Older Adults In South Korea Research Articles

Spatiotemporal variability of the association between greenspace exposure and depression in older adults in South Korea

Abstract Background A number of studies based on young to middle aged adult and child samples have found that exposure to greenspace and bluespace can have a positive impact on mental health and well-being. However, there is limited research among older adults and the extant studies have provided mixed results. The present study was designed to examine how the association between these forms of exposure and depressive symptoms among older adults varies as a function of different spatially and temporally resolved exposure metrics. Methods The sample consisted of 617 individuals (46.19% female) aged ≥ 60 years of age. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Individuals’ greenspace exposure was quantified using spatially and temporally resolved metrics, including monthly and annual averaged satellite-derived normalized difference vegetation index (NDVI) across multiple buffer distances (250 m to 2,000 m) centered at participants’ home address. We also quantified exposure to blue-greenspace from a highly detailed land use and land cover dataset. A multivariable logistic regression model assessed the association between greenspace and blue-greenspace exposure and depressive symptoms, adjusting for age, sex, income, education, marital status, current smoking, alcohol status, medical conditions, temperature, crime rate, population density, and per capita park area. Results We found a significant association between exposures to greenspace and blue-greenspace and depressive symptoms (CES-D cutoff ≥ 4) among older adults. After adjusting for confounding variables, the odds of depressive symptoms were significantly decreased by an IQR increment in residential exposure to greenspace [odds ratio (OR) = 0.67; 95% confidence interval (95% CI), 0.49 ~ 0.91] and blue-greenspace (OR = 0.59; 95% CI, 0.41 ~ 0.84) measured nearby their home address (i.e., as close as 250 m). When stratified by household income level, the association was only significant among low-income individuals. We also found temporal variation in the association between depressive symptoms and monthly NDVI-based greenspace exposure, in which the odds of depressive symptoms were the lowest for greenspace in cold months (i.e., January, February, and March). Conclusions Our findings suggest that neighborhood greenspace may serve as a protective factor against depression among older adults, but the benefits may depend on the spatial and temporal context. More investigation is needed to replicate our findings on the spatial and temporal variations of greenspace exposure metrics and their effects on depressive symptoms.

Analysis of the impact of digital literacy on life satisfaction (2019–2022) for older adults in South Korea: a national community-based panel study

This study analyzed the effects of digital literacy on life satisfaction in older adults aged 65 years and above in modern day Korea. It utilized raw data from the 2019–2022 Report on the Digital Divide, an annual survey conducted by the Korean Ministry of Science and Information and Communications Technology. A total of 4,216 participants were assessed from 2019–2022. Correlation between digital literacy and life satisfaction was analyzed using Pearson correlation analysis and polynomial linear regression analysis. Life satisfaction was significantly positively correlated with digital access, digital competency, and digital utilization in all the years. In 2019, participants’ life satisfaction score rose significantly by 0.15 with every one-point increase in digital competency. It further rose by 0.035 in 2020, 0.030 in 2021, and 0.116 in 2022. Digital literacy was consistently positively correlated with life satisfaction in each year from 2019–2022. Of the three main elements, digital competency had the strongest impact and digital information, income, and education level also significantly impacted life satisfaction. While digital competency improved steadily from 2019 to 2022, it remains below 50% for Korea’s older adult population. Further efforts are required to improve digital competency and subsequent life satisfaction among Korea’s older adult population.

Nursing in integrated community care for older adults in South Korea

Nursing in integrated community care for older adults in South Korea

Exploring social activity patterns among community-dwelling older adults in South Korea: a latent class analysis

BackgroundWith the trend of digitalization, social activities among the older population are becoming more diverse as they increasingly adopt technology-based alternatives. To gain a comprehensive understanding of social activities, this study aimed to identify the patterns of digital and in-person social activities among community-dwelling older adults in South Korea, examine the associated factors, and explore the difference in depressive symptoms by the identified latent social activity patterns.MethodsData were extracted from a nationwide survey conducted with 1,016 community-dwelling older adults (mean age 68.0 ± 6.5 years, 47.8% male). The main variables assessed were digital social activities (eight items), in-person social activities (six items), and depressive symptoms (20 items). Data were analyzed using latent class analysis, multinomial logistic regression, and multiple linear regression.ResultsWe identified four distinct social activity patterns: “minimal in both digital and in-person” (22.0%), “moderate in both digital and in-person” (46.7%), “moderate in digital & very high in in-person” (14.5%), and “high in both digital and in-person” (16.8%). Younger age, living in multi-generational households, and higher digital literacy were associated with a higher likelihood of being in the “moderate in both digital and in-person” than the “minimal in both digital and in-person” group. Younger age, male, living in multi-generational households, residing in metropolitan areas, no dependency on IADL items, doing daily physical exercise, and higher digital literacy were associated with a higher likelihood of being in the “moderate in digital & very high in in-person” than the “minimal in both digital and in-person” group. Younger age, living in multi-generational households, no dependency on IADL items, doing daily physical exercise, and higher digital literacy were associated with a higher likelihood of being in the “high in both digital and in-person” than the “minimal in both digital and in-person” group. Depressive symptoms were significantly higher in the group with minimal engagement in both digital and in-person activities, compared to other three groups.ConclusionsThis study highlights distinct patterns of social activities among Korean community-dwelling older adults. Since older adults with minimal social activity engagement can be more vulnerable to depressive symptoms, interventions that address modifiable attributes, such as supporting digital literacy and facilitating physical activity of older adults, could serve as potential strategies to enhance their social activity engagement and, consequently, their mental well-being.

