Korean Elderly Research Articles

Association of Dietary Quality with Subjective Health-Related Perception and Chronic Diseases According to Age Segmentation of Korean Elderly

Association of Dietary Quality with Subjective Health-Related Perception and Chronic Diseases According to Age Segmentation of Korean Elderly

The Mediating Effect of Stress on Relationship between Oral Health Behaviors and Health-related Quality of Life in the Korean Elderly

The Mediating Effect of Stress on Relationship between Oral Health Behaviors and Health-related Quality of Life in the Korean Elderly

The Relationship between Physical Activity and Quality of life in Korean Elderly Male with Osteopenia and Osteoporosis

The Relationship between Physical Activity and Quality of life in Korean Elderly Male with Osteopenia and Osteoporosis

Dairy Consumption and Risk of Metabolic Syndrome in Korean Adults and Elderly People.

Background: To investigate the association of dairy consumption with metabolic syndrome (MetS) in a representative sample of Korean adult and elderly population. Methods: We used data from the Korea National Health and Nutrition Examination Survey, 2013-2018. A total of 18,206 adults (19-64 years) and 5113 elderly people (≥65 years) were included in the analysis. Dairy product consumption was assessed with a 24-hr dietary recall, and the subjects were divided into three groups based on their total dairy consumption (0, <1, ≥1 serving/day). The primary outcome, MetS, was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Korean Society for the Study of Obesity. Results: After adjusting for covariates, high dairy consumption was associated with 12% lower odds of MetS in adults compared with no dairy consumption [odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78-0.998, P for trend = 0.048]. A similar inverse association was found in adult men (OR 0.84, 95% CI 0.71-0.99), but no significant association was found in adult women (OR 0.93, 95% CI 0.78-1.11). For the elderly, high dairy consumption was associated with 20% lower odds of MetS (OR 0.80, 95% CI 0.65-0.98, P for trend = 0.020); a significant inverse association was shown in elderly women (OR 0.72, 95% CI 0.56-0.94) but not in elderly men (OR 0.93, 95% CI 0.68-1.28). Conclusion: Our findings suggest that one or more servings/day of dairy products were associated with lower prevalence of MetS in Korean adult men and elderly women.

Television Viewing and Cognitive Dysfunction of Korean Older Adults.

This study examined the association between television (TV) viewing and cognitive dysfunction in elderly Koreans. Among participants of the 2014 National Survey of Older Koreans, 9644 were considered in this study. To better identify the association between two factors, propensity score (PS) matching with exact method was used. Finally, 168 viewers and non-viewers each were selected based on estimated PS on key variables and eliminating double matches. Multivariate logistic regression analysis was performed when controlling for possible covariates. Viewers were more likely to have cognitive dysfunction than non-viewers, with significant differences in most covariates. After correcting confounding effects of these covariates with PS matching, TV viewing was found to be a significant risk factor of cognitive dysfunction, along with absence of diagnosed hypertension and non-participation in physical leisure activities. TV viewing might be associated with increased risk of cognitive dysfunction in later life. Appropriate education and strategies to minimize TV viewing among older adults should be established to contribute to attenuating cognitive aging. More interventional studies can help older adults, caregivers, and healthcare professionals explore the cognitively beneficial alternatives to TV use considering the impact of socioeconomic factors of selecting TV viewing as a preferred leisure activity.

A multicenter, randomized controlled feasibility trial for the programs of the SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at‐risk elderly people (SUPERBRAIN)

