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Background: Centenarians are considered the most successful human biological aging model. However, the characteristics and patterns of research among centenarians have not been described or analyzed. Thus, this study aimed to disclose the historical landscape of global research on centenarians. Methods: This bibliometric study investigated historical evidence on centenarian research published in the Scopus database. The bibliometrix package in R was used to perform visual and quantitative analyses of research metrics, trends, and patterns. Results: Of the 2,061 documents included between 1887 and 2023, 84.2% (n=1,736) were published as articles with primary data. We identified international collaboration and annual growth rates of 21.4% and 3.15%, respectively. The United States published the highest number of papers on centenarians (n=786), whereas the publications from Italy had the highest impact (h-index of 90). Based on the frequency of keywords, mortality, genetics, dementia, Alzheimer's disease, and immunosenescence are a few of the most studied topics among centenarians, with emerging research related to mitochondrial DNA and comparison of results between nonagenarians and centenarians. Italy, the United States, and China lead the global research collaboration network, collaborating most frequently with Japan and European countries. Conclusion: Global research on centenarians has grown over the last 20 years, primarily led by Italy, the United States, and China. Latin American and African countries have conducted little or no research on centenarians. The most widely studied topics include mortality, cognition, immunosenescence, and genetics. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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]

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]

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]

Background: This study examined the association between memory function and reduced olfactory and gustatory function among independent community-dwelling older adults. Methods: This cross-sectional study included 127 older adults (65.4% women). We assessed their memory, odor, and taste identification skills. Open essence (OE) test and taste strips (TS) were used to identify hyposmia (OE test ≤6) and hypogeusia (TS test ≤8), respectively. Results: Participants with severe hyposmia had significantly poorer memory functions compared to participants without severe hyposmia. After adjusting for covariates, multivariate logistic regression models revealed a significant association between immediate recognition performance and a decreased likelihood of severe hyposmia (odds ratio=0.65; 95% confidence interval 0.47--0.90). We observed no significant association between taste function and memory. Conclusion: Memory function may be associated with olfactory impairment in older adults. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. Methods: We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. Results: From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. Conclusion: Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly. [ABSTRACT FROM AUTHOR]

Background: This study categorized older Korean adults' social networks and analyzed their characteristics and digital literacy differences based on type. Methods: We analyzed data from 9,377 Korean older adult participants of the 2020 National Survey of Older Koreans, and performed latent class analysis (LCA) chi-square and Welch's F analyses to understand the characteristics of each social network type. The Games--Howell post-hoc test was applied to determine the significance of differences between groups. Results: The three social network types derived using LCA were "child-centered," "child-friend," and "friend-centered." The digital literacy levels differed significantly according to social network type. Conclusion: The results of this study can be used to propose intervention programs and services associated with older adults' social networks by examining their social network types and the corresponding differences in digital literacy. [ABSTRACT FROM AUTHOR]

Background: Falls are a global concern affecting people of all ages; however, older adults are particularly vulnerable to age-related factors and foot-related issues. Footwear is critical for preventing falls, as it provides stability and protection against slips, trips, and falls (STFs). However, a significant gap exists in the systematic exploration of the safety aspects of footwear design for fall prevention in older adults. Methods: This comprehensive review applied a meticulous search strategy encompassing prominent databases, including Google Scholar, ScienceDirect, SCOPUS, MEDLINE, ResearchGate, and PubMed. This review synthesized and analyzed existing research to bridge knowledge gaps and provide insights into optimal footwear choices for older adults in terms of design features such as fit, fixation, heel height, collar height, slip resistance, and sole/ insole hardness. Results: The results underscore the importance of specific design features for preventing falls among older adults. A proper fit, secure fixation, appropriate heel and collar heights, slip resistance, and sole/insole hardness significantly contributed to fall prevention. These findings offer valuable guidance for optimizing footwear designs to enhance comfort, stability, and safety in the daily lives of older individuals. Conclusion: This comprehensive review fills a critical knowledge gap regarding the safety of footwear designs for fall prevention in older adults. The identified design features play a vital role in reducing the risk of falls and offer practical recommendations for the development of safer footwear. Ultimately, this study contributes to the existing knowledge base and supports efforts to prevent STFs in older adults through improved footwear design. [ABSTRACT FROM AUTHOR]

