Community-dwelling Older Adults In Korea Research Articles

Purposes of Internet Use and Its Impacts on Physical and Psychological Health of Korean Older Adults.

Older adults engage in online activities for various purposes. An increasing number of studies are establishing connections between the purposes of internet use and their impacts on health outcomes. This study aimed to examine how the purposes of internet use affect self-rated health and depressive symptoms among Korean older adults. A nationally representative survey of community-dwelling older adults in Korea was used in the analysis (n = 5094). Instrumental internet use (using the internet to access various forms of information, services, and other resources) in Korean older adults was as common as interpersonal communication use, and the purposes of internet use were mainly for information seeking for everyday needs and engaging in various activities for enjoyment. Internet use for interpersonal communication and instrumental purposes was significantly associated with depressive symptoms and self-rated health. Internet use for instrumental purposes had a greater impact on self-rated health (β = -0.186) and depressive symptoms (β = -0.160) compared with the impacts of interpersonal communication internet use on self-rated health (β = -0.101) and depressive symptoms (β = -0.047). The findings highlighted the necessity of designing interventions that take into account the different purposes of internet use for older adults in order to maximize its benefits, paying special emphasis for information seeking online.

PROFILES OF DIGITAL LITERACY AMONG COMMUNITY-DWELLING KOREAN OLDER ADULTS: A LATENT PROFILE ANALYSIS

Abstract Digital divide exists among not only between older and younger generations but also within the older adult population. Understanding digital literacy profiles among older adults is important to identifying strategies for reducing digital divide among this population. This study aimed to identify profiles of digital literacy among community-dwelling older adults and examine associated factors. Data were collected from a national survey of 1016 community-dwelling older adults in Korea (average age 68.0±6.5 years, 47.8% male). Digital literacy was evaluated across three domains: ’Information and Communication’ (9 items), ’Contents Creation and Management’ (4 items), and ’Safety and Security’ (9 items). Latent profile analysis and multinomial logistic regression yielded three digital literacy profiles: “Low-level” (35.7%, n=363), “Middle-level” (39.2%, n=398), and “High-level” (25.1%, n=255). Compared to the low-level group, a higher likelihood of belonging to the middle level group was associated with younger age, higher education level, higher dependence on instrumental activities of daily living, longer digital device use, and participating in offline social activities. Similarly, a higher likelihood of belonging to the high-level group was associated with younger age, higher education level, higher dependence on instrumental activities of daily living, longer digital device use, better physical well-being, doing daily physical exercise, and greater social support. These findings suggest characteristics associated with lower digital literacy, including older age, lower education level, and reduced functional independence. To promote digital literacy in older adults, potential strategies encompass tailored access and guidance for digital device use specifically tailored to older adults, alongside efforts to nurture social connectedness.

Prevalence and associated factors of cognitive frailty in community-dwelling older adults: Results from the Korean longitudinal study of aging.

Cognitive frailty, a condition characterized by physical frailty with cognitive impairment, is emerging as a determinant of adverse health outcomes in older adults. However, its prevalence and correlation with associated factors are unknown in the aging population of Korea. To estimate the prevalence of cognitive frailty and identify factors associated with it among older Korean adults. A secondary analysis was performed using the Korean Longitudinal Study of Aging seventh survey dataset collected in 2018. Multinomial logistic regression analyses were conducted to examine the association between cognitive frailty and demographic, psychosocial, oral health and physical function factors. Individuals aged ≥65 years and without dementia were included (N = 1024). Participants were classified into four groups based on the presence or absence of physical frailty and mild cognitive impairment. This article is executed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. The prevalence of cognitive frailty in the study sample was 11.2%. The results of multinomial logistic regression showed that advanced age, being female, lower education levels, heart disease, arthritis or rheumatoid arthritis, underweight, depression, non-social activity, poor oral health and functional limitation were significantly associated with cognitive frailty. Cognitive frailty is prevalent among community-dwelling older adults in Korea. The findings provide primary care providers with insights about effective strategies for identifying at-risk individuals and will guide the development of population-level interventions to prevent or delay the onset of physical frailty and cognitive impairment in older adults. The findings provide practical information to healthcare providers for identifying cognitive frailty in older adults. The risk factors of cognitive frailty, such as psychosocial, oral health, and physical function factors, should be thoroughly monitored for older adults. Health personnel working in primary care have a critical role in identifying risk and beneficial factors and promoting preventative strategies that enhance health outcomes.

