Korean Survey Research Articles

SOCIOECONOMIC INEQUALITIES IN HEALTHY AGING OF OLDER KOREAN ADULTS: AN AGE-PERIOD-COHORT ANALYSIS

Abstract As South Korea’s healthy life expectancy continues to increase, reaching 73 years in 2021 and ranking third in the world, there is growing interest in assessing functional ability as well as its disparity across various older population segments. The study aimed to investigate healthy aging trends by socioeconomic status in the recent decade among Koreans aged 65 years or older and to analyze the age, period, and cohort effects. Data were from the four waves, about 10,000 people in each wave, of the National Survey of Older Koreans conducted every three years from 2011 to 2020. The physiological, physical, cognitive, psychological, and social dimensions were combined to create the healthy aging index (HAI), with higher scores indicating a healthier state. Socioeconomic status included education, household income, and wealth. A multilevel analysis with a cross-classified random effects model was performed. An overall trend of healthy aging in the past decade was evident, but the gap between the highest and lowest levels of education has widened. The 1935-1944 birth cohort showed a significant decrease in HAI, suggesting a long-lasting negative effect of early life adversity in the latter years of colonial rule. There was a strong age effect, demonstrating a quadratic decline in HAI over the life course. Even though the last ten years have shown a general trend toward healthy aging, socioeconomic disparity persists. The study’s findings underscore the need for policies on healthy aging to consider the life-long vulnerability of certain aging population segments characterized by adverse early life experiences.

HOW DOES AWARENESS OF SOCIAL SERVICES PLAY A ROLE IN THE RELATIONSHIP BETWEEN RELATIONAL RESOURCES AND THE AIP?

Abstract The process of ‘Aging in Place (AIP)’ encompasses a variety of declines in physical capabilities, adaptability to environmental changes, and the breadth of interpersonal relationships. The AIP is not just about staying in the community; it also involves the availability of requisite resources to address the needs that emerge throughout the AIP journey. In this context, relational resources such as an individual’s social capital, may serve as a significant asset. Nonetheless, the availability of relational resources is not uniform among older adults, and it might be risky to solely rely on relational resources, potentially resulting in an excessive burden on the enhancement of AIP sustainability. Instead, social services can act as supportive resources. The purpose of this study is to examine the moderating role of perceived awareness of social services in the relationship between relational resources and the intention to AIP. Logistic regression was conducted using data from the 2020 National Survey of Older Koreans (n=10,097). The results show that older adults who have more relational resources are likely to have more intention to AIP and specifically, the association is stronger at a higher awareness of services. The findings show that there is a need for a range of social engagement programs to provide more opportunities to build relational resources in later life, thus increasing the likelihood of AIP. Policy efforts are also needed to increase awareness of social services among older adults and so, they can plan their AIP with the assurance of various available supports.

Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health

Purpose: As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines. Methods: The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines. Results: 1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk. Conclusion: These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

The Independent Association Between Changes in Physical Activity Participation Time and Dyslipidemia Risk

Background and AimThis study aimed to examine the independent association between changes in participation time across different types of physical activities and dyslipidemia. Methods and ResultsThe study utilized data from a large-scale cohort survey of Koreans, comprising a total of 2,543 participants recruited during 2011-2012 and 2013-2014. Physical activity participation times by type were assessed using validated questionnaires, and changes in these participation times over two years were categorized into four groups(Consistently Inactive, Formerly Active, Newly Active, and Consistently Active). Dyslipidemia was classified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multiple logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) to assess the association between changes in physical activity participation times and dyslipidemia. The analysis revealed that, when adjusting for sex and age, the Consistently Active group had a 40% lower odds ratio (OR=0.60, 95% CI=0.45, 0.81) of dyslipidemia compared to the Consistently Inactive group. Similar results were observed after adjusting for various confounding factors. Also, being newly active(OR=0.75, 95% CI=0.58, 0.97) or consistently active(OR=0.63, 95% CI=0.41, 0.97) in moderate-intensity physical activity, as well as being consistently active(OR=0.76, 95% CI=0.61, 0.95), in walking, independently reduced the risk of dyslipidemia after adjusting for various confounding variables. ConclusionsMaintaining a high level of physical activity was associated with a reduced risk of dyslipidemia. Therefore, national recommendations should focus on sustaining and increasing physical activity levels to manage dyslipidemia effectively.

Association between alcohol consumption and sleep difficulty in a nationwide Korean survey

Abstract Background: The data on the association between alcohol intake and sleep quality in a community-based setting are lacking. This study examined overall sleep difficulty according to alcohol habits among Korean adults. Materials and Methods: We analyzed data from 4937 adults who responded to questions about sleep difficulty and drinking habits from the 2019 Korea National Health and Nutrition Examination Survey. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for substantial sleep difficulty based on the frequency or amount of alcohol consumption in total and age- and sex-stratified subgroup analyses. Results: Approximately 8.5% of the study population had substantial sleep difficulty. Individuals who drank <1 per week (frequency) or 1–2 cups per time (amount) had the lowest prevalence of substantial sleep difficulty, even compared with nondrinkers. Among drinkers, the association between alcohol use and sleep difficulty was significant in a dose-dependent manner (P for trend: 0.003 in frequency and < 0.001 in amount). Subgroup analysis revealed that significant linear relationships were robust for adults aged <50 years ([ORs] 1.20 [95% CIs 1.03–1.40] for frequency and 1.25 [1.10–1.42] for amount) and females (1.26 [1.10–1.44] for amount). Conclusion: Alcohol consumption is associated with increased sleep difficulties, especially in younger adults and women, underscoring the need for targeted interventions and in-depth research on the effects of alcohol on sleep.

Factors Affecting Cognitive Decline in Rural and Urban Elderly: Utilizing Data from 2020 National Survey of Older Koreans

Factors Affecting Cognitive Decline in Rural and Urban Elderly: Utilizing Data from 2020 National Survey of Older Koreans

Subjective and objective health according to the characteristics of older adults: Using data from a national survey of older Koreans.

As society rapidly ages, older adults are becoming an important national issue. Health is a multidimensional concept and both objective and subjective health must be managed. This study investigated factors that influence the subjective and objective health of older adults. This study analyzed the data of 9391 people aged ≥65 years using raw data from a 2020 survey of senior citizens. The relationships among the characteristics of older adults, such as demographic variables, lifestyle, external activities, environment, physical function, depression, cognition, activities of daily living, satisfaction with life and health, perceived health level, and number of diseases, were investigated. Older adults who drink and do not exercise generally have good objective health but poor subjective health. Older adults who mainly engage in external activities tend to have poor subjective health despite good objective health. The factors affecting subjective health in older adults were depression, cognition, physical factors, activities of daily living, and satisfaction. This study identified the differences between subjective and objective health based on the characteristics of older adults. As many variables affecting the health of older adults have been identified, these basic data will help prepare various programs to promote a healthy life for older adults.

The association between the type of offline social participation and digital literacy among Korean older adults: a cross-sectional study

BackgroundPoor social connections are associated with poor digital literacy. Poor digital literacy could induce poor outcomes in daily life or health status, especially among older adults. This study aimed to investigate the effect of social participation based on its absolute magnitude on digital literacy and to confirm the well-known fact that social participations are good for digital literacy is applicable regardless of activity types in a sample of older Korean adults.MethodsA total of 9,297 adults aged 65 years or older from the 2020 National Survey of Older Koreans were analyzed. All data were self-reported. Poor digital literacy was defined by limited usage of digital devices. Offline social participation was evaluated using seven different social activities: senior community activities, learning activities, religious activities, volunteer work, leisure, political groups, and club activities. Multivariable logistic regression analysis with covariate adjustment was used for the analysis.ResultsEngaging in more than two types of social participation was associated with higher digital literacy: adjusted odds ratio (aOR) 1.965, 95% confidence interval (CI) 1.567–2.465 for two types of participation, and aOR 2.558, 95% CI 2.040–3.208 for more than three types of participation. Additionally, social participation occurring less than once a month and most types of offline activities were associated with improved digital literacy. However, senior community activities were negatively associated with digital literacy (aOR 0.762; 95% CI 0.681–0.852).ConclusionsIn this sample of older Korean adults, it was found that the lower the social participation, the poorer the digital literacy. This association may induce the isolation of older adults from societies especially for older adults with senior community activities.

Exploring servicescape in coastal and marine tourism: insights from text mining and application of Kano model

ABSTRACT Employing text mining and the Kano model, this study aimed to delineate and categorize the components of the coastal and marine tourism servicescape. The research utilized text mining technology to analyze 132,545 Korean language text entries from the Naver platform, identifying 80 key terms associated with the coastal and marine tourism servicescape. A network of these terms was then constructed, segmented into three clusters reflecting the servicescape dimensions: “ambient conditions”, “spatial layout and functionality”, and “signs, symbols, and artifacts”. These clusters were further distilled into 18 elements, establishing a comprehensive framework for analysis. Subsequently, the study utilized the Kano model to analyze 823 South Korean survey responses, categorizing the elements into four qualities: attractive, one-dimensional, must-be, and indifferent. The findings provided a nuanced understanding of the servicescape in coastal and marine tourism, offering theoretical contributions and practical implications for tourism management and policymaking.