The factors related to depressive symptoms in urban older adults in South Korea: a study based on the Seoul Aging Survey

PurposeThis study aims to comprehensively examine the determinants of depression among urban older adults in Seoul, utilizing the social-ecological model to address multifaceted influences.MethodsA comprehensive analysis was conducted using data from the 2022 Seoul Aging Survey, which surveyed 2,914 individuals aged 65 and above. A multiple logistic regression analysis was performed to identify factors contributing to depressive symptoms, including socio-demographic characteristics, health behaviors and status, research accessibility, social support, and environmental influences.ResultsThis study revealed that poor subjective health (OR = 1.47) and the presence of multiple chronic diseases (OR = 1.59) significantly increased the risk of depressive symptoms among urban older adults. From a social support standpoint, living alone was associated with a higher risk of depression (OR = 1.66), low food security (OR = 2.56), and low digital competency (OR = 2.70) were all significant predictors of depressive symptoms. Additionally, a lack of engagement with cultural facilities (OR = 2.15) was identified as a critical environmental factor contributing to depression.ConclusionsThe findings underscore the need for comprehensive policy and practical interventions aimed at preventing chronic disease, enhancing social support networks, improving digital literacy, ensuring food security, and expanding access to healthcare and cultural facilities. Such measures are crucial in mitigating depression among urban older adults, thereby enhancing their overall well-being and quality of life.

A Reciprocal Relationship between Formal and Informal Social Engagement and Handgrip Strength of Older Adults in South Korea

Introduction: The relationship between social engagement and handgrip strength has been underexplored. Further, no prior research examined a plausible reciprocal association between them. Methods: The study employed the seven waves of data (2006–2018) from the Korean Longitudinal Study of Aging (KLoSA) survey (7,927 respondents, mean age: 59 years old at wave 1 [71 years old at wave 7], women: 58%). It used ML-SEM, a cross-lagged panel model with fixed effects fitted by structural equation modeling with maximum likelihood estimation. In particular, the ML-SEM examined whether a reciprocal relationship existed between formal social engagement (number of association memberships and frequency of organizational activities)/informal social engagement (frequency of contact with familiar persons) and handgrip strength (the average of the four dynamometer measurements). Results: The empirical analyses identified a systematic reciprocal association between formal social engagement and handgrip strength. Specifically, formal social engagement was positively associated with handgrip strength over time (the number of association memberships standardized coefficient: 0.012*, the frequency of organizational activities standardized coefficient: 0.022***). Conversely, handgrip strength was positively related to the number of memberships (the handgrip strength standardized coefficient: 0.025*) and the frequency of organizational activities (the handgrip strength standardized coefficient: 0.042**). Conclusion: The study thus supports the social causation proposition that formal social engagement in and through diverse associations may be positively associated with handgrip strength. It also validates the health selection argument that handgrip strength may increase the likelihood of formal social engagement.

재가 노인의 돌봄 유형에 따른 우울 영향요인

Purpose : This study examines how different types of care－formal and informal－affect depressive symptoms in older adults at home. Methods : Using data from the 2020 National Survey on Older Adults in South Korea, which included responses from 498 elderly individuals receiving care, we conducted logistic regression analyses to identify factors influencing depressive symptoms based on the type of care received. Results : The analysis showed significant differences in depressive symptoms between those receiving formal and informal care. In the formal care group, a better subjective perception of health was associated with a lower likelihood of depressive symptoms (OR＝0.47, p＜.001), while an increase in chronic conditions (OR＝1.15, p＝.007) and higher dependency in instrumental daily activities (OR＝1.08, p＜.001) increased the risk of depressive symptoms. Conversely, improved cognitive function was linked to reduced depression risks (OR＝0.96, p＜.001). In the informal care group, similar trends were observed. Notably, family cohabitation significantly influenced depressive symptoms outcomes, highlighting the importance of family support in care dynamics. Access to necessary facilities and adequate care provision also emerged as critical factors in mitigating depressive symptoms risks across both care types. Conclusion : The study underscores the importance of tailored interventions that enhance care accessibility and adequacy, particularly in informal settings, to improve mental health outcomes among the elderly.

The Effects of Health and Unmet Dental Care Needs on the Health-Related Quality of Life in Korea Older Adults: A Nationwide Study

Background: The purpose of this cross-sectional study was to assess the relationship between oral health, unmet dental needs and health-related quality of life in South Korea older adults. Methods: The present study used raw data from the 2019~2020 Korea National Health and Nutrition Examination Survey, and analyzed 4956 participants aged over 65 yr. Hierarchical multiple regression analysis was used for associations between oral health, unmet dental needs, and HRQoL. Results: The EQ-5D index differed according to tooth pain, chewing difficulty, speaking problem, subjective oral health status, oral examination, and unmet dental care needs (P<0.001). In the model 2, male, under 75 yr of age, high school graduate or higher, employed, living with a spouse, no stress, good subjective health status, no speaking problem, and no unmet dental care needs were associated with higher EQ-5D index (Adj R2 = 27.6%, P<0.001). Conclusion: To improve the HRQoL of older adults in South Korea, oral health problems need to be minimized through oral disease prevention and oral health education programs.

Long-Term Care Insurance for Older Adults in Terms of Community Care in South Korea: Using the Framework Method.

This study aimed to analyze the long-term care insurance for older adults in South Korea in terms of community care. An analytical framework was designed for the study, focusing on comprehensiveness, adequacy, and integration. The findings suggest that Korean LTCI is significantly limited for the development of community care. First, in terms of comprehensiveness, the use of visiting nurses and the availability of short-stay services have been significantly reduced, and the supporting services for informal caregivers are at the beginning stage of their introduction. Second, in terms of adequacy, the quantity of benefits, such as three to four hours of care a day, are insufficient to meet older adults' substantial needs. Furthermore, the overall quality of home care services is low, particularly with regard to short-stay services and welfare equipment. Finally, in terms of integration, basic linkage of organizations has not been properly conducted in local areas, and there remains an absence of care managers in the LTCI system. To cope with these challenging issues, the following policy measures are suggested: the activation of rehabilitation services, the expansion of benefit quantities, the improvement of service quality, and the creation of organizational linkages through local authorities and long-term care centers.

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.

Fostering collective impact in arts-based interventions and cultural programs for creative well-being of older adults

Despite growing interest in research into how the arts impact older adults’ health and well-being, there are many related complexities that are yet to be fully understood. This is partly due to the fact that documentation and analysis of arts-based interventions and cultural programmes for older adults in the public service domain are relatively new and uncommon. Furthermore, the effective implementation and the delivery of such inter­ventions to ageing people generally involve many stakeholders, often with divergent interests and priorities. This article presents an interview-based study that explores the diverse experiences of professionals from different sectors who have been involved in delivery of arts-based interventions and cultural programmes for older adults in South Korea and Finland. The study maps out similarities and differences in the approaches taken and the challenges faced in such interventions, using the five themes of the narrative interviews that have been conducted. The study findings highlight the need for supporting collective efforts among the diverse stakeholders to provide effective arts-based interventions and cultural programmes for ageing people. We argue that such efforts will ultimately become catalysts for synergetic actions that address the interconnected and encompassing challenges of an ageing society.

Family support, housing, and care needs of older adults in South Korea

Family support, housing, and care needs of older adults in South Korea

Impact of a Pilot Project for Integrated Care on Hospitalization Rate among Older Adults in South Korea.

Since 2019, the Korean government has implemented a pilot project for integrated care to encourage healthy aging of older adults. This study investigated the changes in hospitalization rates among older adults who participated in the integrated care pilot project. Administrative survey data collected from 13 local governments and the National Health Insurance Database were used in present study. The participants comprised 17,801 older adults who participated in the pilot project between August 01, 2019 and April 30, 2022 and 68,145 matched controls. A propensity score matching method was employed to select the control group, and this study employed difference-in-differences (DID) approach to examine variations in the hospitalization rate. The DID analysis revealed that the odds ratio for rates of hospitalization among older adults who participated in the pilot project was 0.88 (95% confidence interval [CI] 0.84, 0.91) in comparison to control group. In specifically, as compared to the control group, the odds ratio for hospitalization rates among the pilot project's discharged patients was 0.17 (95% CI 0.15, 0.20). Although not statistically significant, the odds ratio of older adults who utilized LTCI services was 0.93 (95% CI 0.83, 1.05), and the odds ratio of older adults who applied for LTCI but were rejected or were intensive social care was 1.09 (95% CI 0.95, 1.26) compared to the comparison group. The findings imply that the discharged patient group had greater medical demands than the other types, and it can be claimed that this is the group that may anticipate greater efficacy while using health services. In addition, the integrated care services provided by the pilot project have the effect of reducing unnecessary hospitalization such as social hospitalization. Participants in the integrated care pilot project showed a lower hospitalization rate than the older adults who did not participate in the project but had similar characteristics. In particular, the admission rate of discharged patients showed a sharp decline.

