Korean Elderly Patients Research Articles

Polypharmacy and associated factors in South Korean elderly patients with dementia: An analysis using National Health Insurance claims data.

Dementia is accompanied by several symptoms, including cognitive function decline, as well as behavioral and psychological symptoms. Elderly patients with dementia often experience polypharmacy, the concurrent use of multiple medications, due to chronic comorbidities. However, research on polypharmacy in patients with dementia is limited. This study aimed to characterize polypharmacy and associated factors among elderly patients with dementia in South Korea, and compare the characteristics of patients with and without dementia patients. From the National Health Insurance Service (NHIS)-Senior cohort database, we extracted data on patients aged≥60 years who received outpatient treatment in 2019. Polypharmacy was defined as the concurrent use of five or more different oral medications for ≥90 days; excessive polypharmacy referred to the concurrent use of ten or more different oral medications for ≥90 days. We compared the prevalence of polypharmacy between patients with and without and identified the associated factors using a logistic regression model. About 70.3% and 23.7% of patients with dementia exhibited polypharmacy and excessive polypharmacy, respectively. After adjusting for conditions such as age and Charlson's comorbidity index, the likelihood of polypharmacy and excessive polypharmacy significantly increased over time after the diagnosis of dementia. Additionally, under the same conditions, Medical Aid beneficiaries with dementia were more likely to experience polypharmacy and excessive polypharmacy compared to patients with dementia covered by National Health Insurance (NHI). This study reports the latest evidence on the status and risk factors of polypharmacy in elderly patients with dementia. We proposed that careful monitoring and management are required for patients at high risk for polypharmacy.

Clinical Significance of Discordance between Hip and Spine Bone Mineral Density in Korean Elderly Patients with Hip Fractures.

The clinical significance of BMD discordance has not yet been elucidated. The objective of this study was to evaluate the clinical significance of BMD discordance between the hip and spine for hip fractures. The BMD was measured and related factors were investigated in 109 elderly patients hospitalized for a hip fracture (fracture group) and 109 patients hospitalized without a hip fracture (non-fracture group). BMD discordance of the hip and spine was classified as minor discordance (normal and osteopenia, and osteopenia and osteoporosis) and major discordance (normal and osteoporosis). The risk of hip fracture was calculated according to the type of discordance: no discordance, low hip, and lower spine. There was no significant difference between the general characteristics of the fracture group and the non-fracture group. The rate of BMD discordance and low hip discordance were significantly higher in the fracture group (53.2%, 43.1%) than in the non-fracture group (28.4%, 19.3%). The odds ratio of hip fracture was 2.86 times higher in patients with BMD discordance than in those without discordance and 3.42 times higher in the patients with low hip discordance than in those without no hip discordance. The presence of discordance, particularly when there is low hip discordance, might be related to the hip fractures.

#4964 ASSOCIATION OF DIETARY INTAKE WITH SERUM LEVELS OF PHOSPHORUS AND POTASSIUM IN THE ELDERLY HEMODIALYSIS PATIENTS IN KOREA

