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.

Associations Between Poor Appetite, Sarcopenia, and Cognitive Function in Community-dwelling Malaysian Older Adults: Sook Yee Lim, Yoke Mun Chan, Maw Pin Tan, Shahrul Bahyah Kamaruzzaman, Rahimah Ibrahim; J Prev Med Public Health. 2025;58(6):589-598. Published online November 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.196

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Abstract Summary PDF: Objectives
This study aimed to explore the associations between poor appetite, sarcopenia, and cognitive function among Malaysian older adults.
Methods
This nationwide study involved 1086 community-dwelling older adults aged 55 years and above. Poor appetite was defined using a self-reported question, while cognitive function was assessed with the Montreal Cognitive Assessment. Sarcopenia was identified based on handgrip strength, 6-meter gait speed, and muscle mass, in accordance with the Asian Working Group for Sarcopenia 2019 criteria. Associations between poor appetite, sarcopenia, and cognitive function were analyzed using both univariate and multivariate analyses.
Results
Multivariate analysis revealed that handgrip strength (β=0.067, p=0.012) and gait speed (β=1.080, p=0.017) were significantly associated with cognitive function after adjusting for confounders such as age, ethnicity, marital status, education, and alcohol and smoking consumption. However, no significant association was observed between poor appetite and cognitive function, nor was any moderation effect found between poor appetite and sarcopenia-related traits on cognitive function.
Conclusions
Our study confirms that low muscle strength and reduced physical performance are significantly associated with an increased risk of cognitive impairment among community-dwelling older adults. These findings underscore the critical importance of muscle strength and physical performance in preserving cognitive function—a decline that is not inevitable with age. Routine screening and early detection of muscle health and cognitive function are essential, and should be followed by intervention strategies targeting muscle health to mitigate cognitive decline in aging populations.; Summary

Key Message
Lower muscle strength and slower gait speed were independently associated with poorer cognitive function in Malaysian older adults, while poor appetite showed no direct or moderating effect on cognition. These findings underscore the importance of routine screening and early interventions targeting muscle health to help prevent cognitive decline in aging populations.

Exploring the Role of Social Welfare Expenditures in Depressive Symptoms Among Older Adults in Korea: Ji-Su Lee, Eun Sil Yoon, Yeongchae Song, Seowoo Park, Young Kyung Do; J Prev Med Public Health. 2025;58(4):370-378. Published online February 18, 2025; DOI: https://doi.org/10.3961/jpmph.24.403

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Abstract Summary PDF: Objectives
This study aimed to explore the role of community-level social welfare expenditures in depressive symptoms among older adults in Korea, with a particular focus on living arrangements.
Methods
Multi-level data—comprising individual-level data from the 2019 Community Health Survey and regional-level data from the Korean Statistical Information Service—were analyzed using multi-level ordered logistic regression. The dependent variable was the severity of depressive symptoms as measured by the Patient Health Questionnaire-9 score, and the primary independent variables were per capita social welfare expenditure, living arrangements, and their cross-level interaction term.
Results
Older adults living alone exhibited more severe depressive symptoms compared to those living with others (odds ratio [OR], 1.22; p=0.006). Higher community social welfare expenditure was significantly associated with reduced depressive symptom severity (OR, 0.73; p=0.019). Moreover, the protective effect of social welfare expenditure was more pronounced among older adults living alone than among those not living alone (OR, 0.92; p=0.046). Social welfare expenditure was highly correlated with social cohesion, which weakened its independent association with depressive symptoms.
Conclusions
This study highlights the potential of community-level social welfare expenditure to mitigate depressive symptoms among older adults, particularly those who live alone. In light of the rising number of older adults living alone, these findings suggest that non-medical interventions, such as enhanced social welfare programs, may help alleviate depression in this vulnerable population. The strong positive correlation between social welfare expenditure and social cohesion also raises further research questions regarding their interrelationship.; Summary

Korean summary
자치단체의 일인당 사회복지 지출이 증가할수록 해당 지역에 거주하는 노인의 우울 증상이 전반적으로 감소하는 결과를 보였고 이러한 연관성은 특히 독거 노인에게서 더 뚜렷하게 나타났다. 이 결과는 노인인구 규모 및 독거 노인 비율의 증가가 초래할 수 있는 노인 정신 건강의 부정적 영향을 비의료적, 사회적 개입을 통해 완화할 수 있음을 시사한다.

Key Message
Higher community-level social welfare expenditure was associated with lower severity of depressive symptoms among older adults, with this association more pronounced among those living alone. Given the rising number of older adults living alone, these findings highlight the potential of non-medical, social interventions to alleviate depression in this vulnerable population.

Association Between Geriatric Oral Health Assessment Index and Cardiovascular Disease in Korean Older Adults: Kyu-Taek Lim, Ji-won Choe, Seung-sik Hwang; J Prev Med Public Health. 2025;58(1):103-112. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.569

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Abstract Summary PDF

Objectives
This study examined the association between oral health-related quality of life (OHRQoL), as assessed by the Geriatric Oral Health Assessment Index (GOHAI), and cardiovascular disease (CVD) outcomes among Korean older adults.
Methods
Data from 5413 participants in the Korean Longitudinal Study of Aging were analyzed. GOHAI scores were categorized as either “poor” (<40) or “not poor” (≥40). Generalized estimating equation models were used to assess the relationship between GOHAI scores and CVD prevalence, with analyses stratified by sex.
Results
Poor GOHAI score was significantly associated with elevated odds of CVD (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.07 to 1.19; p<0.001). This association was stronger in female (OR, 1.36) compared to male (OR, 1.12). Poor oral health is indicative of systemic inflammation and age-related vulnerabilities, underscoring the utility of the GOHAI as an instrument for early identification of CVD risk.
Conclusions
Poor oral health, as measured by the GOHAI, is associated with an increased risk of CVD among older adults, especially female. These findings support the use of the GOHAI as a cost-effective screening tool for the early assessment of CVD risk. Further research is warranted to explore inflammatory biomarkers and sex-specific mechanisms that could inform targeted interventions.

Summary

Korean summary
노년층에서 구강건강 관련 삶의 질(OHRQoL)이 낮을수록 심혈관계 질환(CVD) 위험이 높아지며, 특히 여성에서 더 두드러졌습니다. 본 연구는 노년 구강 건강 평가 지수(GOHAI)를 사용했습니다.

Key Message
Poor GOHAI scores are associated with higher CVD risk, with stronger effects in females. This highlights the potential of GOHAI as an effective tool for early detection and prevention of CVD.

Citations

Citations to this article as recorded by

Assessment of oral health-related quality of life and its association with periodontal status in geriatric patients
Seval Ceylan Şen, Özlem Saraç Atagün, Gülbahar Ustaoğlu, Zeynep Hazan Yildiz
BMC Oral Health.2025;[Epub] CrossRef
Evaluation of the Geriatric Oral Health Assessment Index Based on Oral Health-Related Behaviors and Status of Older Adults in Gangneung-si
Jin-Sun Choi, Hye-Rim Jeon, Soo-Myoung Bae, Sun-Jung Shin, Bo-Mi Shin, Hye-Young Yoon, Hyo-Jin Lee
Journal of Dental Hygiene Science.2025; 25(4): 360. CrossRef

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.

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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

Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health: Dwi Rosella Komalasari, Chutima Jalayondeja, Wattana Jalayondeja, Yusuf Alam Romadon; J Prev Med Public Health. 2025;58(2):199-207. Published online November 29, 2024; DOI: https://doi.org/10.3961/jpmph.24.423

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Abstract Summary PDF: Objectives
The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.
Methods
A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.
Results
Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016).
Conclusions
Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.; Summary

Key Message
The ICF model offers a comprehensive framework to assess health and QoL in older adults living in rural and urban areas. Both areas highlight the distinct advantages and challenges unique. Cardiovascular endurance is a vital factor in determining the QoL for older adults in rural areas, while hemoglobin levels, age, and cognition shape the well-being of those in urban environments.

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; J Prev Med Public Health. 2025;58(2):188-198. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374

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Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients’ needs and concerns, thereby helping manage the challenges of medication-related burdens.

Summary

Key Message
Older adults with chronic diseases experienced an increasing burden in taking medication with multimorbidity, number of medicines and duration of illness. Motivation and familial support is crucial to minimize these burdens.

