Association between Timed Up and Go Test and Subsequent Functional Dependency

BACKGROUND@#This study aimed to evaluate the association between baseline results of the Timed Up and Go (TUG) test and subsequent functional dependency occurrence.@*METHODS@#From the National Health Insurance Service-Senior Cohort database, we identified 39,519 people who participated in the National Screening Program for Transitional Ages at the age of 66 during 2007–2008. Impaired mobility was defined as taking 10 seconds or longer to perform the TUG test. Functional dependency occurrence was defined as the initiation of receiving national Long-Term Care Insurance services—home care or admission to long-term care facilities. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) for dependency occurrence according to baseline TUG test results.@*RESULTS@#The mean follow-up period was 5.7 years. Occurrence rates of dependency were 2.0 and 3.4 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. Impaired mobility was associated with a higher risk of functional dependency occurrence (adjusted HR [aHR], 1.65; 95% confidence interval [CI], 1.40–1.95; P < 0.001). Additionally, in the subgroup analysis for the participants with intact baseline activities of daily living, impaired mobility was associated with a higher risk of dependency occurrence (aHR, 1.65; 95% CI, 1.33–2.04; P < 0.001).@*CONCLUSION@#The TUG test might be a useful predictive marker of subsequent functional dependency occurrence. Intervention to prevent functional dependency may be helpful for older adults with impairment on the TUG test.

Association between Timed Up and Go Test and Subsequent Functional Dependency

BACKGROUND@#This study aimed to evaluate the association between baseline results of the Timed Up and Go (TUG) test and subsequent functional dependency occurrence.@*METHODS@#From the National Health Insurance Service-Senior Cohort database, we identified 39,519 people who participated in the National Screening Program for Transitional Ages at the age of 66 during 2007–2008. Impaired mobility was defined as taking 10 seconds or longer to perform the TUG test. Functional dependency occurrence was defined as the initiation of receiving national Long-Term Care Insurance services—home care or admission to long-term care facilities. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) for dependency occurrence according to baseline TUG test results.@*RESULTS@#The mean follow-up period was 5.7 years. Occurrence rates of dependency were 2.0 and 3.4 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. Impaired mobility was associated with a higher risk of functional dependency occurrence (adjusted HR [aHR], 1.65; 95% confidence interval [CI], 1.40–1.95; P < 0.001). Additionally, in the subgroup analysis for the participants with intact baseline activities of daily living, impaired mobility was associated with a higher risk of dependency occurrence (aHR, 1.65; 95% CI, 1.33–2.04; P < 0.001).@*CONCLUSION@#The TUG test might be a useful predictive marker of subsequent functional dependency occurrence. Intervention to prevent functional dependency may be helpful for older adults with impairment on the TUG test.

Association between Timed Up and Go Test and Subsequent Functional Dependency

The concept and need of comprehensive geriatric assessment

Comprehensive geriatric assessment (CGA) is a diagnostic process evaluating frail older patient's medical problems and functional status to make overall plan for treatment and long-term care plan. It emphasizes on functional status and quality of life and uses interdisciplinary team and assessment tool frequently. CGA is associated with significant benefit in improved diagnostic accuracy with increased survival, improved physical and cognitive function, appropriate medication use, reduced hospital and nursing home use and reduced health care costs. Although frailty patients might have greatest benefits, careful periodic screening and follow up monitoring of all older persons is also very important. The goal of CGA in the older patients might be independence. To improve the quality of life of frail old patients and to reduce long-term care population number and care costs, performing geriatric assessment would be the best choice in geriatric field.

