Middle-aged Korean Adults Research Articles

The Effect of Coffee Consumption on the Prevalence of Diabetes Mellitus: The 2012-2016 Korea National Health and Nutrition Examination Survey.

An inverse association between coffee consumption and the risk of diabetes mellitus (DM) has been observed. However, little is known about this association in Koreans, although they are now among the top global consumers of coffee. Therefore, the aim of this study was to evaluate the association between the prevalence of DM and the amount of coffee consumption using a unit of exact measurement, regardless of the type of coffee consumed. This study was based on data acquired from the Korea National Health and Nutrition Examination Survey 2012–2016. The participants who completed the survey were included in the statistical analysis (n = 14,578). Subjects were stratified by age (19–39 years old: young adult; 40–64 years old: middle-aged adult) and gender (men, women). The amount of coffee was measured using a teaspoon (tsp) unit corresponding to 5 mL of powdered coffee and was analyzed as a continuous variable. The mean powdered coffee intake per day was 1.97 tsp in women groups, 2.24 tsp in young adult men, and 2.72 tsp in middle-aged men. The frequency of coffee consumption showed an inverse relationship with the amount of coffee intake at a time. With each 1-tsp increment in daily coffee intake, the odds of DM were 0.89 (95% confidence interval (CI): 0.86–0.92, p < 0.001) and 0.93 (95% CI: 0.90–0.95, p = 0.003) in middle-aged women and men, respectively. Coffee consumption was inversely correlated with the prevalence of DM even with adjustment for covariates in middle-aged adults. We delineated that the prevalence for DM decreased as coffee intake increased in Korean middle-aged adults. Therefore, our data represented an inverse association between coffee consumption and the prevalence of DM, although Koreans have a unique coffee-drinking habit.

Carbohydrate and sodium intake and physical activity interact with genetic risk scores of four genetic variants mainly related to lipid metabolism to modulate metabolic syndrome risk in Korean middle-aged adults.

Metabolic syndrome (MetS) risk is influenced by genetic and environmental factors. The present study explored genetic risk scores (GRS) of genetic variants that influence the MetS and the effect of interactions between GRS and nutrient intake on MetS risk. The genetic variants that influence MetS risk were selected by genome-wide association study after adjusting for age, sex, area of residence and BMI in 8840 middle-aged adults. GRS were calculated by summing the risk alleles of the selected SNP and divided into low (0-1), medium (2-3) and high (4-7) risk groups, and the relationships between the MetS and GRS were determined by logistic regression after adjusting covariates involved in MetS risk. We also analysed the interaction between GRS and lifestyles. Four genetic variants (APOA5_rs651821, EFCAB4B_rs4766165, ZNF259_rs2160669 and APOBEC1_rs10845640) were selected because they increased MetS risk after adjusting for covariates. Individuals with medium-GRS and high-GRS alleles had a higher MetS risk by 1·48- and 2·23-fold, respectively, compared with those with low-GRS after adjusting for covariates. The increase in MetS risk was mainly related to serum TAG and HDL-cholesterol concentrations. The GRS had an interaction with carbohydrate (CHO) and Na intakes and daily physical activities for MetS risk. In conclusion, Asian middle-aged adults with high-GRS alleles were at increased MetS risk mainly due to dyslipidaemia. High daily physical activity (≥1 h moderate activity per d) reduced the MetS risk but a low-CHO diet (<65 % of total energy intake) increased the risk in carriers with high-GRS alleles. Low Na intake (<1·6 g Na intake/4 MJ) did not decrease its risk.

Association between Total Sugar Intake and Metabolic Syndrome in Middle-Aged Korean Men and Women.

