Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.

Citations

• Promoting an international consensus on frailty assessment: An urgent call to address the challenges of perioperative management in an aging population
  Ying Xia, Wei Tang
  BioScience Trends.2026;[Epub]     CrossRef
• International landscape of guidelines for perioperative frailty assessment and barriers to clinical translation
  Ya-nan Ma, Kenji Karako, Ying Xia, Peipei Song, Xiqi Hu
  BioScience Trends.2026;[Epub]     CrossRef
• Effect of a wearable-sensor-assisted multicomponent exercise program on physical fitness, cognition and quality of life in frail older adults
  Genghong Tu, Lining Liu, Huiyi Tang, Weizhong Chen, Bagen Liao
  Translational Exercise Biomedicine.2025; 2(3): 201.     CrossRef
• Frailty assessment utilization around the globe–a systematic review
  Samantha Gaston, Elle Billman, Lichy Han, David Drover
  The Journal of Frailty & Aging.2025; 14(6): 100088.     CrossRef
• Exercise Prescription for Frail Older Adults: Impact on Handgrip Strength and Gait Speed – A Systematic Review
  Andreia Carvalho, Vânia Cerqueira Palma, Maria Teresa Tomás
  Physical & Occupational Therapy In Geriatrics.2025; : 1.     CrossRef
• Summary of best evidence for prevention and management of frailty
  Yinning Guo, Xueyi Miao, Jieman Hu, Li Chen, Yimeng Chen, Kang Zhao, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu
  Age and Ageing.2024;[Epub]     CrossRef
• Frailty: Assessment and Intervention
  Hana Moon, Geon Ho Lee, DaeHyun Kim
  Keimyung Medical Journal.2024; 43(2): 100.     CrossRef
• Clinical practice guidelines for frailty vary in quality but guide primary health care: a systematic review
  Huaxin Si, Jiaqi Yu, Qinqin Liu, Yanyan Li, Yaru Jin, Yanhui Bian, Xiaoxia Qiao, Wenyu Wang, Lili Ji, Yan Wang, Jian Du, Cuili Wang
  Journal of Clinical Epidemiology.2023; 161: 28.     CrossRef
• Yaşlılarda Kırılganlığın Önlenmesi ve Yönetiminde Kanıta Dayalı Yaklaşımlar
  Ayşe Buket DOĞAN, Özlem CANBOLAT
  Sağlık Bilimlerinde Değer.2023; 13(3): 501.     CrossRef
• Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
  Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
  Epidemiology and Health.2023; 46: e2024008.     CrossRef
• Up-to-date knowledge of frailty
  Chang Won Won
  Journal of the Korean Medical Association.2022; 65(2): 108.     CrossRef
• Current status of nutrient intake in Korea: focused on macronutrients
  Seung-Won Oh
  Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef

Background
: Symptoms of musculoskeletal system is a common problem, followed by those of respiratory system. Most patients with problems of musculoskeletal system are examined and treated by a primary doctor. This research was performed to inquire into a method which can increase the effectiveness and the precision of history taking in patients with problems of musculoskeletal system in primary care and also to assess a self-marking method were patients can mark their pain site on a normalized picture.

Methods : In the department of family medicine and rehabilitation of an university hospital in Seoul, 44 patients with musculoskeletal pain on their first visit in an outpatient clinic were asked to put marks on a normalized picture and also mark the degree of pain with a visual analog scale from 0 to 10, before history taking. After history taking, the doctor also marked the spot of the patient's pain on the normalized picture and then compared the spots together. After comparing the two pictures of the doctor's and the patients', they then drew another picture with only one spot to avoid overlapping spots. We compared the differences among the patients in every decade from ages 20 to 60 and divided the value of visual analog scale into 3 groups concerning the spots drawn by patients, and compared the relations between them.