Where Should Senior Welfare Centers Stand in Older Adult Care in South Korea?

Senior Welfare Centers, the vital community facilities known mostly as leisure venues for older adults in South Korea, are expanding their roles as older adult care providers to respond to the aging population. However, their roles remain unclear, which makes it difficult to utilize their potential and establish a position in older adult care. This study conducted qualitative research to clarify and seek the role of Senior Welfare Centers by exploring their experiences in two major older adult care services, Community Care and Customized Care, through a focus group interview conducted with 13 Senior Welfare Center professionals. Using qualitative thematic analysis, the findings resulted in two main themes: (1) experiences of Community Care and Customized Care and (2) redefining the role of Senior Welfare Centers in older adult care. Nine subthemes presented limitations in the care system and possible strategies to ameliorate the care roles of Senior Welfare Centers. The findings indicate recommendations at the facility, client, and governmental levels for Senior Welfare Centers to reestablish their position in older adult care. The study recommends future research to study policies and care services maximizing strengths and potentials of Senior Welfare Centers to redesign optimized older adult care in South Korea.

COVID-19 and depressive symptoms among older adults in South Korea

This study analyzed the effects of COVID-19 and gender differences in depressive symptoms in older adults using data from the 7th (2018) and 8th (2020) surveys of the Korean Longitudinal Study of Aging. A panel two-way-fixed effects model was used to control for individual fixed effects and time effects. A 0.1% point increase in the intensity of COVID-19 was associated with an average increase of 1.5 points out of 10 on the Center of Epidemiologic Studies Depression Scale, 10-item version (CES-D10) among older adults. The increase in depression was greater among women. Depressive factors due to COVID-19 among older adults are more likely to be related to negative emotions or interpersonal relationships than to physical and behavioral decline. Depression prevention policies for older adults should be informed by these gender differences. While older men require assistance with instrumental activities of daily living such as housework, meal preparation, etc., older women should be provided with online socialization opportunities to interact with others.

Cost-effectiveness of the adjuvanted quadrivalent influenza vaccine for older adults in South Korea

ABSTRACT South Korea’s National Immunization Program administers the quadrivalent influenza vaccine (QIV) to manage seasonal influenza, with a particular focus on the elderly. After reviewing the safety and immune response triggered by the adjuvanted QIV (aQIV) in individuals aged 65 and older, the Ministry of Food and Drug Safety in Korea approved its use. However, the extensive impact of aQIV on public health is yet to be fully understood. This study assessed the cost-effectiveness of replacing QIV with aQIV in South Korean adults aged 65 years and older. A dynamic transmission model, calibrated with national influenza data, was applied to compare the influence of aQIV and QIV on older adults and the broader population throughout a single influenza season. This study considered both the direct and indirect effects of vaccination on the elderly. We derived the incremental cost-effectiveness ratios (ICERs) from quality-adjusted life-years (QALYs) and costs incurred, validated through a probabilistic sensitivity analysis with 5,000 simulations. Findings suggest that transitioning to aQIV from QIV in the elderly would be cost-effective, particularly if aQIV’s efficacy reaches or exceeds 56.1%. With an ICER of $29,267/QALY, considerably lower than the $34,998/QALY willingness-to-pay threshold, aQIV presents as a cost-effective option. Thus, implementing aQIV with at least 56.1% efficacy is beneficial from both financial and public health perspectives in mitigating seasonal influenza in South Korea.

Gendered Trends in Formal and Informal Care Utilization Among Older Adults in South Korea

ABSTRACT Drawing on data from two waves of the Korean Longitudinal Study of Ageing (2010 and 2018), this study examined how community-dwelling older men and women (65+) with functional limitations utilized formal and informal sources of care and how their patterns of care utilization changed over time. The usage patterns of formal and informal caregiving services were categorized into three groups: (a) informal help only, (b) formal-informal mix, and (c) no help from either. More men and women used both formal and informal help for their care needs in 2018 than in 2010 (15% compared to 7%). The proportion of older men who relied on informal help only remained similar across survey years, whereas a smaller proportion of older women relied on informal help only in 2018. Although formal care use has been expanded in South Korea, older men continue to utilize help from their families. However, for older women, the proportion who did not receive any help increased – despite an increase in formal care utilization. These findings highlight the importance of considering gendered resources in caregiving in Korea.