The association between depressive symptoms with fear of falling and cognitive decline in older adults in the Korean community: An analysis of the Korean Longitudinal Study of Aging (KLoSA), 2006–2020

ObjectivesThis study aimed to investigate the effects of fear of falling (FOF) on cognitive decline in older adults in the Korean community, depending on the presence of accompanying depressive symptoms. MethodsA total of 6263 individuals were included in the final analysis. Based on their baseline evaluation results for depressive symptoms and FOF, the subjects were divided into four groups: “normal control” (NC, n = 3783), “depression only” (Dep-only, n = 291), “fear of falling only” (FOF-only, n = 1755), and “depression with fear of falling” (Dep-FOF, n = 434). Cognitive decline was defined as a loss of more than three points in the K-MMSE score in participants with at least two years of follow-up. We examined the association between FOF accompanied by depressive symptoms and cognitive decline using a multivariate Cox proportional hazard model. ResultsCognitive decline occurred in 76.3%, 68.5%, 63.9%, and 56.4% of the Dep-FOF, FOF-only, Dep-only, and NC groups, respectively. Our findings suggest that individuals with FOF do not always have cognitive decline (HR = 1.03, 95% CI = 0.95–1.12, P = 0.43) compared to individuals without FOF. Furthermore, depressive symptoms with FOF are associated with a higher risk of cognitive decline (HR = 1.23, 95% CI = 1.08–1.41, P = 0.002) in community-dwelling older adults in Korea. ConclusionHealthcare providers should be attentive to community-dwelling older adults who experience both depressive symptoms and FOF because our findings suggest that this unique combination increases the risk of cognitive decline.

Factors influencing mobility in community-dwelling older adults during the early COVID-19 pandemic: a cross-sectional study

BackgroundIn older adults, mobility is important for maintaining their independence and quality of life, and it influences their physical, cognitive, and social health. This study aimed to identify the physical and psychosocial factors that affected the mobility of community-dwelling older adults, aged 65 years or older, who were socially isolated during the coronavirus disease 2019 (COVID-19) pandemic due to stay-at-home policies.MethodsThe participants in this study were 214 community-dwelling older adults in Korea, and a cross-sectional survey was conducted from December 2020 to January 2021. Variables included participants’ general characteristics, mobility, sitting time, depression, social support, and cognitive function.ResultsMultiple linear regression analysis showed that the factors influencing older adults’ mobility during the COVID-19 pandemic were depression (β=-0.29, p < .001), age (65–74 years old) (β = 0.19, p = .002), a lower level of education (β=-0.17, p = .006), two or more comorbidities (β=-0.18, p = .001), sitting time (β=-0.17, p = .004), and the ability to drive a vehicle (β = 0.14, p = .017).ConclusionsHome healthcare interventions are needed to limit psychosocial issues and improve mobility for older adults who had limited mobility during the COVID-19 pandemic.

Development of a medication review tool for community-dwelling older adults in Korea.

With the aging population, older adults are more likely to receive outpatient care. Therefore, it is necessary to identify drug-related problems (DRPs) and potentially inappropriate medications (PIMs) associated with adverse clinical outcomes in community-dwelling older adults. This study aimed to develop a medication review tool for community-dwelling older adults in Korea. We developed the tool using three steps: (i) establishment of a preliminary list by reviewing 21 existing tools, (ii) a two-round Delphi survey to evaluate clinical appropriateness and (iii) a two-round Delphi survey to evaluate applicability. The list was categorized into 23 diseases/conditions with five types of DRPs. The interventions for each item have been described. The preliminary list contained 100 items. The final list contained 81 items, including 17 general PIMs, 26 PIMs under specific disease/conditions, 16 potential drug interactions, 20 potential omissions and 2 PIMs requiring dose adjustment. We developed a disease-based explicit medication review tool that can be used in primary care. This tool would assist primary care healthcare providers in identifying inappropriate medication use, which may help reduce adverse clinical consequences in older adults. Further studies are required to validate the clinical efficacy of this tool.