The Impact of Cognitive Impairment on Life Satisfaction in Older Adults: Examining the Double Mediating Roles of Neighborhood Satisfaction and Social Participation

ABSTRACT The environment plays an integral role in the lives of individuals with cognitive decline. This study analyzed data from the National Survey of Older Koreans (2020) (9,885 older Koreans). The results showed that cognitively impaired group had lower community environment satisfaction than the cognitively healthy group, which led to lower social participation and lower life satisfaction, and the double mediation effect was significant (B = −.001, p < .001). However, there was no direct effect of cognitive status on life satisfaction (B = .004, p = .759). The findings highlight the imperative for the development of neighborhood environments that foster social engagement among older adults experiencing cognitive decline.

Enhancing or Compensating? Role of On- and Offline Social Capital and Technological Self-Efficacy on Subjective Well-Being among Immigrants and Natives.

The ability and self-efficacy to utilize the internet and technological devices has become critical during the COVID-19 pandemic. By examining the role of on- and offline social capital as a moderator in the relationship between technological self-efficacy (TSE) and subjective well-being, this study aims to contribute to the understanding of whether the social compensation or social enhancement hypotheses explain the well-being of immigrants in South Korea during the COVID-19 pandemic. We analyzed data from the 2020 Digital Divide Survey of immigrants (n = 700) and native-born Koreans (n = 6,910) aged ≥18 years. In the ordinary least squares regression model, subjective well-being (SWB) was the dependent variable and TSE was the independent variable. Online social capital, including bonding and bridging, was the moderating variable. Moreover, we tested the moderated moderation of nativity and on- and offline social capital. The results showed that bonding and bridging on- and offline social capital played a positive role in the SWB of both immigrants and native-born Koreans; bridging played a greater role among immigrants than among native-born Koreans. Furthermore, the interaction between TSE and online bonding social capital has a stronger association with the SWB of immigrants, as supported by the moderated moderation model. In line with the social enhancement hypothesis, immigrants with more online bonding social capital showed a stronger positive association between TSE and subjective well-being. Our results suggest that culturally adapted technological education for immigrants can be tailored to meet their unique needs and experiences.

No association between allergy history and adult height: a nationwide Korean survey

No association between allergy history and adult height: a nationwide Korean survey

Predictors of life satisfaction among older men living alone: Analysis of the 2020 National Survey of Older Koreans: A cross-sectional study

Predictors of life satisfaction among older men living alone: Analysis of the 2020 National Survey of Older Koreans: A cross-sectional study

Body Mass Index as a Determinant of Lower Limb Function and Community Well-Being in Older Adults: Analysis of 2020 National Older Korean Survey Data.

This epidemiological research investigated the relationship between body mass index (BMI) and lower limb function and community well-being among the older population (≥65 years old) in South Korea. Using the 2020 National Survey of Older Koreans (N = 10 097; Mage = 73.6 ± 6.63; MBMI = 23.6 ± 2.61), the study identified underweight (2.3%), normal (72.8%), and obese (24.9%) groups. Findings revealed significant associations between BMI and lower limb function, with underweight individuals facing greater physical challenges (P < .05-.01). Underweight participants were also found to live farther from key community locations, possibly reflecting social and environmental factors (P < .01) and expressed higher dissatisfaction with community environments (Ps < .05-.01). The study emphasizes the need for tailored community planning and health care strategies, focusing on the unique needs of the underweight older adults, considering South Korea's rapidly increasing older population.

Relationship between Tooth Brushing and Hand Washing by Family Type among Adolescents: A 2020 Nationally Representative Korean Survey

Habits formed during adolescence tend to persist into adulthood, and correcting poor habits or behaviors during this time is more effective than at other times. Particularly, parents and caregivers should encourage good hygiene habits in their adolescent children by setting a positive example themselves. Using logistic regression, we analyzed the association between brushing teeth after lunch and washing hands before lunch by family type among 54,848 adolescents from the 17th Youth Health Behavior Survey raw data in 2021. Four logistic regression models were used to adjust for confounders hierarchically. In all models, adolescents who practiced tooth brushing after lunch were 2.09 times more likely to practice hand washing before lunch than those who did not. With and without adjustment, we found that the association between adolescents’ tooth brushing and hand washing practices in two-parent households was stronger than the association between adolescents’ tooth brushing and hand washing practices in single-parent households. Associations were found between tooth brushing and hand washing practices, and these associations were higher among adolescents in two-parent households than among adolescents in single-parent households. The finding of a significant link between family type and personal hygiene habits indicates the need for interventions to enhance the oral health of children and adolescents. Such interventions should be customized to reflect the specific characteristics of the child’s household.