Development and Validity and Reliability of Korean Comprehensive Assessment Tools for Geriatric Ambulatory Care

BACKGROUND: The purpose of this study was to develop and to evaluate the applicability of the Korean comprehensive geriatric assessment tools through reliability and validity testing. METHODS: We developed standard and short-form assessment tools comprised of questionnaires on medical, functional, mental, socioeconomic status and lifestyle information and functional tests. The tools were administered as test-retest on 111 elderly outpatients at four university hospitals and two welfare centers in Seoul. Weighted kappa value, kappa value, Pearson's correlation coefficients and overall percent agreement were calculated to evaluate reliability. Validity coefficient was estimated by using the reliability coefficient. RESULTS: Reliability and validity coefficients were higher than 0.50 (fair or good) for 29 of 36 items. For test-retest reliability, the median was 0.66 (range, 0.29 to 1.00) for the kappa value and 0.83 (range, 0.53 to 1.00) for the Pearson's correlation coefficients. Compared to the standard form, the short-form assessment questionnaires showed to be reliable and valid. CONCLUSION: The Korean Comprehensive Assessment Tools, both the standard form and the short form, were shown to be a reliable and valid screening medium for assessing the health status of the elderly in the ambulatory care setting. These instruments can be used conveniently for comprehensive outpatient geriatric assessment.

The Korean Physical Activity Questionnaire for Elderly (PAQE): Development and Evaluation of Validity and Reliability

BACKGROUND: As individuals age, there is an obvious decline in their physical activity level. Thus, this is an area where an easy to use assessment instrument is needed. But presently, there is no tool that meets this need. In addition, there is no such instrument tailored for the Korean elderly. This study aimed to fill this void by developing a physical activity assessment instrument for this particular population that is easy to use. METHODS: Item collection was performed through a literature review and a survey of 100 elderly individuals residing in a community setting. Items were selected through expert consensus; and the Physical Activity Questionnaire for elderly (PAQE) was created. For validation, 120 community dwelling elderly persons were enrolled. PAQE and an accelerometer were administered to each participant, and the questionnaire was re-administered 2 weeks later. The Spearman rho between the questionnaire and the accelerometer was calculated for concurrent validity. The Cronbach's alpha was calculated for internal consistency. Test-retest reliability was assessed by calculating the Spearman rho. RESULTS: Of the 119 participants, 80.34% were female with the average age being 72.74+/-7.29 years. Energy expenditure measured by the accelerometer was 220.36+/-96.96 kcal/day compared to 368.33+/-257.29 kcal/day measured through the developed questionnaire. Although the Spearman rho between the energy expenditure measured by the accelerometer and calculated through the recreational activity report in the questionnaire was 0.235 (p=0.011), the total energy expenditure was 0.105 (p=0.259) and the energy expenditure by household activity was 0.002 (p=0.983). The Cronbach's alpha was 0.781. The Spearman rho was 0.720 (p<0.001) for test-retest reliability. CONCLUSION: Our findings show that PAQE is a reliable questionnaire, a valid instrument for estimating energy expenditure during recreational physical activity in the Korean elderly person. However, energy expenditure of household activity did not correlate well with the accelerometer. In conclusion, the PAQE questionnaire can be used to assess kinds and frequency of household activities.

Factors Associated with a Decline in Activities of Daily Living in Patients with Dementia at Geriatric Hospitals: A 6 Month Prospective Study

BACKGROUND: Decreased activities of daily living (ADL) in elderly people are related to decreased quality of life and death and are a clinically important issue. However, few studies have investigated the various characteristics and risk factors for a decline in ADL among elderly in-patients in geriatric hospitals in Korea. METHODS: In total, 163 elderly in-patients with dementia in three geriatric hospitals located in Incheon, Gwangju and Yongin, Korea were surveyed prospectively for associated factors of a decline in ADL after 6 months. RESULTS: On average, the subjects were 79.4+/-7.6 years old, and 67.5% were female. Approximately 63% had Alzheimer type dementia, 36.8% only attended primary school, 73.0% were widowed, and 38.7% had been admitted to hospitals for less than 1 year. The Korean version of the Mini Mental State Examination (K-MMSE) score was 14.1+/-6.5, and the clinical dementia rating was 1.9+/-0.9. In total, 8.6% were bed-ridden and 59.5% and 64.6% had never experienced fecal and urinary incontinence, respectively. Total ADL scores declined after 6 months follow-up, and significantly associated factors were low K-MMSE score, fecal incontinence, and co-existence of fecal and urinary incontinence. CONCLUSION: Low K-MMSE scores, fecal incontinence, and the co-existence of fecal and urinary incontinence were associated with ADL declines in elderly in-patients with dementia in long-term care hospitals located in three cities in Korea.