Cross sectional association between cognitive frailty and disability among community-dwelling older adults: Focus on the role of social factors.

This study aimed to investigate the prevalence of cognitive frailty and the influence of social factors on the association between different levels of cognitive frailty and disability. A nationally representative survey of non-institutionalized community-dwelling older adults in Korea was used. A total, 9,894 older adults were included in the analysis. We assessed the effects of social factors using social activities, social contacts, living arrangements, emotional support, and satisfaction with friends and neighbors. The prevalence of cognitive frailty was 1.6%, which was consistent with other population-based studies. Hierarchical logistic analysis demonstrated that the association between different levels of cognitive frailty and disability was attenuated when social participation, social contact, and satisfaction with friends and community were included in the model, and the magnitude of these effects differed across the levels of cognitive frailty. Considering the influence of social factors, interventions to enhance social relationships can help slow down the progression of cognitive frailty to disability.

Factors Associated with Aging in Place among Community-Dwelling Older Adults in Korea: Findings from a National Survey.

Ever since baby boomers started turning 65 years old in 2020, Korea is set to become a super-aged society by 2025. This makes it the world's fastest-aging society. Aging in place (AIP) has become a policy direction to prepare for an aging society and improve older adults' quality of life. It refers to the ability of older adults to remain in their homes and communities as they age, allowing them to reside in their place of preference and access the services they require to promote their quality of life. A cross-sectional study design was employed using data sampled from the 2020 National Survey of Older Koreans. In total, 9930 older adults (aged between 65 and 99 years old) participated. The results confirmed that the intention to pursue AIP is related to personal factors (education, income, house ownership, smoking, exercise, depression), interpersonal and communal factors (unmet healthcare needs, need for home care services, family contact), and policy level factors (basic pension beneficiary, long-term care services) using an ecological model. The findings may promote individual health behaviors and help fill the gap between unmet healthcare needs and community care services that positively influence older adults' AIP.

PHYSICAL FRAILTY AS A PREDICTOR OF INCIDENT DISABILITY IN SPECIFIC-IADL ITEMS AMONG OLDER ADULTS

Abstract This study investigated the 2-year impact of physical frailty on disability (activities of daily living [ADL], instrumental ADL [IADL], and mobility) and mortality among community-dwelling older adults in Korea. We used data from 2,905 older adults aged 70–84 years who participated in the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016–2017) and Wave 2 (2018–2019) with all five components of Fried’s physical frailty phenotype. Of these,277 (7.8 %) were frail and 1,312 (45.2 %) were robust. In the 2-year follow-up, multivariate analysis showed significant differences in frailty status for all disabilities (ADL, IADL, mobility) and mortality incidence. Both pre-frail (odds ratio [OR]=1.48, 95% confidence interval [CI]= 1.06–2.05) and frail (OR = 5.11, 95% CI=2.78–9.39) statuses showed increased risks of mobility disability. The incidence of ADL disability was significant only in frail older adults (OR =10.26, 95% CI=3.16–33.31). Both pre-frailty (OR =1.55, 95% CI=1.03–2.32) and frailty (OR =4.11, 95% CI=2.35–7.18) status were significantly associated with the incidence of IADL limitations. Frailty status was associated with disability in mobility-related items of IADL (going out, using transportation, and shopping) among men, and was associated with most IADL items among women after 2 years. The results of this study emphasize the need for sex-specific policies and frailty prevention programs, with a focus on detecting frailty before it leads to irreversible disability or other negative health outcomes. These findings may provide a framework for frailty prevention in community-dwelling older adults.

