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In the face of an ever-increasing wave of an aging population, this paper provides an update on the current status of geriatric medicine in Korea, comparing it with global initiatives and suggesting future directions. Older adults require a multifaceted approach, addressing not only comorbidity management but also unmet complex medical needs, nutrition, and exercise to prevent functional decline. In this regard, the World Health Organization's Integrated Care for Older People guidelines underscore the importance of patient-centered primary care in preventing a decline in intrinsic capacity. Despite these societal needs and the ongoing aging process, the healthcare system in Korea has yet to show significant movement or a shift toward geriatric medicine, further complicated by the absence of a primary care system. We further explore global efforts in establishing age-integrative patient-centered medical systems in Singapore, Australia, Canada, the United Kingdom, and Japan. Additionally, we review the unmet needs and social issues that Korean society is currently facing, and local efforts by both government and a private tertiary hospital in Korea. In conclusion, considering the current situation, we propose that the framework of geriatric medicine should form the foundation of the future healthcare system. [ABSTRACT FROM AUTHOR]

The Taiwanese government has been facing severe challenges pressed by population ageing. The government started taking the issue of long-term care seriously since the first rotation of the political parties in 2000. However, early plans for long-term care were limited in terms of coverage. The Long-Term Care 2.0 Plan"a tax-funded, universal plan"was implemented in 2016. Soon after its implementation, the number of service organizations and the coverage of service increased sharply. This paper takes Taiwan as an example to discuss the designs of long-term care, and strategies to expand services. With many countries currently under pressure in long term care needs, Taiwan's experience could serve as a good example on how to achieve such policy goal within a short period of time. In addition, policy challenges for expanding long-term care are discussed. [ABSTRACT FROM AUTHOR]

Background: In at-risk older adults, gait speed is an important factor associated with quality of life and falling risk. In this study, we assessed whether therapeutic exercise could improve gait speed. Methods: We conducted a meta-analysis to evaluate the 'best' therapeutic exercise method by analyzing each exercise in terms of intensity, type, and several gait speed indices. For the analysis, we gathered 122 papers through a database search and selected 9 (n=627) that were appropriate for the meta-analysis. Results: In 8 of the 9 included papers, gait speed improved with therapeutic exercise. Usual gait speed (n=246) improved more than maximal gait speed (n=574). A resistance program was more effective than a nonresistance program for improving maximal, but not usual, gait speed. We also found that the effects of therapeutic exercise were greater in noncommunity than in community-dwelling elderly people. Conclusion: In conclusion, therapeutic exercise was effective in improving gait speed. [ABSTRACT FROM AUTHOR]

Older adults often experience functional decline following acute medical care. This functional decline may lead to permanent disability, which will increase the burden on the medical and long-term care systems, families, and society as a whole. Post-acute care aims to promote the functional recovery of older adults, prevent unnecessary hospital readmission, and avoid premature admission to a long-term care facility. Research has shown that post-acute care is a cost-effective service model, with both the hospital-athome and community hospital post-acute care models being highly effective. This paper describes the post-acute care models of the United States and the United Kingdom and uses the example of Taiwan's highly effective post-acute care system to explain the benefits and importance of post-acute care. In the face of rapid demographic aging and smaller household size, a post-acute care system can lower medical costs and improve the health of older adults after hospitalization. [ABSTRACT FROM AUTHOR]

Almost six decades after the first proposals to define and evaluate the quality of individual aging, the first indexes for assessing the aging process at the societal level have appeared. Moreover, in five years, three different scores for measuring societal aging have been developed and tested in different areas. The Global AgeWatch Index focused on 96 countries from around the world, while the Active Ageing index is limited to the European Union countries and the Ageing Society Index targets Organization for Economic Co-operation and Development countries. This paper analyzed and compared the results of these three indexes. The rankings vary little at the bottom end of the scale, with the same countries consistently ranked among the lowest scores (for example, Poland ranked last among the European countries in the three indexes). The same is true at the top of the rankings, with Sweden, the Netherlands, and Ireland consistently among the high-scoring countries. However, the three indices tend to differently rank the countries in the middle. The United States, for example, is ranked ninth in the Global Age Watch 2015 and third in the Ageing Societal Index 2018. In cases in which the results are not consistent, it is difficult for politicians and policymakers to adequately identify needs and orient the policy to promote active and healthy aging. There is clearly a compelling need for wide-scale debate to reach a consensus on a comprehensive score or index at the societal level. [ABSTRACT FROM AUTHOR]