Reliability and Validity of Korean Version of Falls Efficacy Scale-International (KFES-I)

OBJECTIVE: To develop and validate the Korea version of falls efficacy scale-international (KFES-I) in Korean elderly which was developed to assess fear of falling in older people and have been already validated in some European countries. METHOD: Surveys of 385 older persons from the public health center in Korea based on KFES-I and fall questionnaire such as presence, frequency of fracture within last 6 months, and combined medical illness were taken. KFES-I was composed with 16 items of activities of daily living including social activities and graded from 1 to 4 in each item. Two-week KFES-I re-test data were collected. Reliability and validity estimates were computed as well as KFES-I sum scores according to age, sex, and falls history. RESULTS: Cronbach's alpha was 0.971 and mean inter-item correlation was 0.665. Test-retest Pearson correlation coefficient was 0.960 (p<0.01). As expected, KFES-I scores were associated with age, sex, and falls history (p<0.05). In addition, the KFES-I discriminated between sub-groups somewhat better than the original ten-item KFES scale. CONCLUSION: KFES-I appears to be a reliable and valid method for measuring fear of falling in older adults. This study provides the preliminary evidence that KFES-I is a useful tool in evaluating Korean elderly who fear falling.

The Relationship between Korean Version of Falls Efficacy Scale - International and Frequency of Falls in the Healthy Elderly Visiting the Public Health Centers

OBJECTIVE: To see whether there is a relationship between Korean Falls Efficacy Scale-International (KFES-I) developed for measuring fear of falling and frequency of fall. METHOD: KFES-I was composed with 16 items of activities of daily living including social activities and graded from 1 to 4 in each item. Surveys of 250 patients over 65 years of age from the public health center of Kang-dong and Seong-buk based on KFES-I and fall questionnaire such as presence, frequency and severity of fracture within last 6 months, and combined medical illness were taken. The data of KFES-I, fall questionnaire, and the inter-relationship of KFES-I items had been analyzed by Spearman and Kendall test. RESULTS: There was strong positive correlation between KFES-I total score and the frequency of falls. Four items (item 4, 7, 11, 15) of KFES-I showed strong correlation with the frequency of falls. There was significant difference in KFES-I total score between control and fracture groups (p<0.05). CONCLUSION: Our results showed that there was strong positive correlation between frequency of falls and KFES-I. It is suggested that frequency of falls can be predicted by KFES-I.

Understanding of Aging

There is no consensual definition of aging, at present. Aging is said to be all the changes of organism from its birth to death including maturation, development and adulthood and increase of probability of dying with time. And some scientists use senescence as the progressive accumulation of irreversible degenerative changes leading to loss of homeostasis and lack of adaptation to stress to differentiate from aging. Primary or normal aging process is conceptually considered to be universal changes with age, independent of environmental and lifestyle factors. And basic mechanism of intrinsic aging is still unknown. Secondary aging changes include the environmental and disease effects. It is not easy to distinguish normal aging from disease. Successful aging describes high physical, cognitive and social function with no disability and disease. Future research of aging toward successful aging involves study about basic me-chanism of aging with behavioral and societal changes, epidemiologic and clinical research about age related diseases and human longevity study. Identifying factors and interventions will lead to long and healthy human lifespan by delaying of aging process and prevention of disability and the age related diseases.

