has more significant meaning to older people than other age groups, since the older are more likely to spend greater time within the home through lower income, lessening mobility or loss of companions (Gilroy, 2005). Also the older tend to cling to their homes and attach to possessions than the younger. Older people's possessions are the things that memories of their lives were absorbed. Therefore, possession display can role as a mean of showing their past lives and memories. Gilroy and her colleagues (2005, 2006) found that there was a certain pattern of possession display in English older people's households, and that older people would like to express self-identity through decorating their own homes with their precious possessions. Then, isn't it interesting to find out if there is any pattern of possession display or decoration items in Korean older people's households as well? Thus, the aim of this study is to describe pattern of possession display as a mean of expressing self-identity in Korean older people's households. Interview with older people was used to find out the way and reason of display possessions. Observation method including taking photos and hand-drawings was also added in order to demonstrate detail condition of display items in the house. Possessions display and furniture arrangement in the living room and bedroom were investigated to find out a certain pattern of display and meaning. Research objects were healthy older people aged over 60, who are living independently from their adult children, and who can manage housekeeping by themselves. 32 households were investigated in the area of Seoul, Kyunggi, Chungchungnam, and Kangwon provinces. The findings demonstrate that most precious possession for Korean older people is photo of themselves; especially one taken in their younger age. The reason of it is because the photo reminds them of their heydays when they were vital. Photo of the most beloved one is displayed more frequently in the bedroom than in the living room indicating consistence with English case. As symmetrical display pattern was dominant in case of English older people's households, no dominant display pattern is found in Korean case. Korean older people also cling to their homes and possessions and want to keep their dwelling space as large as what they use now. It is notable that even after they become older and frail, they want sufficient space to display possessions as a mean of self-identity expression. Attachment to possessions and decoration can give older people significant meaning of identity, and it is the reason why architects or interior designers have to meet older people's needs. It needs consideration that residents are allowed to bring their old furniture and precious possessions when they move in elderly housing unit in order to minimize environmental shock, as well as feeling at home. This subject could suggest a clue to designers or architects who have to meet residents' needs in space design of elderly housing or facilities in the future. Psychological well-being of older people can be met by making them feel at home wherever they live. They need space where they can express their own identity and personality even in case when they have to live in a limited small space like elderly housing unit or nursing home.

Restricted Blood Flow Exercise in Sedentary, Overweight African-American Females May Increase Muscle Strength and Decrease Endothelial Function and Vascular Autoregulation

  • Bond, Vernon;Curry, Bryan Heath;Kumar, Krishna;Pemminati, Sudhakar;Gorantla, Vasavi Rakesh;Kadur, Kishan;Millis, Richard Mark
    • 대한약침학회지
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    • 제20권1호
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    • pp.23-28
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    • 2017
  • Objectives: Exercise with partially restricted blood flow is a low-load, low-intensity resistance training regimen which may have the potential to increase muscle strength in the obese, elderly and frail who are unable to do high-load training. Restricted blood flow exercise has also been shown to affect blood vessel function variably and can, therefore, contribute to blood vessel dysfunction. This pilot study tests the hypothesis that unilateral resistance training of the leg extensors with partially restricted blood flow increases muscle strength and decreases vascular autoregulation. Methods: The subjects were nine normotensive, overweight, young adult African-Americans with low cardiorespiratory fitness who underwent unilateral training of the quadriceps' femoris muscles with partially restricted blood flow at 30% of the 1-repetition maximum (1-RM) load for 3 weeks. The 1-RM load and post-occlusion blood flow to the lower leg (calf) were measured during reactive hyperemia. Results: The 1-RM load increased in the trained legs from $77{\pm}3$ to $84{\pm}4 kg$ (P < 0.05) in the absence of a significant effect on the 1-RM load in the contralateral untrained legs (P > 0.1). Post-occlusion blood flow decreased significantly in the trained legs from $19{\pm}2$ to $13{\pm}2mL{\cdot}min^{-1}{\cdot}dL^{-1}$ (P < 0.05) and marginally in the contralateral untrained legs from $18{\pm}2$ to $16{\pm}1mL{\cdot}min^{-1}{\cdot}dL^{-1}$ (P = 0.09). Changes in post-occlusion blood flow to the skin overlying the trained and the contralateral untrained muscles were not significant. Conclusion: These results demonstrate that restricted blood flow exercise, which results in significant gains in muscle strength, may produce decrements in endothelial dysfunction and vascular autoregulation. Future studies should determine whether pharmacopuncture plays a role in treatments for such blood vessel dysfunction.

