Purpose: The purpose of this study was to evaluate the effects of a comprehensive exercise program for the prevention of urinary incontinence (UI), frailty, and depression, as well as the promotion of physical function in community-dwelling elderly female living alone. Methods: A nonequivalent control group pretest-posttest design was employed. The participants were 76 vulnerable elderly female with a mild-to-moderate urinary incontinence. The exercise group completed 12 weeks of a moderate intensity, comprehensive exercise program. Descriptive statistics, independent t-tests and ANCOVA were used for data analysis with SPSS. Results: Upon the completion of the 12-week exercise program, significant improvements for UI symptoms (p=.001), timed up and go (p<.001), frailty (p=.006), and depression (p<.001) were observed, but not for hand grip strength (p=.053). Conclusion: The findings of this study indicate that the 12-week comprehensive exercise program for the prevention of urinary incontinence had positive effects on improving UI symptoms, physical function, levels of frailty and depression in elderly women living alone. More prolonged exercise programs with other types of exercise should be developed for these vulnerable elderly women, and future studies are encouraged to confirm the effect of the comprehensive exercise program in other settings.
Purpose: The purpose of this secondary analysis study was to examine the incidence of abuse and the contributing factors for that abuse among the Korean elderly with stroke. Methods: Data were derived from the 2008 Korean National Survey on Older Adults. The participants were 934 community-dwelling elderly with stroke. Data were analyzed using the Rao-Scott $x^2$-test, simple logistic regression and multiple logistic regression with the PASW 18.0 complex samples analysis module. Results: The prevalence of elder abuse was 13.5%. Emotional abuse (10.0%) was the most frequently reported abuse, followed by financial neglect (3.8%), caring neglect (3.3%), financial abuse (2.1%), and physical abuse (1.9%). 44.6% of the perpetrators of emotional abuse were coresidential family members. Participants without spouses (odds ratio=2.05, 95% CI=1.14~3.68), those without diabetes (odds ratio=2.24, 95% CI=1.15~4.39), and depressed participants (odds ratio=2.72, 95% CI=1.34~5.52) were more likely to be abused. Conclusion: Emotional abuse was the most frequently reported type of abuse while physical abuse was least frequent among the elderly with stroke. Nurses caring for the elderly with stroke should be aware of the types of abuse and risk factors such as lack of spouse and incidents of depression.
Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.
Purpose: The purposes of this study were to identify correlation of spiritual well-being, social support, life satisfaction and depression in the community dwelling elderly, and to explore a possibility to apply the spiritual well-being, and social support as resources to promote welfare of the elderly. Methods: A structured questionnaire was used to obtain data from a convenience sample of 222 senior citizens, who visited social welfare centers in Gangwon-do from September to October, 2010. Data were analyzed using t-test, ANOVA, and multiple regression. Results: There were significant differences in spiritual well-being based on religion, satisfaction to religion, economic status, physical health, and life satisfaction. Social support was significantly different according to economic status, physical health, life satisfaction, and social gathering. The existential well-being, family support, and special support had a significant effect on life satisfaction, and demonstrated positive correlations with the well-being of the elderly. Conclusion: Spiritual well-being and social support have significant effects on depression and life satisfaction of senior citizens. Thus spiritual well-being and social support can be considered as important factors that improve the elderly's quality of life.
BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.
Purpose : The purpose of this study was to investigate functional disability for the elderly in rural Korea and to identify influencing factors of functional disability. Methods : The data were collected for 76 community-dwelling elderly in rural area and above 65 years. We assessed cognitive function, functional disability, depression using LACLS, WHODAS 2.0, SGDS-K. Data were analyzed using descriptive statistics for general characteristics of subjects, Spearman's correlation among LACLS, SGDS-K, WHODAS 2.0, age, educational levels. And multiple regression was used to find influencing factors of functional disability. Results : As a result of this study, we identified that WHODAS 2.0 total score was 50.59, summary score was 9.94 and functional disability of the elderly in rural area is in the 70th percentile. The highest level of disability occurred in areas related to 'life activities (household)', 'participation in society' and the lowest level of disability occured in areas of 'self-care', 'getting along with people'. Functional disability was significantly correlated with age (r=.398), cognitive function (r=-.547), depression (r=-.563) but not educational levels (r=-.215). Finally, we confirmed that depression (𝛽=.371), cognitive function (𝛽=-.263), widowed status (𝛽=.303), age (𝛽=.272), non-participation of community program (𝛽=.165) was significantly influencing factors of functional disability and the explanatory power of these factors was 52.80 %. Conclusion : This study revealed important factors of functional disability. Therefore, we need to consider these factors when we developed program related to health for the elderly (aged > 65 years) in rural Korea. Further, we need to standardize WHODAS 2.0 in order to enhance its applicability in clinical practices.