Background: Although the relationship between medication status, symptomatology, and outcomes has been evaluated, data on the prevalence of polypharmacy and potentially inappropriate medications (PIMs) and the association of polypharmacy and PIMs with swallowing function during follow-up are limited among hospitalized patients aged =65 years with dysphagia. Methods: In this 19-center cohort study, we registered 467 inpatients aged =65 years and evaluated those with the Food Intake LEVEL Scale (FILS) scores =8 between November 2019 and March 2021. Polypharmacy was defined as prescribing =5 medications and PIMs were identified based on the 2023 Updated Beers Criteria. We applied a generalized linear regression model to examine the association of polypharmacy and PIMs with FILS score at discharge. Results: We analyzed 399 participants (median age, 83.0 years; males, 49.8%). The median follow-up was 51.0 days (interquartile range, 22.0-84.0 days). Polypharmacy and PIMs were present in 67.7% of and 56.1% of patients, respectively. After adjusting for covariates, neither polypharmacy (ß=0.05; 95% confidence interval [CI], -0.04-0.13, p=0.30) nor non-steroidal anti-inflammatory medications (ß=0.09; 95% CI, -0.02-0.19; p=0.10) were significantly associated with FILS score at discharge. Conclusion: The results of this study indicated a high proportion of polypharmacy and PIMs among inpatients aged =65 years with dysphagia. Although these prescribed conditions were not significantly associated with swallowing function at discharge, our findings suggest the importance of regularly reviewing medications to ensure the appropriateness of prescriptions when managing older inpatients. [ABSTRACT FROM AUTHOR]

Background: Challenges of polypharmacy and the impact of coronavirus disease 2019 (COVID-19) pandemic in older patients require further investigation. This retrospective study analyzed the progression of polypharmacy and anticholinergic burden in older patients in a primary care setting before, during, and after the COVID-19 pandemic. Methods: This 3-year cross-sectional study (2019, 2020, and 2021) comprised a dynamic cohort of individuals aged =75 years, who attended the Arrabal Primary Care Center in Zaragoza, Spain. Older patients with polypharmacy (=5 medications) were identified according to their electronic health records. We collected demographic and clinical data, including medication prescriptions, diagnoses, and anticholinergic risks, and performed descriptive and statistical analyses. Results: This study included a total of 1,928 patients with a mean age of 83.52±0.30 years. Over the 3-year study period, the mean number of medications prescribed increased, from 9.4 in 2019 to 10.4 in 2021. The prevalence of excessive polypharmacy (=10 medications) increased from 39% in 2019 to 45% in 2021. The most commonly prescribed drugs were anilides, proton pump inhibitors, benzodiazepine derivatives, and platelet aggregation inhibitors. Women had a higher prevalence of illnesses and anticholinergic drug prescriptions than men. Conclusion: The results of this study highlighted an upward trend in polypharmacy and excessive polypharmacy among older patients in primary care settings. Future research should focus on optimizing medication management and deprescribing strategies and minimizing the adverse effects of polypharmacy in this population. [ABSTRACT FROM AUTHOR]

Background: This study examined the bidirectional and temporal-ordinal relationship between loneliness and back pain. Methods: Data from 7,730 participants in waves 6 (2012-2013), 7 (2014-2015), and 8 (2016-2017) of the national English Longitudinal Study of Ageing were analyzed. Back pain was graded on a scale of 0-10 (0, no discomfort; 10, unbearable pain). Loneliness was measured using the Revised University of California Los Angeles Loneliness Scale. A targeted minimum loss-based estimator was used to examine the bidirectional longitudinal associations between back pain and loneliness. Results: No loneliness in waves 6 and 7 (relative risk [RR]=0.76; 95% confidence interval [CI], 0.61-0.94), no loneliness in wave 6 but loneliness in wave 7 (RR=0.58; 95% CI, 0.50-0.68), and loneliness in wave 6 but not in wave 7 (RR=0.69; 95% CI, 0.57-0.86) were associated with significant risk reductions of back pain in wave 8 compared with the scenario of loneliness in waves 6 and 7. Mild back pain in wave 6 but moderate back pain (RR=0.55; 95% CI, 0.35-0.86) or severe back pain in wave 7 (RR=0.49; 95% CI, 0.34-0.72) showed a significant risk reduction of loneliness in wave 8 compared with severe back pain in waves 6 and 7. Conclusion: Loneliness may be a risk factor for back pain, and back pain may be a risk factor for loneliness. The results of this study will inform the development of more effective interventions for loneliness and back pain. [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]

Background: Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology. Methods: We identified relevant articles on geriatrics and gerontology using the search terms "geriatrics," "gerontology," "older people," and "elderly." VOSviewer was used to perform bibliometric analysis. Results: A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395). Conclusion: These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them. [ABSTRACT FROM AUTHOR]