The Association of Perceived Neighborhood Walkability and Environmental Pollution With Frailty Among Community-dwelling Older Adults in Korean Rural Areas: A Cross-sectional Study

  • Kim, Mi-Ji;Seo, Sung-Hyo;Seo, Ae-Rim;Kim, Bo-Kyoung;Lee, Gyeong-Ye;Choi, Yeun-Soon;Kim, Jin-Hwan;Kim, Jang-Rak;Kang, Yune-Sik;Jeong, Baek-Geun;Park, Ki-Soo
    • Journal of Preventive Medicine and Public Health
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    • 제52권6호
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    • pp.405-415
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    • 2019
  • Objectives: The aim of this study was to evaluate the associations of frailty with perceived neighborhood walkability and environmental pollution among community-dwelling older adults in rural areas. Methods: The participants were 808 community-dwelling men and women aged 65 years and older in 2 rural towns. Comprehensive information, including demographics, socioeconomic status, grip strength, polypharmacy, perceived neighborhood environment (specifically, walkability and environmental pollution), and frailty, was collected from participants using face-to-face interviews conducted between June and August 2018. Perceived neighborhood walkability was measured using 20 items that were selected and revised from the Neighborhood Environment Walkability Scale, the Neighborhood Walkability Checklist from the National Heart Foundation of Australia, and the Physical Activity Neighborhood Environment Survey. The Kaigo-Yobo Checklist was used to assess participants' frailty. Results: The overall prevalence of frailty in this community-dwelling population was 35.5%. Sex, age, cohabitation status, educational attainment, employment status, grip strength, and polypharmacy were significantly associated with frailty. In the logistic regression analysis, frailty was associated with low perceived neighborhood walkability (adjusted odds ratio [aOR], 0.881; 95% confidence interval [CI], 0.833 to 0.932; p<0.001) and severe perceived neighborhood environmental pollution (aOR, 1.052; 95% CI, 1.017 to 1.087; p=0.003) after adjusting for sex, age, cohabitation status, educational attainment, employment status, monthly income, grip strength, and polypharmacy. Conclusions: More studies are warranted to establish causal relationships between walkability and environmental pollution and frailty.

여성노인의 허약 상태 예측을 위한 보행변동성 및 체력의 역할 검증 (Role of Gait Variability and Physical Fitness as a Predictor for Frailty Status in Older Women)

  • 진영윤;박진국;강현식
    • 한국체육학회지인문사회과학편
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    • 제57권6호
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    • pp.263-272
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    • 2018
  • 본 연구는 여성노인의 허약 상태에 대한 보행 변동성과 체력의 역할을 검증하고자 하였다. 본 연구 기관의 지역사회에 거주하는 65세 이상 여성노인 168명(나이 75.07±5.40)을 대상으로 인구사회학적 특성, 신체조성, 보행 변인 및 변동성, 체력, 인지기능, 우울상태를 측정하였다. 그리고 Fried et al.(2001)의 허약진단 지표(체중감소, 정서적 고갈, 신체활동, 보행속도, 악력)를 기준으로 정상, 전-허약, 허약으로 구분하였다. 허약 상태 예측을 위한 보행 변인 및 변동성 그리고 체력의 역할을 검정하기 위해 로지스틱 회귀분석을 실시하였다. 그 결과, 나이, 교육수준, 보유한 질병 수, 일상생활수행능력 및 인지기능 점수와 우울점수를 통제 한 후 허약그룹은 정상그룹(OR=1)과 비교하였을 때, 두 다리 지지비율(OR=1.48, 95% CI=0.10-2.21, p=.049) 및 분당 보폭수(OR=2.06, 95%CI=1.20-3.43, p=.009)의 변동성이 통계적으로 높게 나타났으며, 상체근력(OR=0.49, 95%CI=0.31-0.77, p=.002)이 낮은 것으로 나타났다. 결론적으로 본 연구에서 허약의 예측인자로 나타난 두발 지지비율 및 분당 보폭수의 변동성 그리고 상체근력은 허약 상태를 예측하고 평가하는데 중요한 지표로 사용될 수 있을 것으로 판단된다.