Nutr Res Pract.  2024 Jun;18(3):372-386. 10.4162/nrp.2024.18.3.372.

Development of a frailty prevention program including nutrition and exercise interventions for older adults in senior daycare centers in South Korea using a mixed methods research design

Affiliations
  • 1Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Korea
  • 2The Korean Institute of Nutrition, Hallym University, Chuncheon 24252, Korea
  • 3Department of Physical Education, Hallym University, Chuncheon 24252, Korea

Abstract

BACKGROUND/OBJECTIVES
The growing aging population has led to an increased utilization of senior daycare centers. This study was conducted to design a program to enhance the health of older adults in senior daycare centers in Chuncheon City, South Korea.
SUBJECTS/METHODS
The study explored the health conditions and dietary patterns of older adults in senior daycare centers. Participants included staff and older adults from senior daycare centers in Chuncheon City. A mixed methods research design was used to obtain both qualitative and quantitative data. Qualitative insights were obtained through in-depth interviews with 26 staff members and older adults, coupled with observations made at 10 senior daycare centers. The quantitative component comprised structured questionnaires and physical measurements of 204 older adults at these centers.
RESULTS
Many of the older adults relied on the meals provided by the center due to their limited cooking abilities. Dental health issues and dysphagia were common. Interviews highlighted the budgetary constraints of the centers in providing wholesome meals and the need for government support to alleviate meal expenses and enhance quality. A structured survey of older adults showed that the average age was 83.3 yrs, with an average of 2 chronic conditions per participant. Frailty analysis of the participants revealed that 56.2% were prefrail and 32.0% were frail. Almost half of the participants (47.0%) used dentures. Based on these findings, a preventive intervention program was proposed, addressing the specific needs and challenges of older adults while promoting overall well-being and preventing frailty.
CONCLUSION
Tailored health promotion strategies are crucial in senior daycare centers. Recommended interventions include staff nutrition education, improved dietary plans, and cost-effective strength training programs. These interventions aim to reduce frailty and enhance the quality of life of older adults in the community via interventions in daycare centers.