Citations

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Medication-related quality of life among individuals utilizing the advanced electronic service for dispensing medications in Saudi Arabia
Ammar Alshamlan, Abdullah Alkattan, Sakinah Alghazal, Manea Almunjem, Ahmed Alkhalifah, Mahdi Almunjem, Eman Alsalameen, Taif Albassri, Asya Alhadad, Amal Alhaqbani
Discover Public Health.2025;[Epub] CrossRef
Latent Profile Analysis and Influencing Factors of Medication-Related Burden in Multidrug-Resistant Tuberculosis Patients in Chengdu, China
Yuanyuan Li, Qiaolin Yu, Rong Yao, Xiaoyi Yang, Bin Wan, Xia Zhao, Yinping Hu, Yan Zhou, Li Dai, Xiaoli Liu, Enchun Xie, Fang Huang, Fanghui Xie, Zhouli Guo
Patient Preference and Adherence.2025; Volume 19: 3387. CrossRef

Development of Machine Learning Models to Categorize Life Satisfaction in Older Adults in Korea: Suyeong Bae, Mi Jung Lee, Ickpyo Hong; J Prev Med Public Health. 2025;58(2):127-135. Published online October 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.324

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Abstract Summary PDF

Objectives
This study aimed to identify factors associated with life satisfaction by developing machine learning (ML) models to predict life satisfaction in older adults living alone.
Methods
Data were extracted from 3112 older adults participating in the 2020 Korea Senior Survey. We employed 5 ML models to classify the life satisfaction of older adults living alone: logistic Lasso regression, decision tree-based classification and regression tree (CART), C5.0, random forest, and extreme gradient boost (XGBoost). The variables used as predictors included demographics, health status, functional abilities, environmental factors, and activity participation. The performance of these ML models was evaluated based on accuracy, precision, recall, F1-score, and area under the curve (AUC). Additionally, we assessed the significance of variable importance as indicated by the final classification models.
Results
Out of the 1411 older adults living alone, 45.3% expressed satisfaction with their lives. The XGBoost model surpassed the performance of other models, achieving an F1-score of 0.72 and an AUC of 0.75. According to the XGBoost model, the five most important variables influencing life satisfaction were overall community satisfaction, self-rated health, opportunities to interact with neighbors, proximity to a child, and satisfaction with residence.
Conclusions
Overall satisfaction with the community environment emerged as the most significant predictor of life satisfaction among older adults living alone. These findings indicate that enhancing the supportiveness of the community environment could improve life satisfaction for this demographic.

Summary

Korean summary
본 연구는 2020년 노인실태조사에 참여한 3,112명의 독거노인 데이터를 활용하여 이들의 삶의 만족도를 분류하는 머신러닝 모델을 개발하였다. 아울러, 해당 모델을 통해 독거노인의 삶의 만족도 분류에 영향을 미치는 주요 변수를 도출하였다. 본 연구는 독거노인의 삶의 만족도 향상을 위해 고려해야 할 핵심 요인들을 제시한다는 점에서 의의가 있다.

Key Message
This study developed a machine learning model to classify life satisfaction among 3,112 older adults living alone, based on data from the 2020 Korea Senior Survey. Furthermore, the study identified key variables that contribute to the classification of life satisfaction in this population. These findings provide insights into important factors that should be considered to enhance the life satisfaction of older adults living alone.

Citations

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Prevalence of depression and its associated factors among Korean women: A cross-sectional study in Seoul
Thi Thanh Lan Nguyen, Van Cuong Nguyen
Archives of Psychiatric Nursing.2025; 57: 151928. CrossRef
Designing a Social Prescribing Model to Enhance the Holistic Well-Being of Older Adults in Indonesia
Sukri Palutturi , St. Rosmanelly, Mutia Nur Rahmah , Eun Woo Nam, Mi-hwa Kang
Salud, Ciencia y Tecnología.2025; 5: 2235. CrossRef

The Associations Between Physical Activity and Mental Health Problems in Middle-aged Indonesians: Sri Handayani, Siti Isfandari, Diyan Ermawan Effendi, Rozana Ika Agustiya, Irfan Ardani, Arief Priyo Nugroho, Yunita Fitrianti; J Prev Med Public Health. 2024;57(4):379-387. Published online July 12, 2024; DOI: https://doi.org/10.3961/jpmph.24.003

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Abstract Summary PDF

Objectives
Mental health issues have become a growing concern worldwide. Research has shown that regular physical activity (PA) can positively affect mental health. This study investigated the associations between PA and mental health problems (MHPs) in middle-aged Indonesians.
Methods
The study utilized data from the 2018 Indonesian Basic Health Research Survey and used a cross-sectional approach. The participants included individuals aged 40-60 years who completed the 20-question Self-Reporting Questionnaire. A logistic regression was performed to analyze a sample of 263 930 data points.
Results
Nearly 10.4% of the participants suffered from mental health issues. Notably, among those who did not engage in moderate and vigorous PA, a sign of MHPs was found in 12.5% of participants. Those who met World Health Organization standards for PA were less likely to experience MHPs (10.1%). This study found a significant association between PA and mental health. After adjusting for smoking, alcohol consumption, non-communicable diseases, and socio-demographic variables like age, sex, education, occupation, marital status, and residence, the connection between PA and mental health became even stronger (adjusted odds ratio, 0.81; 95% confidence interval, 0.78 to 0.85; p<0.001).
Conclusions
Regular PA has been shown to affect mental health positively. Therefore, it is important to improve health education and efforts to raise awareness among middle-aged Indonesians about the importance of PA in maintaining good mental health.

Summary

Key Message
This study revealed a significant association between physical activity (PA) and mental problems (MHPs) among middle-aged Indonesians. Individuals who engaged in moderate to vigorous PA were less likely to experience MHPs compared to those who did not meet recommended PA levels. This association remained strong after adjusting confounding variables such as smoking, alcohol consumption, non-communicable diseases, and socio- demographic factors. Therefore, promoting regular physical activity could be a beneficial strategy for improving mental health status in this population.

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USO DE ANTIDEPRESSIVOS E ANSIOLÍTICOS PÓS PANDEMIA E SEUS IMPACTOS: REVISÃO DE LITERATURA
Francivania Silva de Oliveira, Francisca Sabrina Vieira Lins, José Guilherme Ferreira Marques Galvão, Diego Igor Alves Fernandes de Araújo, Rafaela de Oliveira Nóbrega
Revista Multidisciplinar do Nordeste Mineiro.2025; 10(1): 1. CrossRef
Domain-specific physical activity and depressive symptoms in Korean adults: An isotemporal substitution study using KNHANES data
Jungmi Park, Hee-Kyoung Nam, Sung-Il Cho, Henri Tilga
PLOS One.2025; 20(12): e0338722. CrossRef
PREVALÊNCIA DO USO DE ANTIDEPRESSIVOS E/OU ANSIOLÍTICOS EM PRATICANTES DE ATIVIDADE FÍSICA DE UMA ACADEMIA DE TERESINA
Mariana Lima Teixeira, Ivair de Sousa Lima, Luís Felipe Araújo Pereira Lustosa, Paula Lins Gonçalves, Aureliano Machado de Oliveira
Revista Contemporânea.2024; 4(12): e7097. CrossRef

Association Between Objective Social Isolation and Unmet Medical Needs: A Nationwide Cross-sectional Study in Korea: Jeong Min Yang, Seul Ki Lee, Jae Hyun Kim; J Prev Med Public Health. 2024;57(3):242-251. Published online April 27, 2024; DOI: https://doi.org/10.3961/jpmph.23.516

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Objectives
The aim of this study was to analyze the relationship between objective social isolation (SI) and unmet medical needs (UMN) in adults aged 19 and older.
Methods
A cross-sectional analysis was conducted of 208 619 adults aged 19 and older, excluding missing data, using the 2019 Korea Community Health Survey. To analyze the association between objective SI and UMN, the chi-square test and logistic regression analysis were performed.
Results
The prevalence of UMN was 1.14 times higher (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06 to 1.23) among those with SI than among those without SI, and the OR for groups with 5 SI types was 2.77 (95% CI, 1.86 to 4.12) compared to those with no SI types. In addition, a stratified analysis by age group showed that the association between SI and UMN existed even in groups under 64 years old. However, among those aged 65 and older, SI was associated with an OR of 1.53 (95% CI, 1.37 to 1.71) for UMN compared to non-SI. As the number of SI types increased, the prevalence of UMN also increased, indicating a strong association between SI and UMN in older adults.
Conclusions
This study found that individuals with SI experienced UMN due to fear and anxiety about interpersonal relationships. Therefore, based on the results of this cross-sectional study, it is necessary to investigate the causal relationship between SI and UMN through future longitudinal data.

Summary

Korean summary
본 연구는 2019년 지역사회건강조사를 활용하여 사회적 고립과 미충족의료 간의 연관성을 분석한 연구이다. 분석 결과 사회적 고립이 있을 경우 비사회적고립 집단에 비하여 미충족의료 경험률이 높았고, 사회적 고립의 강도가 높아질수록 강한 연관성을 발견할 수 있었다. 본 연구 결과를 바탕으로 미충족의료 취약 집단에 대한 정책적, 제도적 기반 마련이 요구된다.