SEX DIFFERENCES IN THE ASSOCIATION BETWEEN BODY COMPOSITION AND 2-YEAR CHANGE IN COGNITIVE FUNCTION

Abstract In the process of aging, the loss of lean mass and increase in fat mass are associated with cognitive decline. This study investigated sex differences in the association between body composition and changes in cognitive function in community-dwelling older adults in Korea. A total of 1,420 participants (aged 70–84 years, 54.2% men) of the Korean Frailty and Aging Cohort Study with data from baseline and 2-year follow-up surveys were included. Body composition was measured using dual-energy X-ray absorptiometry and cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet. The total fat mass was lower in men than in women (p&amp;lt; 0.001), whereas total lean mass was higher in men than in women (p&amp;lt; 0.001). Total body fat mass was positively associated with the time taken to finish the Trail Making Test-A only in women (standardized beta coefficient [ß]= -1.371, p=0.018), and a negative association was observed between trunk fat mass and digit span total only in men (ß= -0.092, p=0.039). Appendicular lean mass was significantly positively associated with word list recognition only in women (ß=0.087, p=0.010) and was significantly positively associated with digit span total (ß=0.108, p=0.027) and digit span forward (ß=0.081, p=0.025) only in men. The results of this study indicated that higher fat mass was associated with the protection of decline in cognitive function only in women, while lean mass was positively associated with a change in cognitive function in both sexes.

Chronic Loneliness, Gender, and Trajectories of Change in Hand Grip Strength in OlderAdults.

This study examined whether exposure to chronic loneliness is associated with a persistent decline in hand grip strength among community-dwelling older adults in Korea, and this association varies by gender. This study analyzed data from 2,570 adults aged 65 or older collected over the course of 7 waves (12years) of the Korean Longitudinal Study of Ageing from 2006 to 2018 (1,403 women and 1,167 men). Exposure to chronic loneliness was assessed by the experience of loneliness over a period of years, and hand grip strength was measured by an objective diagnostic tool. Gender-stratified fixed effects models were estimated to determine whether the association between chronic loneliness and hand grip strength differs by gender while accounting for time-invariant individual heterogeneity. Chronic loneliness was associated with a persistent decline in hand grip strength in older adults over an extended period of time. Gender-specific analyses revealed that only men continued to experience a decline in hand grip strength up to the fifth and subsequent waves of exposure (b=-1.889). By contrast, for older women, a significant decrease in hand grip strength was observed only in the second wave of exposure (b=-0.690). These gendered trajectories were statistically significant. Chronic loneliness impairs the physical health of older adults in the long run. These physical health consequences of chronic loneliness were more pronounced among older men than older women. The study's findings inform the development of interventions that mitigate the adverse health consequences of chronic loneliness.

The Impact of Social Network Characteristics on Health among Community-Dwelling Older Adults in Korea: Application of Social Network Analysis.

Objectives: Population aging is a reality in most developed countries. In this era, an important health issue for these countries is promoting health and quality of life in the elderly population. Older adults’ social networks are associated with health and quality of life. Therefore, this study examines the association between the characteristics of social networks (friendship networks) and the subjective well-being of community-dwelling older adults. Methods: This study was conducted between June 2015 and August 2015 with a total of 146 participants. The size and density of social networks were analyzed using social network analysis. Additionally, to investigate the impact of social networks on health, a multiple linear regression analysis was performed using NetMiner 4.0. Statistical significance was set at p < 0.05. Results: In terms of Model 1, which used social network characteristics as variables, the higher the out-degree (376.161) and in-closeness (201.825), the better the health. In contrast, the higher the in-degree (−279.167) and out-closeness (−52.620), the poorer the health. Regarding Model 2, which used sociodemographic characteristics as variables, the higher the out-degree (218.747) and in-closeness (170.075), the better the health. In addition, religion had a negative effect on health, and a high level of education had a positive effect on health. Conclusions: The findings suggest that higher out-degree and in-closeness intensity positively affect the health of older adults, but higher in-degree and out-closeness intensity negatively affect health. Therefore, health professionals should use appropriate strategies to increase the strength of social networks to improve the health of older adults living in the community.