Social Workers’ Perspectives on Socially Isolated Older Adults Living with a Robot Companion

ABSTRACT Addressing depression and social isolation among solo-living older adults in South Korea requires a multi-faceted approach. This study aims to explore the advantages and obstacles of a robotic elder care program by analyzing social workers’ viewpoints regarding interactions between older adults and a companion robot named Hyodol. Through the purposive sampling method, we conducted comprehensive interviews with 10 social workers who are pioneering the integration of robots in elder care. The study participants observed and compared the demographic characteristics of users and non-users, elucidated usage patterns, described the roles of robot companions, and shared remarkable instances. Overall, the experiences of these social workers underscored the positive influence of Hyodol in offering companionship, care, and emotional support, especially in circumstances where clients experienced isolation or lacked regular family interactions. In addition, social workers’ perspectives hold significant value in comprehending the genuine effects of anthropomorphism – the inclination to attribute human-like qualities and emotions to robots. Our investigation revealed the existence of two distinct modes of personification among older adults, which we have labeled as “imagination” and “projection.”

The moderating effect of care time on care-related characteristics and caregiver burden: differences between formal and informal caregivers of dependent older adults.

This study examined differences in care burden between formal and informal caregivers of dependent older adults according to care-related characteristics, and whether care time had a moderating effect on the relationship between care-related characteristics and caregiver burden. Participants were formal (n = 520) and informal caregivers (n = 142) of dependent older adults in South Korea. Caregiver burden was measured using the Korean version of the Zarit Burden Interview. Data were analyzed using hierarchical regression with interaction terms and moderation analysis. Caregiver burden was higher for informal caregivers than formal caregivers. Factors associated with an increased risk of caregiver burden in both formal and informal caregiver of dependent older adults were caregivers' stress, physical strain, and care time. Care time significantly moderated the relationship between care attitude and care burden only among formal caregivers. When formal caregivers' care time was 1 standard deviation higher than the mean value, care attitude was significantly associated with care burden (bsimple = -0.903, SE = 0.106, p < 0.001). The caregiver burden of dependent older adults can be reduced by providing interventions to attenuate the effects of modifiable risk factors that were identified in this study. And to weaken the relationship between care attitude and burden of formal caregivers who have long care hours, a positive social atmosphere for care should be provided in addition to education. To realize sustainable care, policy considerations that reflect the results of this study will help solve the problem of formal and informal caregiver burden of dependent older adults.

Epidemiology of Accidental Injuries at Home and Related Risk Factors for Mortality among Older Adults in South Korea: A Retrospective Cohort Study.

Background and Objectives: Accidental home injuries among older adults are increasing globally, but reporting is limited. This study aims to establish foundational data for program development and policies to prevent accidental injuries at home in older adults by using data on the occurrence of accidental injuries at home and analyzing the risk factors of mortality due to accidental injuries among adults aged 65 years and older. Materials and Methods: This retrospective study used data from the community-based Severe Trauma Survey in South Korea. This study identified general, injury-related, and treatment-related characteristics of older adults who were transported to the emergency department with accidental injuries at home. Single-variable and multiple logistic regression analyses were used to identify risk factors for mortality after injury. Results: The majority of older adults in this study who experienced accidental injuries at home were aged 75 to 84 (42.8%) and female (52.8%), with 1465 injured from falls and slips (68.0%). Risk factors for mortality included older age (≥85 years) (ORs 2.25, 95% CI 1.47-3.45), male sex (ORs 1.60, 95% CI 1.15-2.20), mechanism of injury (falls or slips vs. contact injury, ORs 6.76, 95% CI 3.39-13.47; airway obstruction vs. contact injury, ORs 13.96, 95% CI 6.35-30.71), higher severity (moderate vs. mild, ORs 2.56, 95% CI 1.45-4.54; severe vs. mild, ORs 12.24, 95% CI 6.48-23.12; very severe vs. mild, ORs 67.95, 95% CI 38.86-118.81), and receiving a blood transfusion (ORs 2.14, 95% CI 1.24-3.67). Conclusions: Based on these findings, the home and community environments where older adults live should be inspected and monitored, and in-home accidental injury prevention strategies should be developed tailored to the characteristics of older adults' risk factors and their injury-related characteristics.