Key Message
This study analyzed the association between social isolation and unmet medical needs using the 2019 Korea Community Health Survey. The analysis revealed that individuals experiencing social isolation had a higher rate of unmet medical needs compared to the non-social isolation group. Furthermore, a stronger association was observed as the intensity of social isolation increased. Based on the results of this study, there is a need to establish policy and institutional foundations to support vulnerable groups with unmet medical needs.

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Hanna Rinne, Ari-Pekka Sihvonen, Visa Väisänen, Lars Leemann, Anna-Mari Aalto
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Health-related Quality of Life in Elderly Asian American and Non-Hispanic White Cancer Survivors: Suzanne Vang; J Prev Med Public Health. 2023;56(5):440-448. Published online September 13, 2023; DOI: https://doi.org/10.3961/jpmph.22.464

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Objectives
The purpose of this study was to assess predictors of health-related quality of life (HRQoL) in elderly Asian American and non-Hispanic White cancer survivors.
Methods
We conducted cross-sectional secondary data analyses using the combined datasets from the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey.
Results
Elderly Asian American cancer survivors reported a lower mental HRQoL but a comparable physical HRQoL relative to elderly non-Hispanic White cancer survivors. Stress factors, such as comorbidities, difficulties with activities of daily living, and a history of depressive symptoms, along with coping resources like self-rated health and the ability to take the survey in English, were significantly associated with mental and physical HRQoL. Among elderly Asian American cancer survivors, a significantly lower mental HRQoL was observed among those taking the survey in the Chinese language.
Conclusions
The findings suggest that race exerts a differential impact on HRQoL. Interventions should be designed to address the distinct cultural, linguistic, and systemic needs of elderly Asian American cancer survivors. Such an approach could assist in reducing cancer-related health disparities.

Summary

Key Message
Secondary data analyses of the Surveillance, Epidemiology, and End Results program and the Medicare Health Outcomes Survey combined datasets reveal that elderly Asian American cancer survivors had poorer mental health-related quality of life (HRQoL) compared to their non-Hispanic White counterparts. Elderly Asian American cancer survivors who did not complete the survey in English had significantly worse mental HRQoL than their Asian American counterparts who did. These findings point to the need for increased research to identify and address the distinct cultural, linguistic, and system-related needs of elderly Asian American cancer survivors in order to optimize HRQoL in this population.

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Min Xiao, Lei Ji, Xiaoyan Qian, Xi Chen, Meng Xiu, Zhuoran Li, Heng Cao, Shanshan Chen, Qing Li, Qiao Li, Xiang Wang, Jiani Wang, Yiqun Li, Xiaojuan Zheng, Jintao Zhang, Pin Zhang
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Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia: Thresya Febrianti, Ngabila Salama, Inggariwati , Dwi Oktavia; J Prev Med Public Health. 2023;56(3):231-237. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.008

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Objectives
This study aimed to identify risk factors associated with coronavirus disease 2019 (COVID-19) mortality in pre-elderly and elderly individuals in Jakarta, Indonesia.
Methods
We employed a case-control study design, utilizing secondary data from the Epidemiology Surveillance, Immunization Prevention, and Disease Control Sections of the DKI Jakarta Provincial Health Office, collected from December 2020 to January 2021. The study included 188 cases and an equal number of controls. Cases were COVID-19 patients confirmed to have died, as reported by hospitals and communities and subsequently verified by healthcare workers. Control subjects were patients who completed a 14-day isolation period and had been officially declared recovered by healthcare professionals. The dependent variable was the mortality of COVID-19 patients in the January 2021 period. The independent variables consisted of demographic data (age and sex), clinical symptoms (cough, runny nose, anosmia, diarrhea, headaches, abdominal pain, muscle pain, and nausea/vomiting), and comorbidities (hypertension, heart disease, and diabetes). Multivariate analysis was conducted using multiple logistic regression.
Results
The multiple logistic regression analysis revealed several factors associated with COVID-19 fatalities in Jakarta: age of 60 years or older (odds ratio [OR], 4.84; 95% CI, 3.00 to 7.80), male (OR, 2.38; 95% CI, 2.41 to 3.68), dyspnea (OR, 3.93; 95% CI, 2.04 to 7.55), anosmia (OR, 0.13; 95% CI, 0.04 to 0.46), and heart disease (OR, 4.38; 95% CI, 1.04 to 18.46).
Conclusions
The control and prevention of COVID-19 among elderly individuals require particular vigilance. When a COVID-19 case is detected within this demographic, prompt treatment and medication administration are crucial to mitigate the presenting symptoms.

Summary

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SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan: Lyudmila Yermukhanova, Zhanar Buribayeva, Indira Abdikadirova, Anar Tursynbekova, Meruyert Kurganbekova; J Prev Med Public Health. 2022;55(6):539-548. Published online October 11, 2022; DOI: https://doi.org/10.3961/jpmph.22.360

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Objectives
The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan.
Methods
The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires.
Results
The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners.
Conclusions
The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees’ working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

Summary

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Brief Report

Effects of Forest Therapy on Psychological Improvement in Middle-aged Women in Korea: Bum-Jin Park, Won-Sop Shin, Chang-Seob Shin, Poung-Sik Yeon, Chung-Yeub Chung, Si-Hyung Lee, Dong-Jun Kim, Youn-Hee Kim, Chang-Eun Park; J Prev Med Public Health. 2022;55(5):492-497. Published online September 20, 2022; DOI: https://doi.org/10.3961/jpmph.22.086

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Objectives
Women experience more stress in middle age than in other periods of their lives. Therefore, health management programs that enable middle-aged women to cope with and manage stress are needed. This study investigated the psychological effects of a meditation-focused forest therapy program among 53 middle-aged women living in urban areas in Korea.
Methods
Participants were divided into 2 groups: one group underwent the program for 3 days in a forest, followed by 3 days in an urban environment, and the other group underwent the program for 3 days in the urban environment, followed by 3 days in the forest. The psychological effects of the forest therapy program were evaluated using the Profile of Mood States-Brief (POMS-B). Differences in mood state before and after the program conducted in the forest (experimental group) and in the urban environment (control group) were evaluated using the paired-samples t-test.
Results
The program in the forest significantly reduced tension, depression, anger, fatigue, and confusion among the domains of the POMS-B. The program in the urban area significantly reduced tension, but not depression, anger, fatigue, or confusion.
Conclusions
Meditation-focused forest therapy programs are expected to contribute to promoting psychological health and enhancing the quality of life of middle-aged women.

Summary

Korean summary
중년 여성이 건강을 관리할 수 있는 프로그램이 필요하다. 이 연구는 명상 중심의 산림치유 프로그램이 중년 여성의 심리적 건강 증진에 효과적인지 검증하기 위해 프로그램 시행 전후에 참가자의 기분상태(POMS-B)를 측정하여 비교하였다. 결과에 의하면 긴장, 우울, 분노, 피곤, 혼돈이 통계적으로 유의하게 감소하였다.

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Original Articles

Regional Differences in the Effects of Social Relations on Depression Among Korean Elderly and the Moderating Effect of Living Alone: Chanki Kim, Eun Jee Chang, Chang-yup Kim; J Prev Med Public Health. 2021;54(6):441-450. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.337

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Abstract Summary PDF Supplementary Material

Objectives
Socioeconomic disadvantages interact with numerous factors which affect geriatric mental health. One of the main factors is the social relations of the elderly. The elderly have different experiences and meanings in their social lives depending on their socio-cultural environment. In this study, we compared the effects of social relations on depression among the elderly according to their living arrangement (living alone or living with others) and residential area.
Methods
We defined social relations as “meetings with neighbors” (MN). We then analyzed the impact of MN on depression using data from the Korean Longitudinal Study of Aging Panel with the generalized estimating equation model. We also examined the moderating effect of living alone and performed subgroup analysis by dividing the sample according to which area they lived in.
Results
MN was associated with a reduced risk of depressive symptoms among elderlies. The size of the effect was larger in rural areas than in large cities. However, elderly those who lived alone in rural areas had a smaller protective impact of MN on depression, comparing to those who lived with others. The moderating effect of living alone was significant only in rural areas.
Conclusions
The social relations among elderlies had a positive effect on their mental health: The more frequent MN were held, the less risk of depressive symptoms occurred. However, the effect may vary depending on their living arrangement and environment. Thus, policies or programs targeting to enhance geriatric mental health should consider different socio-cultural backgrounds among elderlies.

Summary

Korean summary
본 연구는 사회적 관계가 노인의 우울에 미치는 영향이 독거 상태 및 거주 지역에 따라 달라지는지 확인하였다. 사회적 관계를 이웃과의 만남 빈도로 정의하고 고령화연구패널자료를 분석한 결과 사회적 관계의 효과 크기는 대도시에서 가장 작었고 독거의 조절효과는 농어촌에서만 유의하였다.

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Anung Ahadi Pradana, Robbert J.J. Gobbens, Huei-Ling Chiu, Chen-Ju Lin, Shu-Chun Lee
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Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study: Kyungduk Hurh, Yoonsik Park, Gyu Ri Kim, Sung-In Jang, Eun-Cheol Park; J Prev Med Public Health. 2021;54(1):63-72. Published online December 30, 2020; DOI: https://doi.org/10.3961/jpmph.20.315

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Abstract Summary PDF Supplementary Material

Objectives
Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults.
Methods
This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry.
Results
In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS.
Conclusions
Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.

Summary

Korean summary
본 연구에서는 국민건강영양조사 자료를 이용하여, 국내 60세 이상 노인 인구에서 악력 저하 및 양손 악력의 비대칭과 우울증 유병과의 상관관계를 분석하였다. 분석 결과 60세 이상 여성에서 악력 저하 및 양손 악력의 비대칭이 우울증 유병과 관련이 있었으며, 악력 저하와 비대칭이 동반된 경우에는 우울증 유병에 대하여 상가작용이 존재하였다. 이는 향후 노인의 악력 측정 시, 양손 악력의 비대칭에 대하여도 주목할 필요가 있음을 시사한다.

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Effects of the Out-of-pocket Payment Exemption in the Public Health Center on Medical Utilization of the Korean Elderly: Kiryong Nam, Eunhye Park, Yuhjin Chung, Chang-yup Kim; J Prev Med Public Health. 2020;53(6):455-464. Published online October 20, 2020; DOI: https://doi.org/10.3961/jpmph.20.341

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Abstract PDF

Objectives
The distribution of hospitals in Korea is unbalanced in terms of accessibility. Many local public health centers (PHCs) exempt out-of-pocket payments (OOPs) based on local government laws to increase coverage. However, this varies across administrative regions, as many make this exemption for the elderly, while others do not. This study aimed to evaluate the effects of the OOP exemption at local PHCs among elderly individuals.
Methods
This study used online data on Korean national law to gather information on individual local governments’ regulations regarding OOP exemptions. Individual-level data were gathered from the 2018 Community Health Survey and regional-level data from public online sources.
Results
The study analyzed 132 regions and 44 918 elderly people. A statistical analysis of rate differences and 2-level multiple logistic regression were carried out. The rate difference according to whether elderly individuals resided in areas with the OOP exemption was 1.97%p (95% confidence interval [CI], 1.07 to 2.88) for PHC utilization, 1.37%p (95% CI, 0.67 to 2.08) for hypertension treatment, and 2.19%p (95% CI, 0.63 to 3.74) for diabetes treatment. The regression analysis showed that OOP exemption had an effect on hypertension treatment, with a fixed-effect odds ratio of 1.25 (95% CI, 1.05 to 1.48).
Conclusions
The OOP exemption at PHCs can affect medical utilization in Korea, especially for hypertension treatment. The OOP exemption should be expanded to improve healthcare utilization in Korea.

Summary

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Access of older people to primary health care in low and middle-income countries: A systematic scoping review
Saydeh Dableh, Kate Frazer, Diarmuid Stokes, Thilo Kroll, Dirceu Henrique Paulo Mabunda
PLOS ONE.2024; 19(4): e0298973. CrossRef

Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea: Seungkook Ki, Jihye Yun, Jinhee Kim, Yunhwan Lee; J Prev Med Public Health. 2019;52(5):333-343. Published online September 20, 2019; DOI: https://doi.org/10.3961/jpmph.19.163

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults.
Methods
Data were collected from the baseline survey (2016-2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias.
Results
The mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis.
Conclusions
Dental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.

Summary

Korean summary
임플란트 내지 임플란터블 디바이스는 생활 양식에 미치는 영향이 적고 직접적인 행동이나 복잡한 기술을 덜 필요로 하므로 임플란트는 라이프스타일 변경보다 더 수정성이 있는 효과적인 개입이 될 수 있다. 이 연구에서는 임플란터블 디바이스의 일종인 치아 임플란트와 인지 기능 사이의 관계를 조사하였다. 연구 결과 70세 이상의 지역사회 거주 노인에 있어 치아 탈락의 치료로서 치아 임플란트가 인지 기능과 연관성이 있음을 보여주었다. 치아 임플란트는 인지 예비능력의 보존에 기여하는 것으로 생각되며, 지역 사회 거주 노인에서 인지 저하의 예방으로서 치아 임플란트 치료를 충분히 고려해볼 수 있을 것이다.

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The Relationship between Removable Dental Prostheses and Brain Activity in Elderly Individuals: Systematic Review
Arpit Sikri, Jyotsana Sikri, Rinshul Saroch, Charanjeet Singh Gill, Rimple Gupta, Chetan Pathak
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Shin Who Park, Woo Chul Son, Miji Kim, Chang Won Won, Won Kim
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Predicting cognitive decline using tongue pressure: a novel, non-invasive screening strategy for dementia in geriatric dentistry
Sowmya Srinivas, S. Arjun, Veena More, M. S. Aparna, K. Ramesh, Vidya G. Doddawad
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Syed Ershad Ahmed, Jayashree Mohan, Parithimar Kalaignan, Saravanan Kandasamy, Ramesh Raju, Bharath Champakesan
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Estimating Influenza-associated Mortality in Korea: The 2009-2016 Seasons: Kwan Hong, Sangho Sohn, Byung Chul Chun; J Prev Med Public Health. 2019;52(5):308-315. Published online August 23, 2019; DOI: https://doi.org/10.3961/jpmph.19.156

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Abstract Summary PDF

Objectives
Estimating influenza-associated mortality is important since seasonal influenza affects persons of all ages, causing severe illness or death. This study aimed to estimate influenza-associated mortality, considering both periodic changes and age-specific mortality by influenza subtypes.
Methods
Using the Microdata Integrated Service from Statistics Korea, we collected weekly mortality data including cause of death. Laboratory surveillance data of respiratory viruses from 2009 to 2016 were obtained from the Korea Centers for Disease Control and Prevention. After adjusting for the annual age-specific population size, we used a negative binomial regression model by age group and influenza subtype.
Results
Overall, 1 859 890 deaths were observed and the average rate of influenza virus positivity was 14.7% (standard deviation [SD], 5.8), with the following subtype distribution: A(H1N1), 5.0% (SD, 5.8); A(H3N2), 4.4% (SD, 3.4); and B, 5.3% (SD, 3.7). As a result, among individuals under 65 years old, 6774 (0.51%) all-cause deaths, 2521 (3.05%) respiratory or circulatory deaths, and 1048 (18.23%) influenza or pneumonia deaths were estimated. Among those 65 years of age or older, 30 414 (2.27%) all-cause deaths, 16 411 (3.42%) respiratory or circulatory deaths, and 4906 (6.87%) influenza or pneumonia deaths were estimated. Influenza A(H3N2) virus was the major contributor to influenza-associated all-cause and respiratory or circulatory deaths in both age groups. However, influenza A(H1N1) virus–associated influenza or pneumonia deaths were more common in those under 65 years old.
Conclusions
Influenza-associated mortality was substantial during this period, especially in the elderly. By subtype, influenza A(H3N2) virus made the largest contribution to influenza-associated mortality.

Summary

Korean summary
계절 인플루엔자는 심각한 호흡기 합병증으로 진행할 수 있어 질병 부담의 추산이 중요한 질병이다. 현재까지는 연령별, 인플루엔자 연관 사망을 정확하게 추산하기 어려웠으나, 본 연구에서는 이를 추산하기 위해 고안된 다양한 방법 중 음이항 회귀 분석을 이용하여 2009년부터 2016년간 인플루엔자 아형별 연관 사망을 추산하였다. 그 결과, 전체 사망자 중 65세 미만에서 약 6,774명, 65세 이상에서 약 30,414명의 연간 인플루엔자 사망이 추산되었고, 이는 특히 인플루엔자 아형 중 전체 연령에서 A(H3N2) 연관 사망이 가장 많은 비율을 차지했다.

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Demographic and Survivorship Disparities in Non–muscle-invasive Bladder Cancer in the United States: Munseok Seo, James R. Langabeer II; J Prev Med Public Health. 2018;51(5):242-247. Published online August 23, 2018; DOI: https://doi.org/10.3961/jpmph.18.092

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Abstract PDF

Objectives
To examine survivorship disparities in demographic factors and risk status for non–muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute’s Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

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Чи може бути гормонотерапія елементом комбінованого радикального лікування хворих на низькодиференційований рак сечового міхура?
P. G. Yakovlev
Шпитальна хірургія. Журнал імені Л. Я. Ковальчука.2019; (3): 75. CrossRef

How Much Do Older Adults Living Alone in Rural South Korea Know About Dementia?: Mi Sook Kim, Dong-Soo Shin, Yong-jun Choi, Jin Soon Kim; J Prev Med Public Health. 2018;51(4):188-195. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.17.084

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Abstract PDF

Objectives
This study aimed to examine the level of dementia knowledge of older Korean adults living alone in rural areas and to identify related factors.
Methods
A cross-sectional descriptive design was applied. The participants were 231 older adults living alone who were recruited from 12 of the 13 primary health care posts in the rural area of Chuncheon. Participants’ level of dementia knowledge was assessed using the Dementia Knowledge Scale. Data were analyzed using descriptive statistics, and the t-test, analysis of variance, chi-square test, and Mann-Whitney test were applied.
Results
Participants’ mean age was 77.3±5.4 years, and women comprised 79.7% of the sample. Over half of the participants (61.9%) had no formal education, and all the participants were enrolled in Medical Aid. The participants’ average percentage of correct answers was 61.6%. The highest rate (94.4%) was for the item “Dementia can change one’s personal character.” The item with the lowest proportion of correct answers was “Dementia is not treatable” (23.4%). Dementia knowledge was significantly associated with age, education, health coverage, source of living expenses, and dementia risk.
Conclusions
Dementia knowledge among Korean rural older adults living alone was relatively low. Participants’ misconceptions about symptoms and treatment could hinder them from seeking early treatment. The results of this study suggest the need for active outreach and health care delivery for rural older adults living alone in South Korea.

Summary

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Estimates of Long-Term Care Utilization and Lifetime Distribution of Medical Cost for Dementia in Korea
Seok Jong Chung, Jee Eun Lee, Dong Wook Kim, So Ra Yoon, Dong Gyo Shin, Moon Young Choi, Jun Hong Lee
Korean Journal of Clinical Geriatrics.2021; 22(1): 22. CrossRef
The Changes for Strength of Oropharyngeal Muscles in Patients with Dementia and Dysphagia
Eun Kyu Ji, Hae Hyun Wang, Sung June Jung, Kyoung Bo Lee, Joon Sung Kim, Bo Young Hong, Tae-Woo Kim, Seong Hoon Lim
Brain & Neurorehabilitation.2019;[Epub] CrossRef

The Association Between Oxidative Stress and Depressive Symptom Scores in Elderly Population: A Repeated Panel Study: Changwoo Han, Youn-Hee Lim, Yun-Chul Hong; J Prev Med Public Health. 2016;49(5):260-274. Published online August 23, 2016; DOI: https://doi.org/10.3961/jpmph.16.029

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Abstract PDF Supplementary Material

Objectives
Previous epidemiological studies about oxidative stress and depression are limited by hospital-based case-control design, single-time measurements of oxidative stress biomarkers, and the small number of study participants. Therefore, in this study, we analyzed the association between biomarker of oxidative stress and depressive symptom scores using repeatedly measured panel data from a community-dwelling elderly population.
Methods
From 2008 to 2010, a total of 478 elderly participants residing in Seoul, Korea, were evaluated three times. Participants underwent the Korean version of the Short Form Generic Depression Scale (SGDS-K) test for screening depression, and urinary malondialdehyde (MDA) levels were measured as an oxidative stress biomarker. We used a generalized estimating equation with a compound symmetry covariance structure to estimate the effects of oxidative stress on depressive symptom scores.
Results
A two-fold increase in urinary MDA concentration was significantly associated with a 33.88% (95% confidence interval [CI], 21.59% to 47.42%) increase in total SGDS-K scores. In subgroup analyses by gender, a two-fold increase in urinary MDA concentration was significantly associated with increased SGDS-K scores in both men and women (men: 30.88%; 95% CI, 10.24% to 55.37%; women: 34.77%; 95% CI, 20.09% to 51.25%). In bivariate analysis after an SGDS-K score ≥8 was defined as depression, the third and the fourth urinary MDA quartiles showed a significantly increased odds ratio(OR) of depression compared to the lowest urinary MDA quartile (third quartile OR, 6.51; 95% CI, 1.77 to 24.00; fourth quartile OR, 7.11; 95% CI, 1.99 to 25.42).
Conclusions
Our study suggests a significant association between oxidative stress and depressive symptoms in the elderly population.

Summary

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Farzam Kamrani, Amirhossein Ataei Kachouei, Narges Fereydouni, Davoud Tanbakuchi, Habibollah Esmaily, Mohsen Moohebati, Hanie Mahaki, Ali Rezaee, Susan Darroudi, Majid Ghayour-Mobarhan, Gordon A. Ferns
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Neurochemical Research.2023; 48(6): 1798. CrossRef
Evaluation of the Physical Health and Dietary Intake of the Low-Income Elderly with Impaired Mobility for the Design of a Health Meals-on-Wheels Intervention Program in Seoul
Hyeja Chang, Junghyun Kim, Chaewon Park
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Ata Rafiee, Juana Maria Delgado-Saborit, Peter D. Sly, Hoda Amiri, Mohammad Hoseini
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Dirga Kumar Lamichhane, Dal-Young Jung, Yee-Jin Shin, Kyung-Sook Lee, So-Yeon Lee, Kangmo Ahn, Kyung Won Kim, Youn Ho Shin, Dong In Suh, Soo-Jong Hong, Hwan-Cheol Kim
International Journal of Hygiene and Environmental Health.2021; 237: 113823. CrossRef
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Suene Vanessa da Silva Souza, Priscila Batista da Rosa, Vivian Binder Neis, Júlia Dubois Moreira, Ana Lúcia S. Rodrigues, Morgana Moretti
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Oxidative stress, antioxidant defense and depressive disorders: A systematic review of biochemical and molecular markers
Maiza Lacerda Barbosa, Ag-Anne Pereira Melo de Meneses, Rai Pablo Sousa de Aguiar, João Marcelo de Castro e Sousa, Ana Amélia de Carvalho Melo Cavalcante, Sharbel Weidner Maluf
Neurology, Psychiatry and Brain Research.2020; 36: 65. CrossRef
Changes in the concentrations of inflammatory and oxidative status biomediators (MIP-1 α, PMN elastase, MDA, and IL-12) in depressed patients with and without posttraumatic stress disorder
Ewa A. Ogłodek
Pharmacological Reports.2018; 70(1): 110. CrossRef
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Jinkyung Cho, Youngyun Jin, Hyunsik Kang
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Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.2017; 2(7): 599. CrossRef

Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study: Sang-Wook Yi, Heechoul Ohrr; J Prev Med Public Health. 2015;48(2):105-110. Published online March 11, 2015; DOI: https://doi.org/10.3961/jpmph.15.003

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Abstract PDF

Objectives
Recently, low systolic blood pressure (SBP) was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men.
Methods
From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR) were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004.
Results
Among the participants aged 60 and older, the lowest SBP (<90 mmHg) category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1) and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4) compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8) and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2) also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older.
Conclusions
Our findings suggest that low SBP (<90 mmHg) may increase vascular mortality in Korean men aged 60 years or older.

Summary

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Relationship between systolic blood pressure and all-cause mortality: a prospective study in a cohort of Chinese adults
Chunsheng Li, Youren Chen, Qiongbing Zheng, Weiqiang Wu, Zhichao Chen, Lu Song, Shasha An, Zhifang Li, Shuohua Chen, S. L. Wu
BMC Public Health.2018;[Epub] CrossRef
Baseline and longitudinal change in blood pressure and mortality in a Chinese cohort
Jian-Bing Wang, Qiu-Chi Huang, Shu-Chang Hu, Pei-Wen Zheng, Peng Shen, Die Li, Huai-Chu Lu, Xiang Gao, Hong-Bo Lin, Kun Chen
Journal of Epidemiology and Community Health.2018; 72(12): 1083. CrossRef
Low Systolic Blood Pressure and Vascular Mortality Among More Than 1 Million Korean Adults
Sang-Wook Yi, Yejin Mok, Heechoul Ohrr, Jee-Jeon Yi, Young Duk Yun, Jihwan Park, Sun Ha Jee
Circulation.2016; 133(24): 2381. CrossRef

Factors That Affect Suicidal Attempt Risk Among Korean Elderly Adults: A Path Analysis: Junsoo Ro, Jongheon Park, Jinsuk Lee, Hyemin Jung; J Prev Med Public Health. 2015;48(1):28-37. Published online January 14, 2015; DOI: https://doi.org/10.3961/jpmph.14.030

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Abstract PDF

Objectives
Among the Korean elderly (those 65 years of age and older), the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey) that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects.
Methods
Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson’s correlation test, and path analysis.
Results
Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts.
Conclusions
Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.