Factors associated with willingness to complete advance directives in older adults

This study aimed to examine the factors associated with willingness to complete advance directives (ADs) in community-dwelling older adults. In total, 121 community-dwelling older adults in Korea completed the questionnaires inquiring about their willingness and perceptions in completing ADs (susceptibility, severity, benefits, barriers, and cues to action), which were based on the Health Belief Model. The mean score for willingness to complete ADs was 6.2 (SD = 3.6). A multiple linear regression analysis showed that higher scores of perceived severity (β = 0.199, p = 0.021), perceived benefits (β = 0.221, p = 0.016), and cues to action (β = 0.159, p = 0.030) were associated with a greater willingness to complete ADs. However, higher scores of perceived barriers (β = -0.409, p < 0.001) were likely to lower the willingness to complete ADs. This study highlights that future interventions aimed at increasing AD completion rates in older adults should consider improving perceived severity, benefits, and cues to action and minimizing perceived barriers.

&lt;p&gt;Prevalence of Sarcopenia in Community-Dwelling Older Adults According to Simplified Algorithms for Sarcopenia Consensus Based on Asian Working Group for Sarcopenia&lt;/p&gt;

PurposeThis study sought to identify the prevalence of sarcopenia in community-dwelling Korean older adults and validate two simplified diagnostic algorithms based on the Asian Working Group for Sarcopenia (AWGS) algorithm for identifying sarcopenia.Patients and MethodsPatients (n = 338) aged ≥65 years participated in this cross-sectional study. Muscle strength was measured by hand grip strength, physical performance by gait speed, and muscle mass by the skeletal muscle mass index (SMI). Sarcopenia was assessed using the AWGS-recommended algorithm and two simplified algorithms (A and B). Algorithms A and B were validated with respect to the AWGS-recommended algorithm using the chi-square test, and the sensitivity and specificity were obtained.ResultsSarcopenia prevalence, determined using the AWGS-recommended algorithm, was 40.3% and 41.3% in men and women, respectively. The overall prevalence of sarcopenia was 41.0% by the AWGS-recommended algorithm, 37.6% by algorithm A, and 37.6% by algorithm B; 111 participants were diagnosed with sarcopenia using all three methods (p = 0.157).ConclusionWe established sarcopenia prevalence among rural community-dwelling adults in Korea and confirmed that the simplified algorithms were suitable for the identification of sarcopenia in rural community-dwelling older adults in Korea. Further studies are needed to assess whether these simplified algorithms are applicable to older Asian adults with functional and/or cognitive impairment and nursing home residents.

Multilevel Effect of Neighborhood Social Cohesion and Characteristics on Suicidal Ideation Among Korean Older Adults

This study examined the effect of neighborhood factors on suicidal ideation of community-dwelling older adults in Korea. To understand the effect of neighborhood factors (neighborhood social cohesion, satisfaction with neighborhood safety, living environment, suicide rate, proportion of social welfare agencies, proportion of social welfare expenses) and individual factors (health, social relationships) on suicidal ideation of older adults, we conducted a multilevel logistic regression analysis. The 2017 Community Health Survey of Korea included data on 67,820 people aged 65years or older and in 255 neighborhoods. At the individual level, the presence of suicidal ideation was associated with less education attainment, lower family income, not living with a spouse, fewer social networks, fewer social activities, more depressive symptoms, and lower health-related quality of life. At the neighborhood level, lack of social cohesion, a higher suicide rate, and a smaller social welfare budget were significantly effect related to the probability of suicidal ideation.

Gender Differences in the Impact of Intergenerational Support on Depressive Symptoms among Older Adults in Korea.