Keyword

Long-term care; aged; frailty; qualitative research; survey

Reference

1. Murray CJ, Salomon JA, Mathers C. A critical examination of summary measures of population health. Bull World Health Organ. 2000; 78:981–994. PMID: 10994282.
2. Vasunilashorn S, Steinman BA, Liebig PS, Pynoos J. Aging in place: evolution of a research topic whose time has come. J Aging Res. 2012; 2012:120952. PMID: 22175020.
3. Wiles JL, Leibing A, Guberman N, Reeve J, Allen RE. The meaning of “aging in place” to older people. Gerontologist. 2012; 52:357–366. PMID: 21983126.
4. Campbell M, Stewart T, Brunkert T, Campbell-Enns H, Gruneir A, Halas G, Hoben M, Scott E, Wagg A, Doupe M. Prioritizing supports and services to help older adults age in place: a Delphi study comparing the perspectives of family/friend care partners and healthcare stakeholders. PLoS One. 2021; 16:e0259387. PMID: 34752475.
5. Ellen ME, Demaio P, Lange A, Wilson MG. Adult day center programs and their associated outcomes on clients, caregivers, and the health system: a scoping review. Gerontologist. 2017; 57:e85–e94.
6. Lally F, Crome P. Understanding frailty. Postgrad Med J. 2007; 83:16–20. PMID: 17267673.
7. Na WR, Kim JY, Kim HJ, Lee YJ, Sohn CM, Jang DJ. The relationship between nutrition status and risk of frailty in cognitive impaired elderly in daycare center (DC Center). J Korean Soc Food Sci Nutr. 2021; 50:88–94.
8. Tieland M, Franssen R, Dullemeijer C, van Dronkelaar C, Kyung Kim H, Ispoglou T, Zhu K, Prince RL, van Loon LJ, de Groot LC. The impact of dietary protein or amino acid supplementation on muscle mass and strength in elderly people: individual participant data and meta-analysis of RCT’s. J Nutr Health Aging. 2017; 21:994–1001. PMID: 29083440.
9. de Labra C, Guimaraes-Pinheiro C, Maseda A, Lorenzo T, Millán-Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr. 2015; 15:154. PMID: 26626157.
10. Allison R 2nd, Assadzandi S, Adelman M. Frailty: evaluation and management. Am Fam Physician. 2021; 103:219–226. PMID: 33587574.
11. Rogers NT, Marshall A, Roberts CH, Demakakos P, Steptoe A, Scholes S. Physical activity and trajectories of frailty among older adults: evidence from the English Longitudinal Study of Ageing. PLoS One. 2017; 12:e0170878. PMID: 28152084.
12. Espinoza SE, Fried LP. Risk factors for frailty in the older adult. Clin Geriatr. 2007; 15:37–44.
13. Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, Fried LP, Ferrucci L. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci. 2006; 61:589–593. PMID: 16799141.
14. Xue QL, Bandeen-Roche K, Varadhan R, Zhou J, Fried LP. Initial manifestations of frailty criteria and the development of frailty phenotype in the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci. 2008; 63:984–990. PMID: 18840805.
15. Chung MJ, Kwak TK, Kim HY, Kang MH, Lee JS, Chung HR, Kwon S, Hwang JY, Choi YS. Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure. J Nutr Health. 2018; 51:87–102.
16. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012; 16:601–608. PMID: 22836700.
17. World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Geneva: World Health Organization;2000.
18. Misu S, Doi T, Asai T, Sawa R, Tsutsumimoto K, Nakakubo S, Yamada M, Ono R. Association between toe flexor strength and spatiotemporal gait parameters in community-dwelling older people. J Neuroeng Rehabil. 2014; 11:143. PMID: 25297707.
19. Uritani D, Fukumoto T, Matsumoto D, Shima M. Associations between toe grip strength and hallux valgus, toe curl ability, and foot arch height in Japanese adults aged 20 to 79 years: a cross-sectional study. J Foot Ankle Res. 2015; 8:18. PMID: 25972928.
20. Kashiko F, Atsuko M, Takuyuki K, Nozomi K, Ryouhei N, Yasunori S, Takahiko F, Minna S. Foot problems and their associations with toe grip strength and walking speed in community-dwelling older individuals using day services: a cross-sectional study. Nurs Rep. 2023; 13:697–720. PMID: 37092490.
21. Tsuyuguchi R, Kurose S, Seto T, Takao N, Fujii A, Tsutsumi H, Otsuki S, Kimura Y. The effects of toe grip training on physical performance and cognitive function of nursing home residents. J Physiol Anthropol. 2019; 38:11. PMID: 31462272.
22. Confortin SC, Schneider IJ, Antes DL, Cembranel F, Ono LM, Marques LP, Borges LJ, Krug RR, d’Orsi E. Life and health conditions among elderly: results of the EpiFloripa Idoso cohort study. Epidemiol Serv Saude. 2017; 26:305–317. PMID: 28492772.
23. Aslam M, Vaezi MF. Dysphagia in the elderly. Gastroenterol Hepatol (N Y). 2013; 9:784–795. PMID: 24772045.
24. Uritani D, Fukumoto T, Matsumoto D, Shima M. Reference values for toe grip strength among Japanese adults aged 20 to 79 years: a cross-sectional study. J Foot Ankle Res. 2014; 7:28. PMID: 24855492.
25. Kucukerdonmez O, Navruz Varli S, Koksal E. Comparison of nutritional status in the elderly according to living situations. J Nutr Health Aging. 2017; 21:25–30. PMID: 27999846.
26. Brownie S. Why are elderly individuals at risk of nutritional deficiency? Int J Nurs Pract. 2006; 12:110–118. PMID: 16529597.
27. Hsieh YM, Sung TS, Wan KS. A survey of nutrition and health status of solitary and non-solitary elders in Taiwan. J Nutr Health Aging. 2010; 14:11–14. PMID: 20082048.
28. Jung YM, Kim JH. Comparison of cognitive levels, nutritional status, depression in the elderly according to living situations. J Korean Acad Nurs. 2004; 34:495–503.
29. Ham SW, Kim KH. Evaluation of the dietary quality and nutritional status of elderly people using the Nutrition Quotient for Elderly (NQ-E) in Seoul. J Nutr Health. 2020; 53:68–82.
30. Rho J. Drug-nutrient interactions in elderly patients. J Clin Nutr. 2014; 6:11–18.
31. Musacchio E, Perissinotto E, Binotto P, Sartori L, Silva-Netto F, Zambon S, Manzato E, Corti MC, Baggio G, Crepaldi G. Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors. Acta Odontol Scand. 2007; 65:78–86. PMID: 17453425.
32. Lamy M, Mojon P, Kalykakis G, Legrand R, Butz-Jorgensen E. Oral status and nutrition in the institutionalized elderly. J Dent. 1999; 27:443–448. PMID: 10399411.
33. Schindler JS, Kelly JH. Swallowing disorders in the elderly. Laryngoscope. 2002; 112:589–602. PMID: 12150508.
34. Westergren A, Unosson M, Ohlsson O, Lorefält B, Hallberg IR. Eating difficulties, assisted eating and nutritional status in elderly (> or = 65 years) patients in hospital rehabilitation. Int J Nurs Stud. 2002; 39:341–351. PMID: 11864657.
35. Kang SJ, Kim JH, Ko KJ. Effects of aerobic, resistance, balance exercise program on skeletal muscle index, functional fitness, and health-related quality of life in frail elderly women. Asian J Kinesiol. 2015; 17:9–20.
36. Zdzieblik D, Oesser S, Baumstark MW, Gollhofer A, König D. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015; 114:1237–1245. PMID: 26353786.
37. Hsieh TJ, Su SC, Chen CW, Kang YW, Hu MH, Hsu LL, Wu SY, Chen L, Chang HY, Chuang SY, et al. Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial. Int J Behav Nutr Phys Act. 2019; 16:119. PMID: 31791364.
38. Ng TP, Feng L, Nyunt MSZ, Feng L, Niti M, Tan BY, Chan G, Khoo SA, Chan SM, Yap P, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med. 2015; 128:1225–1236.e1. PMID: 26159634.
39. Kim E, Lee H, Lee SH. The effects of community-based fall prevention exercise program on lower extremity muscle strength, balance ability and fall efficacy in older adults. J Muscle Joint Health. 2021; 28:102–110.
40. Fitzpatrick SE, Reddy S, Lommel TS, Fischer JG, Speer EM, Stephens H, Park S, Johnson MA. Physical activity and physical function improved following a community-based intervention in older adults in Georgia senior centers. J Nutr Elder. 2008; 27:135–154. PMID: 18928194.
41. Rubenstein LZ, Josephson KR, Trueblood PR, Loy S, Harker JO, Pietruszka FM, Robbins AS. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. J Gerontol A Biol Sci Med Sci. 2000; 55:M317–M321. PMID: 10843351.
42. Strategy WG. Action Plan on Ageing and Health. Geneva: World Health Organization;2017.
43. Statistics Korea. Elderly population statistics [Internet]. Daejeon: Statistics Korea;2023. cited 2024 March 25. Available from: https://kostat.go.kr/board.es?mid=a10301010000&bid=10820&act=view&list_no=427252.
Full Text Links
  • NRP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr