Journal of Preventive Medicine and Public Health

Original Articles

The Role of Family Interaction Frequency on Depressive Symptoms in Korean Older Adults Aged ≥80 and Living Alone: Horim A. Hwang, Bo Yung Bae, Hyunsuk Jeong, Minsun Yun, Jungeun Choi, Yujin Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2026;59(1):86-94. Published online December 1, 2025; DOI: https://doi.org/10.3961/jpmph.25.222

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Abstract Summary PDF Supplementary Material: Objectives
Korea is one of the fastest-aging societies, and a large proportion of its older population lives alone. This study examined the impact of family interaction frequency on the association between living alone and depressive symptoms among older adults aged ≥80 years using nationally representative survey data.
Methods
Among the 229 099 participants of the 2019 Korea Community Health Survey, 15 672 participants aged ≥80 years who either lived with close family or lived alone were included in the analysis. Participants living alone were classified according to the frequency of family interaction, ranging from less than once a month to more than once a week. The outcome variable was moderate to severe depressive symptoms, defined as a Patient Health Questionnaire-9 score of ≥10.
Results
The prevalence of depressive symptoms was higher among older adults living alone (9.4–14.1%, depending on the frequency of family interaction) than among those living with close family (6.5%). Older adults living alone who interacted with family less than once a month were more likely to report depressive symptoms compared with those living with close family (adjusted odds ratio [aOR], 1.71; 95% confidence interval [CI], 1.36 to 2.15). Weekly family interaction mitigated the impact of living alone on the prevalence of depressive symptoms (aOR 1.10; 95% CI, 0.84 to 1.42). The influence of family interaction on the association between living alone and depressive symptoms remained consistent across subgroups of men, women, and those with difficulty in daily activities.
Conclusions
Encouraging regular interaction among family members could serve as an effective strategy to protect the mental health of older adults.; Summary

Korean summary
본 연구는 2019년 지역사회건강조사에 참여한 만 80세 이상의 노인 15,672 명의 자료를 활용하여, 가족과의 정기적인 소통이 독거로 인한 우울증상 유병률의 증가에 미치는 요인을 확인하고자 하였다. 가까운 가족인 배우자 또는 자식과 동거하는 노인들과 비교해 보았을 때, 주 1회 이상의 소통을 하는 독거 노인들의 우울증상 교차비는 유의하게 높지 않았다. 가족과의 정기적인 소통의 보호효과는 성별 또는 일상생활에 어려움에 따른 층화 분석을 한 경우에도 일관된 효과를 보였다.

Key Message
This study explored whether sufficiently frequent family interactions mitigate the increased odds of reporting depressive symptoms due to living alone among older adults aged ≥80. Family interaction of once a week or more frequent mitigated the impact of living alone among the older adults. The protective effect of family interaction remained consistent across gender and difficulty in daily activities.

Frailty Index Predicts Future All-cause Mortality and Quality of Life: A 2-Year Follow-up Study Among Korean Older Adults From a Population-based Cohort Study: Woolim Ko, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(6):572-580. Published online November 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.210

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Abstract Summary PDF Supplementary Material: Objectives
The frailty index (FI), a proxy measure of accelerated biological aging, predicts adverse outcomes in older adults. We investigated whether the FI predicts mortality in a community-based Korean older adult population and its association with subjective health status over 2 years.
Methods
This prospective cohort study included 936 community-dwelling individuals aged ≥60 years. The FI, calculated from 28 self-reported baseline variables, was scored on a scale from 0 to 1 (<0.25: non-frail; 0.25-0.34: mildly frail; ≥0.35: moderately to severely frail). The primary outcome was 2-year all-cause mortality. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Quality of life was assessed using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L), with the proportions reporting extreme problems and prevalence ratios of problems across frailty groups. Analyses were conducted using the GENMOD procedure in SAS version 9.4.
Results
Of the 936 participants, 111 (11.9%) were non-frail, 230 (24.6%) were mildly frail, and 595 (63.6%) were moderately to severely frail. The prevalence of moderate to severe frailty increased with age. The moderate-severe frailty group had a ≥5-fold increased risk of mortality compared to the non-frail group (adjusted RR, 5.79; 95% CI, 1.39 to 24.07). Among those completing follow-up, the moderate-severe frailty group reported more problems across all EQ-5D-3L domains at 2 years.
Conclusions
Frail older adults are at increased risk of mortality, but this risk was significant only for those in the moderate-to-severe frailty category at 2-year follow-up. The FI is a valuable predictor of premature death and health challenges in older adults.; Summary

Korean summary
2년의 추적 관찰 기간 동안, 기저 시점의 중등도에서 중증의 노쇠 상태에 있던 노인은 노쇠하지 않은 노인에 비해 사망 위험이 5배 이상 높았으며, EQ-5D-3L로 평가한 다양한 삶의 질 영역에서도 더 큰 어려움을 겪는 것으로 나타났다. 이러한 결과는 특히 중등도에서 중증의 노쇠 상태가 임상적 위험뿐만 아니라 주관적 삶의 질을 개선하기 위한 우선적 개입이 필요할 수 있음을 시사한다. 본 연구는 노인의 건강 결과를 향상시키기 위해서는 개별 질환 관리뿐 아니라 노쇠 상태를 체계적으로 평가하고 관리하는 것이 중요함을 제안한다.

Key Message
During the two-year follow-up period, older adults who were moderately to severely frail at baseline had a more than fivefold higher risk of death compared with those who were non-frail, and they also experienced greater difficulties across various quality-of-life domains as measured by the EQ-5D-3L. These findings suggest that moderate to severe frailty may require high-priority interventions to improve not only clinical risks but also subjective quality of life. This study indicates that, to improve health outcomes in older adults, it is important to systematically assess and manage frailty in addition to addressing individual diseases.

Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey: Horim A. Hwang, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(3):260-268. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.486

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Abstract Summary PDF Supplementary Material

Objectives
Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.
Methods
Of the 228 340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68 246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included 934 participants in the adherence group (2.0%) and 13 420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.00 to 1.18).
Conclusions
Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.

Summary

Korean summary
혈당조절이 되지 않는 당뇨병이 수면 관련 문제의 발생 위험을 높이는 것은 기존 연구에서 알려져 있었으나, 당뇨관리 여부가 지역사회에 거주하는 당뇨환자들의 수면의 질에 미치는 영향은 충분히 탐구 되지 않았었다. 당뇨 관리 (연 2회 이상 당화혈색소 검사, 매년 당뇨합병증 검사, 당뇨관리교육 이수)에 순응하지 않는 당뇨환자들은 당뇨가 없는 일반인들에 비해 수면 문제를 호소할 가능성이 유의하게 높은 것이 확인되었다. 이는 당뇨 유병기간으로 층화분석하였을때도 일관되게 확인되었다.

Key Message
Uncontrolled diabetes is associated with increased risk of sleep-related problems, but the knowledge on the impact of poor diabetes management on the sleep quality of community dwelling patients with diabetes is limited. Diabetes patients who did not adhere to diabetes management (<2 hemoglobin A1c tests, did not take diabetes complication test, or received diabetes management education) were more significantly more likely to report overall poor sleep quality than those without diabetes. The above association remained significant when the patients were stratified by diabetes duration.

Citations

Citations to this article as recorded by

Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study
Nur Mohamed, Rahma Haji Mohamud, Fadumo Hilowle, Tigad Ali, Yusuf Abdirisak Mohamed, Adan Gabow, Hawa Mohamed, Nor Sidow, Mohamed Sheikh Hassan, Mohamud Waberi
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1949. CrossRef

Prevalence of Depressive Disorder of Outpatients Visiting Two Primary Care Settings: Sun-Jin Jo, Hyeon Woo Yim, Hyunsuk Jeong, Hoo Rim Song, Sang Yhun Ju, Jong Lyul Kim, Tae-Youn Jun; J Prev Med Public Health. 2015;48(5):257-263. Published online September 21, 2015; DOI: https://doi.org/10.3961/jpmph.15.009

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Abstract PDF

Objectives
Although the prevalence of depressive disorders in South Korea’s general population is known, no reports on the prevalence of depression among patients who visit primary care facilities have been published. This preliminary study was conducted to identify the prevalence of depressive disorder in patients that visit two primary care facilities.
Methods
Among 231 consecutive eligible patients who visited two primary care settings, 184 patients consented to a diagnostic interview for depression by psychiatrists following the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. There were no significant differences in sociodemographic characteristics such as gender, age, or level of education between the groups that consented and declined the diagnostic examination. The prevalence of depressive disorder and the proportion of newly diagnosed patients among depressive disorder patients were calculated.
Results
The prevalence of depressive disorder of patients in the two primary care facilities was 14.1% (95% confidence interval [CI], 9.1 to 19.2), with major depressive disorder 5.4% (95% CI, 2.1 to 8.7), dysthymia 1.1% (95% CI, 0.0 to 2.6), and depressive disorder, not otherwise specified 7.6% (95% CI, 3.7 to 11.5). Among the 26 patients with depressive disorder, 19 patients were newly diagnosed.
Conclusions
As compared to the general population, a higher prevalence of depressive disorders was observed among patients at two primary care facilities. Further study is needed with larger samples to inform the development of a primary care setting-based depression screening, management, and referral system to increase the efficiency of limited health care resources.

Summary

Citations

Citations to this article as recorded by

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Soroush Bijani, Fatemeh Sadat Kashfi, Sadaf Zahedi-Vanjani, Keivan Nedaei, Ali Sharafi, Ali Kalantari-Hesari, Mir-Jamal Hosseini
Heliyon.2024; 10(7): e28964. CrossRef
Depression rates and health-seeking behavior in primary care: Andersen model of health- care utilization
Lana Alhalaseh, Karim Alsawalha, Mohammed Qussay Al-Sabbagh, Farah Al-Khaleefa
Psychology, Health & Medicine.2023; 28(6): 1503. CrossRef
Prevalence of depressive disorders in a primary care setting in Ho Chi Minh City, Vietnam: A cross-sectional epidemiological study
Ho Nguyen Yen Phi, Truong Quoc Tho, Bui Xuan Manh, Tran Anh Ngoc, Pham Thi Minh Chau, Nguyen Trung Nghia, Tran Trung Nghia, Huynh Ho Ngoc Quynh, Nguyen Tien Huy, Ngo Tich Linh, Pham Lê An
The International Journal of Psychiatry in Medicine.2023; 58(2): 86. CrossRef
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Min-Jeong Lee, Eunyoung Lee, Bumhee Park, Inwhee Park
Kidney Research and Clinical Practice.2022; 41(2): 231. CrossRef
Prevalence of depressive symptoms in urban primary care settings: Botswana
Keneilwe Motlhatlhedi, Keneilwe Molebatsi, Grace N. Wambua
African Journal of Primary Health Care & Family Medicine.2021;[Epub] CrossRef
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Jaesung Heo, Mison Chun, Young-Taek Oh, O Kyu Noh
Journal of Gynecologic Oncology.2019;[Epub] CrossRef
The prevalence of suicidal ideation and depression among primary care patients and current management in South Korea
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International Journal of Mental Health Systems.2017;[Epub] CrossRef

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