Results : The pain spots drawn by doctor only were on the lumbar spine and the shoulder whereas most of pain spots drawn by patients only were on the upper back, the cervical spine, and the lumbar spin. The older the patient and the lower the degree of pain was, the more humerous it had spots.

Conclusion : It is considered that with a general history taking method and a self-marking method, clinical effectiveness will be great to the patients having pain on the abdomen, the cervical spine, and the lumbar spine and to those who are elderly and with lower pain spots.

Background
: According to different characteristics of health dimensions and its consisting item contents, valid and useful health status assessment tool for the elderly is rare. Because of the continuous increase in elderly population with functional disability in Korea, the need for a valid Korean health status assessment tool for the elderly is growing. Therefore, we have attempted to develop a Korean Health Status Measure for the Elderly in this study.

Methods : We gathered important health related items from 671 individuals aged 60 years and over to form item pool with interview. Then we classified all items into representative items according to its meaning with the experts in geriatrics. With these representative items we constructed a preliminary questionnaire. After wards we performed a pilot study for evaluating understandability, accessibility, item analysis, reliability and for detecting other modifiable limitations. After completing the pilot study we finally developed the Korean Health Status Measure for the Elderly (KoHSME V1.0)

Results : The number of collected health related items were 2,500 in the item pool. After classification of items in the pool, 40 representative items were selected for constructing preliminary version of the KoHSME. And we added 3 items of ‘general health perception’ dimension to 40 common representative items to construct a preliminary version of the KoHSME. It took an average of 18.8 minutes to complete the preliminary questionnaire by the elderly in the pilot study. Most responders (90.9%) thought the questionnaire was not difficult to understand. After the pilot study we added 2 items (wearing clothes, pain frequency) and omitted 1 item (eating). Finally, the KoHSME V1.0 questionnaire consisted of 44 items and 6 domains such as physical function, emotional function, social function, pain, sexual function, and general health perception. All items were Likert scale except pain intensity item, which was visual analogue scale.

Conclusion : The KoHSME V1.0 to assess health status and quality of life for the Korean elderly was developed. We think the KoHSME V1.0 is a reliable instrument for assessing health related to quality of life in the elderly. After documenting the validity, the KoHSME V1.0 can be a useful tool for comprehensive assessment of health status in the eelderly and for the medical outcome study.

Background
: Estrogen deficiency after menopause is a major reason of bone loss in postmenopausal women. YSM (years since menopause) is negatively related with BMD in postmenopausal women. Bone loss after menopause is accelerated in early stage of menopause, and then decreases. There are some evidence that body weight can prevent bone loss in menopausal women. Therefore, we evaluated associations of the general characteristics and lumbar BMD of postmenopausal Korean women, and determined the rate of bone loss after menopause at 5-year interval.

Methods : BMD was measured by DEXA system, and physical, anthropometric data including body fat were obtained in 1006 peri- and postmenopausal women. Pearsons correlation coefficients were made among physical, anthropometric data and lumbar BMD. To determine the contributable factors for lumbar Bmd, multiple regression analysis was done.

Results : 1) In Pearsons correlation analysis among body composition YSM and spinal BMD, YSM was strongly associated negatively with spinal BMD. 2) On the other hand, weight and BMI was associated positively with psinal BMD. 3) The percent difference in spinal BMD between perimenopause and 5-years after menopause was 15.3%. 4) Years since menopause, body weight was revealed as and important factor that predicted spinal BMD by multiple stepwise regression analysis.

Conclusion : We conclude that YSM and body weight were revealed as important factors that can predict spinal BMD in postmenopausal women.

Background
: There are very few cohort studies on the hypertension in family practice. In order to investigate epidemiological characteristics of hypertensive patients and assess the safety and tolerabiliy of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out.

Methods : A total of 1,181 patients were observed from July 1997 to August 1999. At 2,4,8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment is continued and development of any adverse reactions.