Abstract Background and Aims Dietary management of elderly (>60 years old) hemodialysis(HD) patients is very important for solving health problems and improving quality of life. Hyperphosphatemia and hyperkalemia in elderly HD patients are closely related to intake of dietary phosphorus and potassium from Koreans’ unique eating patterns. It is very difficult to manage the diet of hemodialysis patients due to the unique eating patterns of elderly Koreans. In the daily meal pattern, sodium and potassium contents are high in grain-based foods, soups, stews, and seasoned vegetables. And, there are various recipes for meals using a range of condiments, which increase serum phosphorus level. For this reason, it is necessary to educate dietary management using real-time Apps for the elderly in Korea. This study was designed to provide the base data for the development of a self-dietary management App for Korean elderly HD patients. Method This study was conducted on 237 elderly HD patients (149 males and 88 females) at nationwide 18 university hospitals. We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 23 food meal items based on the Korean usual diets. For this dietary status evaluation, a newly constructed potassium and phosphorus content DB was used. Results The average age of the patients was 69.7± 11.6 years for men and 69.2±6.9 years for women and the duration of HD was 5.4 ± 4.9 years for men and 5.5±4.2 for women. The mean body mass index (BMI) was 23.24 ± 2.99 kg/m2, mean serum phosphorus level was 5.03 ± 9.59 mg/dl, and mean serum potassium level was 5.41 ± 8.58 mEqL. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of the subjects, and hyperkalemia(> 5.0 mEq/L) in 35.4%. Energy and protein were significantly lower than recommended intakes of HD patients(P = .027, P = .015). Lower intake of energy and protein was more significant in women. The intake of sodium and potassium was significantly higher than recommendation(P = .014, P = .021), which was more excessive in men. Serum phosphorus levels showed positive correlation with intake frequency of mixed grains rice (P = .011), noodle without broth(P = .000), vegetable soup(P = .039), and roasted beef(P = .047) in male patients. In case of female patients, intake of sweet potatoes was correlated with hyperphosphatemia (P = .047). Serum potassium levels showed a positive correlation with intake of Kimchi(P = .000), noodle without broth(P = .000), and ham(P = .018) in men. In women, sweet potatoes(P = .027) and medium-potassium fruits(P = .047) were correlated with serum potassium level. On the other hand, intake of white rice showed negative correlation with serum potassium levels(P = .037) in both sex. Conclusion Dietary management along with medical treatment is essential for maintaining serum phosphorus and potassium levels within acceptable ranges because the composition of the daily routine diet is very unique and varies in Korea. The results of this study showed that the intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels in the elderly Korean HD patients. In addition, limiting intake of sweet potatoes, medium and high potassium vegetables & fruits to under three servings per week is recommended. Therefore, customized dietary management needs to be regulated according to each individual's dietary pattern for the Korean elderly HD patients. Major variables found in this study can be used in the development of new App for customized self-dietary management.

Physical Therapy Assessment Tool Threshold Values to Identify Sarcopenia and Locomotive Syndrome in the Elderly.

This study aimed to evaluate sarcopenia and locomotive syndrome in Korean elderly patients, analyze the closely related factors, and determine the threshold for distinguishing participants with sarcopenia, locomotive syndrome, and non-disease. To this end, we enrolled 210 subjects aged 65 years or more and classified them into the sarcopenia (n = 36) and locomotive syndrome (n = 164) groups; a control group was also included (n = 10). We evaluated the characteristics of these patients using the Timed Up and Go (TUG) test and Berg Balance Scale (BBS) and performed statistical analysis. Our findings showed statistically significant differences between the groups, leading to the derivation of a significant threshold value. The threshold value of the TUG test between the control and locomotive syndrome groups was 9.47 s; the threshold value of the BBS was 54 points, respectively. The threshold value of the TUG test between the locomotive syndrome and sarcopenia groups was 10.27 s, and the threshold value of the BBS was 50 points, respectively. These findings suggest that sarcopenia is closely related to locomotive syndrome, and that sarcopenia and locomotive syndrome can be identified using a physical therapy diagnostic evaluation tool.

Adherence to Antidepressants in Korean Elderly Patients with Major Depressive Disorder

Adherence to Antidepressants in Korean Elderly Patients with Major Depressive Disorder

Interdisciplinary Co-Design Research Practice in the Rehabilitation of Elderly Individuals with Chronic Low Back Pain from a Senior Care Center in South Korea

The rehabilitation practices encounter multifaceted problems inherent in the current context of the elderly with chronic low back pain (LBP). We addressed a particular multifaceted problem in the current context using an interdisciplinary co-design research practice that consists of three phases: context exploration, patient-expert interaction, and patient-centered rehabilitation. Using an empirical study integrated with this practice, we investigated 30 Korean elderly patients suffering from LBP and introduced an exercise program design. In the context exploration phase, we found that the elderly patients neglected proper posture during work causing spine instability and resultantly developing chronic LBP. The patient–expert interaction phase explored latissimus dorsi (LD) and lumbar erector spinae (LES) muscles as the back trunk muscles that had caused LBP in most of these elderly patients. In the patient-centered rehabilitation phase, we designed an exercise program with exercise protocols and an exercise object for flexion and extension of trunk muscle relaxation and stabilization. Using electromyography (EMG), we found that the exercise program significantly increased the muscle activation levels of the muscles and reduced LBP. Our practice defines and addresses a multifaceted problem with several challenges both in healthcare design and the problem itself. This integrated approach can easily be expanded and adapted to other domain-related research projects that possess characteristics of complex problems.