Despite the introduction of a diagnostic code and acceptance of a diagnostic process for sarcopenia as a new health technology in Korea, many practitioners remain unfamiliar with the evaluation of sarcopenia. Thus, the Korean Working Group on Sarcopenia (KWGS) developed clinical practice guidelines for the diagnosis of sarcopenia in older Korean adults. A two-phase Delphi interview comprising 19 questions was conducted with 40 expert panelists, 22 of whom participated in the first round between June and August 2022. The second round of the Delphi interview included the remaining 11 questions that were not agreed upon in the first round. The screening process for sarcopenia includes various questionnaires and examinations used in different research and clinical settings. The diagnostic process for sarcopenia was simplified by combining the steps of case finding and assessment. The Short Physical Performance Battery test was given particular emphasis owing to its multifaceted nature. Regardless of muscle mass, having low muscle strength with low physical performance is considered clinically relevant and newly defined as "functional sarcopenia." Comprehensive geriatric assessment is important for diagnosing sarcopenia. The KWGS's clinical guideline aims to facilitate the early detection of sarcopenia by allowing various screening tools to be used in a unified process and reducing confusion about which tools to use for diagnosis. This recommendation expands the conceptual definition of sarcopenia as a complex pathophysiological state in line with the concept of frailty and aims to stimulate further research on the diagnosis and management of sarcopenia in clinical settings. [ABSTRACT FROM AUTHOR]

Background: This study developed a preliminary instrument to measure nurses' infection prevention compliance against emerging respiratory infectious diseases and to verify the reliability and validity of the developed instrument. Method: The participants were 199 nurses working at a university hospital with more than 800 beds and two long-term care hospitals. Data were collected in May 2022. Results: The final version of the developed instrument consisted of six factors and 34 items, with an explanatory power of 61.68%. The six factors were equipment and environment management and education, hand hygiene and respiratory etiquette, infection risk assessment and flow management, protection of employees in contact with infected patients, ward access management of patients with infectious diseases, and wearing and removing personal protective equipment. We verified the convergent and discriminant validities of these factors. The instrument's internal consistency was adequate (Cronbach's α=0.82), and the Cronbach's α of each factor ranged from 0.71 to 0.91. Conclusion: This instrument can be utilized to determine the level of nurses' compliance with infection prevention activity against emerging respiratory infectious diseases and will contribute to measuring the effectiveness of future programs promoting infection-preventive activities. [ABSTRACT FROM AUTHOR]

Background: Osteosarcopenia, a combination of osteopenia/osteoporosis and sarcopenia, is a common condition among older adults. While numerous studies and meta-analyses have been conducted on the treatment of osteoporosis, the pharmacological treatment of osteosarcopenia still lacks evidence. Denosumab, a human monoclonal antibody, has shown encouraging results for the treatment of osteosarcopenia. Our systematic review and meta-analysis aimed to investigate the potential dual role of denosumab as an anti-resorptive agent and for other beneficial muscle-related effects in patients with osteosarcopenia, and to evaluate whether denosumab can be a treatment of choice compared to bisphosphonate. Methods: Relevant literature was collated from the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Google Scholar databases. The primary outcome was denosumab's effect on lumbar spine bone mineral density (LS BMD), handgrip strength, and gait speed change. The secondary outcome was the effect of denosumab on appendicular lean mass (ALM). The outcomes were presented as mean difference (MD). A random effects model was used in the analysis to represent the population. The risk of bias was assessed using funnel plots. Results: Out of the 3,074 studies found, four full-text studies met the inclusion criteria, including 264 and 244 participants in the intervention and control groups, respectively. Regarding a primary outcome, our meta-analysis showed that denosumab showed no significant differences in LS BMD and gait speed changes compared to other agents--MD=0.37, 95% confidence interval (CI), -0.35 to 0.79; p=0.09 and MD=0.11; 95% CI, -0.18 to 0.40; p=0.46, respectively. Denosumab had a significant effect on handgrip strength change compared to standard agents--MD=5.16; 95% CI, 1.38 to 18.94; p=0.007, based on the random effects model. Conclusions: Denosumab was better than bisphosphonate and placebo in improving muscle strength (handgrip strength). Therefore, denosumab may be favored in individuals with osteosarcopenia to improve muscular performance and reduce fall risk. [ABSTRACT FROM AUTHOR]

The long-term care insurance (LTCI) system was introduced in Japan in 2000 to address the demands of older persons with disabilities based on the concept of a user-oriented social insurance system with support for independence. Older people with a certification for LTCI service needs can utilize facility services, in-home services, and community-based services depending on their physical and cognitive impairments. After the implementation of the LTCI system, there was a rapid increase in persons certified for LTCI service needs, with a corresponding increase in the financial burden on the government. Therefore, the Japanese government started a disability prevention program in which older people were screened for frailty by the Kihon checklist in addition to a high-risk approach with appropriate prevention programs in each community. After unsatisfactory outcomes of the high-risk approach for disability prevention, the government changed the primary strategy to a community-based population strategy to build a community to seamlessly provide preventive, medical, and long-term care and welfare and housing services to all individuals. Further improvement of the community-based integrated care system is needed for healthy aging in a superaged society. [ABSTRACT FROM AUTHOR]