Results : Calcium channel blockers(CCBs) were the most commonly prescribed initial drug class(44.2%) in family practice, followed by angiotensin converting enzyme inhibitors(ACEI) (21.0%), angiotensin II receptor antagonists(ARA) (11.8%), B-blockers(9.6%), a-blockers(3.9%), and diuretics(3.6%), During the first 12 weeks, the percentage of subjects continuing their initial ACEIs(40.7%) was substantially lower than the percentages that of subjects continuing ARAs(66.2%), a- blockers*(63.0%), CCBs(61.3%), B-blockers(55.8%), and diuretics(53.5%), respectively(P<0.001), The following adverse reactions were detected: cough(7.5%), headache(6.1%), dizziness(3.9%), flushing(3.7%), and impotence(2.4%). The incidence of cough associated with ACEI(27.9%), was higher than those of other classes(P<0.01)

Conclusion : CCBs were the most commonly prescribed initial drug class in family practice, followed by ACEIs, ARAs, B-blockers, a-blockers, and diuretics. The tolerability of antihypertensive medication was the highest in Korean patients treated with ARAs, followed by CCBs, B-blockers, diuretic, a-blocker, and ACEIs.

Background
: Urinary tract infection (UTI) is one of the most common diseases dealt with by primary physicians. UTI is common in the elderly and has a great influence on the quality of the elderly's life. Thus, we conducted a study in one nursing home to find out the prevalence of bacteriuria and epidemiologic characteristics of the elderly.

Methods : The study was performed twice on April 12 and on May 4, 1999 among 108 subjects residing in a nursing home of Hanam City. The authors inquired the subjects pertaining to the history of UTI symptoms, collected urine samples by midstream clean-catch technique and catheterization and performed routine and microscopic urine analysis and urine culture.

Results : The overall prevalence of bacteriuria in subjects was 23.1%(25/108) ; 20%(3/15) in males and 23.7% (22/93) in females. The prevalence of the bedridden subject was 40.9% (9/22). Among the urine samples of 25 cases which were positive in the urine culture, E. Coli was found in 15 cases(60%). The sensitivity, specificiy, positive and negative predictive value of pyuria for bacteriuria were 44.0%(11/25), 87.9%(73/83), 52.3%(11/21) and 83.9%(73/87), respectively, while those of nitrite test for bacteriuria were 64.0%(16/25), 97.5%(81/83), 88.%(16/18) and 90.0%(81/90), respectively. The prevalence of bacteriuria increased by 16.23% as age increased by ten years using the Cochran-Armitage's linear trend test.

Conclusion : The prevalence of becteriuria in the elderly residing in a nursing home was higher than that of the elderly residing in a community. In the elderly over 60 years old, the prevalence of bacteriuria increased as the age increased. Immobility is considered as a risk factor of bacteriuria. Bacteriuria may be treated by antibiotics focused on E. Coli. Thus, we can expect improvement in the quality of life as well as extension of life span.

Background
: About 80 percent of Korean population over 55 years old show radiographic signs of osteoarthritis. Hence, osteoarthritis has become one of the most important public health problem among the old age. Despite the importance of this disease, proper methods for evaluation and diagnosis of osteo-arthritis have not been developed. Authors have investigated the sensitivity and specificity of thermography in diagnosing osteoarthritis.

Methods : Twenty patients who had visited the department of family medicine, Korean University Hospital, with non-traumatic knee pain during the period from April 1 to May 30, 1999, were included in the study. Patients had gone through series of careful history taking, physical examination and laboratory evaluations for clinical evaluation of osteoarthritis of the knee joints. Furthermore, the radiographic and thermographic examination of both knee joints were assessed.

Results : Among the twenty patients who have been examined, 15 patients were to have shown radiographic abnormality; on the other hand, 14 patients showed thermographic abnormality. Seventeen patients showed clinical manifestations of osteoarthritis. Twelve patients, among those who had clinical osteoarthritis, were shown to have osteoarthritis in both image studies, i,e. radiographic and thermographic abnormalities. All patients who had not shown clinical osteoarthritis, were normal on both image studies. The sensitivity and specificity of thermography in diagnosing osteoarthritis were 80% and 80%, respectively (P<0.05).

