Machine learning-based classification and risk factor analysis of frailty in Korean community-dwelling older adults.

Frailty is a dynamic reversible state, characterized by frequent transitions between frailty status over time. The timely and effective detection of frailty is important to prevent adverse health outcomes. This study aims to develop machine learning-based classification models for frailty assessment and to investigate its risk factors. A total of 1,482 subjects, 1,266 robust and 216 frail older adults, were analyzed. Sixteen frail risk factors were selected from a random forest-based feature selection method, then used for the inputs of five ML models: logistic regression, K-nearest neighbor, support vector machine, gaussian naïve bayes, and random forest. Data resampling, stratified 10-fold cross-validation, and grid search were applied to improve the classification performance. The logistic regression model using the selected features showed the best performance with an accuracy of 0.93 and an F1-score of 0.92. The results suggest that machine learning techniques are an effective method for classifying frailty status and exploring frailty-related factors.Clinical Relevance- Our approach can predict frailty using data collectable in clinical setting and can help prevent and improve by identifying variables that change frailty status.

A Study on the Contribution of Medial and Lateral Longitudinal Foot Arch to Human Gait.

This study aimed to investigate the contribution of medial longitudinal arch and lateral longitudinal arch in human gait and to study the correlation between foot features and gait characteristics. The foot arch plays a significant role in human movements, and understanding its contribution to spatiotemporal gait parameters is vital in predicting and rectifying gait patterns. To serve the objectives, the study developed a new foot feature measurement system and measured the foot features and spatiotemporal gait parameters of 17 young healthy subjects without any foot structure abnormality. The foot-feature parameters were measured under three movement conditions which were sitting, standing, and one-leg standing conditions. The spatiotemporal gait parameters were measured at three speeds which were fast, preferred, and slow speeds. The correlation study showed that medial longitudinal arch characteristics were found to be associated with temporal gait parameters while lateral longitudinal arch characteristics were found to be associated with spatial gait parameters. The developed system not only eases the burden of manual measuring but also secures accuracy of the collected data. Inviting variety of subjects including athletes and people with abnormal foot structures would extend the scope of this study in the future. The findings of this study break new ground in the field of the foot- and gait-related research work.Clinical Relevance-This study demonstrated that the medial longitudinal arch and lateral longitudinal arch characteristics were related to the temporal and spatial gait parameters, respectively. These underlying findings can be applied to investigate relationships between foot abnormality and gait characteristics.

World Health Organization Integrated Care for Older People (ICOPE) and the Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) Study in Korea.

The World Health Organization (WHO) recently endorsed the proposal for a Decade of Healthy Ageing (2020-2030). The WHO defines "healthy aging" as "the process of developing and maintaining the functional ability that enables wellbeing in older age." Among the strategies for the Decade of Healthy Ageing, the WHO has suggested enhancing intrinsic capacity, promoting functional ability, and implementing the Integrated Care for Older People (ICOPE) package. The WHO has defined steps for ICOPE evaluation and scale-up and is performing a prospective study in 2-3 countries (low and middle income, high income) to test its feasibility in 2021-2022 and a multinational randomized study to validate its clinical efficacy and effectiveness in 2022-2024. Intrinsic capacity and frailty represent two faces of the same coin, with one indicating the reserves of the individual and the other indicating the deficits that accumulate with age. The Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) study is the first integrated care program for frailty or functional decline in primary care in Korea. The results suggest that the ICOOP_Frail study can be utilized as a reference for ICOPE studies in Korea or at least to provide important findings for the forthcoming ICOPE implementation study in Korea.

Prevalence of Physical Frailty and Its Multidimensional Risk Factors in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study.

Frailty is defined as a state of increased vulnerability to stressors, and it predicts disability and mortality in the older population. This study aimed to investigate the standardized prevalence and multidimensional risk factors associated with frailty among Korean community-dwelling older adults. We analyzed the baseline data of 2907 adults aged 70-84 years (mean age 75.8 ± 3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and prefrailty was 7.9% (95% confidence interval (CI) 6.8-8.9%) and 47.0% (95% CI, 45.1-48.8%), respectively. The following 14 risk factors were significantly associated with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive symptoms, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer Timed Up and Go, and low Short Physical Performance Battery score (p < 0.05). Physiconutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.