Background: The SarQoL, a quality-of-life questionnaire specific to sarcopenia, was developed in 2015 and has since been translated into a number of other languages. The main reason to introduce this new Ukrainian version of the questionnaire was to measure sarcopenic individuals' perceptions regarding their positions in life in the context of their culture and value systems. Methods: The questionnaire was translated using a forward-backward approach with a pre-test. A total of 49 participants were recruited for the validation study. Sarcopenia was diagnosed according to the Ishii test. The validation analyses included discriminative power, internal consistency, floor and ceiling effects, construct validity, and test-retest reliability. We compared the SarQoL questionnaire to the Short-Form 36 and the EuroQoL-5 Dimensions. Results: A total of 28 participants out of 49 were categorized as probably sarcopenic. They had a significantly lower quality of life (overall score 58.43±17.13 vs. 69.89±13.31; p=0.014). The internal consistency was excellent (α=0.898), with none of the domains showing a disproportionate influence on the homogeneity of the questionnaire. Convergent construct validity was also confirmed. The results indicated a near-perfect degree of test-retest reliability. Conclusions: The first Ukrainian version of the questionnaire is equivalent to the available original English version. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to develop and validate the Korean Frailty Index for Primary Care (KFI-PC) based on a comprehensive geriatric assessment. Methods: We developed a 54-item KFI-PC comprising 10 standard domains: cognitive status including delirium or dementia; mood; communication including vision, hearing, and speech; mobility; balance; bowel function; bladder function; ability to carry out activities of daily living; nutrition; and social resources. To test its validity, we applied KFI-PC to participants of the Korean Frailty Aging and Cohort Study (KFACS). We analyzed 1,242 participants (mean age, 77.9±3.9 years; 47.2% men) from the KFACS who visited 10 study centers in 2018, after excluding 32 participants with missing data required to assess Fried's physical frailty phenotype. Results: The mean KFI-PC score was 0.17±0.08, ranging from 0.02 to 0.52. The median KFI-PC score was higher in women than in men, and there was a trend toward higher values in older age groups. The prevalence of frailty when applying a generally used frailty index cutoff point of >0.25 was 17.5% in the whole study sample. As a construct validation of KFI-PC, the area under the receiver operating characteristic curve for Fried's physical frailty was 0.921, and the optimal cutoff value to predict frailty phenotype was 0.23. The KFI-PC score also correlated well with physical, cognitive, and psychological functions; nutritional status; disability in activities of daily living; and instrumental activities of daily living. The Cronbach's alpha coefficient of the 54 total items was 0.737. Conclusion: We developed KFI-PC with 53 deficits, including comprehensive geriatric assessment components, and demonstrated the acceptable construct validity and internal consistency of KFI-PC. [ABSTRACT FROM AUTHOR]

Frailty is a loss of functional reserve that compromises a person's ability to cope with stressors such as surgery. Identifying and quantifying frailty may enable intensive rehabilitation interventions, caregiver support, or consideration of palliative care before surgery. This study describes the characteristics of five frailty screening tools, namely the Geriatric 8, Vulnerable Elders Survey-13, the Groningen Frailty Indicator, Edmonton Frailty Scale (EFS), and Clinical Frailty Scale. We further propose an approach incorporating a frailty scale into preoperative assessment, wherein older patients undergoing elective general surgery are screened using EFS, and frail patients are offered comprehensive geriatric assessment. The expected outcome is an individualized patient- centered care plan that will reduce frailty and optimize the patient's condition before surgery. [ABSTRACT FROM AUTHOR]

Dementia reduces a person's ability to perform their activities of daily living and is the leading cause of morbidity worldwide. While most preventive measures are ineffective in reducing dementia risk, active treatment of hypertension in middle-aged and older adults without dementia may reduce the incidence of dementia. Hypertension is associated with vascular dementia but may also affect the manifestations of Alzheimer disease. Observational studies support the association between hypertension and white matter lesions, hippocampal atrophy, and cognitive decline. Both increased and decreased blood pressure were related to the development of white matter lesions. Cohort studies showed that hypertension treatment and treatment duration were associated with lower cognitive decline. This review describes findings from randomized controlled studies on the effects of antihypertensives on cognitive decline. Only the Systolic Hypertension in Europe (Syst-Eur) trial using calcium-channel blockers demonstrated a significant reduction in dementia incidence. Further studies are required to evaluate the long-term benefits of antihypertensive treatment in dementia. [ABSTRACT FROM AUTHOR]

Background: Korea, as one of the fastest-aging countries worldwide, requires an improved healthcare service model for older adults. We evaluated the current healthcare system and developed a service model based on information and communication technologies (ICT) for use in older patients in long-term care facilities (LTCF). Methods: We conducted a qualitative literature review, focus group interviews (FGIs), and structured survey to identify the current technology use and status of healthcare systems. We then developed a web-based platform with necessary, high-priority, and usable content for the care of older patients in LTCF. Results: We reviewed 60 (23 hypertension, 18 diabetes, and 19 heart failure) articles on iinformation and communication technologies (ICT)-based disease management for clinical effectiveness and improved patient satisfaction. FGIs and structured surveys were used to evaluate the inconvenience in patient and medical information transfer between hospitals and cost and time required for its process. Accordingly, we confirmed the unmet need for an ICT-based service model for management, monitoring, and consultation among older patients and developed the Health-RESPECT (integrated caRE Systems for elderly PatiEnts using iCT), a service platform for older patients residing in LTCF. The medical information exchange system was used to transfer medical information. Health-RESPECT includes an established algorithm for evidence-based comprehensive geriatric assessment and customized management; chronic disease management; management of potentially inappropriate medications; rehabilitation; and consultation and videoconferencing. Conclusion: This study identified the current status and unmet needs of healthcare systems for older adults. We developed an ICT-based system to manage older institutionalized patients. However, the Health-RESPECT service model requires further validation. [ABSTRACT FROM AUTHOR]

Background: We aimed to analyse the trends in ageism among health care providers and medical students in the Republic of Korea. Methods: We used the Fraboni Scale of Ageism (FSA), Relating to Older People Evaluation (ROPE) questionnaire, Anxiety about Aging Scale (AAS), and the Facts on Aging Quiz II to assess ageism in medical students (n=90), nurses (n=114), and physicians (n=83). We grouped health care providers based on the percentage of aged patients (over 65 years) that they treated. Results: Compared to the other groups, physicians had more knowledge about aging and the highest and lowest total scores in the FSA and ROPE, respectively. The total FSA scores were negatively correlated with the percentage of aged patients treated. Regarding the ROPE score, negative and positive ageist behaviors were positively correlated with the percentage of aged patients. Conclusions: Ageism and ageist behavior among physicians differed from previous reports and those of the other groups mentioned in the present study. Although physicians had more knowledge of aging, they had expressed a high levels of ageism. However, they did not act ageistically. Health care providers who treat a large number of older patients had minimal ageism but more ageist behavior. These findings indicate that continued education of geriatrics and ageism for medical staff and prospective medical personnel could help improve this situation. [ABSTRACT FROM AUTHOR]

Background: Effective pain management is a fundamental human right. However, global disparities in pain management practices exist across health settings. This study explored healthcare practitioners' views on pain management in the acute care hospital setting. Methods: The focus groups included clinical specialties most likely to encounter patients with 'difficult to manage pain', namely those in the Geriatrics and Palliative Care Unit (2 doctors and 3 nurses), Critical Care Unit (7 doctors), and the Pain Management Team (3 doctors and 2 nurses). The transcripts were analyzed using a qualitative thematic analysis. Results: The data analysis revealed four themes. Theme 1, 'Being too safe' described the presence of apprehensive attitudes among patients and healthcare practitioners that limits the appropriate use of diverse and tailored pain medications in acute care hospital settings. Theme 2, 'Working as a team' described the need for collaborative approaches to achieve hospital-wide evidence-based pain management. Theme 3, 'Adaptation for local and cultural preferences' explored how pain was perceived through cultural lenses and suggested strategies to tailor pain management to local and cultural preferences. Finally, Theme 4, 'Driving acute pain management forward' listed clinician solutions for improving pain management in acute care hospital settings toward a pain-free hospital initiative. Conclusion: Despite advances in pain medicine and pain teaching strategies, effective pain management is proportionate to both clinical and cultural preferences. Future studies should investigate the standardization of global pain management tools and guidelines to fit the local culture and context. [ABSTRACT FROM AUTHOR]

Diabetes is an important health problem with the population aging. Previously, it is well established that diabetes is associated with microvascular and macrovascular complications, but recently, several data suggest that diabetes is accompanied with frailty as well as disability among the older adults. Considering the clinical significance of frailty and disability, it is important to understand the pathway from diabetes to frailty and/or disability. Additionally, it is strongly recommended to find a new therapeutic intervention are required to meet the increasing demand of managing older diabetic patients with the population aging. [ABSTRACT FROM AUTHOR]

The gut microbiome is deeply associated with both skeletal muscle and brain function. In particular, gut microbiome dysbiosis may accelerate age-related diseases by affecting these systems. Although there is increasing evidence of the correlations between the gut microbiome and skeletal muscle and brain, it remains unclear whether changes in the gut microbiome due to exercise training can lead to healthy aging. This review covers the current status of gut microbiome-related research and future directions related to aging (e.g., physical frailty and cognitive dysfunction) as well as the effect of exercise training on both. We reviewed relevant literature including original articles and reviews identified from searches of the PubMed, Google Scholar, SCOPUS, EBSCOHost, ScienceDirect, Cochrane Library, and EMBASE databases using the following terms: 'gut microbiome', 'exercise', 'physical frailty', and 'cognitive dysfunction'. We identified a strong positive correlation between cognitive dysfunction or physical frailty and the gut microbiome. Furthermore, exercise had a significant effect on the composition of the gut microbiome. These results suggest that exercise training can prevent physical frailty or cognitive dysfunction by altering the gut microbiome. However, the exact mechanism by which these effects occur is not yet clear. Further studies are needed to determine whether exercise training can prevent age-related diseases by balancing the gut microbiome. [ABSTRACT FROM AUTHOR]

Background: Population aging is a global phenomenon with opportunities and challenges. The numbers and proportions of older people are increasing in almost every country. This study aimed to evaluate the perceptions of nursing homes among final-year medical students. Methods: This qualitative study used the word association test as a data collection tool to obtain the reflections regarding nursing homes among final-year students, and the concept of "nursing homes" was defined in face-to-face interviews of the volunteer students. Results: Analysis of data collected from 51 students regarding nursing homes resulted in five main categories (old age [frequency, f=74], positive affect emotions [f=66], negative affect emotions [f=165], loneliness [f=75], and abandonment [f=46]) based on the reflections that the term "nursing home" evoked among the students. In the present study, the final-year students primarily used more negative expressions. Conclusion: Qualitative studies with students, such as those included in the present study, can provide important clues for the development of educational curriculum and social health policies. [ABSTRACT FROM AUTHOR]

Background: We aimed to compare 4 automatic devices with a conventional stopwatch for measuring gait speed. Methods: We used 4 experimental devices to automatically measure gait speed: 1) Gaitspeedometer (GSM) 1, with laser sensors; 2) GSM2, with ultrasound sensors; 3) GSM3, with infrared sensors; and 4) GSM4, with a light detection and ranging sensor. To assess compatibility between different versions of GSMs, we collected 426 data points from 4 young engineers walking at random speeds and with varying postures. We used these data to convert gait speed measured by GSM1 and 2 for compatibility with GSM3 in the Korean Frailty and Aging Cohort Study (KFACS) dataset. Results: Mean gait speeds measured with GSMs 1-4 were 1.7% slower (R2=0.997), 12.2% faster (R2=0.993), 1.3% slower (R2=0.999), and 4.3% slower (R2=0.996), respectively, than the gait speed measured with a stopwatch. The concordance correlation coefficient between each GSM and the stopwatch was higher than 0.9. Using linear regression analysis with no constant term, conversion formulas for GSMs were established for the KFACS dataset using GSM1 and GSM2. Conclusion: The 4 methods of automatic gait speed measurement and the manually measured gait speed correlated well with each other, and we hope these new technologies reduce barriers to measuring older people's gait speed in busy clinical settings. [ABSTRACT FROM AUTHOR]

Mycobacterium abscessus comprises rapidly growing mycobacteria, and the clinical manifestations of M. abscessus skin infection include papule, nodule, ulcer, scar and mixed form. The cutaneous infections have been reported due to minor trauma, cosmetic therapy, acupuncture and disseminated infection. A 75-year-old man presented with pruritic diffuse various sized erythematous papuloplaques and pustules on the neck and chest for 2 months. The cutaneous lesions were spread around the wound of the shaving on the neck. The histopathologic findings were consistent with abscess showing infiltrations of neutrophils and lymphocytes in the dermis and negative findings were observed on immunohistochemical stain including acid-fast bacilli stain. One month later, mycobacterial culture result showed positive findings, and the pathogen was identified by reversetranscriptase polymerase chain reaction with hybridization. The patient was treated with combination of clarithromycin and ethambutol for 5 months and there is no evidence of recurrence after 6 months of follow-up. Herein, we report a case of M. abscessus cutaneous infection through minor trauma caused by shaving in the elderly. [ABSTRACT FROM AUTHOR]

The Korean Geriatrics Society was founded on October 3, 1968. Over the 50 years since then, the Society has incessantly strived to stay attuned to the aging society and to achieve an increasingly greater research impact in the field of gerontology and geriatric medicine. The Society has passed through periods of preparation for a leap forward, followed by rapid growth, expansion, and maturity. As a result, the Society has gained a firm foothold at home and abroad as a leading research society for both qualitative and quantitative achievements in geriatric medicine. At this juncture, with an ultra-aging society being just around the corner, we are celebrating its 50th anniversary and anticipating our second half-century with great enthusiasm about our mission and role as a leading geriatric research organization. [ABSTRACT FROM AUTHOR]

Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/ kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/ kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea. [ABSTRACT FROM AUTHOR]

Sarcopenia is defined as an age-associated decline in muscle mass and function caused by several etiologies and mechanisms. Muscle mass and function do not decrease concurrently, and a loss of muscle function may be more highly associated with adverse health outcomes. Despite the clinical significance of sarcopenia, no universally operational definition of sarcopenia or standardized intervention programs are currently available. Sarcopenia, osteoporosis, and obesity share several pathophysiological mechanisms, and a combination of these entities may lead to an increased risk of musculoskeletal, cardiometabolic, and psychological morbidities especially in geripause populations. Treatment for sarcopenia is mainly nonpharmacological, however, various drugs are currently being developed. It is conceivable that sarcopenia is the next immediate clinical target in musculoskeletal science. [ABSTRACT FROM AUTHOR]

Even though social factors that determine frailty in older people contribute to adverse health outcomes, there is little consensus in terms of the definition of social frailty. Therefore, in this article we reviewed literature on social frailty and attempted to define the term. Although we found that living alone, social participation, economic hardship, and other such factors are associated with a decline in activities of daily living and increased risk of disability, we have not reached an agreement on either the most effective methods of assessing social frailty or the most effective interventional approaches to address social frailty. Further investigations are needed to define social frailty and identify effective interventions to promote active aging by focusing on the social aspects in older adults with social frailty. It would be reasonable to think that this approach will also improve physical and cognitive frailty. [ABSTRACT FROM AUTHOR]

Background: Falls, in older adults, can worsen physical functioning and lead to serious complications. Thus, as a means of preventive intervention, this high-risk group should be screened. The aim of the present study was to investigate whether reaction time is clinically applicable as a fall risk assessment tool. Methods: The study participants were community-dwelling older adults aged 65 years or older, who scored 24 or more in the Korean version of the Mini-Mental State Examination, and did not have difficulty with communication and comprehension. To investigate the relationship between hand reaction time and fall risk, we used items from a recently developed computerized apparatus, which includes 2 fall risk assessment tools: the Short Physical Performance Battery (SPPB) and Berg Balance Scale (BBS). Results: Reaction time was negatively correlated with the total SPPB (r=-0.314, p<0.001) and BBS scores (r=-0.164, p<0.001); the scores were higher when reaction times were lower. Multiple linear regression analyses also showed that the total SPPB (β=-0.30; 95% confidence interval [CI], -0.26 to -0.02) and BBS scores (β=-0.14; 95% CI, -0.26 to -0.02) significantly increased as the reaction time decreased. Conclusion: Reaction time was significantly correlated with the SPPB and BBS, confirming the possibility of its use in tools for fall risk assessment. [ABSTRACT FROM AUTHOR]

In 2014, the Innovative Medicines Initiative funded a 48-million Euros project entitled "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies" (SPRINTT). The SPRINTT consortium federates partners from academia, industry, and the private sector to address an important gap in the geriatric field: the lack of a standardized and clinically relevant definition of sarcopenia. In particular, the SPRINTT project aims to involve all major stakeholders in the framing of a skeletal muscle-specific risk profile that exposes the individual at risk of negative health-related outcomes (in particular, disability), is amenable to benefiting from preventive interventions, and meets the standards requested by regulatory agencies. During the first year of activity, the SPRINTT consortium has implemented a "Physical Frailty & Sarcopenia" (PF&S) condition that considers existing evidence and regularly exchanges information with the European Medicines Agency. This condition is currently the study objective of a 3-year randomized controlled trial in multiple countries across Europe. The trial aims to verify whether a multicomponent intervention (based on physical activity and nutritional counseling) can prevent the onset of mobility disabilities in community-dwelling older persons with PF&S. The present article provides an overview of the SPRINTT background and rationale and explains the details of the PF&S condition. [ABSTRACT FROM AUTHOR]

Background: Early diagnosis and treatment of dementia has become a critical medical issue; however, knowledge and understanding of dementia in the general population remains insufficient. Accurately determining and increasing the level of knowledge of dementia will help improve dementia treatment and prevention. Methods: Using a questionnaire, we examined the degree of interest in dementia, comprehension of dementia, and level of knowledge of dementia among 716 middle-aged and elderly individuals without a history of stroke or dementia. We conducted an analysis of these associations with risk factors of dementia. Results: Most participants had an interest in dementia (93.3%) and a comprehension of dementia (91.1%). An analysis of the association between the level of knowledge of dementia, according to the characteristics of the participants and each variable, showed that higher education level, presence of a spouse, and higher level of interest in dementia exhibited a statistically significant positive correlation. Conclusion: This study shows that the level of knowledge about dementia in the community is relatively high for those participants who have a high interest in dementia or higher education level. To increase awareness of dementia and reduce dementia-associated socioeconomic costs, educational activities could be tailored to fit the level of education or interest in dementia of individuals, as an effective intervention for community-dwelling healthy adults. [ABSTRACT FROM AUTHOR]