Conclusion : Hot spots or asymmetric distribution in the knee joint area of osteoarthritis patients were in thermographic examination. Thermography has shown efficacy in the evaluation of osteoarthritis.

Background
: The purpose of this study was to examine the smoking behavior and knowledge, attitude on smoking behavior of elementary school children was begin to expose cigarette smoking.

Methods : In October 1995, a total of 4,251 school children randomly sampled from 27 elementary schools in Seoul and 23 elementary schools in Incheon were assessed with self-completing question-naire pertaining to smoking behavior and knowledge, attitude on smoking.

Results : The smoking experience rate of 5th. grade school children in this study was 13.4% in boys and 2.9% in girls. The current smoking rate was 1.04% in boys and 0.15% in girls. The mean knowledge score was found to be higher in boys than in girls. However, the mean attitude score was found to be higher in girls than in boys. Important risk factors of 'smoking experience' were male sex, smoking mother, smoking siblings, higher knowledge scores and lower attitude scores on smoking.
There were significant positive correlations between knowledge and attitude scores. The knowledge scores were influenced by sex, smoking experience and religion. The attitude scores were influenced by sex, smoking experience, smoking status of father and smoking status of siblings.

Conclusion : Children who had experienced smoking had higher knowledge scores and lower desi-rable attitude scores. The smoking prevention program should give attention to this exposure group and based on the education model which influence to the attitude and behavior of children rather than providing information about the health hazards of smoking.

Background
: To prepare the basic educational data for primary care physicain who work to maintain and enhance the health of people in community. The authors carried on disease frequency analysis in medical Insurance in Korea.

Methods : To clarify the frequency of reasons which made people to use health delivery system in Korea, the authors has made descriptive study with 113,244,548 cases of actual visits to the health delivery system of Korean medical insurance from January 1st to December 31st of the year 1991. The objectives of this study are 100,000 random sampling cases of medical visits among 113,244,548 actual cases of those.

Results : 1. Females(54.5%) have made more frequent medical visits to the health care system than males(45.5%) 2. The frequent diagnoses are acute upper respiratory infection of multiple or unspecified site, acute bronchitis&bronchiolitis, acute nasopharyngitis, acute tonsilitis and acute pharyngitis in order. 3. There is a significant dissimilarity of disease pattern between the in-parient and out-patient group. Among the upper twenty frequent disease, only five disease are concord between the two groups. 4. There are higher prevalence of respiratory infections in the first and second decade, genitourinary infections in the third and forth decade, gastrointestinal diseases in the fifth and sixth decade and then hypertension above the seventh decade.

Conclusion : 53.3% of all visits to health care system were upper twenty frequent diseases. The people who have acute, transient problems made more frequent visits to the primary health care system than to the secondary or tertiary of those. It is needed to encourge primary health care system.

Background
: Primary health care institution has the important role for satisfying the national health care need primarily. In Korea, primary care has not taking the responsibility for resolving the increasing health need effectively and has been weakened. So, we intended to suggest what act as the cause of bringing the weakness of primary care and how can we solve this problem. We analyzed the characteristics of components of the charges per case among the types of health care facility for twenty common diseases in Korea.

Methods : We used Insured medical record of Federation of Korean Medical Insurance Societies from Feb. 1st to 28th of the year 1990, and we selected 16,445 cases from total 88,471,051 cases by using systemic random sampling.

Results : The charge per case was hightest in the tertiary health care institution and it was 2.9 times larger than that of primary care for the same disease. In the tertiary health care institution, the amount of cost for the oral drug was 54.3% and that for the medical examination was 17.0% of the charge per case, and compared with primary health care institution, the former was 20.6% and the latter was 4.1%, respectively. So, we found that the amount of cost for oral drug and medical examination in tertiary health care institution was greater than that of primary health care institution.