Summary

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Association between sarcopenia and suicidal ideation in a nationwide population-based study
Eyun Song, Soo Yeon Jang, Min Jeong Park, Ahreum Jang, Kyeong Jin Kim, Ji Hee Yu, Nam Hoon Kim, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Nan Hee Kim, Sei Hyun Baik, Kyung Mook Choi
Scientific Reports.2025;[Epub] CrossRef
Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
Nicolas Raschke, Amir Mohsenpour, Leona Aschentrup, Florian Fischer, Kamil J. Wrona
BMC Public Health.2022;[Epub] CrossRef
Suicidal Behavior Among Elderly Inpatients: its Relation to Functional Disability and Pain
Suzaily Wahab, Tien Yong Chua, Rosdinom Razali, Zanariah Mat Saher, Iman Hakimi Zamzam, Mohamad Adam Bujang
Psychology Research and Behavior Management.2022; Volume 15: 737. CrossRef
Parks and green areas and the risk for depression and suicidal indicators
Kyoung-bok Min, Hyun-Jin Kim, Hye-Jin Kim, Jin-young Min
International Journal of Public Health.2017; 62(6): 647. CrossRef
Prevalence and Predictive Factors of Depression in Community-Dwelling Older Adults in South Korea
Jae Soon Yoo, Sun Ju Chang, Hyun Sook Kim
Research and Theory for Nursing Practice.2016; 30(3): 200. CrossRef

Levothyroxine Dose and Fracture Risk According to the Osteoporosis Status in Elderly Women: Young-Jin Ko, Ji Young Kim, Joongyub Lee, Hong-Ji Song, Ju-Young Kim, Nam-Kyong Choi, Byung-Joo Park; J Prev Med Public Health. 2014;47(1):36-46. Published online January 29, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.1.36

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Abstract PDF

Objectives

To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history.

Methods

We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ≥65 years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ≤50 µg/d, 51 to 100 µg/d, 101 to 150 µg/d, and >150 µg/d. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status.

Results

Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the >150 µg/d group, compared with the 51 to 100 µg/d group, was 1.93 (95% CI, 1.14 to 3.26).

Conclusions

While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

Summary

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Association of Polypharmacy and Bone Mineral Density: A Cross-Sectional Analysis of Geriatric Inpatients in Germany
Stylianos Kopanos, Sandra Nicole Scheel, Bettina Eggert, Ulrich Thiem, Joachim Feldkamp
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Thyroid dysfunction and osteoporosis: A two-sample bidirectional Mendelian randomization study
Minshun Zhu, Yuwen Wang, Yu Liang, Xingyu Wang, Jianhua Zhang, Dongyan Wang, Mao Yang
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Osteoporosis evidence landscape to inform policy and practice: A comprehensive scoping review
Rajaa M. Al-Raddadi
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Diagnosis and therapeutic approach to bone health in patients with hypopituitarism
Justyna Kuliczkowska-Płaksej, Aleksandra Zdrojowy-Wełna, Aleksandra Jawiarczyk-Przybyłowska, Łukasz Gojny, Marek Bolanowski
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Hypopituitarism and bone disease: pathophysiology, diagnosis and treatment outcomes
Amit Akirov, Yaron Rudman, Maria Fleseriu
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Diversity of the diet is correlated with osteoporosis in post-menopausal women: an Iranian case-control study
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Endocrinology and Metabolism.2023; 38(2): 175. CrossRef
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Social Network Characteristics and Body Mass Index in an Elderly Korean Population: Won Joon Lee, Yoosik Youm, Yumie Rhee, Yeong-Ran Park, Sang Hui Chu, Hyeon Chang Kim; J Prev Med Public Health. 2013;46(6):336-345. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.336

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108 Download
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Abstract PDF

Objectives

Research has shown that obesity appears to spread through social ties. However, the association between other characteristics of social networks and obesity is unclear. This study aimed to identify the association between social network characteristics and body mass index (BMI, kg/m²) in an elderly Korean population.

Methods

This cross-sectional study analyzed data from 657 Koreans (273 men, 384 women) aged 60 years or older who participated in the Korean Social Life, Health, and Aging Project. Network size is a count of the number of friends. Density of communication network is the number of connections in the social network reported as a fraction of the total links possible in the personal (ego-centric) network. Average frequency of communication (or meeting) measures how often network members communicate (or meet) each other. The association of each social network measure with BMI was investigated by multiple linear regression analysis.

Results

After adjusting for potential confounders, the men with lower density (<0.71) and higher network size (4-6) had the higher BMI (β=1.089, p=0.037) compared to the men with higher density (>0.83) and lower size (1-2), but not in the women (p=0.393). The lowest tertile of communication frequency was associated with higher BMI in the women (β=0.885, p=0.049), but not in the men (p=0.140).

Conclusions

Our study suggests that social network structure (network size and density) and activation (communication frequency and meeting frequency) are associated with obesity among the elderly. There may also be gender differences in this association.

Summary

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The Relationship Between the Social Network of Community-living Elders and Their Health-related Quality of Life in Korean Province: Jun Tae Lim, Jong-Heon Park, Jin-Seok Lee, Juhwan Oh, Yoon Kim; J Prev Med Public Health. 2013;46(1):28-38. Published online January 31, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.1.28

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Abstract PDF

Objectives

This study aimed to collect information that will help enhance the social networks and improve the quality of life among elderly people by observing the relationship between their social network and health-related quality of life (HRQoL) and by analyzing social network factors affecting HRQoL.

Methods

This study was based on the 2008 Community Health Survey in Yeoncheon County. Three hundred elders were included in the study population. We compared the revised Lubben Social Network Scale (LSNS-R) score and Euro quality of life-5 dimensions health status index by demographic characteristics and chronic disease prevalence. We analyzed the data using multiple regression and tobit regression by setting the HRQoL as the dependent variable and social network and other characteristics as the independent variables. We analyzed social network factors by using factor analysis.

Results

The LSNS-R score differed significantly according to age and existence of a spouse. According to the results from the hierarchical multiple regression analysis, the LSNS-R explained 0.10 of the variance and LSNS-R friends factor explained 0.10 of the variance. The tobit regression indicated that the contribution of the LSNS-R family size factor to the regression coefficient of the independent variable that affected the HRQoL was B_T=2.96, that of the LSNS-R family frequency factor was B_T=3.60, and that of LSNS-R friends factor was B_T=5.41.

Conclusions

Social networks among elderly people had a significant effect on HRQoL and their networks of friends had a relatively higher effect than those of family members.

Summary

Citations

Citations to this article as recorded by

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Zolpidem Use and Risk of Fracture in Elderly Insomnia Patients: Dong-Yoon Kang, Soyoung Park, Chul-Woo Rhee, Ye-Jee Kim, Nam-Kyong Choi, Joongyub Lee, Byung-Joo Park; J Prev Med Public Health. 2012;45(4):219-226. Published online July 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.4.219

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Abstract PDF

Objectives

To evaluate the risk of fractures related with zolpidem in elderly insomnia patients.

Methods

Health claims data on the entire South Korean elderly population from January 2005 to June 2006 were extracted from the Health Insurance Review and Assessment Service database. We applied a case-crossover design. Cases were defined as insomnia patients who had a fracture diagnosis. We set the hazard period of 1 day length prior to the fracture date and four control periods of the same length at 5, 10, 15, and 20 weeks prior to the fracture date. Time independent confounding factors such as age, gender, lifestyle, cognitive function level, mobility, socioeconomic status, residential environment, and comorbidity could be controlled using the casecrossover design. Time dependent confounding factors, especially co-medication of patients during the study period, were adjusted by conditional logistic regression analysis. The odds ratios and their 95% confidence intervals (CIs) were estimated for the risk of fracture related to zolpidem.

Results

One thousand five hundred and eight cases of fracture were detected in insomnia patients during the study period. In our data, the use of zolpidem increased the risk of fracture significantly (adjusted odds ratio [aOR], 1.72; 95% CI, 1.37 to 2.16). However, the association between benzodiazepine hypnotics and the risk of fracture was not statistically significant (aOR, 1.00; 95% CI, 0.83 to 1.21). Likewise, the results were not statistically significant in stratified analysis with each benzodiazepine generic subgroup.

Conclusions

Zolpidem could increase the risk of fracture in elderly insomnia patients. Therefore zolpidem should be prescribed carefully and the elderly should be provided with sufficient patient education.

Summary

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English Abstract

The Effect of Outpatient Cost Sharing on Health Care Utilization of the Elderly.: Myunghwa Kim, Soonman Kwon; J Prev Med Public Health. 2010;43(6):496-504.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.496

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Abstract PDF

OBJECTIVES
The purpose of this study was to analyze the effect of outpatient cost-sharing on health care utilization by the elderly. METHODS: The data in this analysis was the health insurance claims data between July 1999 and December 2008 (114 months). The study group was divided into two age groups, namely 60-64 years old and 65-69 years old. This study evaluated the impact of policy change on office visits, the office visits per person, and the percentage of the copayment-paid visits in total visits. Interrupted time series and segmented regression model were used for statistical analysis. RESULTS: The results showed that outpatient cost-sharing decreased office visits, but it also decreased the percentage of copayment-paid visits, implying that the intensity of care increased. There was little difference in the results between the two age groups. But after the introduction of the coinsurance system for those patients under age 65, office visits and the percentage of copayment-paid visits decreased, and the 60-64 years old group had a larger decrease than the 65-69 years old group. CONCLUSIONS: This study evaluated the effects of outpatient cost-sharing on health care utilization by the aged. Cost sharing of the elderly had little effect on controlling health care utilization.

