여성노인의 허약에 대한 체력 분별점 제시: 국민체력100 노인기 체력검사항목을 중심으로
Fitness Cut-off Values for Frailty in Korean Elderly Women: National Fitness Award for Elderly
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초록
본 연구의 목적은 여성노인을 대상으로 허약과 관련된 체력요인을 알아보고 그 체력의 분별점을 제시하는 것이다. 연구대상은 2014년(1차년도) ‘국민체력100 한국인 건강체력 기준개발’ 사업에 참여한 65세 이상 여성노인 444명(72.29±5.29세)으로 하였다. 측정변인으로 신체적 특성, 혈압, 그리고 국민체력100 노인기 체력검사항목을 측정하였으며, 허약노인과 정상노인의 분류는 ‘Kihon Checklist’를 이용하였다. 연구결과, 허약노인은 19.1%(85명)로 나타났으며, 허약노인이 정상노인에 비해 연령, 체중, 그리고 비만지표(체질량지수, 체지방량, 허리둘레)가 유의하게 높은 것으로 나타났다. 허약유무에 따른 체력 비교에서 연령과 체질량지수를 보정한 후에도 허약노인이 정상노인에 비해 상대악력, 의자에앉았다일어서기, 의자에앉아3m표적돌아오기, 8자보행, 2분제자리걷기의 체력수준이 유의하게 낮은 것으로 나타났다. ROC curve를 이용한 각각의 체력 분별점은 상대악력 34.13%, 의자에앉았다일어서기 14회, 의자에앉아3m표적돌아오기 7.09초, 8자보행 30.88초, 2분제자리걷기 93회로 나타났다. 또한 각각의 분별점을 기준으로 체력수준이 낮은 집단은 높은 집단에 비해 허약의 위험(odds ratio)이 연령과 체질량지수를 보정한 후에도 1.86-2.77배 높은 것으로 나타났다. 결론적으로 본 연구에서 제시된 체력의 분별점은 국내 여성노인의 허약예방을 위한 적정체력수준인 것으로 사료되며, 추후 성별 및 연령대별로 세분화된 체력의 분별점 제시를 위한 후속 연구가 이루어져야 한다.
Abstract
Frailty in older adults is related to an increased risk for poor health outcomes including falls, disability, hospitalization and mortality. The purpose of this study was to determine the thresholds of a functional fitness associated with frailty for community-dwelling woman aged 65 or older. In this study, the National Fitness Award(NFA) items for elderly were utilized as the physical function and fitness testing for korean elderly women. The total of 444 community-dwelling woman completed the testings. Frailty status was classified by the Japan LTCI system ‘Kihon Checklist’ in the study. The prevalence of the frailty was 19.1% in the study. The frail elderly were older and showed higher obesity index such as weight, body mass index (BMI), percent body fat and waist circumference than the normal elderly. After adjusting for age and BMI which was related to frailty, fitness testing items were compared depending on frailty. As the result, the frail elderly showed significantly lower fitness levels in grip strength, 30-second chair stand test, timed up and go, figure-of-8 walk around two cones, and 2-minute step test than the normal elderly. When the fitness cut-off values were analyzed using the ROC curve, also, grip strength: 34.13%, 30-second chair stand test: 14 reps, timed up and go: 7.09 seconds, figure-of-8 walk around two cones: 30.88 seconds, and 2-minute step test: 93 reps. In addition, based on the cut-off values of each fitness item, the group with a low fitness level showed a 1.86 to 3.09 higher odds ratio of frailty than the group with a high fitness level, even after age and BMI were adjusted. In conclusion, these findings indicate that the fitness cut-off values in this study are fitness levels for preventing frailty of Korean elderly women and there will be a need for a large-scale study including subdivided fitness cut-off values for each age group and targets elderly men as well.
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