Elderly Korean Population Research Articles

Associations between Systemic and Dental Diseases in Elderly Korean Population

Background and Objectives: Modernization and population aging have increased the prevalence of systemic diseases, such as diabetes and hypertension, which are often accompanied by various dental diseases. Our aim was to investigate associations between common dental conditions and major systemic diseases in an elderly Korean population. Materials and Methods: Utilizing electronic medical record data from 43,525 elderly patients, we examined the prevalence of systemic diseases (diabetes, hypertension, rheumatoid arthritis, osteoporosis, dementia) and dental conditions (caries, periodontal disease, pulp necrosis, tooth loss). The analysis focused on the correlations between these diseases. Results: Significant associations were found between systemic diseases and an increased prevalence of dental conditions. Patients with systemic diseases, especially those with multiple conditions, had higher incidences of periodontal disease and tooth loss. The correlation was particularly strong in patients with diabetes and rheumatoid arthritis. Interestingly, temporomandibular joint disorder was less frequent in this cohort. Conclusions: The findings highlight the importance of integrated dental care in managing systemic diseases in elderly populations. Enhanced dental monitoring and proactive treatment are essential due to the strong association between systemic diseases and dental conditions. Collaboration between dental and medical professionals is crucial for comprehensive care that improves health outcomes and quality of life for elderly patients.

Comparison of the air change per hour measured over four seasons in the residential buildings of the urban, rural, and industrial areas of South Korea: K-IOP Study

Air infiltration, calcuated by air changes per hour (ACH) is a key factor in assessing the potential amount of air borne pollutants moving from outdoor into indoor spaces. We measured the natural ACH through fall, winter, spring, and summer (2 weeks/season), in 81 nonsmoking elderly houses located in urban (n = 29), industrial (n = 26) and rural (n = 26) areas from 2021 to 2022 consecutively. Indoor CO2 data measured at dawn (01:00 to 05:00 a.m.) over four season was used to estimate the ACH. Moreover, morning ACHs were also calculated from the CO2 level monitored in the morning, when the levels were dropped significantly with opening a window during fall, winter, and spring. The ACH at dawn over the four seasons ranged from 0.02 to 0.03,while that in the morning with opening a window was 0.2 to 0.3. Our multivariate regression models demonstrated that the difference in CO2 concentration during dawn was positively associated with the ACH change after adjusting for seasonality. In addition, after controlling for the study area, ACH was approximately 50 % higher during summer than during the other seasons (p < 0.05). This study elucidates the seasonal and regional distributions of ACH; a determination of these patterns may further contribute to future simulation or prediction studies assessing the associations among indoor air quality, activity patterns and ventilation practices among Korean elderly population.

Analysis of HTT CAG repeat expansion among healthy individuals and patients with chorea in Korea

BackgroundAlthough the epidemiology of Huntington's disease (HD) in Korea differs notably from that in Western countries, the genetic disparities between these regions remain unclear. ObjectiveTo investigate the characteristics and clinical significance of cytosine-adenine-guanine (CAG) repeat size associated with HD in the Korean population. MethodsWe analyzed the CAG repeat lengths of the HTT gene in 941 healthy individuals (1,882 alleles) and 954 patients with chorea (1,908 alleles) from two referral hospitals in Korea. We presented normative CAG repeat length data for the Korean population and computed the reduced penetrance (36–39 CAG) and intermediate allele (27–35 CAG) frequencies in the two groups. Furthermore, we investigated the relationship between intermediate alleles and chorea development using logistic regression models in individuals aged ≥55 years. ResultsThe mean (±standard deviation) CAG repeat length in healthy individuals was 17.5 ± 2.0, with a reduced penetrance allele frequency of 0.05 % (1/1882) and intermediate allele frequency of 0.69 % (13/1882). We identified 213 patients with genetically confirmed HD whose CAG repeat length ranged from 39 to 140, with a mean of 45.2 ± 7.9 in the longer allele. Compared with normal CAG repeat alleles, intermediate CAG repeat alleles were significantly related to a higher risk of developing chorea (age of onset range, 63–84 years) in individuals aged ≥55 years. ConclusionsThis study provides insights into the specific characteristics of CAG repeat lengths in the HTT gene in the Korean population. The reduced penetrance and intermediate allele frequencies in the Korean general population seem to be lower than those reported in Western populations. The presence of intermediate alleles may increase the risk of chorea in the Korean elderly population, which requires further large-scale investigations.