There is increasing evidence emerging that suggests high sugar intake may adversely increase the incidence of chronic diseases. However, there are only a few related studies in Korea. Based on the current Dietary Reference Intakes for Koreans, this study examined whether total sugar intake above 20% of the total energy was a risk factor for metabolic syndrome in middle-aged Korean adults. This cross-sectional study involved 7005 adults (3751 men and 3254 women) aged 40–69 years, who participated in the Korean Genome and Epidemiology Study (KoGES), a large community-based cohort study. Daily total sugar intake was estimated using a validated food frequency questionnaire. About 9% and 16% of the men and women, respectively, derived >20% of energy intake from total sugar. The males in this category had a significantly higher odds of obesity defined as having a BMI ≥ 25 (OR = 1.491, 95% CI = 1.162–1.914), low HDL-cholesterol (OR = 1.313, 95% CI = 1.038–1.660), and metabolic syndrome (OR = 1.332, 95% CI = 1.038–1.709) than those who received a lower proportion of energy intake from total sugar. These results suggest that high (>20%) energy intake from total sugar may be associated with an increased risk of metabolic syndrome in middle-aged Korean men.

Reading habit, non-formal learning participation and literacy skills of the Korean middle-aged adults: Applying Bourdieu’s theoretical perspective

Reading habit, non-formal learning participation and literacy skills of the Korean middle-aged adults: Applying Bourdieu’s theoretical perspective

Identification of Dietary Patterns Associated with Incidence of Hyperglycemia in Middle-Aged and Older Korean Adults.

Little is known about the association between dietary patterns and hyperglycemia incidence among Korean adults. Hence, we aimed to prospectively investigate the major dietary patterns associated with hyperglycemia among middle-aged and older Korean adults. In total, 55,457 adults (18,292 men and 37,165 women) aged 40 to 79 years, who were previously enrolled in the Health Examinee Study of the Korean Genome and Epidemiology Study and had no history of type 2 diabetes mellitus (T2DM) or cancer at baseline, were included. Dietary patterns were identified by a factor analysis based on dietary data, which were assessed at baseline using a validated food-frequency questionnaire. Participants were classified as having hyperglycemia if fasting blood glucose levels were ≥126 mg/dL or physician diagnosed T2DM during follow-up. Multivariable Cox proportional hazard models were used to examine the associations between each dietary pattern and future hyperglycemia risk after adjusting for potential confounders. After a mean follow-up of 4.9 years, 2574 new cases of hyperglycemia were identified. Using a factor analysis, four distinct dietary patterns were identified: “prudent;” “fatty fish, meat, and flour-based food;” “coffee and sweets;” and “whole grain (men)” or “white rice (women).” The “prudent” pattern was inversely associated with hyperglycemia risk only in women (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.63–0.89; p for trend = 0.0003). Conversely, women in the highest quintile of the “fatty fish, meat, and flour-based food” pattern showed an increased risk of hyperglycemia (HR, 1.22; 95% CI, 1.03–1.44; p for trend = 0.0210) compared with those in the lowest quintile. The “coffee and sweets” and “white rice” patterns were not associated with hyperglycemia risk in women. The dietary patterns observed in men had no associations with hyperglycemia incidence. Our findings suggest that a diet rich in vegetables, mushrooms, seaweeds, fruits, and soy products and low in fatty fish and high-fat meat may potentially play a protective role in T2DM development with sex differences in middle-aged and older Korean adults.

Comparison of association between physical activity and resting metabolic rate in young and middle-aged Korean adults.

[Purpose]The purpose of this study was to comparatively investigate the correlation among body composition, resting metabolic rate (RMR), and physical activity (PA) between young and middle-aged Korean adults.[Methods]A total of 53 [male n=23, female n=30] subjects were included in this study, among whom 34 subjects were healthy young adults [male n=18, female n=16] and 19 were middle-aged adults [male n=5, female n=14]. The body composition and RMR of all the participants were measured after overnight fasting (≥8 h). The Korean version of the WHO Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity.[Results]Body composition was not significantly different between young adults and middle-aged adults. Whole-body bone mineral density and bone mineral contents (BMC) were significantly lower in middle-aged adults than in young adults. Total blood cholesterol (TC) and blood glucose levels were significantly higher in middle-aged adults (TC; 195.21 ± 43.34, glucose; 103.57 ± 12.61 mg/dL) than in young adults. RMR was significantly lower in middle-aged adults (1619.57 ± 290.28 kcal/day) than in young adults (1894.37 ± 405.00 kcal/day). In middle-aged adults physical activity (PA). PA (METs, min, EE) was inversely correlated with fat mass (FM, kg, and %) and blood triglyceride (TG) level in young adults. In middle-aged adults, PA showed a significant positive correlation with lean body mass (LBM), FM (%), and RMR. Furthermore, PA EE showed significant interrelatedness with BMC among middle-aged adults.[Conclusion]These results demonstrated that high PA levels enable LBM and RMR maintenance in middle-aged adults. Furthermore, in young adults, more PA is required to induce change in body composition.

Health behaviors and health status of Korean middleaged men by marital status: Korea Community Health Study, 2015.

OBJECTIVESPrevious studies have shown that marital status is associated with household composition and living arrangements, which partially explain observed differences in health status according to marital status. However, due to the rapid socioeconomic and demographic transformations of the last few decades, the distribution of marital status among middle-aged adults has become more diverse. Therefore, this study aimed to obtain up-to-date information on the associations between marital status and health and to investigate the implications of these findings for conventional explanations of the health effects of marriage.METHODSThe data for this study were obtained from the 2015 Korean Community Health Study. We compared 4 modifiable lifestyle behaviors—smoking, alcohol consumption, physical activity, and self-rated health status—as outcome variables in association with marital status in Korean middle-aged men (age 40-44) living in Seoul and other regions.RESULTSMarried men showed the lowest cigarette smoking prevalence and the highest subjective health status both before and after adjusting for education and income. The odds of engaging in vigorous physical activity did not show a major difference before and after adjustment for income and education.CONCLUSIONSIn married men, the prevalence of cigarette smoking was lowest and subjective health status was highest, similar to previous studies. However, the prevalence of engaging in physical activity was highest in divorced/widowed/separated men. The health behaviors and health status of Korean middle-aged adults should be more closely followed, since they are representative of demographic changes in the Korean population.

Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study.

BackgroundWe aimed to report the prevalence and correlates of high-risk alcohol consumption and types of alcoholic beverages.MethodsThe baseline data of the Health Examinees-Gem (HEXA-G) study participants, including 43,927 men and 85,897 women enrolled from 2005 through 2013, were used for analysis. Joinpoint regression was performed to estimate trends in the age-standardized prevalence of alcohol consumption. Associations of demographic and behavioral factors, perceived health-related effects, social relationships, and the diagnostic history of diseases with alcohol consumption were assessed using multinomial logistic regression.ResultsThe prevalence of alcohol consumption remained higher in men during the study period and increased in women. The amount of alcohol consumed has increased in women, especially that from beer and makgeolli, a traditional Korean fermented rice wine. Older participants were less likely to be high-risk drinkers (men and women who drink more than 40 or 20 g/day of alcohol, respectively) and drink Soju, a distilled liquor, and beer, and more likely to drink makgeolli. Educational level was negatively associated with high-risk drinking. However, it was positively associated with the consumption of strong spirits and wine. Smoking was associated with high-risk drinking and the consumption of soju and strong spirits. Engaging in regular exercise and having stress were associated with drinking all types of beverages except for soju.ConclusionsSex-specific trends in alcohol consumption were influenced by demographic, behavioral, and perceived health-related factors. The findings will help improve the understanding of alcohol-related problems and provide evidence for establishing country-specific policies and campaigns in Korea.