Objective: This study aimed to assess the effectiveness of a balance training program in improving balance and functional independence to reduce fall risks among community-dwelling elders. Design: A multi-center randomized controlled trial Methods: A total of 66participants were randomly assigned to a balance training group or a control group. The balance training program, conducted three times a week for 32 weeks, included warm-up exercises, main balance training exercises, and cooldown stretch exercises. Outcome measures included the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), and Modified Barthel Index (MBI). Results: The balance training group demonstrated significant improvements in all outcome measures, indicating enhanced balance, improved functional mobility, and increased independence in activities of daily living. In contrast, the control group showed only slight improvements in BBS, TUGT and MBI scores. Conclusions: These findings provide evidence supporting the effectiveness of balance training programs in reducing fall risk and promoting health and wellbeing among community-dwelling elders. Future research should aim to refine the design of these programs and assess the sustainability of the observed improvements.
Purpose: This study aimed to identify depression and its predictors among Korean community-dwelling elderly with mild cognitive impairment. Methods: Secondary data analyses of the data collected by the "Study on tailored integration program for reinforcing cognitive and physical function of the frail elderly. The study used data from one-to-one interviews using structured questionnaires. The subjects were 346 community-dwelling elderly who visited a healthcare center in Seoul, Korea. A descriptive correlational study design was utilized to explore depression and its predictors including physical factors and psychosocial factors among the elderly with mild cognitive impairment. Data were analyzed using t-test, Pearson's correlation, and hierarchical regression. Results: Mean score of depression was within normal limit $11.61{\pm}6.69$. Somatic symptoms, negative life events (severity), social support were shown as significant predictors of depression. The most influential predictor for depression was somatic symptoms (${\beta}$=.340, $p$ <.001). Conclusion: To prevent and relieve depression in the elderly with mild cognitive impairment, nursing intervention strategies which consider well-balanced physical and psychosocial aspects are needed. In particular, a specific nursing intervention strategy is required to improve physical health of the elderly with mild cognitive impairment.
Fall is one of the most intimidating health conditions in elders. Comprehensive assessment is necessary to understand the individual and environmental aspects of the falls such as balancing abilities, depression, and quality of life. The purpose of this study was to compare the balancing ability, depression, and quality of life between elderly fallers and elderly non-fallers. Thirty-two community-dwelling elders (fifteen males and seventeen females between 65 and 83 years old), who have experienced fall on walking during last twelve months, were involved in the elderly fallers group. And twenty-four males and twenty-two females between 65 and 83 years old of community-dwelling elders, who have no experienced fall on walking during last twelve months, were involved in the elderly non-fallers group. Berg balance scale (BBS), timed up and go test (TUG), and functional reach test (FRT), were used to evaluate the ability of the physical balance. 'Beck depression scale in Korean' questionnaire was used to assess the depression. 'Korean version of World Health Organization Quality of Life Assessment Instrument-Bref' questionnaire was used to assess the quality of life. The results were as follows: 1) Balancing abilities measured by the BBS, TUG in the elderly fallers group were meaningfully lower than that of the elderly non-fallers group (p<.05), whereas no significant difference in the FRT was found (p>.05). 2) Depression level in the elderly fallers group was significantly higher than that of the elderly non-fallers group (p<.05). 3) Quality of life in the elderly fallers group was significantly lower than that of the elderly non-fallers group, excluding environment domain (p<.05). Therefore, in order for clinical evaluation of the community-dwelling elders those with reduced balancing ability, it is necessary to evaluate and understand the fall experience, depression, and quality of life.
Purpose: The aim of this study is to identify the influence of visual and hearing impairment on the activities of daily living of community dwelling elderly. Methods: Data were collected by home visiting interviewers from 452 older people aged 65 years or older living in community. Resident Assessment Instrument MDS-HC(2.0version) was used for data collection. Data analysis for descriptive statistics, Chi-square test and multiple regression was made by SAS 6.2 Results: 34.7% of the subject had hearing impairment and 64.3% had visual impairment Among IADL. one half of them were dependent in ordinary house work and meal preparation. In the case of ADL. 13.9% of subjects were dependent in bathing and 8.9% in personal hygiene. There was significant difference in IADL performance by visual and hearing impairment On the other hand, ADL performance showed the significant difference. only in the case of hearing impairment. As the result of input of visual and hearing impairment in the process of regression. variances were increased from 3% to 11%. Conclusions: Large proportions of older people living in the community have visual and hearing impairment. It could be confirmed that hearing and vision were significant factors influencing on IADL performance of older people. Intervention and support policy for elderly needs to focus on improvement of visual and hearing impairment.
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