Background: In a rapidly aging population, the importance of the quality of life of the elderly has been emphasized. The need for special care services according to an individual's physical, emotional, and social functions changes with aging. This study was conducted to analyze the needs of home dwellers in terms of health-care services for active aging. Methods: The study subjects were 869 adults older than 40 years who lived in houses. They responded to a survey that inquired about the importance of each health-care item for active aging at home. The important items for active aging at home were graded by using a 5-point Likert scale. Results: Among the items, "affection" topped the list, with 4.68 points, followed by cognitive function (4.67 points) and "social relations" (4.59 points). The top 3 items had no significant differences between the age groups. However, some items related to activities of daily living (ADL; including bathing, eating, and ambulating.) and instrumental ADL (IADL; including taking medicines and preparing meals) had significant differences between the age groups. Compared with the subjects in the older age groups, the subjects in the forties age group placed less importance on ADL and IADL. Conclusion: For the subjects who lived in houses, affection, cognitive function, and social relation are highly important for as active aging, regardless of age. ADL and IADL are regarded as more important in ≥50 years age groups. [ABSTRACT FROM AUTHOR]

Sarcopenia has been defined as the considerable loss of skeletal muscle mass and strength that results in frailty in the elderly. Because muscle tissue plays diverse important roles in human, sarcopenia presents many negative health-related consequences including impaired energy homeostasis, falls and cardiovascular disease, and subsequently higher mortality. It is becoming evident that sarcopenia has a negative impact on the healthy life of the elderly. The European Working Group on Sarcopenia, the International Working Group on Sarcopenia and the Asian Working Group on Sarcopenia have released position statement regarding sarcopenia, and more recently the Foundation for the National Institutes of Health Sarcopenia Project has provided a new guideline for assessment of sarcopenia. At this time, there have been several data delineating the status of sarcopenia in Korea. This review focuses on largescale cohorts that assessed sarcopenia and highlights the controversies surrounding the clinical definition and prevalence of sarcopenia in Korea. [ABSTRACT FROM AUTHOR]

Background: With a rapidly aging population, more elderly patients are being hospitalized than before. Thus, a comprehensive geriatric assessment medium is needed to carefully evaluate geriatric patients. The author's university hospital has a geriatric medicine team to where patients are referred for comprehensive evaluations. Their services will be introduced here. Methods: From December 2010 to January 2012, the team performed comprehensive geriatric assessments comprising of a thorough review of systems, physical examination, and surveys, and reviewed past medical records of the elderly hospitalized patients aged 65 or over, referred from the Department of Orthopedics. Results: Of total 58 patients, 4 patients (6.9%) had severe dysfunction in the activities of daily living with the score of 16 or higher. Twenty-two patients (73.3%) had cognitive impairment or dementia upon assessing cognitive function after excluding those previously diagnosed with dementia or those within 5 days after surgery, thus predisposed to delirium who had tested mini mental state examination for cognitive function level test. Fifteen patients (31.3%) had mild depression, while four (8.3%) had moderate depression; and 37 patients (67.3%) were at moderate risk and five (9.1%) were at high risk for developing delirium. Conclusion: A comprehensive evaluation of the functional status of elderly hospitalized patients was helpful in detecting medical problems other than the initial diagnosis. A significant proportion of the elderly patients we assessed were suspected to have cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: The development of the medicine and the rise in the expectation of living has led the Korea into an aging society and the senior population in the Korea continues to grow. The objective of this study is to investigate the clinical features of geriatric ocular trauma in in a regional emergency medical center. Methods: We retrospectively reviewed the medical records of 163 eyes of 146 patients older than 65 with ocular trauma who visited Emergency Room of Dongguk University Gyeongju Hospital from March 1, 2007 tofebruary 29, 2012. Results: In all patients, the incidence of the geriatric ocular trauma in patients over 65 was 7.3% (146 patients). And it was found to be 2.4 times more common in males (103 patients, 70.5%) than it was in females (43 patients, 29.5%). The mean age of patients was 70.7 years. Geriatric ocular trauma occurred mostly in the summer and the most common place of occurrence was the streets. Traffic accidents were the most common reason (35 patients, 24%) and the most common form of ocular trauma was the corneal erosion (42 patients, 21.1%). Conclusion: Through this study we found out the characteristics and the tendency of geriatric ocular trauma. And these results can be helpful in the prevention of geriatric ocular trauma and the improvement on treatment of geriatric ocular trauma. [ABSTRACT FROM AUTHOR]