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Original Article

Factors Related to Perceived Life Satisfaction Among the Elderly in South Korea.: Minsoo Jung, Carles Muntaner, Mankyu Choi; J Prev Med Public Health. 2010;43(4):292-300.; DOI: https://doi.org/10.3961/jpmph.2010.43.4.292

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Abstract PDF

OBJECTIVES
This study attempted to explore the aging phenomena that now characterize much of Korean society, and assessed issues associated with the life satisfaction experienced during the process of aging. METHODS: By employing the National Survey on the State of Life and the Desire for Welfare of the Elderly, 2004 in South Korea this study attempted to identify the factors that determine subjective life satisfaction among the elderly. The data utilized herein consisted of 3278 elderly people aged 65 years or older, from 9308 households. RESULTS: The results of analysis from the final model after the introduction of 19 variables in 8 factors showed statistically similar explanatory power in men (adj. R2=0.320) and in women (adj. R2=0.346). We found that economic condition was the most influential factor in both men (B=0.278) and women (B=0.336) except perceived health condition variables. The second most influential variable in life satisfaction was health checkups in men (B=0.128) and degree of nutritional diet in women (B=0.145). Those who had experience with chronic diseases also reported significantly lower perceived life satisfaction and this was particularly true of women. CONCLUSIONS: The aging society requires an understanding of the lives of elderly individuals. This study explored factors associated with life satisfaction in old age by using a life satisfaction model. The success of an aging society begins with an accurate understanding of the elderly, and thus political attention will need to be focused on this matter.

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English Abstracts

Measuring Workload of Home Visit Care Activities Using Relative Values.: Seong Ok Han, Eun Cheol Park, Dae Ryong Kang, Im Ok Kang; J Prev Med Public Health. 2008;41(5):331-338.; DOI: https://doi.org/10.3961/jpmph.2008.41.5.331

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Abstract PDF: OBJECTIVES
The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. METHODS: The participants of this study were 126 homehelpers of 50 home visit care agencies at the 2nd Longterm Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. RESULTS: Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. CONCLUSIONS: The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.; Summary

Association of Social Support and Social Activity with Physical Functioning in Older Persons.: Kyunghye Park, Yunhwan Lee; J Prev Med Public Health. 2007;40(2):137-144.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.137

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Abstract PDF

OBJECTIVES
According to Rowe and Kahn (1998), successful aging is the combination of a low probability of disease, high functioning, and active engagement with life. The purpose of this study was to assess the relationship between active engagement with life and functioning among the community-dwelling elderly. METHODS: Data were collected from Wave 2 of the Suwon Longitudinal Aging Study (SLAS), consisting of a sample of 645 persons aged 65 and older living in the community. A social activity checklist and social support inventory were used as measures of engagement with life, along with the Physical Functioning (PF) scale as a measure of functioning. The effects of social support and social activity on physical functioning, taking into account the covariates, were analyzed by hierarchical linear regression analysis. RESULTS: Maintenance of social activity and social support were significantly associated with higher physical function, after adjusting for sociodemographic and healthrelated covariates. Social support appeared to be more prominent than social activity in predicting physical functioning. CONCLUSIONS: Social support and social activity are potentially modifiable factors associated with physical function in older persons. Studies examining the role social engagement may play in preventing disability are warranted.

Summary

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Journal of Preventive Medicine and Public Health.2010; 43(4): 292. CrossRef
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Original Articles

Availability of the Time and Change Test in Screening for Dementia in the Elderly.: Jung Ae Rhee, Eun Kyung Chung, Min Ho Shin; Korean J Prev Med. 2003;36(2):101-107.

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Abstract PDF: OBJECTIVES
Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Time and Change (T and C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. METHODS: The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11: 10, and the change test the ability to make 1, 000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T and C ratings were validated against a reference standard based on the physician? diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T and C Test, the mean K-MMSE scores were compared with the results of the T and C Test in the elderly from a rural community. RESULTS: The T and C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T and C Test were significantly related in the elderly from a rural community (p< 0.01). The T and C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete. CONCLUSION: The T and C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T and C Test will be used for the widespread cognitive screening of aging populations.; Summary

The Development of Physical Functioning Scale for Community-Dwelling Older Persons.: Yun Hwan Lee, Kyung Jong Lee, Geun Shik Han, Soo Jin Yoon, Yeon Kyung Lee, Chan Ho Kim, Jeong Lim Kim; Korean J Prev Med. 2002;35(4):359-374.

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Abstract PDF: OBJECTIVES
To develop a physical functioning instrument for older adults living in the community. METHODS: A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. RESUJLTS: Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PF) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, survey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. CONCLUSIONS: The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.; Summary

Physical Activity and Hip Fracture in Elderly People: A Cohort Study in Korea.: Kyung Eun Youn, Seung Mi Lee, Yooni Kim, Byung Joo Park; Korean J Prev Med. 2002;35(4):351-358.

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Abstract PDF: OBJECTIVE
To evaluate the relationship between physical activity and the risk of hip fracture in the elderly Korean people. METHODS: The study population was a Physical Activity Subcohort (n=8,908) extracted from the Korean Elderly Pharmacoepidemiological Cohort (KEPEC). Physical activity information was obtained from a mailed questionnaire surveys. The outcome data was collected from claims data gathered between Jan. 1993 and Dec. 1998. A hospital survey relating to potential cases was conducted to confirm the final diagnoses. The abstracted data was reviewed by a medical doctor before the final diagnoses were confirmed. A mailing questionnaire survey was performed to obtain information on potentially confounding variables, including alcohol intake, smoking habits, weight, height and postmenopausal duration. There were 79 confirmed cases hospitalized due to hip fractures between Jan. 1993 and Dec. 1998. Relative risk of physical activity scores on the hip fracture, and their 95% confidence intervals, were estimated by a Cox's proportional hazard model using SAS for Windows ver. 6.12. RESUJLTS: Compared to the reference group, the adjusted relative risk of hip fracture associated with the most physical active category; after controlling for age, weight and alcohol intake in the males, and for weight, alcohol intake and postmenopausal duration in the females, were 1.04 (95% CI=0.35-3.06) and 0.44 (95% CI=0.26-0.77), respectively. CONCLUSIONS: Physical activity may protect elderly women from hip fracture.; Summary

Reproductive History and Hip Fracture in the Elderly Women in Korea: A Cohort Study.: Seung Mi Lee, Yooni Kim, Koung Eun Youn, Byung Joo Park; Korean J Prev Med. 2002;35(4):305-312.

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Abstract PDF: OBJECTIVES
The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. METHODS: The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. RESUJLTS: Following up 5,219 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25 - 1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34 - 1.08) compared with those who had giving birth at 22 years or older. CONCLUSIONS: According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.; Summary

The Effect of Strengthening Exercise Program on the Physical Activity, Activities of Daily Living, Social Behavior and Functional Performance of the Elderly in a Home for the Aged.: Hyun Sook Kim, Chee Kyung Chung, Kang Sook Lee; Korean J Prev Med. 2002;35(2):107-115.

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Abstract PDF: OBJECTIVES
To evaluate the effects of a strengthening exercise program on the physical activity, activities of daily living(ADL), social behavior and functional performance of the elderly in a home for the aged. METHODS : We administered a survey questionnaire that consisted of questions to establish general characteristics, health habits and status, physical activity, ADL, and social behavior. Additionally, a physical fitness and functional performance examination was performed on subjects who were 65 years old or older. Study subjects numbered 33 in the experimental group and 35 in the control group. For intervention, we used a strengthening exercise program of the upper and lower limbs for 12 weeks(5 times/week) using dumbbells and lead-packed weights. RESULTS: After the strengthening exercise program, the scores of physical activity and social behavior were significantly higher than the control group and the before exercise measurements. Moreover, the variables of functional performance were significantly higher than in the control group or the before exercise records. CONCLUSION: These results indicate that a strengthening exercise program can improve the score of physical activity, ADL and social behavior, as well as decrease the time(sec) of functional performance of the elderly in a home for the aged.; Summary

Drug Utilization Review of Antiulcerative Agents in Korean Elderly Inpatients.: Wonsik Lee, Seung Mi Lee, Hye Won Koo, Byung Joo Park; Korean J Prev Med. 2002;35(1):41-48.

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Abstract PDF: OBJECTIVES
To review the drug prescription pattern of antiulcerative agents for elderly inpatients. METHODS: The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1994. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription. Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. RESULTS: The number of patients prescribed antiulcerative agents was 1,059 (64.9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by H2 antagonist (16.0%). Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the total omeprazole prescriptions. CONCLUSIONS: Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulcerative agents.; Summary

Prevalence and Associated Factors of Falls in the Elderly Community.: Joon Pil Cho, Kyung Won Paek, Hyun Jong Song, Yoon Seok Jung, Hae Won Moon; Korean J Prev Med. 2001;34(1):47-54.

