J Korean Acad Community Health Nurs.  2016 Mar;27(1):51-59. 10.12799/jkachn.2016.27.1.51.

The Effect of a Comprehensive Intervention Program on the Functional Status and Bone Density of the Socially-Vulnerable and Frail Elderly

• Lee IS
• Lee KO

• KMID: 2391745
• DOI: http://doi.org/10.12799/jkachn.2016.27.1.51

Abstract

PURPOSE
The purpose of this study is to provide a disease management, nutrition education, and group exercise program for three months to the moderately frail elderly whose physical functions have deteriorated, and to investigate its effects in order to develop an intervention program.
METHODS
As a quasi-experiment, this study was conducted based on non-equivalence studies designed as a similar experiment. The milk intake group and calcium intake group participated in the disease education, individual nutrition education, and group exercise program for three months, and the control group was visited once in the three months by a nurse who provided disease education, nutrition education, and oral instruction of exercise, and asked them to exercise on their own every day. For the data analysis, χ2-test, ANOVA and Scheffé test were used.
RESULTS
After three months of intervention, there was a significant difference in the frailty level (p=.029) and bone density (p=.001) between the groups.
CONCLUSION
The comprehensive intervention program had an effect on the bone density and the frailty level of the socially-vulnerable and moderately frail elderly, suggesting that the program can be used as a nursing intervention to prevent functional deterioration and damage of the moderately frail elderly.

Keyword

Elderly; Frail; Bone density

MeSH Terms

Aged
Bone Density*
Calcium
Disease Management
Education
Frail Elderly*
Humans
Milk
Nursing
Statistics as Topic
Calcium

Reference

References

1. Korean Statistical Information Service. Part attempt to estimate future population 2013-2040 [Internet]. Seoul: Statistics Korea;2014. [cited 2016 February 1] Available from:. http://kosis.kr/.

2. Shin YH. Nursing intervention for frail elderly. Keimyung Journal of Nursing Science. 2006; 10(1):25–30.

3. Rennie MJ, Wackerhage H, Spagenburg EE, Booth FW. Control of the size of the human muscle mass. Annual Review Physiology. 2004; 66:799–828.

4. Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Van Ness PH. A rehabilitation program for the prevention of functional decline: Effect on higher-level physical function. Archives of Physical Medicine and Rehabilitation. 2004; 85(7):1043–1049.

5. Mitniski AB, Graham JE, Mogilner AJ, Rockwood K. Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatrics. 2002; 2(1):1–8. http://dx.doi.org/10.1186/1471-2318-2-1.

6. Jung KH, Oh YH, Lee YK, Son CK, Park BM, Lee SY. . Senior survey. Research Report. Seoul: Ministry of Health and Welfare;2011. Report No.: 2012-04.

7. Jung KH, Oh YH, Kim EN, Kim JH, Sun WD, Oh MA. . Senior survey. Research Report. Seoul: Ministry of Health and Welfare;2014. Report No.: 2014-61.

8. Yoo JS, Jeon MY, Kim CG. Effects of a fall prevention program on falls in frail elders living at home in rural communities. Journal of Korean Academy of Nursing. 2013; 43(5):613–625.

9. Cusimano MD, Kwok J, Spadafora K. Effectiveness of multifaceted fall-prevention programs for the elderly in residential care. Injury Prevention. 2008; 14:113–122. http://dx.doi.org/10.1136/ip.2007.017533.

10. Kwon MS. Effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders. Journal of Korean Academic Nursing. 2011; 41(2):165–174.

11. Michel JP, Alfonso J. Cruz-Jentoft, Cederholm T. Frailty, exercise and nutrition. Clinics in Geriatric Medicine. 2015; 31(3):375–387.

12. De Boer IH, Tinker LF, Connelly S, Curb JD, Howard BV, Kestenbaum B. . Calcium plus vitamin D supplementation and the risk of incident diabetes in the women’s health initiative. Diabetes Care. 2008; 31(4):701–707.

13. Boonen S, Vanderschueren D, Haentjens P, Lips P. Calcium and vitamin D in the prevention and treatment of osteoporosis a clinical update. Journal of Internal Medicine. 2006; 259(6):539–552.

14. Lee IS, Ko Y, Lee KO, Yim ES. Evaluation of the effects of a frailty preventing multi-factorial program concentrated on local commucities for high-risk younger and older elderly people. Journal of Korean Academic Community Health Nursing. 2012; 23(2):201–211.

15. Kwon SM, Park JS. The effect of health promotion program for frail elderly residents on health promoting behavior and health status. The Korean Academic Society of Adult Nursing. 2013; 25(2):194–206.

16. Lee HY, Choi SM, Choi SH. The effects of Korean DASH diet education with Calcium/Vitamin D supplements on nutrient intakes, food consumption, bone turnover markers and bone mineral density among Korean elderly women. Korean Journal of Adult Nursing. 2015; 27(1):94–105.

17. Kim HS, Jung GH, Jang DM, Kim SH, Lee BK. Increased calcium intake through milk consumption and Bone Mineral Density of elderly women living in asan. Journal of the Korean Dietetic Association. 2005; 11(2):242–250.

18. Lee IS, Park YI, Park EO, Lee SH, Jeong IS. Validation of instruments to classify the frailty of the elderly in community. Journal of Korean Academy of Community Health Nursing. 2011; 22(3):302–314.

19. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report. Geneva: World Health Organization;1994. Report No.: 843.

20. Kee BS. A preliminary study for the standardization of geriatric depression scale short-form-Korea version. Journal of the Korean Neuropsychiatric Association. 1996; 35(2):298–307.

21. Yang DW. Production and computerization of dementia screening tool for Korean. Research Report. Sejong: Ministry of Health and Welfare;2002.

22. Cranney A, Horsley T, O’Donnell S, Weiler H, Puil L, Ooi D. . Effectiveness and safety of vitamin D in relation to bone health. Evidence Report/Technology Assessment. 2007; 158:1–235.

23. Park MH, Ha JC, Shin IH, Kim HG, Lee SY, Cho JH. . 2008; survey for the elderly-national living profiles and welfare service needs of older persons in Korea’s survey. Research Report. Seoul: Ministry of Health, Welfare, and Family Affairs and Keimyung University;2009; Report No.: 11-1351000-000316-12.

24. Yirmiya R, Bab I. Major depression is a risk factor for low bone mineral density: A meta-analysis. Biological Psychiatry. 2009; 66(5):423–432.

25. Mun JH, Og JS, Park U. The effect of 12 week exercise program on muscle fitness, flexibility and balance in the fall down female elderly. Exercise Science. 2004; 13(1):77–86.

26. Kim SM. A study of self exercise program for the health of aged. Sport Science in Donga University. 2006; 24(1):31–45.

27. Min YK. Clinician’s guide to prevention and treatment of osteoporosis. Korean Journal of Bone Metabolism. 2008; 15(2):99–108.

28. Shin HA, Om AS. The correlation between dietary intakes of calcium and vitamin D and osteoporosis, hypertension and diabetes mellitus. Korean Journal of Dairy Science Technology. 2009; 27(2):17–23.

29. Hitz MF, Jensen JE, Eskildsen PC. Bone mineral density and bone markers in patients with a recent low-energy fracture: Effect of 1y of treatment with calcium and vitaminD. American journal of clinical nutrition. 2007; 86(1):251–259.