Conclusion : The charge per case of tertiary health care institution was about 3 times greater than that of primary health care institution for the same disease. In our study, we presume the higher medical cost of tertiary health care institution may be due to cost for the more expensive oral drugs and various diagnostic examinations than that of primary health care institution.

Background
: In Korea, tertiary medical care almost totally provided by the university hospitals, which makes the university hospital acting as community-health care centers only. Moreover, the tertiary care hospitals became difficult to performer but also differentiation of specialty in the care are restricted by overloaded patient care in the tertiary care hospital. The purpose of this study is to analyse the functions of tertiary care hospital within the health care delivery system in order to check it university hospital plays its role properly as it should be.

Methods : The authors have selected the patients visited, the doctors trained as residents, the medical students, and the jouranls reported in Guro hospital from Sep. 1983 to Feb. 1992, which were analyzed into the aspects of the care, medical research, medical education and community support. We identified the numbers of the patients and their adresses, disease entities of the patients as the ICD-9 three-digit categories and found out the physician's offices who trained in Guro hospital.

Results : The total number of the patient are 1,548,188 persons(inpatient care) and 2,687,330 persons(outpatient care). The internal medicine is the most. (In patients ; 16.15%, out patient ; 23.16%) The frequency of the disease for 10 years is as follows in descending sequence ; unspecified anemia, essential hypertension, organism unspecified pneumonia, enterocolitis, anemia by complicating pregnancy and childbirth, adult-onset type diabetes mellitus, hypertrophy of tonsils and adenoids, unspecified fetal distress, Caesarean delivery, liver cirrhosis. The number of the papers reported in the each department are 1,407 cases(clinical review 96.0%, experimental reports 4.0%). The number of educated medical students is 1.139 and trained residents are 144 persons. In 144 trained doctors, approximately 28.5% worked in tertiary care hospitals and the remainders are belonged to the primary and secondary health care facilities.

Conclusion : Although the Korea University Guro hospital has been doing well as a tertiary care hospital in the care of the patients, there are many problems in the aspects of the research, medical education and patient care yet.

Background
: Hepatitis C Virus(HCV) infection is known as one of the most important causes of liver diseases such as post-transfusion hepatitis, sporadic hepatitis, liver cirrhosis and hepatocellular carcinoma. The prevalence of antibody to Hepatitis C Virus(anti-HCV) among blood donors was about 0.3-1.5% by first generation enzyme immunoassay(EIA). Second gengration anti-HCV among Korean adults and identify the route of HCV transmission.

Methods : Serum samples from 5,718 adults who visited Korea University Hospital Health Care Center were tested for second generation anti-HCV EIA, serum ALT(alanine aminotranferase), HBsAg, anti-HBs and anti-HBc. Questionnaires including presumptive risk factors of HCV were obtained from 47 anti-HCV positive cases, and those results were compared to the results from 137 anti-HCV negative cases.

Results : The overall prevalence of anti-HCV was 1.6%(89/5,718). The prevalence of anti-HCV increased with aging significantly(P<0.01). The prevalence of anti-HCV in elevated(ALT>40IU/L) serum ALT cases was significantly higher than in normal(ALT≤40IU/L) cases(5.4% vs 1.1% P<0.01). Anti-HCV status was associated with history of transfusion significantly(P<0.05), but the following factors such as operation history, family history of liver diseases, history of sexually transmitted disease, alcohol intake and history of acupuncture or tatooing were not associated with status of anti-HCV.

Conclusion : Prevalence of anti-HCV among Korea adults was 1.8%. Age matched prevalence of anti-HCV in Korean adults was higher than the other countries in North Europe or North America, but similar to that of Spain or Japan. Prevalence of anti-HCV was increased with aging. To elucidate the meaning of anti-HCV positivity in this, futher sutdy is needed