AbstractBackgroundMultidomain interventions can be useful for the prevention of dementia. We have developed the programs of SoUth Korea study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at‐risk elderly people (SUPERBRAIN), which consists of a facility‐based (FMI) and a home‐based multidomain intervention (HMI) program suitable for elderly Koreans. This study aims to investigate the feasibility of the SUPERBRAIN programs before a large‐scale randomized controlled trial (RCT).MethodWe recruited 152 participants from eight centers, among those without dementia aged 60‐79 years with at least one modifiable dementia risk factor. They were randomly assigned: 51 to the FMI arm, 51 to the HMI arm, and 50 to the control arm. The 6‐month multidomain intervention consisted of: management of metabolic and vascular risk factors, cognitive training and social activity, physical exercise, nutritional guidance, and motivational enhancement programs. The intervention program is determined feasible if the following success criteria are met: 1) a minimum retention rate of 75% at week 24; 2) a minimum adherence to the intervention program of 75%; and 3) at least no difference from the control arm in the change of the total scale index score of the Repeatable Battery for the Assessment of Neuropsychological Status from baseline to study end. Main secondary outcomes are disability, depressive symptoms, quality of life, vascular risk factors, physical performance, nutritional assessment, and motivation questionnaire.ResultScreening began in May 2019 and was completed in August 2019. The intervention is ongoing as planned. There were no significant differences in the bassline age (71.7 ± 4.8 vs. 70.9 ± 4.9 vs. 70.7 ± 4.8 years, p = 0.57) and level of education (10.2 ± 4.8 vs. 9.9 ± 5.2 vs. 10.5 ± 4.8 years, p = 0.82) among the FMI, HMI, and control arms. The proportion of women did not differ in FMI, HMI and control arms (72.5% vs. 72.5% vs.78.0%, p = 0.77). The study will be completed in March 2020.ConclusionThis study will inform the applicability of these multidomain intervention programs in at‐risk elderly people and contribute to the success of a subsequent RCT.

Relationship between serum triglyceride to high-density lipoprotein cholesterol ratio and sarcopenia occurrence rate in community-dwelling Chinese adults

BackgroundA study conducted on elderly Korean men showed that a high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio was associated with a high risk of developing sarcopenia. We aimed to determine such an association in community-dwelling Chinese adults.MethodsFrom May 2016 to August 2017, we conducted a cross-sectional study on Chinese adults at the First Affiliated Hospital of Wenzhou Medical University. Univariate and multivariate logistic regression analyses were applied to evaluate a possible relationship between TG/HDL-C ratio and sarcopenia occurrence.ResultsWe included 2613 adults in this study, with 13.85% presenting with sarcopenia. The odds ratios (ORs) for TG and HDL-C were 0.67 (95% confidence interval [CI]: 0.51–0.87), and 1.97 (95% CI: 1.49–2.61), respectively. Moreover, TG/HDL-C ratio was independently associated with sarcopenia status (OR: 0.63; 95% CI: 0.49–0.81).ConclusionsWe found that TG and HDL-C were, respectively, negatively and positively associated with sarcopenia occurrence rate in community-dwelling Chinese adults. However, a negative association was found between sarcopenia occurrence rate and TG/HDL-C ratio.

Association of limb length with cognitive decline in elderly

AbstractBackgroundThere are not many studies about the risk factors of dementia in Korea. Early life nutrition is very important for the body size of grown‐ups. This study investigated the associations of arm and leg length with cognitive decline in a community sample of elderly Korean.Method382 community residents aged 65 or over were clinically assessed for cognitive impairment. Arm length and leg length were measured. Neuropsychological tests, including Korean version of Mini‐mental state examination, Clinical Dementia Rating, and Geriatric Depression Scale were performed for all the participants.ResultBoth arm length and leg length were not associated with decreased cognitive function by correlation analysis. Correlation analysis with adjustment of age and education also did not show any significant correlation.ConclusionWe could not find any correlation between limb length and cognition in an elderly Korean community.

Higher Resting Heart Rate and Lower Relative Grip Strength is Associated with Increased Risk of Diabetes in Korean Elderly Population: Korean National Health and Nutrition Examination Survey 2015-2018

PURPOSE:The purpose of this study was to examine the association of resting heart rate (RHR) and relative hand grip strength (RHGS) with diabetes among Korean adult over 65 years old.METHODS: Cross-sectional analyses were performed using the 2015-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Among 31,649, a total of 4,814 adults over 65 years old were included in this study. Participants were divided into tertile according to their RHR and RHGS. Statistical methods included frequency analysis, ANCOVA (Analysis of covariance) and logistic regression.RESULTS: Participants in the 3rd tertile of RHR (RHR over 73 bpm in men, 74 bpm in women) had 2.00 times [95% Confidence Interval (CI): 1.58-2.54] and 1.80 times (95% CI: 1.44-2.26) higher odds of having diabetes in men and women, respectively, compared with participants in the 1st tertile (RHR below 64 bpm in male, 65 bpm in female). Participants in the 1st tertile of RHGS (RHGS below 0.46 in men, 0.31 in women) had 2.51 times (95% CI: 1.76-3.58) and 1.86 times (95% CI: 1.48-2.35) higher odds of having diabetes in men and women, respectively, compared to participants with 3rd tertile (RHGS over 0.54 in men, 0.38 in women). When a joint association of RHR and RHGS with risks of diabetes were analyzed, participants with the highest RHR and the lowest RHGS had 4.23 times (95% CI: 2.74-6.54) and 2.90 times (95% CI: 1.98-4.23) higher odds of having diabetes compared to participants with the lowest RHR and the highest RHGS in men and women, respectively.CONCLUSIONS: The current study showed that higher RHR and lower RHGS were associated with increased risk of diabetes in Korean elderly population.

Information and Communication Technology Use, Social Support, and Life Satisfaction among Korean Immigrant Elders

This study recruited 150 community dwelling Korean immigrant elders to understand the role of information and communication technology (ICT) use on social support and life satisfaction by utilizing purposive sampling methods. Hierarchical multiple regression results indicated that a high level of smartphone use was significantly related to a high level of social support from families. High levels of smartphone use and social media use were significantly related to a high level of social support from friends. In addition, a high level of social media use was significantly related to a high level of life satisfaction among Korean immigrant elders. The findings of this study may provide insights for social service practitioners working with Korean immigrant elders to develop culturally appropriate services by using ICTs for improving social support systems and quality of life among the population. Future research with a longitudinal and experimental design can be conducted to better understand the long-term patterns of findings and causal relationships.

Trends and Dietary Assessment According to Fruit and Vegetable Intake in Korean Elderly People: Analysis Based on the Korea National Health and Nutrition Examination Survey 1998, 2008, and 2018.

The study aimed to examine the 20-year trends in fruit and non-starch/unsalted vegetable intake among the Korean elderly aged 65 years or older based on the Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3722 elderly citizens aged 65 years or older who participated in the dietary survey (24-h recall of dietary intake) of the 1998, 2008, and 2018 NHANES were selected as the subjects of this study. Fruit and non-starchy/unsalted vegetable intake increased by approximately 86.53 g over the past 20 years, from 268.27 g in 1998 to 355.8 g in 2018. In particular, 65–74-year-olds had an increased intake by approximately 130.38 g over the past 20 years, from 277.34 g in 1998 to 407.72 g in 2018. In addition, snacks intake significantly increased over the past 20 years (p for trend < 0.001). Intake according to daily meal cooking location increased by approximately 130 g over the past 20 years, from 64.50 g in 1998 to 123.39 g in 2008, and to 198.01 g in 2018. The annual proportion of the total elderly population who meet the amount of vegetable food intake recommended by the World Health Organization (WHO)/World Cancer Research Fund (WCRF) (400 g or more fruits and non-starchy vegetables) increased by approximately 11.28%p (percentage points) over the past 20 years, from 21.78% in 1998 to 24.63% in 2008, and to 33.06% in 2018. The results of this study suggest that more fundamental measures are required to increase the fruit and non-starchy vegetable intake among the elderly. Furthermore, it is thought that the results of this study can be used as basic data in establishing dietary policy. In addition, it is thought that it can be used in developing nutrition education and dietary guidelines for enhancing fruit and vegetable intake.

The Association between Major Dietary Pattern and Low Muscle Mass in Korean Middle-Aged and Elderly Populations: Based on the Korea National Health and Nutrition Examination Survey.

Reduced skeletal muscle mass in older populations is independently associated with functional impairment and disability, resulting in increased risk of mortality and various comorbidities. This study aimed to examine the association between major dietary pattern and low muscle mass among Korean middle-aged and elderly populations. A total of 8136 participants aged ≥50 years were included from a cross-sectional study based on the 2008–2011 Korea National Health and Nutrition Examination Survey. The following four distinct dietary patterns were derived using factor analysis: “Condiment, vegetables, and meats”; “wheat flour, bread, fruits, milk, and dairy products”; “white rice, fish, and seaweeds”; and “whole grain, bean products, and kimchi”. A higher “white rice, fish, and seaweeds” pattern score was associated with a lower prevalence of low muscle mass in both men and women, whereas a higher “condiment, vegetables, and meats” pattern score was associated with a higher prevalence of low muscle mass in men. A dietary pattern based on white rice, fish, and seaweeds can be helpful in protecting against loss of skeletal muscle mass in Korean middle-aged and elderly populations. Future research is paramount to confirm the causal association between dietary pattern and the risk of low muscle mass.