Clinical Significance of Discordance between Hip and Spine Bone Mineral Density in Korean Elderly Patients with Hip Fractures

Clinical Significance of Discordance between Hip and Spine Bone Mineral Density in Korean Elderly Patients with Hip Fractures

Relationship between Cataract Surgery and Mortality in Elderly Patients with Cataract: Nationwide Population-Based Cohort Study in South Korea.

We aimed to investigate the relationship between cataract surgery and all-cause and cause-specific mortality in Korean elderly patients with cataract using the Korean National Health Insurance Service-Senior cohort database. Elderly patients (≥60 years) diagnosed with cataract from 2002 through 2012 were included. The baseline characteristics included demographics and systemic and ocular comorbidities. Adjusted Cox regression models with time-varying covariates for cataract surgery were used to assess the relationship between cataract surgery and mortality. The study cohort included 241,062 patients, of whom 127,941 were in the cataract surgery group and 113,121 were in the cataract diagnosis group. The incidence of all-cause mortality was 3.62 deaths/100 person-years and 3.19 deaths/100 person-years in the cataract surgery and cataract diagnosis groups, respectively. Cataract surgery was associated with a decreased hazard of all-cause mortality after adjusting for demographics as well as systemic and ocular comorbidities (hazard ratio (HR), 0.93; p < 0.001). A protective association was noted between cataract surgery and mortality from vascular (HR, 0.92; p < 0.001) or neurologic (HR, 0.64; p < 0.001) causes. Patients with cataract who were 85 years of age and older, women, those who had lower income, and a Charlson comorbidity index score of 5 or more, or those without glaucoma revealed the largest reductions in mortality hazards resulting from cataract surgery.

Association between glaucoma surgery and all-cause and cause-specific mortality among elderly patients with glaucoma: a nationwide population-based cohort study

This population-based, retrospective cohort study aimed to evaluate the association between glaucoma surgery and all-cause and cause-specific mortality among Korean elderly patients with glaucoma. A total of 16210 elderly patients (aged ≥ 60 years) diagnosed with glaucoma between 2003 and 2012 were included, and their insurance data were analyzed. The participants were categorized into a glaucoma surgery cohort (n = 487), which included individuals who had diagnostic codes for open angle glaucoma (OAG) or angle closure glaucoma (ACG) and codes for glaucoma surgery, and a glaucoma diagnosis cohort (n = 15,723), which included patients who had codes for OAG and ACG but not for glaucoma surgery. Sociodemographic factors, Charlson Comorbidity Index score, and ocular comorbidities were included as covariates. Cox regression models were used to assess the association between glaucoma surgery and mortality. The incidence of all-cause mortality was 34.76/1,000 person-years and 27.88/1,000 person-years in the glaucoma surgery and diagnosis groups, respectively. The adjusted hazard ratio (HR) for all-cause mortality associated with glaucoma surgery was 1.31 (95% confidence interval [CI], 1.05–1.62, P = 0.014). The adjusted HR for mortality due to a neurologic cause was significant (HR = 2.66, 95% CI 1.18–6.00, P = 0.018). The adjusted HRs for mortality due to cancer (HR = 2.03, 95% CI 1.07–3.83, P = 0.029) and accident or trauma (HR = 4.00, 95% CI 1.55–10.34, P = 0.004) associated with glaucoma surgery for ACG were significant as well. Glaucoma surgery was associated with an increase of mortality in elderly patients with glaucoma. In particular, the risk of mortality associated with glaucoma surgery due to neurologic causes was significant.

Potentially inappropriate prescribing of cardiovascular system and antiplatelet/anticoagulant drugs among elderly patients: a Korean population-based national study.