Modified Korean MIND Diet: A Nutritional Intervention for Improved Cognitive Function in Elderly Women through Mitochondrial Respiration, Inflammation Suppression, and Amino Acid Metabolism Regulation.

Mild cognitive impairment is associated with a high prevalence of dementia. The study examines the benefits of a modified Korean MIND (K-MIND) diet and explores biomarkers using multi-omics analysis. The K-MIND diet, tailored to the elderly Korean population, includes perilla oil, milk, or fermented milk, and avoids alcohol consumption. As a result, the K-MIND diet significantly improves subjects "orientation to place" in the Korean version of the Mini-Mental State Examination, 2nd edition test. According to multi-omics analysis, the K-MIND diet upregulates genes associated with mitochondrial respiration, including ubiquinone oxidoreductase, cytochrome C oxidase, and ATP synthase, and immune system processes, and downregulates genes related to nuclear factor kappa B activity and inflammatory responses. In addition, K-MIND affects the metabolic pathways of glycine, serine, threonine, tryptophan, and sphingolipids, which are closely linked to cognitive function through synthesis of neurotransmitters and structures of brain cell membranes. The findings imply that the K-MIND diet improves cognitive function by upregulating key genes involved in oxidative phosphorylation and downregulating pro-inflammatory cytokines.

Sarcopenia and Anemia in Elderly Koreans: A Nationwide Population-Based Study.

Sarcopenia and anemia are common diseases in the elderly and are caused by various factors. In this study, the association between sarcopenia and anemia in an elderly Korean population was examined. The Korea Centers for Disease Control and Prevention's cross-sectional, nationally representative Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2011) served as the source of the data for this study. Of the 2769 participants (1167 men and 1602 women) included in this study, a significant association was found between sarcopenia and anemia in the elderly in Korea. In Model 1, unadjusted for covariates, the prevalence of sarcopenia in all participants was 1.805 (95% CI 1.364-2.388) and 2.746 (95% CI 1.740-4.334) in men, and 1.494 (95% CI 1.045-2.138) in women. In Model 4, adjusted for all covariates, the prevalence of sarcopenia in all participants was 1.455 (95% CI 1.064-1.989) and 2.649 (95% CI 1.475-4.755) in men, but it was insignificant in women. While prior studies failed to consider variables such as exercise status and nutritional intake, this research incorporated these factors as covariates. Despite this comprehensive approach, this study still revealed an independent association between sarcopenia and anemia. Moreover, a significant association was uncovered among elderly men, with no corresponding association identified among women.

Unmet Healthcare Needs among the Elderly Korean Population: Before and during the COVID-19 Pandemic

Unmet healthcare needs (UHN) are an important indicator in healthcare management and require sustainable healthcare systems. This cross-sectional descriptive study aimed to identify differences in UHN among the elderly Korean population before and during the first year of the COVID-19 pandemic. Data (N = 3371) from the 8th Korea National Health and Nutrition Examination Survey (2019–2020), specifically focusing on adults aged 65 years and older, were analyzed. The overall prevalence of UHN decreased from 8.2% in 2019 to 7.6% in 2020, but there was no statistical significance (p &gt; 0.05). The leading reasons for UHN were cost burden and mild symptoms in 2020 and cost burden in 2019 (p &lt; 0.05). Compared to 2019, the cost burden in 2020 was lower in men than in women (odds ratio [OR] = 0.287, 95% confidence interval [CI]: 0.113–0.726, p &lt; 0.05), and in the economically active group than in the non-economically active one as to mild symptoms (OR = 0.161, 95% CI: 0.054–0.478, p &lt; 0.05) in multiple logistic regression analyses. In conclusion, these findings imply that sustainable healthcare policies and systems should be tailored to address the targeted population’s healthcare needs, even beyond the COVID-19 era.