Dietary Assessment and Factors According to Fruits and Vegetables Intake in Korean Elderly People: Analysis of Data from the Korea National Health and Nutrition Examination Survey, 2013-2018.

This study analyzed dietary assessment and factors according to fruits and vegetables intake in Korean elderly people. We enrolled 8336 Korean elderly people aged ≥65 who participated in the dietary intake survey (24-h recall methods) of the 2013–2018 Korea National Health and Nutrition Examination (KNHANES). The intake of fruits and unsalted/non-starchy vegetables was 372.06 g/day. According to age group, the intake in the age group 65–74 years as 422.47 g/day, and the intake in the age group 75 years + was 301.12 g/day. Based on the intake of daily meals and snacks, the intake of fruits and unsalted/non-starchy vegetables was the highest in snack-eating individuals (480.96 g/day). The subjects who consumed more than the World Health Organization (WHO)/World Cancer Research Fund (WCRF)’s plant food intake standards (over 400 g/day of intake of fruits and unsalted/non-starchy vegetables) were 35.47% of the elderly people. These results suggest that it is necessary to develop more fundamental strategies to increase fruits and vegetables intake among elderly people. Furthermore, the study outcomes are expected to provide basic information for developing education programs to improve the dietary life of Korean elderly people.

Who Benefits from the Fixed Copayment of Medical and Pharmaceutical Expenditure among the Korean Elderly?

The Korean National Health Insurance system imposes a 30% coinsurance for outpatient medical care and prescription drugs; however, at the age of 65, the coinsurance model changes to a copayment model that offers lower fees for the elderly. Thus, this study aimed to investigate the influence of the copayment model for outpatient visits and prescription drugs on healthcare utilization among the Korean elderly. We compared total outpatient visits, total prescriptions, and out-of-pocket expenses between a case group with copayment reduction (65 years or older) and a control group without any reduction (64 years or younger). We obtained secondary data collected from seven waves of the Korea Health Panel Survey (2010–2016). Outpatient visits increased exclusively in the case group among those with lower income. After adjusting for covariates, the results of the difference-in-differences analysis showed that, compared to the control group, there was a significant increase in outpatient visits among individuals with lower income in the case group. Our study shows that cost sharing changes affect Korean patients with different income levels in different ways.

Association of Receptor for Advanced Glycation End Product (RAGE) Gene Polymorphisms and Serum Levels of Soluble RAGE (sRAGE) with Metabolic Syndrome (MS) in Mexican Population

The evidence of effectiveness and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) among elderly East Asians is limited.We aimed to describe the effectiveness and safety outcomes associated with NOACs and warfarin among elderly Koreans aged ≥80 years.Using the Korean Health Insurance Review and Assessment service database, patients with atrial fibrillation (AF) who were naïve to index oral anticoagulant between 2015 and 2017 were included in this study (20,573 for NOACs and 4086 for warfarin). Two treatment groups were balanced using the inverse probability of treatment weighting (IPTW) method. The clinical outcomes including ischemic stroke, major bleeding including intracranial hemorrhage (ICH) and gastrointestinal bleeding (GIB), and a composite of these outcomes were evaluated.Compared to warfarin, NOACs were associated with lower risks of ischemic stroke (hazard ratio 0.74 [95% confidence interval 0.62–0.89]), and composite outcome (0.78 [0.69–0.90]). NOACs showed nonsignificant trends towards to lower risks of GIB and major bleeding than warfarin. The risk of ICH of NOAC group was comparable with the warfarin group. Among NOACs, apixaban and edoxaban showed better composite outcomes than warfarin. Among the clinical outcomes, only ischemic stroke and the composite outcome had a significant interaction with age subgroups (80–89 years and ≥90 years, P-for-interaction = .097 and .040, respectively).NOACs were associated with lower risks of ischemic stroke and the composite outcome (ischemic stroke and major bleeding) compared to warfarin in elderly East Asians. Physicians should be more confident in prescribing NOACs to elderly East Asians with AF.