Reliability and Validity of Korean Brief Comprehensive Geriatric Assessment Questionnaire

Background: The purpose of this study was to evaluate the applicability of the Korean Brief Comprehensive Geriatric Assessment Questionnaire through testing the reliability and validity of it. Methods: Questionnaire consisted of items on medical, functional, mental, socioeconomic status and lifestyle was administered as test-retest on 78 elderly outpatients at 6 university hospitals in Seoul, Korea. Weighted kappa value, kappa value, Pearson correlation coefficients and overall percent agreement were calculated to measure reliability. Validity coefficient was estimated by using reliability coefficient. Results: Reliability coefficients and validity coefficients were higher than 0.50 (fair or good) for 28 items (87.5%) among 32. For test- retest reliability, median was 1.00 (range, 0.87-1.00) for overall percent agreement, 0.66 (range, 0.27~1.00) for kappa value, and 0.83 (range, 0.65~1.00) for Pearson's correlation coefficients. Differences of reliability and validity were identified by gender for 19 items (59.4%), and by age group for 12 items (37.5%). Conclusion: The Korean Brief Comprehensive Geriatric Assessment Questionnaire appears to be a reliable and valid screening tool. After additional study is performed, this instrument can be used as a useful tool for comprehensive outpatient geriatric assessment.

Risk Factors of Cardiovascular Disease in Korean Exceptional Longevity

BACKGROUND: It has been shown that subjects with exceptional longevity and their offsprings have a lower incidence and delayed onset of age-related diseases. Cardiovascular protective effect through over-presentation of Apo E2 with lower LDL cholesterol level, high HDL cholesterol, and larger size of HDL and LDL particle with cholesteryl ester transfer protein(CETP) genetic variation were suggested as a mechanism of less cardiovascular disease in exceptional longevity. Objective of this study is to examine what risk factors of cardiovascular diseases were related with exceptional longevity in Korea. METHODS: One hundred seventeen centenarians, 179 nonagenarians, 61 octogenarian regional controls were visited and joined after informed written consent was obtained. Age was first identified by National Residence Registry with help of regional government and verified by visiting researchers with birth year animal, age of first child and neighbor's connection memory. Detailed interview with questionnaires about health status and life style, physical examination, physical and cognitive function, and blood tests were performed. Data about risk factors of cardiovascular disease was analyzed and compared exceptional longevity group with regional control group and 455 octogenarian control data from 2001 National Health and Nutrition Examination. RESULTS: Hypertension and diabetes history, hypercholesterolemia and hypertriglyceridemia, obesity and abdominal obesity, and physical inactivity ratio of longevity groups were significantly less than control group. Level of homocysteine, and C-reactive protein and low serum HDL cholesterol ratio were not much different between longevity and control group. CONCLUSION: Fewer risk factors and delayed onset of cardiovascular disease were observed in Korean exceptional longevity group. Future research about genetic protective effect of cardiovascular disease in longevity is required.

Comprehensive Geriatric Assessment

No abstract available.

Comparison of Nutritional Status among Obese, Overweight and Normal Subjects in Seoul / 대한지역사회영양학회지

The nutritional status of middle-aged overweight and control normal subjects were evaluated for the purpose of providing the background information of the degenerative disease control. A survey was conducted with 293 healthy subjects (121 males and 172 females) between the ages 40 - 64. The average BMI (body mass index) of male subjects was 24.5 +/- 2.75, and that of females was 23.5 +/- 2.87. The average values of WHR (waist-hip ratio) were 0.88 +/- 0.04 for males and 0.82 +/- 0.07 for females. The normal BMI group (BMI 18.5 - 22.9) comprised 28.9% of males and 47.1% of females. The percentage of overweight subjects (BMI 23 - 24.9) was 26.4% of males and 30.8% of females. The obese group (BMI > 25) was 44.6% of males and 22.1% of females, showing the greater rate of obese state among male subjects. The average energy intakes were 76.6 +/- 14.9% for males and 77.8 +/- 12.6% for females, protein intakes were 108.0 +/- 24.6% for males and 111.2 +/- 22.7% for females of the RDA levels. The average intakes of other nutrients were above the 75% of RDA levels except calcium. The average nutrient intakes of the three subgroups according to their BMI values were not different for both males and females. There were weak correlations between obesity and blood biochemical indices. There were positive correlations between BMI or WHR and hemoglobin, hematocrit, fasting glucose, total cholesterol, triglyceride, AST or ALT. There were negative correlations between BMI or WHR and HDLcholesterol. These results suggest that the obesity rate of middle-aged is an influential factor of chronic disease. The middle-aged subjects of this study with higher educational and socioeconomic background tend to have desirable nutrition knowledge and attitude, but the application of their knowledge or attitude was relatively poor.