Relationship between protein intake and grip strength in qualitative and quantitative aspects among the elderly in Korea: results from the Korea National Health and Nutrition Examination Survey

BackgroundThis study investigated the association between quantitative and qualitative protein intake and grip strength (GS) in the South Korean population to explore nutritional management for the prevention of sarcopenia.MethodsThis cross-sectional study was based on data from a nationally representative sample of the South Korean elderly population, consisting of 1,531 men and 1,983 women aged 65 years and older who participated in the Korean National Health and Nutrition Examination Survey from 2016 to 2019. Low GS was defined as GS < 28 kg in men and GS < 18 kg in women. Protein intake was assessed using 1-day 24-h recall, and we analyzed absolute protein intake, protein intake by food source, and protein intake compared to dietary reference intake with per body weight or absolute daily recommended value.ResultsThe total and animal protein intake and protein intake from legumes, fish and shellfish were significantly lower in women with a low GS than in those with a normal GS. After adjusting for confounding factors, women who consumed more protein than the estimated average requirement (EAR, 40 g/day for women) were 0.528 times less likely to have low GS than women consuming less protein than the EAR (95% CI: 0.373–0.749), and consuming any amount of protein from legumes were 0.656 times less likely (95% CI: 0.500–0.860) to have low GS than women who did not consume any amount of legume protein.ConclusionsThis study provides epidemiological evidence that adequate protein intake above EAR and protein intake from legumes should be guided for preventing low GS, especially in elderly women.

Determinants, Inequalities and Geographical Differences in Cognitive Performance Amongst the Elderly Population in South Korea

Using the most recent 2018 Korean Longitudinal Study of Aging (KLoSA) survey data, this study aimed to examine the key determinants of cognitive impairment (CI) and to explore the inequalities and geographic differences of CI amongst the South Korean elderly population. The findings show that being super-aged, poor general health, and lack of exercise are positively associated with CI, while household wealth, educational level, participation in social activities and regular exercise all have a significant negative effect on CI. Compared to males, female respondents are more likely to experience CI. We found little difference between the specific determinates for the two subsamples. Inequalities in the prevalence of cognitive impairment were greatest in rural areas as well as amongst the respondents living in the Chungcheong region, Seoul Metropolitan Area and the Kangwan region. The results are helpful for the early intervention and prevention strategies to tackle the cognitive impairment problems of the elderly.

Association Between Changes in Oral Health-Related Quality of Life and Depressive Symptoms in the Korean Elderly Population.

Objectives: The aim of this study was to examine the association between changes in oral health related quality of life (OHRQoL) and depressive symptoms in the elderly South Koreans. Methods: We used the 2018 and 2020 Korean Longitudinal Study of Ageing data. Our study population was a total of 3,604 participants aged over 65 in 2018. The independent variable of interest was the changes in the Geriatric Oral Health Assessment Index as OHRQoL between 2018 and 2020. The dependent variable was depressive symptoms in 2020. Multivariable logistic regression analyzed the associations between changes in OHRQoL and depressive symptoms. Results: Participants with improvement in OHRQoL over 2-year period were likely to have fewer depressive symptoms in 2020. Especially, changes in the oral pain and discomfort dimension score was associated with depressive symptoms. A decline in oral physical function, such as difficulty in chewing and speaking, was also associated with depressive symptoms. Conclusion: Negative change in OHRQoL is a risk factor for depression in elderly. This results suggest the importance of maintaining good oral health in later life, as a protective factor against depression.

Effect of a Single Multi-Vitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018-2020.