Effect of Obesity on Patients Admitted for Supraventricular Tachycardia. An Analysis of the Nationwide Inpatient Sample

The evidence of effectiveness and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) among elderly East Asians is limited.We aimed to describe the effectiveness and safety outcomes associated with NOACs and warfarin among elderly Koreans aged ≥80 years.Using the Korean Health Insurance Review and Assessment service database, patients with atrial fibrillation (AF) who were naïve to index oral anticoagulant between 2015 and 2017 were included in this study (20,573 for NOACs and 4086 for warfarin). Two treatment groups were balanced using the inverse probability of treatment weighting (IPTW) method. The clinical outcomes including ischemic stroke, major bleeding including intracranial hemorrhage (ICH) and gastrointestinal bleeding (GIB), and a composite of these outcomes were evaluated.Compared to warfarin, NOACs were associated with lower risks of ischemic stroke (hazard ratio 0.74 [95% confidence interval 0.62–0.89]), and composite outcome (0.78 [0.69–0.90]). NOACs showed nonsignificant trends towards to lower risks of GIB and major bleeding than warfarin. The risk of ICH of NOAC group was comparable with the warfarin group. Among NOACs, apixaban and edoxaban showed better composite outcomes than warfarin. Among the clinical outcomes, only ischemic stroke and the composite outcome had a significant interaction with age subgroups (80–89 years and ≥90 years, P-for-interaction = .097 and .040, respectively).NOACs were associated with lower risks of ischemic stroke and the composite outcome (ischemic stroke and major bleeding) compared to warfarin in elderly East Asians. Physicians should be more confident in prescribing NOACs to elderly East Asians with AF.

한국 노년층의 씹기 및 말하기 문제, 삶의 질과 우울 실태 조사: 국민건강영양조사 2016 ~ 2018년 자료

한국 노년층의 씹기 및 말하기 문제, 삶의 질과 우울 실태 조사: 국민건강영양조사 2016 ~ 2018년 자료

Physical Activity Amount and Cognitive Impairment in Korean Elderly Population.

The relationship between physical activity amount and cognitive function in elderly Koreans has received little attention. This study therefore aimed to understand the independent and common link between cognitive function and physical activity levels among elderly Korean adults. This study recruited a total of 2746 elderly adults (1348 males and 1398 females). All participants were assessed for cognitive functioning using the Korean Dementia Screening Questionnaire Cognition (KDSQ-C). The computerized Korean version short form of the International Physical Activity Questionnaire (IPAQ) used in this study was entirely based on the long, self-administered, usual week-long IPAQ found in the IPAQ manual of operation. In the unadjusted model, elderly adults who met the recommended level of moderate-to-vigorous physical activity were more likely to have a sufficient level of cognitive function. Hemoglobin, creatinine, cholesterol (TC), triglycerides (TG), LDL-C, and HDL-C differed significantly between groups. A negative correlation was found between KDSQ-C score and the moderate-to-vigorous physical activity (MVPA) amount per week. Physical activity amount is associated with cognition function in Korean elderly adults. Increasing physical activity may improve hemoglobin and creatinine and be involved in improving serum lipid profiles in elderly adults. Thus, physical activity has been suggesting as a useful tool to reduce the risk of cognitive function associated with aging.

노인의 성공적 노화에 대한 영향요인: 자녀의 지지를 중심으로

본 연구는 우리나라 노인의 성공적 노화 인식에 대한 영향 요인을 파악하여 현재와 미래 노인의 성공적 노화를 위한 사회정책적 함의를 도출하고자 하는 목적으로 이루어졌다. 연구의 분석을 위해 국민노후보장패널의 제4차 부가조사(2012년 조사) 자료의 1,590명의 자료를 이용하였고 분석방법으로 회귀분석을 사용하였다. 분석결과 노인들의 성공적 노화에 대한 인식에 영향을 미치는 변인들은 나이, 학력, 배우자 유무, 건강상태, 경제활동, 자녀의 경제적 지지와 정서적 지지로 나타났다. 즉, 연령이 많을수록 성공적 노화 정도가 낮았으며, 교육수준이 높고, 배우자가 있는 경우, 경제적 사회참여를 하는 경우, 경제수준이 안정적이고 건강상태가 좋은 경우, 자녀가 경제적으로 정서적으로 지지하는 경우에 성공적 노화 정도가 높게 나타났다. 향후 영향 변수들을 고려하여 노인의 성공적 노화를 유도하고 증진할 수 있도록 하는 건강중재프로그램 개발에 기여할 수 있다는 점이 본 연구의 의의라고 생각한다.

The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study.

Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs. In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance. Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002). Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.