The association of Vitamin D and Parathyroid Hormone with Bone Mineral Density in Korean Postmenopausal Women

BACKGROUND: Osteoporosis results from bone loss due to menopause [estrogen(E) deficiency] and aging. Initial skeletal effect of menopause is accelerated bone resorption with an increase in seurm calcium(Ca) and compensatory but inadequate bone formation. Secretion of parathyroid hormone(PTH) is suppressed at this time. Postmenopausal osteoporosis results in fractures predominantly of trabecular bone, i.e., vertebra. With aging, secondary hyperparathyroidism by low serum Ca and vitamin D deficiency superim poses. Senile osteoporosis produces hip fractures, area of cortical bone. The aim of this study was to- examine the association of vitamin D[25(OH)D] and intact(i) PTH with bone mineral density(BMD) after controlling for suggested confounding factors, and the possibility of low serum vitamin D and high serum iPTH concentration could impact bone loss in Korean postmenopausal women. METHODS: Data from 188 postmenopausal Korean women aged 42 to 69 were analyzed through BMD, serum 25(OH)D, iPTH, Ca, phosphorus(P), alkaline phosphatase(ALP) and clinical characteristics. Factors affecting BMD was determined by Pearson correlation and the relationship between lumbar and femoral neck BMD and vitamin D[25(OH)D] and iPTH was assessed by multiple regression analysis after adjus- ting for suggested confounding factors. RESULTS: Lumbar and femoral neck BMD, serum Ca, P were decresaed and serum iPTH was increased with aging. In Pearson`s correlation, significant contributing factors to lumbar BMD was age, height, weight, menarche, year since menopause(YSM) and ALP. And significant contributing factors to femoral neck BMD was age, height, weight, menarche, YSM and iPTH. No relationship could be demonstrated between serum vitamin D[25(OH)D] and lumbar and femoral neck BMD. How ever, after controlling for potential confounding factors, a correlation was found between vitamin D[25(OH)D] and both of lumbar (p=0.013) and femoral neck BMD(p=0.077). iPTH was inversely related to femoral neck BMD(p=0.004) only in multiple linear regression. CONCLUSION: Serum vitamin D[25(OH)D] was influencing both of vertebral and femoral neck BMD, which suggests a significant role of vitamin D deficiency in the pathogenesis of postmenopausal osteo- porosis. In age related remodeling and loss of bone, increased serum iPTH might have additive role in cortical bone of femur. These findings suggest that vitamin D is very important for optimal bone health and a deleterious effect of increased iPTH on cortical bone loss. Adequate calcium and vitamin D status have to be maintained to prevent osteoporosis in postmenopausal Korean women.

Factors Affecting Bone Mineral Status of Premenopausal Women / 대한지역사회영양학회지

This study was conducted to investigate dietary and other factors affecting bone mineral density (BMD) in Korean premenopausal women. Seventy-eight premenopausal women who visited the Health Promotion Center for health examinations volunteered to participate in this study. They were divided into two groups according to their bone status as shown by their T-scores: a non-osteoporotic group and a osteoporotic group. The results are as follows: The mean BMDs of the lumbar spine and femoral neck were 1.21 +/- 0.02 g/cm2 and 0.97 +/- 0.04 g/cm2, respectively. The BMD levels of the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.001, respectively). The heights of the women in the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.01) however, their body weights did not show any significant differences although they tended to be lower. The mean daily intake of energy was 1720 +/- 52 kcal. When the nutrient intake was compared with the Korean recommended dietary allowances (RDA), calcium, Fe, vitamin A and riboflavin intakes were lower than the RDA. Their was no significant difference in the nutrient intake of the non-osteoporotic group and osteoporotic group except for the intakes of protein, fat and niacin. Their was no significant difference between the non-osteoporotic group and the osteoporotic group and all were within the normal range. However, the serum alkaline phosphatase level of the osteoporotic group was significantly higher than that of the non-osteoporotic group (p < 0.001). Height measurements showed positive correlations with lumbar spine bone mineral density (LBMD, r = 0.332, p < 0.01) however there was no correlation with femoral neck bone mineral density (NBMD). Age, age at menarche, body weight, body mass index (BMI) and obesity showed no correlation with BMD. The BMD of the lumbar spine was significantly and positively related to the intake of niacin and vitamin C (r = 0.236, p < 0.05; r = 0.274, p < 0.05). Serum levels of calcium and phosphorus showed negative correlations with LBMD (r = -0.698, p = 0.0001; r = -0.503, p = 0.0001, respectively). The results suggested that the BMD of the lumbar spine was positively related to the intake of niacin and vitamin C in premenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss would be have a higher intake of niacin and vitamin C rich foods and engaging habitually in physical activity may have a beneficial effect on BMD in the premenopausal period.