Inadequate nutritional intake is common, especially among elderly individuals. Although micronutrient intake may help fill nutritional gaps, the effects of multi-vitamin and mineral supplements (MVMS) among the Korean elderly are not well known. Therefore, we investigated the nutrition-improving effects of a single MVMS. A total of 2478 people aged ≥65 years who participated in the Korea National Health and Nutrition Survey 2018-2020 were analyzed. Nutrient intake from food and supplements was measured using the 24 h recall method. We compared the nutritional intake and insufficiency between the food-only group (n = 2170) and the food and MVMS group (n = 308). We also evaluated the differences in inadequate nutritional intake after taking MVMS with food. The analysis included vitamins A and C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus. The proportion of insufficient intake ranged from 6.2% to 80.5% for men and from 21.2% to 82.4% for women, depending on the nutrients. Intake of MVMS with food was associated with lower rates of inadequacy (3.8-68.5% for men and 3.3-75.5% for women) compared to the food-only group. The results suggest that micronutrient deficiency frequently occurs in the Korean elderly population and can be improved by MVMS intake.

Evaluation of outcomes with permanent vascular access in an elderly Korean population based on the National Health Insurance Service database.

As nearly half of patients with end-stage kidney disease (ESKD) who initiate hemodialysis (HD) are over 65 years old (commonly defined as elderly), the fistula first strategy is controversial even in HD patients ≥65 years. In Korea's National Health Insurance Service database from 2008 to 2019, 41,989 elderly (≥ 65 years) HD patients were retrospectively reviewed to identify their clinical characteristics and outcomes. Vascular access (VA) patencies, risk factors associated with patencies and patient survival between arteriovenous fistula (AVF) and arteriovenous graft (AVG) were compared. Elderly AVF group (n=28,467) had superior primary, primary assisted, and secondary patencies than elderly AVG group (n=13,522) (all p values are <0.001). Patient survival was also better in the elderly AVF group than in the elderly AVG (p < 0.001). In multivariate Cox regression analyses for diverse outcomes, AVG (vs. AVF) was identified as a risk factor for all-cause mortality (adjusted hazard ratio [HR]: 1.307; 95% confidence interval [CI]: 1.272-1.343; p < 0.001), primary patency (adjusted HR: 1.745; 95% CI: 1.701-1.790; p < 0.001), primary-assisted patency (adjusted HR: 2.163; 95% CI: 2.095-2.233; p < 0.001), and secondary patency (adjusted HR: 3.718; 95% CI: 3.533-3.913; p < 0.001). Our study demonstrated that as a permanent VA for HD, AVF should be strongly considered in elderly (≥ 65 years) ESKD Korean patients. The age limit for AVF creation in ESKD patients should be adjusted more upward.

The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018.

Cataracts and major depressive disorder (MDD) both have high prevalence, representing for major health burdens globally. In this study, we examined the risk of MDD due to cataracts. Data from the 2016 to 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were used, including 4122 participants. Logistic regression analysis was performed to evaluate the odds ratio for MDD in association with cataracts. Controlled variables were age, gender, smoking, dyslipidemia and mobility. Subgroup analysis was performed with stratification by gender. The results reveal that cataracts are significantly correlated with MDD. Elderly people with cataracts were found to be more likely to develop MDD compared to those without cataracts (adjusted odds ratio: 1.654; 95% CI = 1.197-2.286). In subgroup analysis, men (adjusted odds ratio: 2.631; 95% CI = 1.247-5.551) were found to be more likely to develop MDD than women (adjusted odds ratio: 1.510; 95% CI = 1.061-2.150). Cataracts may be a risk factor for MDD in the elderly, especially among the male population.

Gender-Specific Prevalence and Risk Factors of Sarcopenic Obesity in the Korean Elderly Population: A Nationwide Cross-Sectional Study.