The impact of the sleep duration on NAFLD score in Korean middle-aged adults: a community-based cohort study

BackgroundAccumulated evidences indicates that sleep duration and sleep quality may potentially trigger the development of non-alcoholic fatty liver disease (NAFLD), but no studies have explored this causality. In this study, we aimed to investigate the effect of sleep duration on the incidence of NAFLD in Korean middle-aged adults. MethodsAll participants were selected from the cohort of the Korean Genome and Epidemiology Study (KoGES) for a 10-year period. NAFLD was defined by Fatty Liver Index (FLI), NAFLD liver fat score (NLFS), Hepatic Steatosis Index (HSI) and Lipid Accumulation Product (LAP). Multiple logistic regression analysis was used to assess the relationship between sleep duration and NAFLD defined by NAFLD scores. ANCOVA and Spline curve was also used to verify the differences in means of NAFLD scores according to the four sleep duration groups. ResultsIn comparison with those of individuals in the reference group, the OR (95% CI) for NAFLD was 2.230 (1.304–3.813) for group of people who slept more than 8 h, 1.869 (1.298–2.691) for 7–8 h after adjusting for several confounding factors. The odds ratio for the incidence of NAFLD was 1.462 (1.029–2.077) for the group of people who sleep more than 8 h, 1.271 (1.001–1.615) for 7–8 h after adjusting for age, sex, BMI, SBP, DBP, TG, HDL, FDG, smoking, physical activity, daytime napping and night-time shifting (p < 0.01). ConclusionThese findings indicate a relationship between long sleep duration and the elevation of NAFLD scores and support the causality of sleep duration and incidence of NAFLD in Korean middle-aged adults.

The association between dietary pattern and depression in middle-aged Korean adults.

BACKGROUND/OBJECTIVESThe association between dietary patterns and depression has been reported but the results have been inconsistent. This study was conducted to investigate the association between dietary patterns and depression in middle-aged Korean adults.SUBJECTS/METHODSThe participants were selected from a community-based cohort, a subset of the Korean Genome and Epidemiology Study. Depression was assessed using the Korean version of the Beck Depression Inventory (BDI) and those with a BDI score ≥ 16 were defined as having depression. The subjects' food intakes over the year preceding the survey were estimated by using a validated semi-quantitative food frequency questionnaire. Dietary patterns were identified by using factor analysis. Multiple logistic regression was used to assess the association of dietary pattern with depression.RESULTSAmong 3,388 participants, 448 (13.2%) were identified as having depression. We identified two major dietary patterns: ‘Healthy’ dietary pattern was characterized by high intakes of vegetables, soybeans, mushroom, seaweeds, white fish, shellfish and fruits and a low intake of white rice. ‘Unhealthy’ dietary pattern was characterized by high intakes of white rice, meats, ramen, noodles, bread and coffee and a low intake of rice with other grains. Compared with subjects in the lowest quartiles, those in the highest quartiles of the healthy dietary pattern had a significantly lower odds ratio (OR = 0.59, 95% CI: 0.42–0.82, P for trend = 0.0037) after adjusting for potential confounders. In contrast, the unhealthy dietary pattern was negatively associated with depression (OR = 1.65, 95% CI: 1.19–2.28, P for trend = 0.0021).CONCLUSIONThis results suggest that a healthy dietary pattern (rich in vegetables, soybeans, mushroom, seaweeds, white fish, shellfish, and fruits) is associated with low risk of depression. Whereas an unhealthy dietary pattern (rich in white rice, meats, ramen, noodles, bread, and coffee) is associated with a high risk of depression in middle-aged Korean adults.

Prediction of Prehypertenison and Hypertension Based on Anthropometry, Blood Parameters, and Spirometry.

Hypertension and prehypertension are risk factors for cardiovascular diseases. However, the associations of both prehypertension and hypertension with anthropometry, blood parameters, and spirometry have not been investigated. The purpose of this study was to identify the risk factors for prehypertension and hypertension in middle-aged Korean adults and to study prediction models of prehypertension and hypertension combined with anthropometry, blood parameters, and spirometry. Binary logistic regression analysis was performed to assess the statistical significance of prehypertension and hypertension, and prediction models were developed using logistic regression, naïve Bayes, and decision trees. Among all risk factors for prehypertension, body mass index (BMI) was identified as the best indicator in both men [odds ratio (OR) = 1.429, 95% confidence interval (CI) = 1.304–1.462)] and women (OR = 1.428, 95% CI = 1.204–1.453). In contrast, among all risk factors for hypertension, BMI (OR = 1.993, 95% CI = 1.818–2.186) was found to be the best indicator in men, whereas the waist-to-height ratio (OR = 2.071, 95% CI = 1.884–2.276) was the best indicator in women. In the prehypertension prediction model, men exhibited an area under the receiver operating characteristic curve (AUC) of 0.635, and women exhibited a predictive power with an AUC of 0.777. In the hypertension prediction model, men exhibited an AUC of 0.700, and women exhibited an AUC of 0.845. This study proposes various risk factors for prehypertension and hypertension, and our findings can be used as a large-scale screening tool for controlling and managing hypertension.

Effects of processed red meat consumption on the risk of type 2 diabetes and cardiovascular diseases among Korean adults: the Korean Genome and Epidemiology Study

Few studies have evaluated the effects of processed red meat (PRM) consumption on chronic disease risk, especially among low average PRM consumption populations. This study examined association between PRM intake and type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) incidences in Korea. Participants (n = 10,030; aged 40-69years) were recruited from the Ansan-Ansung cohort study, a subset of Korean Genome Epidemiology Study. Validated 103-item semi-quantitative food frequency questionnaire was used to assess dietary information, at baseline (2001-2002) and at second follow-up (2005-2006). T2DM and CVD incidences were identified using biennial questionnaire-based interview during a 10-year follow-up period. Cox proportional hazards regression analysis was used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Over the 10-year follow-up period, 668 and 493 incident cases of T2DM (62,130 person-years) and CVD (63,150 person-years), respectively, were documented. In crude models, comparing the highest and lowest levels of PRM intake, no significant association occurred with incident T2DM [HR, 95% CI (0.94, 0.76-1.17)], while significant association occurred with incident CVD (0.67, 0.51-0.88). However, in adjusted models, this association was no longer significant, showing HRs (95% CI) of PRM intake for T2DM and CVD of 1.07 (0.85-1.35) and 1.14 (0.85-1.55), respectively. PRM intake did not affect T2DM and CVD incidences among Korean middle-aged adults, although extremely low average consumption of PRM may explain the finding. Therefore, limiting PRM intake may not be a top priority for the prevention of chronic diseases in Korean population.

Predictors of Yangsaeng (Health Management) Among Korean Middle-Aged Adults.

This study aimed to examine and identify the predictors of Yangsaeng (health management) among Korean middle-aged adults. A cross-sectional descriptive design was employed. Study participants consisted of 150 middle-aged adults in S and G cities, South Korea. Measures included the Yangsaeng scale, the perceived health state scale, the self-efficacy scale, the Beck Depression Inventory, and the family support scale. The analyses showed that the prediction model for Yangsaeng (health management) among Korean middle-aged adults was significant. The value of the adjusted R was 0.635, which corresponded to the explanatory power of 63.5%. The predictor with the most influence on Yangsaeng (health management) among Korean middle-aged adults was family support, followed by perceived health state, leisure activity, self-efficacy, and religion, respectively. This study provided preliminary evidence that family support is a major and primary predictor of Yangsaeng (health management) among Korean middle-aged adults. Concrete interventions and strategies to improve the Yangsaeng (health management) of Korean middle-aged adults were necessary.

Patterns of household physical activity and risk of mortality in Korea

Introduction Physical activity (PA) has been established as a lifestyle factor, which reduces various chronic diseases and mortality risks. However, most of studies have focused on the leisure time PA as the main interest. Household physical activity (HPA) such as washing clothes by hand, cleaning, dish-washing and gardening could also contribute to achieving recommended level of PA. This study aimed to examine patterns of HPA and association between HPA and the hazard of mortality in Korea. Methods A total of 42,328 men and 83,371 women who were aged from 40 to 69 years old and enrolled in the Health Examinees (HEXA) study from 2004 to 2012 were included in this study. Information of four types of HPA, which are washing clothes by hand, cleaning, dish-washing and gardening, and regular exercise including frequency per week and duration were collected by interviewer-administered self-reported questionnaire. Total MET-hour per week of HPA was calculated by weighted MET for each type of HPA and adding them up. Sex-specific categories according to the level of participation in HPA were defined; nonparticipation, Results Women spent much more time to doing HPA than men. Both men and women were more likely to participating in HPA as being unemployed or house wives, never smoker, having more than median calorie intake, and doing sufficient regular exercise. Men who were more educated or living alone participated more often in HPA, while women participated less in HPA as being more educated or living alone. During the 5.2 years of mean follow-up, 1240 men and 767 women died. HPA was associated with decreasing risk of death; HR (95% CIs) for category 2 vs. category 1 = 0.87 (0.77–0.98) and HR (95% CIs) for category 3 vs. category 1 = 0.90 (0.81–1.01). There was no association in the regular exercise group; HR (95% CIs) for category 3 vs. category 1 = 1.01 (0.86–1.19), however, significant association was shown in the non-exercise group; HR (95% CIs) for category 3 vs. category 1 = 0.82 (0.70–0.96). Although the inverse association between HPA and mortality was observed in both men and women, statistically significant association was shown only for men. Conclusion HPA significantly reduced risk of mortality in middle aged Korean adults, especially in men. Even though the men never participated in exercise, participation in HPA could decrease the risk of death. This study suggests that HPA could provide further health benefit apart from the regular exercise.

중·고령자 자살 생각에 영향을 미치는 지역사회 환경적 요인

Suicide is a growing problem among Korean middle-aged adults, yet little is known about comprehensive environmental determinants that affect suicidal thoughts. This study explores the effects of neighborhood environmental factors on suicidal ideation for middle-aged adults. Data was collected from a survey conducted at local community centers and senior welfare centers in Seoul, and a total of 309 cases were analyzed using logistic regression. The results found that greater distance from the health care center was related to the higher probability of suicidal ideation, and that satisfaction with environmental conditions was statistically associated with suicidal ideation. Also, depressive symptoms increased the risks of suicidal ideation, whereas social capital was not statistically associated with suicidal ideation. Based on the results, this study sheds lights on practical interventions and policy implications to promote the mental health of middle-aged adults and to improve unpleasant neighborhood environment factors in order to prevent suicide.

Effects of A Body Shape Index, Body Mass Index and Waist Circumference in Predicting Cardiovascular Disease Risk Factors in Korean Middle-Aged and Older Adults

Effects of A Body Shape Index, Body Mass Index and Waist Circumference in Predicting Cardiovascular Disease Risk Factors in Korean Middle-Aged and Older Adults

Factors related to quality of life among middle-aged and older korean adults in 2006 and 2014: A nationally representative study

Factors related to quality of life (QoL) were investigated using data from middle-aged and older Korean respondents to the 2006 and 2014 Korean Longitudinal Study of Ageing. Respondents' QoL score in 2014 (6.03 ± 1.69) was lower than in 2006 (6.20 ± 2.12). All socio-demographic and health-related variables seemed to influence QoL in 2006 (R2 = 0.238) and 2014 (R2 = 0.234). Four factors significantly associated with QoL in both years were health, household income, depression, and regular exercise. Rural and mid-sized city dwellers were more likely to have a better QoL than residents of metropolitan areas; residential area had a greater influence on QoL in 2014.

Dietary carbohydrate quality and quantity in relation to the incidence of type 2 diabetes: A prospective cohort study of middle-aged and older Korean adults.