OBJECTIVESTo investigate the prevalence of potentially inappropriate prescribing (PIP) for cardiovascular system (CVS) and antiplatelet/anticoagulant (AP/AC) drugs among Korean elderly patients, using the Screening Tool of Older Persons’ Prescriptions (STOPP) criteria version 2 and to identify the risk factors related to PIP.METHODSThe 2016 National Aged Patient Sample data, comprising National Health Insurance claim records for a random sample of 20% of patients aged ≥ 65 years, were used to calculate PIP prevalence of outpatient prescriptions. For criteria including drug-disease interactions, PIP prevalence per indication was estimated.RESULTSAmong 1,274,148 elderly patients and 27,062,307 outpatient prescription claims, 100,085 patients (7.85%) and 341,664 claims (1.27%) had one or more PIP. The most frequent PIP was “non-steroidal anti-inflammatory drug with concurrent antiplatelet agent (s) without proton-pump inhibitor prophylaxis” in the claim-level (0.97%) and patient-level (6.33%) analyses. “Beta-blocker with bradycardia” (16.47% of claims) and “angiotensin receptor blockers in patients with hyperkalaemia” (23.89% of claims) showed the highest PIP prevalence per indication. Logistic regression analysis revealed that, among the patient and health care provider characteristics, female, older age, more severe comorbidities, polypharmacy, higher level of healthcare organization, and specialty of prescriber were significantly associated with a higher risk of PIP.CONCLUSIONSOur findings of a high prevalence of PIP for CVS and AP/AC drugs among the elderly suggest that an effective strategy is urgently needed to improve the prescription practices of these drugs.

PMU11 Current Status of the Use of Prescription Opioids in Korean Elderly Patients: An Analysis of the Health Insurance Review and Assessment Service-Aged Patient Sample DATA

PMU11 Current Status of the Use of Prescription Opioids in Korean Elderly Patients: An Analysis of the Health Insurance Review and Assessment Service-Aged Patient Sample DATA

Clinical features of Korean elderly patients with antineutrophil cytoplasmic antibody-associated vasculitis.

Background/AimsWe compared the clinical and laboratory data between elderly and non-elderly patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) at diagnosis; further, we investigated the predictors at diagnosis for all-cause mortality and end-stage renal disease (ESRD) occurrence during follow-up in Korean elderly patients with AAV.MethodsWe reviewed the medical records of 191 AAV patients regarding clinical manifestations and laboratory results at diagnosis and during follow-up. The follow-up duration was defined as the period from diagnosis to death for deceased patients or to the time of dialysis for ESRD patients, or to the last visit. Elderly (n = 67) and non-elderly (n = 124) patients were grouped based on an age threshold of 65 years.ResultsAt diagnosis, elderly patients exhibited higher median Birmingham Vasculitis Activity Score (BVAS) and higher frequencies of ANCA positivity and pulmonary manifestations than non-elderly patients. Furthermore, elderly patients exhibited increased median white blood cell count, blood urea nitrogen (BUN), alkaline phosphatase, erythrocyte sedimentation rate, and C-reactive protein and decreased median hemoglobin. However, there were no significant differences in all-cause mortality and ESRD occurrence between elderly and non-elderly patients. Meanwhile, elderly patients exhibited lower cumulative patients’ and ESRD-free survival rates than non-elderly patients. In the multivariable Cox hazards model, BUN, creatinine and serum albumin at diagnosis were independent predictors for ESRD occurrence, whereas there were no independent predictors at diagnosis for all-cause mortality.ConclusionsElderly AAV patients exhibited substantially higher rates of all-cause mortality and ESRD occurrence during follow-up compared than non-elderly AAV patients.

Predictive factors associated with mortality in Korean elderly patients with hip fractures.

It is important to investigate the level of physical function impairment before fracture to predict mortality after hip fracture. This study aimed to examine the predictive factors associated with mortality depending on prefracture physical function impairment among Korean elderly patients. We included 1841 patients aged 65 years and older with hip fractures using osteoporosis-related hip fracture network data from 15 university hospitals in South Korea. The collected data included sociodemographic, nutritional, disease-related, and fracture- and surgery-related factors. For the degree of prefracture physical function impairment, ambulatory ability was classified into community, household, and nonfunctional ambulators. Binominal logistic regression was used to identify the predictive factors for mortality. Analysis showed that mortality rate at the first follow-up after hip fracture was 4.9%, and most patients (77.7%) were community ambulators before fracture. Sociodemographic (older age, male sex), nutritional (low body mass index, low albumin level before surgery), and fracture- and surgery-related (nonsurgical management, complications after surgery) factors significantly predicted mortality, depending on the prefracture ambulatory status. This study emphasizes that nutritional assessment and management as interdisciplinary interventions from hospitalization to follow-ups should be performed to lower malnutrition and mortality risk. Therapeutic management for comorbidities negatively affecting surgery outcomes should be prioritized to reduce postoperative complications and mortality. Surgical treatment should be encouraged if it aligns with the therapeutic goals, even in poor health status.