Sarcopenic obesity (SO) is characterized by the combination of sarcopenia and obesity. This study evaluates the gender-specific prevalence of SO and examines the identified gender-specific risk factors in a community-dwelling elderly population aged 75-84 years. A total of 813 subjects participated in the study via the Korea National Health and Nutrition Examination Survey. The SO prevalence in males and females was 15.46% (95%CI: 11.36-20.70) and 13.59% (95%CI: 10.59-17.28), respectively. The clinical sex-specific risk factors for males were low height, high weight, body mass index, waist circumference, skeletal muscle index, fasting glucose, and triglycerides. The clinical risk factors for females were low height, high weight, body mass index, waist circumference, skeletal muscle index, smoking status, fasting glucose, total cholesterol, and systolic blood pressure. These results are essential to assist healthcare professionals and primary care clinicians with early detection, diagnosis, and intervention for potential SO patients by acknowledging the sex-based prevalence and risk factors.

Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study.

Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status. We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome. Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia. A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.

Effectiveness of Heterologous COVID-19 Vaccine Booster in Korean Elderly Population, 2022.

We conducted a cohort study to assess vaccine effectiveness (VE) of coronavirus disease 2019 vaccine combinations on severe acute respiratory syndrome coronavirus 2 critical infection and death among elderly population in Korea. From January to August 2022, VE against death for 4 doses mRNA recipients was 96.1%, whereas 1-dose viral vector + 3-dose mRNA recipients had VE of 90.8%.

S-47-5: CURRENT STATUS OF HYPERTENSION IN KOREA: A NATIONWIDE POPULATION-BASED STUDY

The Korean Society of Hypertension (KSH)- Hypertension Epidemiology Research Working Group has analyzed national big data to provide an overview of the magnitude and management status of hypertension and their recent trends. The analyses included data for Korean adults aged 20 years or older of the 1998–2020 Korea National Health and Nutrition Examination Survey and the 2002–2020 National Health Insurance Big Data. As of year 2020, the population average of systolic/diastolic blood pressure was 118/76 mmHg in Korean adults aged 20 years or older showing little change in the recent decade. It is estimated that 29% of the adult population aged 20 or older (34% of adults aged 30 or older) have hypertension. The estimated number of people with hypertension was 7.2 million for men and 5.5 million for women. Among them, 2.0 million men and 3.0 million women are aged 65 or older. The number of people diagnosed with hypertension increased from 3.0 million in 2002 to 10.5 million in 2020. During the same period, the number of people using antihypertensive medication increased from 2.5 million to 9.9 million, and the number of people adherent to treatment increased from 0.6 million to 7.4 million. Among antihypertensive prescriptions, 40% of the patients received monotherapy, 44% received dual therapy, and 16% received triple or more therapy. The most commonly prescribed antihypertensive medication was angiotensin receptor blockers (ARB), followed by calcium channel blockers (CCB) and diuretics. Among the adult Korean population aged 20–64, there are 5.9 million controlled hypertension, 3.9 million treated-but-uncontrolled hypertension, 3.2 million diagnosed-but-untreated hypertension, and 1.5 million undiagnosed hypertension. Among the Korean elderly population aged 65 or older, there are 3.6 million have controlled hypertension, 1.5 million treated-but-uncontrolled hypertension, 0.8 million diagnosed-but-untreated hypertension, and 0.4 million undiagnosed hypertension.

Population pharmacokinetic and pharmacodynamic model of propofol externally validated in Korean elderly subjects.