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Abstract PDF: OBJECTIVES
To analyze factors associated with elderly falls in a community dwelling, a comparatively important, but somewhat neglected, health matter. METHODS: Data came from personal interview surveys using a questionnaire of 552 people aged 65 or older living in a community. Socioeconomic, and health related characteristics were investigated as independent variables and experiences of falling in the previous year as the dependent variable. RESULTS: 118(21.4%) of the elderly subjects experienced a fall in the previous year. 24 subjects experienced more than two falls, accounting for 20.3% of the elderly fall victims studied. Factors affecting the falls were families living together, level of daily activity, heart disease, and aconuresis;, therefore an elderly person who lives alone, lives independently, has heart disease, or suffers urinary incontinence had a demonstrated increased chance of falling. CONCLUSION: Groups at risk for falling included elderly persons living alone, living independently, suffering heart disease, or experiencing urinary incontinence. When an elderly fall prevention program is developed and implemented, these results should be considered.; Summary

Effectiveness of Telephone and Postcard Reminders for the Influenza Vaccination: A Study in the Elderly Who Have Visited a Family Practice Center in a Tertiary Care Hospital.: Yun Mi Song, Joo Seop Oh, Seung Heon Han, Chul hoon Choi; Korean J Prev Med. 2000;33(1):109-116.

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Abstract PDF: OBJECTIVES
Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. METHODS: A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. RESULTS: Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. CONCLUSIONS: This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.; Summary

Factors Associated with Physical Functioning among Community-Dwelling Older Adults.: Yunhwan Lee, Kwisook Choi; Korean J Prev Med. 1999;32(3):325-332.

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Abstract PDF: OBJECTIVES
The aim of this study is to identify major factors associated with physical functioning among the Korean elderly. METHODS: Data come from a survey of a nationally representative sample of 2,058 older people aged 60 years or older living in the community. A hierarchical functioning scale was constructed, using upper and lower body mobility, IADLs, and ADLs. Socioeconomic characteristics, chronic conditions, measures of health status, health service use, and social support were analyzed to explore their influence on functioning. Polytomous logistic regression analysis was conducted to identify major contributing factors to different levels of functioning. RESULTS: Persons of older age, female, with chronic diseases (heart disease, stroke, fracture/dislocation) were consistently more likely to show a higher degree of functional limitation. There were variations, however, among other factors; e.g., those with arthritis were more likely to be only mildly impaired, but not moderately or severely impaired. CONCLUSIONS: Older Korean adults living in the community with impaired functioning constitute persons with diverse characteristics. Policy and program activities need to address specific needs of older people in different functioning states.; Summary

Study on the Factors Related to the Cognitive Function and Depression Among the Elderly.: Cheol Ho Shin, Soo Young Kim, Young Soo Lee, Young Chae Cho, Tae Yong Lee, Dong Bae Lee; Korean J Prev Med. 1996;29(2):199-214.

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Abstract PDF: To investigate the factors which affecting the cognitive function and depression of the 65 or more age group, the authors surveyed for the subjects in the region of Taejon and nearby Taejon area. 729 studied subjects were tested for cognitive function with MMSE and depression with GDS. The main results were followings; In the studied subjects, the rate of normal cognitive function was 56.8%, the rate of mildly impaired was 24.l% and the rate of severe impairment was 19.l%. The cognitive function level was closely related to the depression score. As the age increased, the cognitive function was more impaired. Sexual difference was also existed in the cognitive function level and the depression score. After adjusting the effect of age, the variables such as sex, marital status, education level, past job, instrumental ability of daily living, regular physical exercise, frequencies of going out the house, chest discomfort, visual and auditory disturbance, and dizziness had the significant relationship with cognitive function impairment. Among these variables instrumental ADL, age, visual disturbance, and sex showed statistical significance in the logistic regression model. In the multiple stepwise regression, the variables which had significant relationship to depression score were education level, frequencies of going out house, current job and house work activity, regular physical exercise, instrumental ADL, self-rated health and nutritional status, dizziness, visual disturbance, and chest pain. In conclusion, main characteristics which had close relationship to the cognitive function and depression symptoms in the studied subjects were physical function and self rated health status.; Summary

Health status and medical care utilization patterns of rural aged.: Jang Kyun Oh; Korean J Prev Med. 1991;24(3):328-338.

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Abstract PDF: To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows; 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benefits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (P<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6%; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs; the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in the health centers of subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (P<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.; Summary

A Longitudinal Study of the Relationship Between Health Behavior Risk Factors and Dependence in Activities of Daily Living.: Sang Hyuk Jung, Truls Oslash stbye, Kyoung Ok Park; J Prev Med Public Health. 2006;39(3):221-228.

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Abstract PDF: OBJECTIVES
The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. METHODS: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non-Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. RESULTS: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. CONCLUSIONS: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.; Summary

English Abstract

Determining Factors of Intention to Actual Use of Charged Long-term Care Services for the Aged.: Jin Yeong Yoo, Jin Ho Chun; J Prev Med Public Health. 2005;38(1):16-24.

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Abstract PDF: OBJECTIVES
To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. METHODS: Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. RESULTS: About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socio-economic level. Desired charges were about 10, 000 won for the bath service, 20, 000 won for the rests services per day, and about 500, 000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as 63~71%. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. CONCLUSIONS: Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.; Summary

Original Articles

Association of Dietary Factors with Cognitive Impairment in Older Women.: Jin Hee Kim, Yunhwan Lee, Geunshik Han; J Prev Med Public Health. 2004;37(2):174-181.

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Abstract PDF: OBJECTIVE
To examine the association between dietary factors and cognitive impairment in older Korean women living in the community. METHODS: Wave 2 data, from the Suwon Longitudinal Aging Study (SLAS), of 365 women aged 65 years or over, were used. The Korean version of the 30-point Mini-Mental State Examination (MMSE-K) was used to assess cognitive impairment (score< = or19). Dietary habits and frequencies of food group consumption were also examined. RESULTS: A total of 67 women (18.4%) were found to be cognitively impaired. In bivariate analyses, nondietary factors, such as age, marital status, education, income, self-rated health, depression, emotional support, social activity, exercise, and dietary factors, such as self-rated nutritional status, frequency of beans and bean products and milk and dairy products consumption were associated with cognitive impairment. In the multivariate analysis, a higher frequency ( > = or 1 vs. < 1 time/day) of beans and bean products (OR=0.48, 95% CI: 0.23-0.99) and milk and dairy products (OR=0.25, 95% CI: 0.10-0.61) consumption was inversely associated with cognitive impairment, after adjustment for non-dietary factors. CONCLUSION: These results suggest that dietary factors may play a significant role in cognitive impairment of older Korean women.; Summary

Nonsteroidal Anti-inflammatory Drugs Utilization Patterns among the Elderly with Osteoarthritis at Primary Ambulatory Care Units in Busan Metropolitan City, Korea.: Nam Kyong Choi, Yooni Kim, Seung Mi Lee, Byung Joo Park; J Prev Med Public Health. 2004;37(2):150-156.

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Abstract PDF: OBJECTIONS: To investigate the utilization patterns of non-steroidal anti-inflammatory drugs (NSAIDs) among the elderly with osteoarthritis (OA) undergoing primary ambulatory care in Busan metropolitan city, Korea. METHODS: OA patients, aged 65 years and over, were identified from the Korean National Health Insurance Review Agency drug prescription database. The subjects had at least one episode of claim for OA (ICD-10-CM: M15-M19) between August 1, 2000 and February 28, 2002. Trends in the determinations of NSAIDs utilization were identified using chi-squared tests for trend. RESULTS: There were 47, 711 osteoarthritic patients. The total number of visits by these patients was 177, 443, with a total frequency for NSAID prescriptions of 214, 952. Seventy-nine percent of the OA patients were female. NSAIDs were prescribed on 133, 284 visits (75.1%) and the proportion of prescriptions was significantly increased with age. Only the proportion of visit when NSAIDs were prescribed decreased, from 65.1 to 43.5%, during the study period (p< 0.001). However, the proportion of combined treatments with anti-ulcer drugs was increased. The use of NSAIDs injections was decreased. Of the individual NSAIDs, diclofenac (28.7% of total frequency of NSAID prescriptions), piroxicam (15.0%) and talniflumate (8.7%), were the most frequently prescribed. Among the NSAIDs prescribed OA visits, 45.7% used two or more NSAIDs. CONCLUSION: The total proportion of NSAIDs prescribed to the osteoarthritic patients was higher than in other studies. The decline in the use of NSAIDs during the study period, and the frequent selection of safer medications, such as combination therapy with anti-ulcer drug, may reflect the risk awareness of the use of NSAIDs.; Summary

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