Efficacy and Safety of Alitretinoin Therapy in Korean Elderly Patients with Chronic Hand Eczema: A Retrospective Single Center Study.

BackgroundChronic hand eczema (CHE) tends to be refractory to conventional therapy. Previous clinical trials have found that alitretinoin is an effective and well-tolerated treatment for CHE. However, there is a relative lack of data on the effectiveness of alitretinoin in elderly patients.ObjectiveThe aim of this study was to investigate the efficacy and safety of oral alitretinoin in elderly patients with moderate to severe CHE in Korea.MethodsWe retrospectively investigated 46 CHE patients who were treated with either 10 mg or 30 mg of alitretinoin between June of 2016 and July of 2018. The physician's global assessment (PGA) was used to evaluate treatment efficacy. All adverse events were retrospectively evaluated with respect to laboratory testing, including complete blood cell count, fasting blood chemistry, lipid profile, and liver and thyroid function tests.ResultsThe mean patient age in this study was 71.0±5.1 years. The treatment period was over eight weeks. A total of 38 of 46 patients (82.6%) exhibited clinical improvement with PGA ratings of ‘clear’ or ‘almost clear.’ There were 13 patients (28.3%) who experienced an adverse effect, with the most common being headache (13.0%) and gastrointestinal symptoms (8.7%) followed by xerosis (6.5%). A total of 13 patients developed or exhibited worsening hypertriglyceridemia (28.3%).ConclusionAlitretinoin can be considered a safe and effective treatment option in elderly patients with moderate to severe CHE.

Long-term Survival in Korean Elderly Patients with Symptomatic Severe Aortic Stenosis Who Refused Aortic Valve Replacement.

Background and ObjectivesAortic valve replacement (AVR) is the treatment of choice in severe symptomatic aortic stenosis (AS) patients. However, a substantial number of elderly patients refuse AVR and treated medically. We investigated their long-term prognosis.MethodsFrom January 2005 to December 2016, we analyzed elderly patients with severe symptomatic AS who refused to have AVR.ResultsAfter screening of total 534 patients, we analyzed total 180 severe symptomatic AS patients (78±7 years old, 96 males). Hypertension was the most common cardiovascular risk factor (72%) and the most common symptom was dyspnea (66%). Calculated aortic stenosis area was 0.73±0.20 cm2 and mean left ventricular ejection fraction (LVEF) was 57.8±12.2%. Total 102 patients died during follow-up period (39.1±31.0 months). One-, 3-, and 5-year all-cause mortality rate was 21.1±3.0%, 43.1±3.8%, and 56.5±4.2%, respectively. Of them, 87 died from cardiac causes, and 1-, 3-, and 5-year cardiac mortality rate was 18.0±2.9%, 38.2±3.8%, and 50.7±4.3%, respectively. Their all-cause mortality and cardiac mortality were significantly higher than those of controls. Univariate analysis showed that age, anemia, LVEF, and Log N-terminal pro B-type natriuretic peptide (NT-proBNP) were significant parameters in all-cause mortality (p<0.001, p=0.001, p=0.039, and p=0.047, respectively) and in cardiac mortality (p<0.001, p<0.001, p=0.046, and p=0.026, respectively). Multivariate analysis showed that age and anemia were significant prognostic factors for cardiac and all-cause mortality.ConclusionsIn elderly severe symptomatic AS patients who treated medically, their 1-, 3- and 5-year all-cause mortality rate was 21.1±3.0%, 43.1±3.8%, and 56.5±4.2%, respectively. Age and anemia were significant prognostic factors for cardiac and all-cause mortality.

A multicenter, retrospective analysis of elderly patients with acute myeloid leukemia who were treated with decitabine.

Decitabine is widely accepted as the treatment options for elderly acute myeloid leukemia (AML) patients. However, the efficacy has yet been assessed in Asian population. We retrospectively analyzed the outcomes of 80 Korean elderly AML patients who were treated with decitabine. The median age was 74 years (range, 64 to 86 years) and 6 (7.5%), 48 (60.0%), and 25 (31.3%) patients were categorized to favorable, intermediate, and poor risk group, respectively. The median OS was 10.2 months (95% CI 5.0–15.4). Given that decitabine treatment demonstrated improved clinical outcomes, it could be considered as one of the first-line treatment for Korean elderly AML patients.