Background: This study quantitatively and qualitatively analyzed the characteristics and trends of papers published in the Journal of the Korean Geriatrics Society. Methods: Original articles, case reports, review articles published from 2006 to 2013 were retrospectively examined. All of the article research topics, paper-specific corresponding author's affiliations and number of authors were investigated. Original articles were separated and grouped according to research designs. Using the Korean Citation Index, impact factor of this journal was examined and compared with four related journals. Results: Of the 276 articles analyzed, 159 (57.6%) were original articles, 145 (91.2%) were analytic studies, and 36 (22.6%) were experimental studies. The proportion of original articles accounted for about 60% until 2007 but decreased to 41.0% in 2013. By clinical study topics, 37 studies (13.4%) addressed the understanding of geriatric diseases and 45 studies (16.3%) were focused on nervous system diseases. The median number of authors for the 276 studies was 6. Internal medicine accounted for the largest proportion of corresponding author's affiliation (109 studies, 39.5%) studies. Impact factor of the journal increased from 0.05 (4th position) in 2009 to 0.48 (3rd position) in 2011. Conclusion: Articles published in the Journal of the Korean Geriatrics Society increasingly included experimental studies based on evidence-centered medicine, with the proportion of original articles decreasing. The impact factor increased annually along with the journal ranking, compared with other journals. Journal of the Korean Geriatrics Society is judged to be qualitatively improving. [ABSTRACT FROM AUTHOR]

Home-based primary care (HBPC) refers to the type of home care services which provide interdisciplinary primary care services with a comprehensive and continuous manner. Currently, it is getting much attention due to possess potential of converting primary care services from outpatient clinic to home, especially for those who are medically isolated including homebound older adults. This study examined a number of HBPCs introduced in the literature since 1990s, and summarizes the key factors with the analytic framework of 5Ps: purpose, patients, people, process, patterns. The results of this study emphasize that contents of primary care for older population should be different from those of the general population. This paper may be interpreted as the practice guideline of the following policy questions: “How can we design the HBPC if it is introduced in the nearest future?” In the future, it is necessary to have a heated debate concerning what is the most desirable primary care system for older adults. [ABSTRACT FROM AUTHOR]

Valacyclovir is an oral antiviral agent used in the treatment of herpesvirus infection. Although neuropsychiatric symptoms may accompany the use of this drug, valacyclovir is increasingly used to treat herpes zoster, as it is more effective when orally administered. This paper reports one case of neurotoxicity of valacyclovir in patients with end stage renal disease who were undergoing maintenance hemodialysis. Valacyclovir can induce life-threatening neurotoxicity, especially in end stage renal disease patients despite the appropriate dose reduction. Furthermore, Valacyclovir-induced neurotoxicity can be effectively managed by intensive hemodialysis. [ABSTRACT FROM AUTHOR]

When taking into account for social, economic, health disparities over the life courses among older adults, we should observe how such disparities arise and how they are maintained over the generations. The first part of this paper addressed the framework and approaches for understanding lifetime influences on late life disadvantages of health. The second part presented specific examples of late life disparities and their potential sources including chronic diseases, cognitive functions and disabilities. Context was considered to be broad and included early life experiences, descendants of generations and family influences. The third part addressed the roles of specific contextual influences. The final section of this review summarized the limitation of life course approaches and implementations for intervention. For geriatric medicine, it should be expanded into the focus of medical interventions and research of earlier age, with a wider range from individual to community and society, together with various other factors. [ABSTRACT FROM AUTHOR]