This study aimed to investigate whether dietary glycemic load (GL), glycemic index (GI), and carbohydrate intake were prospectively associated with incident type 2 diabetes mellitus (T2DM) in a middle-aged and older Korean populations. Data from the Korean Genome and Epidemiology Study were used. A total of 7294 Korean adults ages 40 y to 69 y and with no previous diagnosis of T2DM or cancer at baseline were followed for 10 y. Dietary GL, GI, and carbohydrate intake were estimated on the basis of participants' responses to a validated, semiquantitative, food-frequency questionnaire at baseline. T2DM was defined according to the World Health Organization and International Diabetes Federation criteria. During 7.7 y (56 377 person-years) of follow-up time, 1259 participants (17.3%) developed T2DM. Grain and its products (particularly refined and whole grains) were the greatest contributors to dietary GL. In the multivariable Cox models, dietary GL was differentially associated with T2DM risk by sex. Men in the highest quintile demonstrated a higher risk of T2DM incidence than did those with the lowest, energy-adjusted, dietary GL (hazard ratio for fifth vs. first quarter = 1.26; 95% confidence interval, 1.05-1.52; P for trend < 0.05) but no association between dietary GL and the risk of T2DM was observed in women. Similar to the findings from the main models, the effect of dietary GL on T2DM incidence according to body mass index, abdominal obesity, and physical activity levels differed substantially by sex. High GL diets may increase the risk of the development of T2DM in middle-aged and older Korean men but not in women. Nutrition education and emphasis on self-monitoring of dietary carbohydrate quality and quantity of overall diets is necessary in the middle-aged and older Korean populations.

Quality of life of middle-aged adults in single households in South Korea.

The number of single households has increased worldwide with middle-aged people in such households indicating the highest increase. However, there is a lack of studies on the topic. This study estimated the quality of life (QOL) by household type for middle-aged Korean adults. We used the Korea National Health and Nutrition Examination Survey data from 2007 to 2015. QOL was analyzed using EQ-5D 3-level, and demographic and health-related variables were included as confounders. The households were divided into single household, married couple without child, other one-generation, married couple with child, single parent with child, other two-generation, and three-generation. Logistic regression using level, strata, and sample weight of data was performed based on average QOL. This study included 18,147 responders aged 45-64 years, with single households constituting 5.7%. Single households having average or less QOL were 48.4%, with men and women constituting 40.1 and 53.3%, respectively. After adjusting socioeconomic factors and health-related factors, the odds ratio (OR) of single households was 1.375 (95% CI 1.122-1.684) compared to the three-generation group. According to the sex, the OR of single households with men was higher (OR 1.552, 95% CI 1.121-2.149). However, no significance was found in women. The study results revealed that middle-aged people in single households had low QOL than those in multi-person households. The trend was significantly observable in men than in women. Because middle-aged adults might transform into elderly with low QOL, program development and social support for middle-aged adults in single households should be provided.

Contrasting Effects of Spousal Education on Depressive Symptoms Among Korean Middle-Aged and Older Adults.

Background Within marital dyads, we focused on the so-called positive spillover effects of one spousal partner’s educational attainment on the health of the other partner. This study examined the relationship between spousal educational attainment and depressive symptoms in Korean older adults.Methods Data were obtained from a sample of marital dyads aged 45 or older (total 6,824 husbands and wives) from the baseline survey of the Korean Longitudinal Study of Ageing. Depressive symptoms were measured by the 10-item Center for Epidemiological Studies Depression scale (CES-D 10). A stepwise actor-partner interdependence model was used to examine the association between own and spousal educational attainment and depressive symptoms, conditioning for covariates.Results Among men, we found that their wives’ educational attainment did not influence their mental health, whereas, among women, their depressive symptoms were inversely related to their husbands’ level of schooling. With regard to own education, more-educated men reported lower psychological distress, whereas, among women, there was no overall association. However, in a subset of Korean women with the highest level of household income, higher educational attainment was associated with more depressive symptoms.Conclusion Our findings underscore the need to incorporate the cultural context in examining the spillover effects of education on health within marriage.