Access to Anti-osteoporosis Medication after Hip Fracture in Korean Elderly Patients

PurposeThis study aims to evaluate access to anti-osteoporosis medication (AOM) and the factors affecting their prescription for Korean elderly patients with a hip fracture. MethodsA cross-sectional study was conducted on hip fracture patients aged 65 years or more using national-level data from 2013 to 2014. The prescription rates of AOM within 3 months after hip fracture were determined and the factors affecting AOM prescriptions were identified through multivariate logistic regression. ResultsA total of 6307 elderly patients were selected from a national medical insurance database, giving an estimated 15,768 patients nationally in a nine-month period. One-third of the patients (33.5%) received an AOM prescription and only 9.4% of the patients were prescribed an AOM with calcium and vitamin D supplements. Being 80 years and older (adjusted OR, 0.78; 95% CI, 0.70–0.88) and having three or more comorbid diseases (adjusted OR, 0.66; 95% CI, 0.55–0.78) were associated with a lower likelihood of an AOM prescription. Female sex (adjusted OR, 2.54; 95% CI, 2.17–2.98), an osteoporosis diagnosis (adjusted OR, 2.50; 95% CI, 2.15–2.91), concurrent thiazolidinedione therapy (adjusted OR, 2.11; 95% CI, 1.29–3.45) and a dual-energy X-ray absorptiometry (DXA) examination after hip fracture (adjusted OR 4.11; 95% CI, 3.67–4.62) were all significant predictive factors for AOM prescription. Bisphosphonates were the most frequently prescribed AOMs (92.2%). ConclusionsThe AOM prescription rate for elderly patients with hip fractures was suboptimal in Korea. Factors affecting an AOM prescription were age, sex, clinical comorbidity, osteoporosis status, concurrent thiazolidinedione therapy, and receiving a DXA examination after hip fracture.

PHS71 - Awareness Gap of Cataract and Age-Related Macular Degeneration among Korean Elderly Patients

PHS71 - Awareness Gap of Cataract and Age-Related Macular Degeneration among Korean Elderly Patients

Is mirtazapine really effective in the treatment of Korean elderly depressed patients with insomnia after previous antidepressant failure?: An open-label, multicenter study

Is mirtazapine really effective in the treatment of Korean elderly depressed patients with insomnia after previous antidepressant failure?: An open-label, multicenter study

Prevalence and Predictors of Polypharmacy among Korean Elderly

ObjectivePolypharmacy is widespread in the elderly because of their multiple chronic health problems. The objective of this study was to investigate the prevalence and predictors associated with polypharmacy in a nationally representative sample of Korean elderly individuals.MethodsWe used the Korea Health Insurance Review and Assessment Service – National Patient Sample (HIRA-NPS) data from 2010 and 2011. We used information on 319,185 elderly patients (aged 65 years or older) between January 1, 2010 and December 31, 2011 from the HIRA-NPS database. We defined ‘polypharmacy’ as the concurrent use of 6 medications or more per person, ‘major polypharmacy’ as 11 medications or more, and ‘excessive polypharmacy’ as 21 medications or more. The frequency and proportion (%) and their 95% confidence intervals were presented according to the polypharmacy definition. Polypharmacy was visualized by the Quantum Geographic Information Systems (QGIS) program to describe regional differences in patterns of drug use. Multivariate ordinal logistic regression was performed to estimate odds ratios (ORs) and their 95% confidence intervals (CI) to investigate the risk factors for polypharmacy.ResultsOf the Korean elderly studied, 86.4% had polypharmacy, 44.9% had major polypharmacy and 3.0% had excessive polypharmacy. Polypharmacy was found to be primarily concentrated in the Southwest region of the country. Significant associations between polypharmacy and the lower-income Medical Aid population (OR = 1.52, 95% CI 1.47, 1.56) compared with National Health Insurance patients was observed.ConclusionsNationwide efforts are needed for managing polypharmacy among Korean elderly patients. In particular, a national campaign and education to promote appropriate use of medicines for the Medical Aid population is needed.