Some Factors Affecting Bone Mineral Status of Postmenopausal Women / 대한지역사회영양학회지

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were 1.02+/-0.02 g/cm2 and 0.81 +/-0.02 g/cm2, respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 +/- 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p<0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

Vitamin D and estrogen receptor gene polymorphism and their interaction associated with bone mineral density in Korean postmenopausal women / 대한내과학회지

BACKGROUND: Strong genetic components to the determination of bone mineral density (BMD) have been suggested by family and twin studies. However, association between gene polymorphism and BMD was not consistent in Korean as well as other ethnic groups. The goal of present study is to evaluate the relationship between vitamin D receptor (VDR) and/or estrogen receptor (ER) gene polymorphism and BMD after adjusting for suggested confounding factors and the possibility of VDR gene by ER gene interaction which could impact the bone mass of Korean postmenopausal women. METHODS: We determined the VDR and ER genotypes using a polymerase chain reaction based Bsm I restriction length fragment polymorphism (RFLP) and Pvu II and Xba I RFLP respectively, in a population based DNA sample of 132 Korean postmenopausal women aged 45 to 71. And then related the VDR and ER genotypes to BMD, bone related hormones, biochemical bone markers, and clinical characteristics in these women. Multiple regression analysis was used to predict variables contributing to BMD. Age, height, weight, years since menopause, VDR B genotype, and ER P and X genotypes were used as independent variables. RESULTS: There was no significant relationship of VDR or ER genotypes to lumbar or femoral neck BMD, hormones, and bone turnover markers. However, after controlling for potential confounding factors, a statistically significant ER X genotype effect on femoral neck BMD (p=0.038), but not on lumbar BMD was observed. Moreover, there was more significant effect on femoral neck BMD by an interaction of VDR B * ER X genotype (p=0.013) in multiple regression analysis. CONCLUSION: The ER X genotype was associated with femoral neck BMD in Korean postmenopausal women. This association was more significant with the VDR B genotype interaction.

Frailty, Gait, and Muscle Strength of the Elderly

No abstract available.

Geriatric Diseases: Characteristics and Preventive Measures

BACKGROUND: For the remembrance of the first 'Older People's Day' on Goober 2nd, The Korean Geriatrics Society (KGS) held geriatric conference for the improvement of the health on the aged. We summarized the discussion. RESULTS: We generally agree that many of the conditions of decrepit old age are not time-determined, but are the results of preventable and tretable illness. Rates of aging and senescence vary markedly in the aged. This has also been observed in different organ systems of the body. The comprehensive geriatric assessment developed in response to the complexity of medical, psychological and social problems occurred in older people It will be more necessary to develop Korean culture specific assessment tools. The proportion of the aged population to the whole is expected to reach 6.8% in the year 2000 and 12.5 % in 2020, forecasting that Korea will indeed enter the era of an aging society in the early 21s1 century. In Korea, geriatric diseases have the characteristic structure having multiple entities. The most common medical problem is arthralgia (with 57.8 % of 65 and older). In Korea, there are three kinds of medical care programs for the aged . medical insurance, medical assistance, and health screening, CONCLUSION: The desire for the improvement of older people's health is increasing now in Korea. Thus KGS suggests 'The Guideline for The Age'.