The Eleveld propofol pharmacokinetic (PK) model, which was developed based on a broad range of populations, showed greater bias (- 27%) in elderly subjects in a previous validation study conducted by Vellinga and colleagues. We aimed to develop and externally validate a new PK-pharmacodynamic (PK-PD) model of propofol for elderly subjects. A population PK-PD model was constructed using propofol plasma concentrations and bispectral index (BIS) values that were obtained from 31 subjects aged 65years older in previously published phase I studies. The predictive performance of the newly-developed PK-PD model (Choi model) was assessed in a separate Korean elderly population and compared with that of the Eleveld model. A three-compartment mammillary model using an allometric expression and a sigmoid Emax model well-described the time courses of propofol concentrations and BIS values. The V1, V2, V3, Cl, Q1, Q2, E0, Emax, Ce50, γ, and ke0 of a 60-kg subject were 8.36, 58.0, 650 L, 1.26, 0.917, 0.669 L/min, 92.1, 18.7, 2.21μg/mL, 2.89, and 0.138 /min, respectively. In the Choi model and Eleveld model, pooled biases (95% CI) of the propofol concentration were 7.78 (3.09-12.49) and 16.70 (9.46-23.93) and pooled inaccuracies were 22.84 (18.87-26.81) and 24.85 (18.07-31.63), respectively. The Choi PK model was less biased than the Eleveld PK model in Korean elderly subjects (age range: 65.0-79.0yr; weight range: 45.0-75.3kg). Our results suggest that the Choi PK model, particularly, is applicable to target-controlled infusion in non-obese Korean elderly subjects.

How Much Does Plant Food (Fruits and Vegetables) Intake Affect the Prevention of Periodontal Disease in the Korean Elderly?

This study, as part of a study on the dietary lives of elderly people, investigates the association between plant food (fruit + non-starchy vegetable) intake and the prevention of periodontal disease among elderly people aged over 65 years. A total of 4514 subjects over 65 years of age participated in a dental survey, health behavior interview, and 24 h dietary recall test for the Korea National Health and Nutrition Examination Survey (KNHANES). Subjects with energy intake of less than 500 kcal or more than 5000 kcal were excluded. The results showed that plant food intake was inversely associated with the prevalence of periodontal disease in the elderly Korean population. The prevalence of periodontal disease decreased with increasing plant food consumption. Compared with those in tertile 1 (T1), subjects in tertile 3 (T3) showed a decrease in periodontal disease of about 26.7% (OR = 0.733). In conclusion, the consumption of plant food lowers the risk of periodontal disease, suggesting that it should be encouraged among elderly Koreans.

Association between Stroke and Abdominal Obesity in the Middle-Aged and Elderly Korean Population: KNHANES Data from 2011-2019.

Obesity and overweight status are primary risk factors for stroke. A relative small number of studies has analyzed the association of abdominal obesity, a crucial indicator for insulin resistance with stroke, compared to general obesity. We aimed to reveal 31,490 records from the Korea National Health and Nutrition Examination Survey (KNHANES). Logistic regression was used to identify the association of abdominal obesity with the risk of stroke. For the multivariate model, covariates were determined based on the cardio-cerebro vascular prediction models. In the sex-specific multivariate logistic regression analysis (including age, antihypertensive drug, diabetes, current smoking, and systolic blood pressure as confounders), the elevated waist circumference (WC) in women was significantly associated with the increased risk for stroke. In case of the categorized form of WC, we discerned the non-linear relationships between WC and the stroke status. The sex-specific associations between the abdominal obesity and stroke status were shown and their relationship pattern exhibited non-linear relationships.

Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors.

With the aging society, musculoskeletal degenerative diseases are becoming a burden on society, and rotator cuff disease is one of these degenerative diseases. The purpose of this study was to examine the incidence of shoulder osteoarthritis and the etiologic factors of rotator cuff disease in the Korean elderly population. A total of 102 patients performing ultrasonography were recruited, and their demographic factors were analyzed. As functional factors, visual analog scale and the peak torque of external and internal rotators of the shoulder using an isokinetic dynamometer were measured. As an anatomical factor, the acromiohumeral distance in the plain radiograph of the glenohumeral anterior-posterior view was used. There were more female patients (65.7%) than male patients (34.3%). The age range with the highest number of respondents was 50–59 years old. The mean visual analogue score was 4.09 (Min 1 to Max 9). Age and dominant hand side factors appear to be the crucial etiologic factors of the presence and severity of rotator cuff disease. The lower net value of the external rotator strength is weakly related to the presence of rotator cuff disease after adjusting for age, and this is the only modifiable factor in the study.