Background: This study examined the relationship between intergenerational support patterns and depressive symptoms among older men and women in Korea. Methods: A nationally representative survey of non-institutionalized, community-dwelling older adults in Korea was used. A total of 7531 older adults (3592 men and 3939 women) was included in the analysis. Results: We observed gender differences in the impact of financial support exchanges on depressive symptoms. A lack of mutual financial support significantly increased the risk of depressive symptoms by 3.83 times (95% CI 2.34–6.24) in men and 1.73 times (95% CI 1.06–2.83) in women. Men who received financial support were more likely to experience depressive symptoms (OR (Odds Ratio), 1.81, 95% CI 1.36–2.42), whereas women who provided financial support were more likely to experience depressive symptoms (OR 2.82, 95% CI 1.21–6.56). The lack of an exchange of emotional support was significantly associated with depressive symptoms in both men (OR 1.49, 95% CI 1.17–1.90) and women (OR 1.87, 95% CI 1.50–2.34). Conclusions: We discuss the evidence of gender differences in intergenerational support exchange patterns and their impact on depressive symptoms within the context of Korean cultures and suggest that future research should be conducted on gender differences in the impact of intergenerational support on mental health across diverse societies.

The Association of Gait Speed and Frontal Lobe among Various Cognitive Domains: The Korean Frailty and Aging Cohort Study (KFACS).

The aim of this study was to determine how gait speed and frontal lobe functionsin community-dwelling older adults in Korea. This was a cross-sectional study. The study used data from the Korean Frailty and Aging Cohort Survey (KFACS), a multi-center longitudinal study addressing 10 centers across urban, rural, and suburban communities in Korea, between 2016 and 2017. A total of 1552 older adults who underwent both gait speed tests and cognitive functions tests during the investigation of the KFACS. Gait speed was assessed by asking participants to walk from a starting point to a point 4 meters away at a normal gait. Cognitive functions were evaluated using various standardized cognitive functions tests. Gait speed was slower when participants were older or less educated The percentage of women, higher BMI, people with lower incomes, singles, smokers, and drinkers was high in the slower gait group. Also, all cognitive function scores were low and depression score was high in the group with slower walking speed. The slower walking speed showed low physical activity score and high prevalence of hypertension, osteoarthritis and osteoporosis. Among the seven cognitive functions (MMSE, memory, TMT, Recall, Recognition, digit span, and Fab), only TMT showed no significant difference between different gait speed groups. The other six cognitive functions showed higher results in the fastest gait speed group (T3), Participants in middle gait speed group (T2) also showed higher results in five of the seven cognitive function scores as well (Memory, Recall, Recognition, digit span, and Fab). In this study, we found correlation between the slower gait speeds and the decrease in cognitive function, and especially the frontal lobe dysfunction was most prominent of all cognitive dysfunctions.

Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea.

ObjectivesThis study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults.MethodsData were collected from the baseline survey (2016-2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias.ResultsThe mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis.ConclusionsDental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.

The predictive relationship between factors related to fear of falling and mortality among community-dwelling older adults in Korea: analysis of the Korean longitudinal study of aging from 2006 to 2014

Objectives This study was conducted to identify the predictive relationship between factors related to fear of falling (FOF) and mortality among community-dwelling older adults in Korea. Method Data were obtained from the Korean Longitudinal Study of Aging (KLoSA). Hierarchical Cox proportional hazards regression analyses were conducted to identify factors related to FOF and correlations of these factors with mortality. Results During the eight-year follow-up period, 964 participants (23.5%) died. Death was more likely to occur in males (hazard ratio [HR], 2.55; 95% confidence interval [95% CI], 2.17–3.00), those 75 years old or older (HR, 2.76; 95% CI, 2.40–3.17), those without education (HR, 1.27; 95% CI, 1.05–1.52), and those living without a spouse (HR, 1.30; 95% CI, 1.11–1.51). Those afraid of falling (HR, 1.41; 95% CI, 1.17–1.70), limiting their activities due to FOF (HR, 1.40; 95% CI, 1.21–1.62), showing symptoms of depression (HR, 1.34; 95% CI, 1.16–1.54), and having low life satisfaction (HR, 1.34; 95% CI, 1.13–1.59) were also more likely to experience decreased lifespans. Conclusion These results suggest that early management and prevention of factors related to FOF should be an effective approach to reducing mortality in older adults.

The Associations between Anger Expression and Insomnia among Community-Dwelling Older Adults in Korea

The Associations between Anger Expression and Insomnia among Community-Dwelling Older Adults in Korea