Spousal Age Difference and Mental Health by Sex: Korean Survey Results

Purpose: Problems in marital relationships due to age gap between a couple may lead to depression and other mental health issues. However, there is a lack of studies that investigated the association between age gap in couples and mental health. Therefore, this study aimed to identify the relationship between spouse age differences and mental health.Methodology: The data of 7,454 couples from the 2008 and 2012 Korean National Health and Nutrition Examination Surveys were used. Multiple logistic regression analysis was performed.Findings: Women who were ≥10 years older or younger than their husbands displayed poor mental health. Odds ratios (ORs) for women who were ≥10 years younger were 1.72, 1.77, 2.24, and 1.69 for stress perception, depression experiences, depression diagnosis, and suicidal ideation, respectively. Furthermore, in women who were older than their husbands, the ORs for cognition of stress and suicidal ideation were 1.32 and 1.41, respectively.Conclusion: These findings support the development of mental health programs and couples’ education via national promotions and projects. Managing women's mental health in couples with large age gap groups could contribute to family stability and reduce divorce rates.

The Trend of Chronic Diseases Among Older Koreans, 2004-2020: Age-Period-Cohort Analysis.

This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence. Using the 2004-2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age-period-cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects. Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time. The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities.

Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use

Objectives This study investigates the correlation between self-reported sensory impairment, cognitive function, digital technology use, and social participation among older adults in South Korea. Method Data from the 2020 National Survey of Older Koreans, comprising a nationally representative sample of 7849 individuals aged 65 years or older, were analyzed. A serial mediation analysis (Model = 6) was conducted using the PROCESS macro for SPSS. Results Following adjustment for covariates, cognitive function and digital technology use serially mediated the relationship between self-reported sensory impairment and social participation among older adults (B = −0.0020, SE = 0.0005, 95% confidence interval [CI] = [−0.0030, −0.0010]). Specifically, self-reported sensory impairment exhibited a negative correlation with cognitive function (B = −0.3277, SE = 0.0753, p < .001), which was positively associated with digital technology use (B = 0.0763, SE = 0.0056, p < .001), subsequently linking to enhanced social participation (B = 0.0784, SE = 0.0037, p < .001). Conclusion Through cross-sectional analysis, this study confirms that self-reported sensory impairment in older adults may precede cognitive decline, hindering digital technology use and reducing social participation. Early diagnosis and treatment are crucial in preventing cognitive decline, while age-friendly digital devices may alleviate cognitive burden and promote social engagement.

의사결정나무분석을 이용한 우리나라 노인의 낙상위험요인 기여도예측 모형

This study reviewed the factors affecting falls based on the results of National survey of Older Koreans in 2017(n=10,235) and2020(n=10,097) before and after COVID-19, and analyzed the structural relationships of risk factors for falls through decision tree analysis. The incidence of falls was 15.9% in 2017 and 6.4% in 2020. The decrease in reported incidents of falls during the COVID-19 pandemicis attributed to the reduced outdoor activities and restrictions on mobility, which naturally result in fewer opportunities for falls to occur. In summarizing the decision tree analysis findings from 2020 and 2017, it is evident that hospitalization, low health satisfaction, and challengesin performing independent activities of daily living are factors associated with an increased risk of falling. Additionally, depression, includingspousal factors, which may contribute to decreased physical activity, is also linked to falls. Recognizing these significant factors allowsfor the early identification of high-risk groups for falls and enables the implementation of interventions aimed at preventing falls more effectively.

Social Network Contact Frequency and Life Satisfaction of the Elderly: Focusing on the Moderating Effect of Digital Capabilities

The aims of this study were to identify (a) the social network contact frequency of the elderly with children, relatives, and friends; (b) the impact of contact frequency (face-to-face/non-face-to-face) on life satisfaction of the elderly; and (c) the moderating effect of digital capabilities of the elderly on the relationship between social contact frequency and life satisfaction. Data were obtained from the National Survey of Older Koreans 2020. The sample comprised 6,119 adults aged 65+ who were in single or couple households. The principal findings were as follows. First, couple households, higher levels of education, and better health status increased life satisfaction of the elderly. Second, the higher the frequency of face-to-face contact with children and the higher the frequency of non-face-to-face contact with friends, the more positive the effect on life satisfaction of the elderly. Third, the interaction effect of the digital capabilities of the elderly differed according to children, relatives and friends. There was a significant and positive moderating effect on the relationship between life satisfaction and the frequency of face-to-face/non-face-to-face contact with children and the frequency of face-to-face contact with relatives. Conversely, there was a significant negative effect on the relationship between life satisfaction and the frequency of face-to-face/non-face-to-face contact with friends. By examining the impact of non-face-toface contact on life satisfaction of the elderly in the era of digital transformation, the findings have significance in that they provide basic data to support policies and education programs aimed at improving the digital capabilities of the elderly.